Critics call for changes to Manitoba's 'unacceptable' English proficiency test requirement for nurses

Some nurses trying to register to practise in Manitoba are failing a mandatory English test even though they're fluent in the language — and critics say that exam is pushing nurses away at a time the province desperately needs them.

The Opposition NDP raised the issue in question period at the legislature on Wednesday, when health critic Uzoma Asagwara urged the government to intervene on the issue.

Asagwara called on the province to make sure its nurse registration is "fair and equitable."

"The government refuses to take action and support these nurses in the ways that they've identified they need to be supported, and that is really unacceptable," the Union Station MLA told reporters after question period.

The test is only required in certain circumstances, like for those who didn't complete the registration process within two years of graduating, said College of Registered Nurses of Manitoba spokesperson Martin Lussier.

That requirement has affected potential nurses like Tamra Keeper from Tataskweyak Cree Nation, who graduated from nursing school in Manitoba and hoped to work in the province.

But because she didn't get licensed until a few months after the two-year mark, she has to take an English proficiency test. So far, she's failed it five times.

"I'm not too sure what happened in those few months that made my English not proficient," Keeper said alongside Asagwara after question period.

"I was born and raised and educated in Manitoba. The only language I speak is English. It seems ridiculous."

Lussier said the college requires potential nurses to take the test after two years because existing evidence on language proficiency shows it can get better or worse over time.

A review by the college suggested the two-year period "represents an appropriate balance point to manage risk and provide applicants with the time needed to complete the registration process," he said.

But Asagwara said that requirement is driving nurses out of Manitoba when the province needs to do the opposite, as nursing shortages cause distress in the health-care system.

Keeper said she's now in talks with hospitals in Saskatchewan about potentially moving there to work. It's a big decision for the mother of two — but right now she said it seems like her only option if she wants to pursue her dream of working in mental health nursing.

'Smells like white supremacy affecting a policy': doctor

Dr. Barry Lavallee, chief executive officer of Keewatinohk Inniniw Minoayawin — a self-governing First Nations health organization — said the English proficiency test was designed from a colonial perspective.

"First Nations people, even if English is their first language, they still think in their own language. And the customs, the way you analyze English, the way you problem solve can be different," Lavallee said alongside Keeper.

"This, to me, smells like white supremacy affecting a policy … that actually denies access to people of colour — including, particularly, First Nations people. And it has to be eliminated."

Lavallee, a family physician with expertise in First Nations health and workforce development for First Nations, said he wants the province to either waive the requirement entirely or analyze it and come up with a better option.

"Come up with something critical that's scientifically sound, [don't] just apply something uncritically. It's unacceptable," he said.

A spokesperson for the Manitoba Nurses Union said she wasn't surprised to see the issue raised, based on anecdotes the organization has heard. 

That includes stories from Indigenous nurses who passed the national nursing exam and are fluent in Cree, for example, "but don't speak in 'Old English' style if you will, so they fail the [language] exam," Brandi Johnson said in an email.

Johnson said the union believes the exam needs to be reconsidered, "not only because it is antiquated (seeing as we no longer speak in such formalities), but also that we are in a serious nursing crisis."

She pointed to the recent decision from Ontario's nursing college to start allowing internationally educated nurses to practise while they work toward full registration as an example of how Manitoba's English proficiency test could adapt.

Lussier said the college is working on making changes to its language proficiency policy and processes, but did not say what those changes will be.

Health Minister Audrey Gordon said during question period the government is working to streamline the nurse registration process in Manitoba. 

A government spokesperson said the province is also working to retain and license Indigneous and internationally educated nurses who would be licensed in any other region.

The government will also announce a health human resources plan in the coming weeks, the spokesperson said in an email.