Thousands of internationally educated nurses sidelined as ERs near closure in Ontario

Tens of thousands of nurses are currently on the sidelines as Ontario hospital emergency rooms are on the brink of closure due to staffing shortages.

That’s because this group of about 26,000 nurses in Ontario is internationally educated, according to the most recent report from the province’s Office of the Equity Commission.

“Of those, 14,000 are registered nurses, which is where the toe really hurts,” said Doris Grinspun, executive director of the Registered Nurses Association of Ontario (RNAO).

University Health Network (UHN) issued a memo to medical staff last week expressing an “urgent need” for “volunteers” to cover nursing shifts in the Toronto Western Hospital emergency department.

“You have emergency rooms that are closing. You have nursing homes that are understaffed. It all boils down to the same thing. Nursing is like the spinal cord of the system. If you don’t have enough nurses, the system can’t work,” Grinspun said.

According to the College of Nurses of Ontario (CNO) website, the registration process for a nurse who was educated outside of Canada takes between three and 18 months. That includes eight registration requirements, such as evidence of practice, language proficiency, and a registration exam.

“Each logging trip is unique. For those who have met more than the registration requirements, CNO can register them as nurses in a matter of weeks,” said Kristi Green, CNO spokesperson.

But for applicants like Karla Ducusin, it took much longer. For her, it took three years.

Ducusin was qualified and practiced as a registered nurse for four years in the Philippines before immigrating to Canada. She entered the country as a caregiver because it was the fastest way to emigrate.

Currently, Ducusin said there are about 400 internationally educated nurses from the Philippines who have come to Canada under the care program. “Imagine if everyone had [nurses] licenses,” he said. “It would help the shortage a lot.”

It took Ducusin two years to complete the required licensing and English exams, which he spent all his savings on. But after his death, he also needed permanent resident status or an open work permit.

After another year, he became a permanent resident and immediately had interviews at various Toronto hospitals.

“Diabetes is diabetes. Alzheimer’s is Alzheimer’s,” Ducusin said. “Caring for people and doing everyday things are pretty much the same thing,” she said.

Grinspun said reducing the time it takes to process these nurses would drastically change the current shortage. A recent RNAO report found that the backlog of internationally educated nursing applicants in Ontario has been growing for more than a decade and has only intensified during the pandemic.

“These are nurses who already live here,” Grinspun said. “It takes us forever to integrate them into the workforce.”

Meanwhile, the workforce is collapsing, said Birgit Umaigba, a registered nurse at a Toronto emergency room.

“Last week I had to extend my shift to a 16-hour shift because there was no one to replace me,” Umaigba said. “How do you get away from a patient who is intubated on life support machines and there is no one to take care of it?”

Some days, Umaigba said she is doing the work of three nurses. She said that means patients will have to sit dirty for hours, developing bedsores.

“People don’t realize how serious this is until they are affected,” he said.

While Umaigba said she sees an immediate need to bring more internationally educated nurses into the workforce, she said it needs to be combined with a long-term solution.

“If internationally educated nurses enter the workforce, they must also be retained,” she said.

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