Making internationally trained nurses work as PSWs is 'exploitative,' RNAO tells province

The association that represents registered nurses in Ontario is blasting a move by the province to invite internationally trained nurses to do the work of personal support workers while not giving them credit for the practical work experience required by the College of Nurses of Ontario.

The memo — sent out by the Ministries of Long-term care and Health on Jan. 17 to long-term care licensees — says the move is in response to staff shortages due to COVID-19-related absences or isolation requirements. It states that select internationally trained nurses (IENs) who are applicants to the college will be eligible to work in long-term care facilities — but as personal support workers (PSWs) or unregulated care providers. 

In its program guide, the ministry also states that the work won't count towards IENs' college requirements to show evidence of practice.

"We find this exploitative," said Doris Grinspun, CEO of the Registered Nurses' Association of Ontario (RNAO).

According to Grinspun, the ministry is telling IENS to "work for a much lower rate" than they'd make as a registered nurse (RN) or a registered practical nurse (RPN) in a long-term care home.

"'But no, we will not count any of the work you are doing for any of the requirements of the college,'" she said.

The memo comes as nurses battle burnout on the front lines of the pandemic with both increased workloads and staff absences due to COVID-19 infections and isolation. While some IENs have recently been dispatched to work in hospitals, the RNAO says there are thousands of others who are ready and able to work. The association is once again urging the Ontario College of Nurses to move faster to register IENs to allow them to work in the province.

'It's kind of degrading'

Charmaine Lazo is an internationally educated nurse from the Philippines who has also worked in Saudi Arabia. She's been here since 2019, has already completed her Ontario education and is a licensed RN and RPN, but is waiting for her permanent residency.

"To be honest, it's kind of degrading," said Lazo, referring to her internationally educated peers being asked to work as PSWs. But she says many understand the difficulties staff are facing in long-term care homes.

"We're ready. We're here, we're ready to help," she told CBC News.

"At least give us something that we can look forward to," said Lazo. She added it's "sad" that the work won't be counted toward their practical experience required for their licensing.

What makes it worse, says nursing clinical instructor Birgit Umaigba, is that the province is grappling with a shortage of nurses.

"These nurses are skilled, knowledgeable experts in their specialities," said Umaigba.

"We need them working as nurses."

The RNAO says the process IENs must complete to be able to work as nurses in Ontario is too lengthy and the College of Nurses needs to streamline it.

Grinspun says she wonders why the college's process takes so long when many internationally trained nurses have more extensive credentials from their own countries. She said she's seen some IENs wait eight to 10 years to be able to work as nurses in Ontario.

College and ministry response

In a statement to CBC News, the College of Nurses of Ontario says the IENs entering the staffing pool in long-term care homes haven't completed their registration requirements, which is why they are working as unregulated care providers 

"Because they are not working under nursing supervision, this experience isn't able to count toward their registration requirements," the statement reads. 

The college says it announced changes to its language proficiency policy early this month to "create efficiencies" for internationally educated applications and said it's working with partners to identify solutions and improve the efficiency of its registration process in 2022.

The Ministry of Health told CBC News it recently launched a program that allows IENs to work as nurses in hospitals, and in that program the work does count toward their College of Nursing registration requirements.

The ministry says IENs being added to the long-term-care staffing pool haven't completed as many of the college requirements as those in the other program, and the LTC program wasn't supposed to support the college requirement of having recent practice experience.

The ministry says, however, the work would: "provide these IENs with valuable experience in the health-care system, particularly in the long-term care sector."