Tens of thousands of nurses on the sidelines as ERs on the brink of closure in Ontario

Tens of thousands of nurses are currently sitting on the sidelines as hospital emergency rooms in Ontario near the brink of closure due to staffing shortages.

That’s because this pool of about 26,000 nurses in Ontario is internationally educated, according to the most recent report from the province’s Office of the Fairness Commission.

“Of those, 14,000 are registered nurses, which is really where the toe is hurting,” Registered Nurses’ Association of Ontario (RNAO) CEO Doris Grinspun said.

University Health Network (UHN) issued a memo to medical staff last week expressing an “urgent need” for “volunteers” to fill nursing shifts at Toronto Western Hospital’s emergency department.

“You have ERs that are closing. You have nursing homes that don't have enough staff. All of it boils down to the same thing. Nursing is like the spinal cord of the system. If you don't have enough nurses, the system cannot function,” Grinspun said.

According to the College of Nurses of Ontario (CNO) website, the registration process for a nurse who was educated outside of Canada takes between three to 18 months. That includes eight registration requirements, such as evidence of practice, language proficiency and a registration exam.

“Each registration journey is unique. For those who have met more of the registration requirements, CNO can register them as nurses in a matter of weeks,” CNO spokesperson Kristi Green said.

But for applicants like Karla Ducusin, it took much longer. For her, it took three years.

Ducusin was qualified and practiced as a registered nurse for four years in the Philippines before she immigrated to Canada. She entered the country as a caregiver because it was the quickest path to immigrate.

Currently, Ducusin said there are around 400 internationally educated nurses from the Philippines who came to Canada under the caregiving program. “Imagine if all of them got [nurses] licenses,” she said. “It would greatly help the shortages.”

It took Ducusin two years to complete the required English and licensing exams, which she spent all of her savings on. But after she passed, she also needed permanent resident status or an open work permit.

After another year, she became a permanent resident and immediately had interviews at several hospitals in Toronto.

“Diabetes is diabetes. Alzheimer’s is Alzheimer’s,” Ducusin said. “Caring for people and doing everyday stuff, it’s pretty much the same,” she said.

Grinspun said lowering the time frame it takes to process these nurses would dramatically change the current shortage. A recent RNAO report found the backlog of internationally educated nurse applicants in Ontario has been growing for over a decade, and has only escalated during the pandemic.

“These are nurses that are already living here,” Grinspun said. “It takes forever for us to integrate them into the workforce.”

Meanwhile, the workforce is collapsing, said Birgit Umaigba, a registered nurse in a Toronto emergency room.

“Last week I had to extend my shift to a 16 hr shift because there was no one to take over for me,” Umaigba said. “How do you walk away from a patient who is intubated on life supporting machines and no one is there to take over?”

Some days, Umaigba said she’s performing the work of three nurses. She said that means patients will have to sit soiled for hours, developing bed sores.

“People don't realize how serious this is until they are affected,” she said.

While Umaigba said she sees an immediate need for bringing more internationally educated nurses into the workforce, she said it needs to be paired with a long-term solution.

“If internationally educated nurses come into the workforce, they too need to be retained,” she said.