An approach to the nursing shortage that’s worth trying

Opinion

Manitoba has a nursing shortage that continues to worsen. The provincial government wants to reduce that gap by adding hundreds of internationally-educated nurses (IENs). As part of that effort, it has devoted considerable energy and expense to attracting nurses from the Philippines. Earlier this week, it announced a marketing campaign that aims to recruit health-care workers from Michigan, Minnesota, North Dakota and South Dakota.

A major obstacle to recruiting IENs is a requirement imposed by the College of Registered Nurses of Manitoba that “labour mobility applicants” must have 450 hours of nursing experience in Canada over the past two years or 1,225 hours over the past five years.

In an April 30 letter to the college, Manitoba Health Minister Uzoma Asagwara wrote that the nursing experience requirements imposed by the college violates interprovincial trade laws, including the Canadian Free Trade Agreement, the New West Partnership Trade Agreement’s labour mobility rules, as well as legislation that requires regulated professions to ensure their registration practices comply with obligations of a domestic trade agreement.

Based upon those concerns, the minister ordered the college to rescind its “currency of practice” requirements within 30 days.

In response to Asagwara’s order, the nursing college argues that abandoning the minimum experience requirements would jeopardize patient safety. It says that the previous government’s decision in 2022 to not require that out-of-province nurses have a minimum of current hours of Canadian practice experience put patients at risk.

It alleges that two patients have died as a result of the 2022 decision, and claims there has been a large increase in complaints about nursing incompetence linked to the labour mobility applicants, including a lack of nursing knowledge, skill and judgment, the inability to take or interpret vital signs, perform a health assessment, safely administer medication or prioritize patient care.

Given that experience, the college notified Asagwara last December that it was reverting to its policy of requiring nurses have Canadian nursing experience. Five months later, the minister has ordered the college to drop the policy once again.

College registrar Deb Elias says that “at the end of last year, 2024, we were very alarmed at the trend that we saw, with a substantial increase in complaints and the significant, gross nursing incompetence that we were seeing … We absolutely support labour mobility and welcome nurses and (nurse practitioners) from across the country. But we also want to uphold patient safety. That is our mandate.”

Manitoba Nurses Union president Darlene Jackson has a slightly different perspective, saying that “this is absolutely unfair to these nurses that are coming in because they are not prepared properly for our health-care system.”

She adds, however, that “it’s in the best interest of the public to allow the college to do what they need to do to follow their mandate to ensure that … everyone practising in the Manitoba system as a nurse is practising safely.”

Elias and Jackson raise valid concerns, but they — and Asagwara — fail to identify a potential solution.

Saskatchewan added 400 internationally-trained nurses to its health-care system last year. That recruiting success, which has helped to reduce the nursing shortage throughout that province, is due in large part to a 14-week “Transition to Registered Nursing in Canada” program offered by the Saskatchewan Polytechnic college.

The program supplements foreign nurses’ previous training with online theory courses overseas, along with in-person lab and clinical components following arrival in Saskatchewan. The objective of the program is to provide IENs with the knowledge, skills and abilities necessary to meet entry-level competencies required to practice as a registered nurse in Saskatchewan.

Some Manitoba colleges offer classes to improve international nurses’ proficiency, but there does not appear to be a comprehensive program offered to IENs in this province similar to that currently available in Saskatchewan. If it does exist, it is a well-kept secret.

Could a similar program for internationally-educated nurses, if offered at universities or colleges in Manitoba, address the patient safety concerns articulated by the province’s nursing college and nurses’ union? Could that, in turn, ultimately help to reduce the shortage of nurses in this province?

Those are questions for leaders in our health-care system to answer, but one thing is clear.

It’s time for Manitoba’s health minister and nurses to stop sniping at each other, and start working together toward finding solutions to the many challenges facing our health-care system. And it’s time to learn from the success of other provinces. If a program similar to that which is currently being offered in Saskatchewan might help to add international nurses to Manitoba’s system without putting patient safety at risk, it’s worth trying.