Current State
Governments see investing in internationally educated nurses (IENs) as an excellent way to increase the supply of qualified nurses in their jurisdictions. Currently, barriers such as streamlined assessment, training and support are impeding the success. Additionally, other provinces and territories in Canada are opening their doors to IENs with little to no assessment of credentials and/or competencies. In addition to heavy competition across provinces for the same resources, this has created a challenge for many from both a recruitment and quality of service perspectives.
Balancing the need to ensure quality and safe care is provided to all people with the need to quickly and efficiently increase the supply of nurses has limited the numbers of IENs who want to come to some Canadian provinces and territories and placed extra time on the registration and licensing process for those IENs who are already here.
Competition Issues
IENs are now finding the fastest and easiest province and/or territory to register and then, as a Canadian nurse, moving to be registered as an endorsement nurse in their location of preference. Reports exist coming from provinces of significant influx of international nurses who are not doing any assessment at the regulatory body level. These IENs are now arriving, with some not being prepared to work in the healthcare system and not fully understanding the Canadian healthcare context. With this, some employers are experiencing quality issues that may affect patient care and health outcomes over time, resulting in IENs not being hired and some being terminated.
IENs are now finding the fastest and easiest province and/or territory to register and then, as a Canadian nurse, moving to be registered as an endorsement nurse in their location of preference.
A Solution
A comprehensive strategy that focuses on investments aimed at efficient, high quality and safe assessment, training and sustainable employment will be successful; seeing health, provider and system outcomes improving as a result of having enough nurses in the system. Modern technology can help facilitate throughput, enable assessments, identify clinical competency areas that needs training early, and in some cases even provide that training or retraining to potential providers.
Mechanisms that limit bottlenecks, reduce process friction, enable automation, and do so while improving clinical quality of providers ensures pipelines are functioning efficiently and effectively, and will ultimately mean more providers of a higher quality in your health system. A strategy such as this, applied to other internationally educated health providers (IEHPs) can be used to increase the capacity and numbers of needed health professionals across the country now and well into the future.