Masks with straps that don’t tie, gowns that fail to fully cover bodies, and shortages of personal protective equipment all characterized working conditions faced by nurses at the start of Canada’s COVID-19 pandemic.
About one in ten nurses in Canada—7.7 percent—are licensed to practice in Canada, but are immigrants. These nurses, despite facing the same hazards treating COVID-19 patients as their colleagues with citizenship, face barriers to career promotion, distrust from fellow nurses and patients, and wage penalties.
As Canada experiences its second wave of COVID-19 cases, some advocates are calling for better recognition of the contributions from foreign-educated nurses by legislators and nursing regulatory bodies. Ahtisham Younas, a Ph.D. candidate at the Memorial University of Newfoundland, is one of them.
Licensed nurses on the front lines
During the pandemic, Younas issued a call to action for better advocacy of foreign-trained nurses, co-authored with Dr. Jude Laoagan Tayaben at Benguet State University, and published in the peer-reviewed Journal of Advanced Nursing in May.
Younas’ experiences as a foreign-trained nurse and his close work with other foreign-trained health care workers motivated his call to action, he explained, in an interview with The Strand.
“I feel immigrant nurses have immensely contributed to Canada’s response towards COVID-19,” he wrote. “I personally know many [foreign-trained] nurses who have worked extra hours during the pandemic and are currently doing so. These nurses have not backed off from working extra hours to offer support to the health care system.”
In Ontario, the provincial government launched an online portal in April to match foreign-trained health care workers—including nurses—with needed placements to reinforce the health-care system. Settings included “public health units, assessment centres, hospitals, nursing homes, and other health-care providers,” as reported by the Toronto Star. The portal received volunteers at a time where there were “outbreaks at 51 nursing homes” across Ontario.
Dr. Ayesha Badiuzzaman, a foreign-trained physician, explained her perspective on why foreign-trained health care workers are willing to serve, in an interview with the Star. “Canada is our country now. What can we do to help Canada?” she said. “We don’t want to just sit here and watch our colleagues battle it out on the front lines.”
Contributions from foreign-educated nurses pre-licensure
The willingness to volunteer has not only been present among licensed foreign-trained nurses, but also immigrant nurses in the process of achieving licensure. Many of these nurses, including Younas, have supported patients in health care settings in roles outside of nursing.
“When this pandemic started, I was completing my final bridging course for the licensure process and also writing my dissertation proposal,” he wrote.
Younas balanced his studies with work in a home care setting. “In addition, I was actively taking care of many vulnerable people with developmental disabilities and making sure that these people [weren’t] exposed to the virus. I am still working for these clients,” he noted.
A petition by Dr. Ali Mahdi, an international medical graduate trained in Ukraine, echoes the willingness of foreign-trained medical professionals lacking licensure to find ways to contribute during Canada’s COVID-19 pandemic.
“Given the prevailing and unprecedented circumstances… we are coming forward to willingly volunteer, hands-on, without expecting to be paid, so we can alleviate front-line workers during this time of crisis,” Dr. Mahdi wrote. The petition has since gathered over 15,000 signatures.
From personal recollection, Younas also wrote he knew pre-licensure immigrant nurses continuing to work “as home support workers… and developmental support workers in hospital and community settings” through the height of the pandemic.
Calls to support foreign-educated nurses
Most immigrants with backgrounds in health care “have trouble getting their foreign credentials recognized in Canada, compared to just 40 percent in other regulated professions,” the Toronto Star reported in 2015.
A call to action by Younas and Dr. Tayaben has been for regulatory bodies and nursing associations to ease the licensing process for foreign-educated nurses to begin practicing during COVID-19. They opined that, since current calls to action by the International Council of Nurses includes advocacy for “expediting nursing student graduation or recalling retired nurses,” expediency should also be extended to foreign-educated nurses.
“Our intention is not to degrade the competencies of students and retired nurses, but to bring into attention that the nursing associations have not advocated for the rightful place of immigrant nurses,” they wrote.
Asked by The Strand about the role of universities in supporting these nurses studying for licensure, Younas reflected: “I know many immigrant nurses who were currently in process of getting their licensure, but the process got delayed due to the pandemic.” He supported actions by universities to help nurses seeking licensure with continuing their education online.
As for licensed foreign-educated nurses, the co-authors called on nursing associations to strongly advocate to ensure they “receive equal compensation, privileges, and respect as the non‐immigrant nurses.”
Younas’ advice for practicing foreign nurses
Speaking on his advice for fellow immigrant nurses, Younas wrote to The Strand: “I would advise immigrant nurses that they should continue to support their respective institutions and the provincial health care system so as to effectively manage the pandemic.”
“I would advise them to hold onto their nursing values such as compassion and care and do their best to support the needs of institutions,” he continued. “Hopefully, their work during [a] pandemic will be recognized even more.”
Reflecting on the physical and mental health toll the pandemic has taken on practitioners, Younas wrote: “I would also encourage them to reach out to professional support groups in their institutions and seek emotional and moral support as needed.” “Although, these are unprecedented times and everyone is stressed out, I am making sure that I stay in touch with other immigrant nurses whom I know and offer as much support as I can.”
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