Good morning.
My name is Dr. Rani Srivastava. I am the president-elect of the board of directors of the Canadian Association of Schools of Nursing, CASN. I also currently serve as dean of nursing at Thompson Rivers University in British Columbia. I have previously worked in roles in practice as vice-president and chief nursing executive. I am not an internationally educated nurse, IEN, but I have worked closely with IENs in practice and education.
The Canadian Association of Schools of Nursing is the national voice for nursing education in Canada, representing 93 member institutions across the country. CASN supports the education of registered nurses, registered psychiatric nurses and nurse practitioners. We commend the House of Commons Standing Committee on Health for undertaking this important study on the integration of IENs. The motion introduced by MP Dan Mazier addresses a critical issue: Canada is facing a nursing workforce crisis. Over the past five years, nursing vacancies have tripled. We have significant challenges in both recruitment and retention. Data from a pan-Canadian survey indicates that four in 10 nurses report that they intend to leave their job—or the profession—or retire within the next year. The impact is significant on the professionals, the quality of care and patient safety.
Internationally educated nurses who choose to migrate to Canada are an invaluable and grossly underutilized resource. We must remove unnecessary bureaucratic barriers for licensure. Internationally educated nurses emigrate to Canada from all over the world. There are variations in education, professional nursing culture and expectations. They have different health care system experience.
The two main barriers faced by IENs are regulatory complexity and workplace integration challenges. Regulatory bodies work to ensure public safety through a rigorous process of credentials recognition. For IENs to be part of a sustained solution, CASN recommends focused attention in three areas: streamlining the registration process, pairing that with quality bridging education, and workplace integration support for both short-term and long-term success. Collectively, we must adopt a coordinated, evidence-informed and ethical approach. Streamlining and harmonizing the registration is already happening. In response to the pandemic and the exacerbation of long-standing nursing shortages, nursing regulatory bodies have collaborated with governments, employers and professional associations.
A recent scan of 20 nursing regulatory bodies across Canada found that while licensure requirements are broadly consistent across jurisdictions, notable differences exist in the pathways, particularly in recency of practice requirements and expedited pathways for internationally educated nurses, leading to inconsistencies and inequities in licensure pathways and creating unnecessary complexity. There is a need to further explore the harmonization and consistency of pathways. This requires commitment. We know that competency assessment is important, but it often becomes the bottleneck. Partnerships between regulators and post-secondary educators can be hugely beneficial.
CASN also asks for an establishment of a joint commission between the Canadian council of nurse regulators, CASN, CNA and employers to ensure alignment between the needs and strengths of all the stakeholders.
Lastly, we ask for the exploration of international partnerships, including Canadian accreditation of international schools and IEN residency structures to reduce this redundancy and accelerate licensure.
Ensuring quality bridging education is the second piece. These are important tools that can support not just entry to practice but also successful integration in both the long term and the short term. These programs require the ability to accommodate the unique needs and experiences of IEN learners through responsive pedagogy and flexible learning-centred programming that is practice-oriented. The ability to provide responsive and effective bridging education hinges on increased sustainable funding of public educational institutions. National standards for bridging education and an accreditation program will ensure the quality of bridging education.
The third prong is to provide practice support for both short-term and long-term integration. This requires commitment and partnership between the IENs entering the workforce and the existing professionals in the system. Employers need to support both, recognizing the needs of both parties.