Gabriela Kosonen spent years working as a nurse in Finland, with the hopes she could travel back to her native British Columbia and put her skills to use helping to solve a staffing shortage in the province’s hospitals and health care centres.
But almost a year-and-a-half into the complex, lengthy and bureaucratic assessment process required to certify her to work in B.C. nursing., with many months more left to go, she admits she sometimes thinks about quitting her lifelong passion of nursing to put her time into a job that might be better appreciated.
“It is frustrating,” said Kosonen, 27, from her family home in Comox. “I was so passionate about this when I started. It was the thing I really I wanted to do, to come here…but it’s just been disheartening.”
Health Minister Adrian Dix unveiled changes Tuesday he said will speed up the process, as well as provide bursaries of up to $16,000 per nurse to help pay the many application fees, tests, assessment and travel costs required to navigate the system.
“The process for internationally educated nurses is complex, it’s costly, and it’s lengthy,” he said. “And that, in a time when we need nurses…is no longer, I think, acceptable.”
The cost of the reforms is $12 million, but B.C. health officials admitted they will only shave off one to two months of a process that currently takes an average of two years for an international nurse.
Dix said he’s also launched a larger review for other changes, and is working with provinces and the federal government to address long waits at the National Nursing Assessment Service – where the process starts, before an internationally trained nurse is sent to the B.C. College of Nurses and Midwives.
On paper, Kosonen could be an incredible asset to B.C.’s health care system – she’s young, has experience in Finland’s hospitals, and in addition to being both a Canadian and Finnish citizen her grandmother was from Haidi Gwaii. She said she’d like to explore her Indigenous heritage by working in health care in B.C.’s First Nations.
Yet she, like hundreds of internationally trained nurses per year, are stuck at the mercy of an archaic accreditation process that allows only mailed paper documents, forces mandatory English tests on people for whom English is their primary language (like Kosonen), has only one certification centre located in Vancouver, requires almost $10,000 in various fees, and, the province admits, can hold up applicants for as long as six years to get through the process.
“I’m half-ready to give up,” said Kosonen. “I feel like I have other pursuits that would be a lot wiser to use my time on.”
She said she understands needing to uphold a high quality of training and care for nurses, but the system feels under-resourced and broken.
“I just feel it’s a little bit unfair, despite their good intentions,” she said.
BC Nurses’ Union president Aman Grewal said the province is in desperate need of more nurses yet she hears constantly about the anxiety and frustration the international accreditation process has caused.
“We know nurses currently working in our province are tired, burnt out and need more support,” said Grewal. “Finding solutions to improve B.C.’s nursing shortage is complex and multi-faceted.
“I believe these efforts to streamline the process is an important step in the right direction.”
Canada’s National Nursing Assessment service, where the process for international nurses begins, says it has an average processing time of 12 weeks. But Kosonen said it took her seven months. Dix acknowledged delays at that level need to be addressed.
From there, Kosonen is directed back to the BC College of Nurses and Midwives, then back to the federal assessment process, where the only assessment centre is in Vancouver and it can take months to get a spot.
B.C.’s reforms are aimed at speeding that part of the process up, allowing international nursing candidates to complete three assessments for multiple types of nursing at one time, reducing a 12-18 hour process down to as little as two to three hours. The province is also moving to double the number of applicants that can be tested in a day.
Then, it’s back to B.C.’s nursing college to assess the results, which can take another six weeks, and then any more referrals to additional training required.
Kosonen admits she’s been the “squeaky wheel” in the process, repeatedly complaining about delays and on Tuesday penning an op-ed in the Victoria Times Colonist about the system.
“I know I’ve done the very best that I can,” she said. “I can’t do anything else to speed it up. And yet, still, it’s going on for me this long when at the same time the news is full of how nurses are burning out and they need them so bad.”
Kosonen said she’s decided to stick with the process to see it through, rather than changing careers out of frustration.
“I just hope that it helps someone that I’ve come out with this information,” she said. “I’m not expecting it to, perhaps, come in time to help me. The announcement by government, it sounds really good.
“But they do have to keep in mind announcing it is one thing, and actually implementing it so that it affects someone in a good way, and the system in a good way, is another.”