Linda Olson is a Registered Nurse (RN), and a holder of a Master’s Degree in Public Health. She has been in the nursing field for over 25 years. With her breadth of knowledge and experience, English Online is extremely fortunate to have her as one of our Career e-Mentors, specifically for our internationally-educated healthcare professionals. Aside from English Online, Linda also teaches in the Canadian Culture and Communications Course for Nurses program (CCCN), and volunteers with a local community development group, an environmental group, and the Canada Games 2017.
We consulted her recently about the registration process for IENs and ended up learning so much more about the current situation in the health care sector in Manitoba, exploring career options, and navigating the labour market.
English Online (EO): Could you please share with us the steps an internationally-educated and trained nurse (IENs) would have to go through to be registered? How long does the process usually take?
Linda Olson (LO): ): The National Nursing Assessment Service (NNAS) is where you would start your process toward nursing registration. They have an Applicant Handbook that can be downloaded at NNAS/SNEI that will give you detailed information. The registration process usually takes from 18 months to five years.
This is a summary of the process as stated in the Handbook:
- Your first step would be to register with the National Nursing Assessment Service (NNAS).
- Submit all documents requested by NNAS.
- NNAS Advisory Report will let you know what else is needed.
- Complete a language test if required.
- Once all NNAS requirements are met, submit an application to the nursing regulatory agency of your choice, in the province of your choice. For example, if you want to practice as an RN in Manitoba, it would be the College of Registered Nurses of Manitoba (CRNM). The regulatory agencies for nurses in Manitoba are: the College of Registered Nurses of Manitoba (CRNM); College of Licensed Practical Nurses of Manitoba (CLPNM); and the College of Registered Psychiatric Nurses of Manitoba (CRPNM).
- This agency will then advise you on your next steps. Most often this will include a Clinical Competency Assessment and a Bridging Program based on your competency.
- Once you have completed and passed all requirements of the regulatory agency, you may apply for a Graduate Nurse license.
- Write the next available nursing registration exam.
- If you pass this exam you are then a nurse in your chosen province.
The first thing I advise IENs is to follow the NNAS instructions. They really lay out the process, and if you miss any of those steps, you’ll have to go back and start again. A major concern is related to bringing nursing education records from another country. Often, there are problems with this. Some IENs may not have the right document, or their documents do not match what is asked for. This can go back and forth, causing delays in time. Sometimes NNAS may ask for the documents to be translated. The IENs must pay for all of these things. So it’s very important to follow instructions step by step.
Another important aspect of the process is the language. That is one of the big steps in the registration process. I advise IENs to practice their English everywhere, not just in language classes. I would suggest that they go out and talk to people to improve their language skills. For example, when going home on the bus, they should approach people to ask directions. In the store, engage the clerk as much as you can, or join the community club where you live. You know, build all those connections. It’s always good to try to speak to more educated people because their language would probably be better and maybe less slang. Also tell them – “I’m here, I’m new, if I’m making mistakes just tell me.” And they’ll help you. Otherwise, nobody will tell you, even if you make the same mistake over and over. Canadians are very polite. They would never correct your English. But if you say, “I really need this,” they will help you. People feel really good about helping, but they have to have permission to do so. Also, when you go out and talk to people, you get a feel of the culture. Learning this is as important as the actual words. This will also help you to avoid cultural misunderstandings.
EO: Is the licensure/registration process the same in all provinces?
LO: No. Each provincial regulatory agency has its own requirements for licensure. You should directly contact the province and regulatory body (i.e. RN, LPN) of your choice for their most up-to-date information on the requirements. It’s a long process.
EO: For certain regulated professions, you can start the registration process in your home country. Is this possible for IENs?
LO: I have a friend who started the process from her home country (the Philippines). And she went through the system a bit faster. Before entering Canada she took the IELTS (International English Language Testing System) which is a more universal language test and is available in many countries. This gave her a bit of a head start and allowed her to study English in a focused way while still working as a nurse in her home country. Once an IEN enters Canada, we usually point them towards the CELBAN (Canadian English Language Benchmark Assessment for Nurses) test because it is geared specifically to nurses.
“There are always jobs for nurses coming into the profession, because the population is increasing and because many of the nurses who are practicing in Manitoba now are close to retiring. However, nursing jobs in Manitoba are now in a state of flux, many nurses are being reassigned to areas of nursing that they did not originally chose.”
EO: What are some of the biggest challenges Internationally Educated Nurses face in their journey to licensure/registration in your opinion?
LO: Some of the challenges that have been mentioned to me are: The long wait times between each stage of the licensing process; the cost; and the number of steps to complete the process.
Usually, IENs will complete one step of the process, such as the language test and then they wait until they can do their next step. What happens is that, for the next step, the seats may be full so they would have to wait again. In the meantime, time is passing and they don’t have a job or they have a job but not the job they want. So I’m hoping to see the process speeded up.
What I did find is that if nurses went to a rural or remote area, they were likely to get in faster into these seats for the next step in the registration process. However, people may not necessarily want to move to a rural area. If they do not have anyone from their home country there they are going to feel really isolated and if they have a spouse, the spouse isn’t likely to get a job because there are less jobs in the rural areas. Also, if they have children they may not have certain kinds of schools available there. It’s not for everybody.
EO: What options do unlicensed or unregistered nurses have if they don’t want to go through the registration process (or what jobs can they have while undertaking registration)?
LO: What I’m seeing in my students who are going through the process of becoming RNs is that many are taking a Health Care Aide (HCA) course, which I believe takes about five months. Even as an IEN you will still need to complete the HCA course to become a certified HCA. Crazy, isn’t it? Some facilities in Winnipeg will still hire uncertified HCA, but this is becoming less common. I taught HCAs at one point and had students who were engineers and agriculturalists taking the HCA course because they said that the process to get into their previous careers was too long. HCA is a steady job, it’s secure, and so that’s why they get into it. In facilities that I worked in I see some IENs just get stuck in these positions because of the long process to become a nurse.
They could also consider a career change but it would depend on each IEN’s personal situation. This would mean assessing a lot of things like their economic standing, years left of working life, desire to remain a nurse, other employment opportunities, geographic region, etc.
There are actually a lot of skills that nurses have that are in high demand in other fields. In my career, I found that I got a lot of my other jobs because of my nursing background. I got a job in agriculture because I was nurse. Even though I had an undergraduate degree in agriculture they hired me because the job was more nursing-related. So even if I was competing with all these people with agriculture degrees, I was in front of the line because I had all these nursing skills. The same thing happened with teaching. In my work now with CCCN I did not require a certification in Nursing, but being a nurse is a bonus. It enables me to work on the materials and see if they were authentic. Another example is research. I have worked in lots of research projects. Nurses manage cases, put together care plans, and work as a team. They use the same skills needed for research.
I regularly look at all kinds of jobs that are available in Winnipeg, even though I am not looking for a job for myself. I take a peek at what skills are being sought after by employers. What are they looking for? I discover that a lot of them are nursing skills. So it’s very interesting.
There are many Internet sites that will send you email notices of jobs as soon as they come available. One that I have been using is called indeed, this is one of many.
EO: Would you say that nursing is a flourishing profession in Manitoba?
LO: There are always jobs for nurses coming into the profession, because the population is increasing and because many of the nurses who are practicing in Manitoba now are close to retiring. However, nursing jobs in Manitoba are now in a state of flux, many nurses are being reassigned to areas of nursing that they did not originally chose. You have probably heard about some wards being closed (like emergency wards in Concordia and Victoria Hospital), some positions have been deleted, so some nurses will be moved to other positions. The situation is that they still have jobs, but they maybe not the jobs they want – the type of shifts they want or a location that is convenient. If they don’t accept what is being offered, they may lose their job. So I think there is going to be a lot of movement. Some people will stay, some won’t. It’s hard to say, but there is still lots of room in the system to absorb more nurses, especially in rural and remote areas. So right now, the demand for nurses has not gone down; however the choices of where to work are narrowing.
I think the health care system last went through these changes in the 1990s. I wasn’t here then, but I watched it on the news – bed closures, lay offs, and strikes. It was so devastating for those working in the system. Then the jobs came back. So there could be lots of demand for nurses and then suddenly, things can fall apart, but you still have the nursing qualification. It is like a long-term investment that retains its value over time.
The other thing that is happening in the health care sector is that we are seeing a lot of RN positions being replaced with LPN positions. This is because LPN courses are now longer than before, and where I work, there is virtually no difference between the job description of an LPN and an RN. It’s just for very specialized situations where they would ask for an RN rather than an LPN. LPNs get paid about $10-15 an hour less than RNs so management is moving towards hiring LPNs. The LPN training here in Manitoba has been lengthened; I think is one of the longest programs. The clinical/bed-side component of the training is comparable to that of an RN.
EO: Would you recommend to internationally-educated and trained nurses that they practice their profession here?
LO: Yes. In most cases, it is easier to build on what you know rather than start with a new profession or job. In general, professionals, such as nurses and engineers have more autonomy than non-professionals.
If you have a nursing license you can move around. As a non-professional, much of your credentials lie with your place of employment, for example ‘working your way up the ladder.’ This puts the worker in a vulnerable position. When you’re a professional your skills are part of your own credentials, so they are portable and can be taken with you if you move to another job. It depends on the situation but in general, professionals are more portable than non-professionals, they have more options, and get paid more.
In the early part of my life, I could see that people could work at a company or a facility for their entire life. But that situation is now almost totally gone. It is now a matter of upgrading to keep current with economics and technology, moving, and retraining, to stay in the job market. It is estimated that most people will change their career at least three times during their working life. I have changed at least nine times, and I’m not finished yet.
EO: Any other message to nurses, especially newcomers who are aspiring to practice their profession in Manitoba?
LO: Your profession gives you more than employment, it also contributes to your quality of life. If you are happy and passionate about your profession, you are more likely to do better at your work. Demand for certain professions increase and decrease depending on the circumstances of the time. In the long run, it is better to work at what you enjoy and what fits with your family’s circumstances.
Do your ‘homework’ on the job market and prepare yourself to look for a job by:
- checking out what jobs are available. What seems to be in the highest demand? What skills are asked for?
- preparing your resume and practice writing cover letters for some of the jobs you see, even if you are not yet qualified for the position. Practice. Be prepared.
- going to job interviews for jobs you are qualified for, such as those in the service industry, even if you do not want the job. You will experience how a Canadian interview is held, you will experience the culture, and you will become less nervous with practice. If you get the job and do not want it you can turn it down. If you are notified that you did not get the job, contact the interviewer and ask how you could have done better, for example, “What were you interested in that I didn’t have?” In most cases, people want to help, but they’re not going to automatically phone you to say what you should and shouldn’t have done. You have to ask. The way to look at it is that this is part of your training. Feedback is very important. The key is to look at everything as a learning experience.
Disclaimer: English Online shares stories of newcomers who have successfully achieved their licensure or certification for the purpose of encouraging other newcomers who are aspiring to practice their regulated professions in Manitoba. As personal circumstances, credentials, and experiences vary from person to person, the experience related in the feature may not be the same for all aspirants. Also, rules, eligibility requirements and procedures may have changed from the time the featured professional completed their licence to the time the story was published. Therefore, it is important that internationally-educated and trained professionals contact and connect with their respective professional associations or regulatory bodies to get up-to-date information. English Online does not provide credential assessment or qualifications recognition services.
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