Canada has a big-time nursing shortage. So why can’t these two fully certified nurses get the OK to practise?

Of note, along with the backlog numbers for the various programs:

A former intensive-care nurse in the Philippines, Katrina Deauna has watched from the sidelines as Ontario — and all of Canada — struggles with chronic nursing shortages laid bare by the pandemic.

While the foreign caregiver enjoys looking after the 18-month-old baby girl and six-year-old son of her Canadian employer, she says, she would rather use her front-line nursing skills and experience to help those fighting for their lives against COVID-19.

Deauna has met all the licensing requirements of the Ontario College of Nursing. All she is missing is the authorization to work — either through a letter that confirms she’s eligible for permanent residence or a bridging open work permit.

“We are ready to practise in our profession. We are just waiting for our papers,” says the 28-year-old, who worked in the intensive-care unit of the Manila Doctors Hospital, one of the top hospitals in the Philippines, for three years until September 2019, when she was hired as a nanny in Toronto.

“They’re talking about the shortages of nurses in Ontario and Canada. And here we are. The only thing that’s keeping us from our practice is a piece of immigration paper.”

According to Ontario’s regulatory body of nurses, there are currently at least 41 applicants who meet all of its registration requirements but are waiting for the immigration authorization to work in Canada. It’s not sure what the numbers are for other provinces.

Statistics Canada reported that in the first three months of this year, the health-care and social-assistance sector had the largest year-over-year increase in job vacancies compared to other sectors, rising by 27,700 to 98,700 vacancies — an increase of 39 per cent. The positions with the largest vacancy increase were registered nurses and registered psychiatric nurses. Half of those positions had been vacant for 90 days or more, according to Statistics Canada.

Ontario has, so far, been hardest hit. With a ratio of 725 registered nurses per 100,000 people, it ranks as the lowest province in Canada and well below the national average of 811 nurses per 100,000 people, according to 2019 data from the Canadian Institute for Health Information.

Hospitals across the province currently have a vacancy rate of 18 to 22 per cent for nurses, the Ontario Nurses’ Association says.

“Some smaller hospitals closed their emergency departments after four o’clock because they don’t have enough staff,” says Vicki McKenna, head of the association, adding that some operating rooms are running at limited capacity for the same reason..

While complaints from internationally trained nurses have traditionally had to do with the lengthy registration and licensing process with regulators, McKenna said it’s deplorable that those who have met the licensing requirement are being held back due to an immigration backlog.

“We need these nurses, and we can’t afford to have them languish on that list, and we can’t afford to lose them to other provinces. The nursing shortages aren’t in Ontario alone. It’s across this country and it’s an international issue,” she said.

“The U.S. is recruiting hard. Our nurses are leaving, in some cases, to what is seen to be greener pastures there, and we can’t afford to sit and watch. We have to do something.”

Reduced processing capacity due to lockdowns here and abroad, as well as travel restrictions worldwide, have wreaked havoc in the immigration system during the pandemic.

As of July 31, more than 561,700 people were in the queue for permanent residence and 748,381 had a pending temporary residence application as students, workers or visitors, while the backlog for citizenship stood at 376,458 people.

Traditionally, many internationally educated nurses from the Philippines, the Caribbean and Africa arrive and work as foreign caregivers while trying to register and restart their licensing process in Canada once they’re here.

The permanent residence backlogs for foreign caregivers began long before the onset of the pandemic in early 2020. In April, Immigration Minister Marco Mendicino announced a move to prioritize the permanent residence applications of 6,000 caregivers by Dec. 31.

The immigration department said it had processed the applications for a total of 3,253 people under the initiative up to Oct. 17, but it’s not known how many of those were caregivers because the number included their family members. Officials were unable to say how much the caregiver backlogs have been reduced since the announcement.

“Immigration, Refugees and Citizenship Canada has prioritized applications from workers in essential occupations in agriculture and health care, where labour is most needed to protect the health of Canadians and ensure a sufficient food supply,” said department spokesperson Rémi Larivière.

“Applicants who intended to work in agriculture or health care but who applied for an open work permit and didn’t have a valid job offer in advance would not be triaged for priority processing.”

Deauna said she was thrilled with the government announcement, but feels those with pending nursing licences should be fast-tracked if Canadian officials are serious about addressing the shortages of nurses in the country in the wake of the pandemic.

She applied for permanent residence and the bridging open work permit in August 2020 but only received an acknowledgment of receipt this past June. Her caregiver work permit has expired since June.

The Ontario licensing process requires of applicants practical nursing experience within the three years before a certificate of registration is issued.

Deauna fears she may have to go back to the Philippines to get back to practice and restart the licensing process if her immigration and nursing certificate don’t come through before June.

“I can’t afford more delay in my permanent residence or open work permit,” she noted.

Leslie Apurada arrived in 2018 under the home support worker program to look after an elderly man with dementia in Montreal and initiated her licensing process with the Ontario College of Nurses a year later.

The former Filipino registered nurse with a psychogeriatric background underwent Canada’s national nursing assessment, registered for prep courses and sat for — and passed — a couple of required nursing exams, all while working full time to look after her client.

Even though her employer was supportive and tried to spare her from overtime work while she was studying for exams and attending courses, Apurada said she was mentally and physically exhausted jumping through all the hoops to get past the final qualifying test in June. She’s since been waiting for her immigration authorization to work.

“During the height of the pandemic … Canada’s prime minister said we’re all in this together. But we, caregivers, feel we’re always pushed to the sideline. No one really answers to us why the backlog for the caregiver programs has been so extensive,” said the 31-year-old, who is now enrolled in an online course about nephrology at Humber College.

“It’s disheartening to see how strained the Canadian health system is while all along we are here. We’ve passed all the exams and we could’ve helped.”

Karla Ducusin, another former RN from the Philippines, came to Canada in late 2018 by way of Israel to look after an elderly couple with medical needs in Markham. She’s responsible for preparing them meals, administering their medications, escorting them to doctor’s appointments and helping with household chores.

The permanent residence application that she filed last October costs $1,050 and each time she extends her caregiver work permit, it’s another $155.

Given she’s now in Canada on the so-called implied status — in transition with a pending permanent residence application in the system, Ducusin said she has lost her OHIP, which requires a temporary foreign worker to have a valid work permit to be eligible. Her caregiver work permit expired last November.

“I want to be able to help my family more financially. My father is sick and my two younger brothers are not working. I could make a lot more money and pay more taxes as a nurse than as a caregiver,” said the 32-year-old, whose file will be closed by the College of Nurses of Ontario if there’s no update for two years.

“This is putting a heavy toll on our mental health. You wake up every day and there’s still no movement in your immigration application. It’s just so frustrating.”

Source: Canada has a big-time nursing shortage. So why can’t these two fully certified nurses get the OK to practise?

About Andrew
Andrew blogs and tweets public policy issues, particularly the relationship between the political and bureaucratic levels, citizenship and multiculturalism. His latest book, Policy Arrogance or Innocent Bias, recounts his experience as a senior public servant in this area.

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