Lucy Reyes knows how hard it is to become a nurse in Canada when you've been trained abroad. She did it herself when she moved to Alberta in 1976, after completing her nursing degree in the Philippines.
In those 46 years, she says the process hasn't gotten much easier.
The current system is convoluted, expensive and takes much too long, says Reyes. She says it takes an average of four years for internationally educated nurses (IENs) to get accredited in Canada.
That's why the Calgarian created the new Philippine Canadian Nursing Association: to push for an easier process for IENs to have their credentials recognized in Canada.
"The credentialing of internationally educated nurses needs a post-implementation review very badly in order to transform the process and make it more realistic to actually help with our manpower crunch across the country," said Reyes, who eventually completed her master's degree in nursing at the University of Calgary.
By making it easier to get their credentials, she says nurses trained abroad can help with ongoing staffing shortages in Canada's overburdened health-care system. It's an issue the industry has been grappling with throughout the pandemic and beyond.
In October, the Alberta government signed a memorandum of understanding with the Philippines to bring more registered and licensed practical nurses to the province.
Alberta's nursing shortage
Kathy Howe, executive director of the Alberta Association of Nurses, says the nursing shortage in Alberta hasn't gotten any better.
"We're still short of all health-care workers, but particularly nurses."
As of Thursday, more than 170 registered nursing positions — for jobs within 50 kilometres of Calgary — were posted on the Alberta Health Services careers website, with even more posted for licensed practical nurses, registered psychiatric nurses and nurse practitioners.
What's interesting though, says Howe, is that there are just as many registered nurses and nurse practitioners registered to work in Alberta this year as there were last year. That means there's just as many nurses who are either resigning or choosing to work casually so they have more control over their schedule.
She says while there's no one answer to the nursing shortage, "we do know that there are literally thousands of IENs across Canada that are … registered to be nurses in other countries, and they're not registered here."
Howe points to the issues Reyes is tackling with the Philippine Canadian Nurses Association: a credentialing process that's lengthy, complex and expensive.
"I think it's exciting to see how they've risen up to this and exciting to see how they're going to support internationally educated nurses," said Howe.
Challenges with the IEN credentialing process
From the difficulty of obtaining documents from their country of origin to a long waitlist to get into a Canadian bridging program, Reyes says IENs face a number of challenges before they can actually work in Canada.
For one, in Alberta, there's one program for IENs to bridge their education to the Canadian nursing program — in Calgary, at Mount Royal University.
According to Mount Royal University, for fall 2023, the bridging program has 107 applicants for 80 spots.
The previous bridging program at Edmonton's MacEwan University closed due to funding.
Howe from the Alberta Association of Nurses says it can take two or three years to get into the program, which requires one year of full-time study to get through the courses.
The average four-year time span it takes to complete the credentialing process is where the problems lie, says Reyes.
IENs must also pass an English proficiency exam, which has an expiration date of two years. Reyes says that's an issue because sometimes when they pass their other required exams, they still can't register as a nurse in Canada because their English test has expired.
Additionally, Reyes says IENs must complete a mandatory application with the National Nursing Assessment Service online, which is expensive.
IENs also need 330 hours of direct supervision to register in Canada, Reyes says.
"My argument to them is these are no longer students. These are already professionals who have proven their worth."
In some cases, "they lost their jobs because the hiring agencies don't have the budget to supervise 330 hours of direct supervision."
To make matters worse, Reyes says the credentialing process is not standardized throughout the country — it differs from province to province.
"What I'm pushing for is … an opportunity for the provincial regulatory bodies to actually meet and develop common standards because we have the same recipients of care."
Work has begun to make the process more straightforward
Alberta's regulatory body, the College of Registered Nurses of Alberta, said in a statement that they're striving to make things more straightforward for all applicants, and they've recently made changes to their process.
That includes expanding the eligibility of bridging programs from other jurisdictions.
Additionally, the CRNA has updated their practice hour requirements — now accepting hours gained through education, competency assessments and an approved nursing refresher or bridging program within the last five years, rather than two.
In the statement, the CRNA said changes are coming to how English language competency is met as well.
"The College will release more details about these changes and other work the CRNA is doing to streamline the application process and remove delays for nurses applying from outside of Canada. Updates to our registration processes will be available on our website as they become available."