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Manitoba orders regulator to remove barrier that prevented some internationally trained nurses from working

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Health Minister Audrey Gordon is promising to remove perhaps the biggest obstacle for internationally trained nurses working in another province who are trying to move back to Manitoba.

Gordon has issued a compliance order that forces the College of Registered Nurses of Manitoba to remove its requirement that internationally educated nurses already licensed in other jurisdictions in Canada be subject to further testing if they’re trying again to be accredited in Manitoba.

The vast majority of people who take the days-long examination, referred to as the clinical competence assessment, are found to need remedial education to be licensed in the province.

The additional requirement has prevented numerous people from returning to Manitoba, critics have said.

“We have a nursing crisis and a staffing crisis in the health system,” Gordon said in an interview Thursday.

“I’ve become quite concerned about the pace of the change in the licensing of nurses here in Manitoba and felt that it was time to take the step of issuing a compliance order.”

Nursing college will follow order

Katherine Stansfield, CEO of the regulatory college, disagrees with the health minister’s position, but said she respects the decision and the college will oblige.

The demand from Gordon’s office, issued on July 26, comes one year less a day from the Manitoba government first informing the college by letter of its concerns regarding the clinical competence assessment requirement, the compliance order says.

It is the first time Gordon has issued such a directive, she said.

The province has faced pressure to bring in more nurses while reports of high vacancy rates, burned-out nurses and continuous mandatory overtime requests have piled up.

Health officials say they’re focused on recruitment and retention, but emphasize staffing shortages are an issue across the country and beyond.

The order asserts the college’s clinical competence assessment demand violates numerous domestic trade agreements and Manitoba’s labour mobility act, which state any worker certified in one jurisdiction must be recognized as qualified to practise elsewhere. Not all Canadian jurisdictions require the same clinical competence assessment.

“These are individuals that are already registered in good standing, working in other jurisdictions across Canada. They come to Manitoba and they feel that the process is far too slow,” Gordon said.

“It is my job as the health minister to ensure that they can do that.”

Katherine Stansfield, the CEO of the College of Registered Nurses of Manitoba (CRNM), is defending the use of the clinical competence assessment as a mechanism to ensure public safety. (Jaison Empson/CBC)

Stansfield said the compliance order disappointed her. She disagrees with the assertion the college breached the labour mobility act, as she states the legislation doesn’t offer guidance for individuals who could skirt a jurisdiction’s requirements — for example, Manitoba’s clinical competence assessment demand — by being certified elsewhere. 

“We felt the labour mobility act was silent on those applicants,” Stansfield said.

Right now, Manitoba’s regulatory body doesn’t require the clinical competence assessment for registered out-of-province nurses who are trying to get licensed in Manitoba for the first time. The compliance order expands that exemption to everyone who is already licensed elsewhere in Canada, Stansfield said.

She said the new provincial order would impact a “handful” of people immediately, but it’s unknown how many nurses never attempted to re-apply in Manitoba because of the more stringent conditions. 

Nurses’ union impressed

Manitoba Nurses Union president Darlene Jackson said her union doesn’t keep track of the number of internationally accredited nurses in other provinces who want to move to Manitoba, but “a lot of these nurses come knocking on our door because they need help and they don’t know where to find it.”

Jackson said she’s pleased the province is taking action. 

“We have been calling out for the government to step up and really, really show us some tangible ways that we are going to give nurses in this province some relief from the workloads, from the mandated overtime,” Jackson said.

“I would say this is an indication that the government has heard our message.”

Despite issuing the order, Gordon commended the regulatory body for its willingness to update the licensing process. She said the college has worked with Red River College Polytech to develop a more accessible pathway for nurses in need of a refresher.

Starting this fall, the nurse re-entry program will replace the existing internationally accredited nurses bridging program and nurse refresher program with a new flexible, self-directed option that can be completed through various means, including virtually.

It’s meant for domestic students who want to return to the profession, internationally accredited nurses seeking licences in Manitoba and other nurses who need to complete particular courses mandated by the regulatory body. 

Gordon said the government would share more of its progress in supporting internationally accredited nurses soon. 

In July, CBC reported that licensed practical nurses who are nearly fully licensed in the province will soon be able to work in health-care facilities under supervision.

As well, the various nursing colleges are working on a system to direct applicants who don’t meet the requirements of one nursing college to pursue another avenue for licensing. 

Stansfield stressed the clinical competence assessment ensures the province maintains a high standard of nursing. Manitoba has nearly 100 more internationally accredited nurses registered in 2021 than it did in 2018, she said. 

“We know that nurses are going successfully through the process because we have the numbers to show it,” Stansfield said.

“It really is about our job to protect the public interest, and that means there are certain criteria people must meet.”

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