Foreign-trained nurses face abrupt game change in Ontario licensing
Published on Tuesday December 18, 2012
TARA WALTON/TORONTO STAR
Filipino nurse Shieraden Dalisay and other foreign-trained nurses worry they won’t qualify to work in their profession under new College of Nurses of Ontario rules.
Filipino nurse Shieraden Dalisay came to Toronto to work as a live-in caregiver in 2008. His dream was always to remain in Canada, but return to his trained profession.
Four years after he began the licensing process with the College of Nurses of Ontario, Dalisay has been told by the professional regulator that he will have to start the entire process over if he doesn’t complete his registration before January 1, when new regulations come into effect.
Under the new rules, an applicant’s previous nursing experience counts toward their licence only if the person worked in nursing within the previous three years, rather than within five years as is the current requirement.
This tighter so-called “safe nursing practice” time frame has suddenly put in jeopardy the career aspirations of Dalisay and other foreign-trained nurses in Ontario.
Although the new criteria applies to all applicants, it will disproportionally disadvantage foreign-trained nurses, who are often consumed by the lengthy process of getting overseas credentials in order — transcripts, employment records, references — while settling in a new country and working survival jobs to make ends meet.
The Ontario Office of Fairness Commissioner acknowledged it has already received several complaints against the College’s changes.
Applicants with nursing experience abroad complain they were only informed of the game-change in September when the College sent a letter to its 21,000 current applicants — 70 per cent internationally trained. The majority of foreign nurses fear they won’t make the Dec. 31 deadline to complete their applications under the old rules.
“The changes came about so suddenly without enough information and awareness within the broader (nursing) community that many people are in crisis, scrambling to get their registration now,” said Zubeida Ramji, executive director of Toronto’s Centre for Internationally Educated Nurses (CARE), a support group that helps foreign-trained nurses return to practice.
“If you look at the journey of immigrants’ migration from one country to another, it’s a trying and challenging process. Settlement takes energy, resources and time. By the time they get to look at what needs to be done with their credentials, significant amount of time would have passed.”
Concern over possible changes to the time frame was echoed in the Registered Nurses’ Association of Ontario’s submission in 2010 to the regulatory body in favour of the five-year status quo.
The College, however, said the changes, approved by the provincial government in June and posted on its website in July, are in keeping with the need to protect the public and ensure nurses are capable of meeting and maintaining practice standards.
“The move to a three-year time frame was supported by the evidence. It applies to all applicants (whether from within or outside Canada) and meets the requirement in the Fair Access to Regulated Professions Act that all applicants be treated fairly, consistently and transparently,” College spokesperson Bill Clarke told the Star in an email.
“Some of these changes . . . also reflect the gradual move to make the entry-to-practice requirements for health care professions consistent across the country.”
Dalisay graduated with a Bachelor of Science degree in nursing from Manila’s Chinese General Hospital nursing college in 2002. He worked in the Philippines as a nurse, then took a job for a year at Saudi Arabia’s largest hospital, King Fahad Medical City, in 2007 as an intensive care nurse.
He arrived here in October 2008 as a live-in caregiver because it proved a much quicker avenue than through the backlogged federal skilled workers program.
Dalisay, 32, started his licensing immediately upon arrival. After his initial application to take the Canadian Registered Nurse Examination was refused, he applied for and passed the lower registered practical nurse exam in January 2011.
He met his minimum two-year live-in employment requirement last December to be able to apply for permanent resident status, but did not receive his open work permit until June. He took the his MELAB English proficiency exam, required by the College, last month but failed because he only had days to prepare.
“When I applied to the College in 2008, they told me I had until October 2013 to get my licence to practise. All of a sudden, they changed it from five to three years,” said Dalisay.
“All of my education and experience will be useless if I don’t meet all the requirements by Dec. 31. I will have to go back to school and start over. It is just so unfair.”
Lyn Shamaine Jalos, whose only missing document for her nursing licence is an open work permit from immigration, said the College could have grandfathered the changes and made the process fair to those who initiated their applications in good faith.
“Giving us just three months notice is not enough. I will have to take a new jurisprudence test. I will have to pay for and study for a different language test,” said Jalos, whose previous nursing experience in the Philippines will no longer be valid on Feb. 15 — her last date working as a nurse was Feb. 15, 2010.
“It is only fair if they applied the old rules to the old applicants and new rules to the new applicants who apply after January 1.”
In 2005, the College grandfathered members who did not have a university degree in nursing when it required a minimum university degree instead of a diploma.
“It seems reasonable to me that the foreign-trained nurses who applied to be licensed in Ontario prior to September should be able to carry through on that process they applied under,” said Vicki McKenna, vice-president of the Ontario Nurses’ Association, the nurses’ union.
However, Clarke said the College is required by law to implement changes to legislation when they come into effect.
“We are required to apply registration processes fairly and equitably in the interest of public protection,” Clarke wrote.
“Applying the same registration requirements for all applicants at a certain point — whether the applicant is currently in the process or beginning a new application as of that date — helps ensure that everyone is being assessed using the same standards for registration.”