November 26, “Access to Employment for Internationally Educated Professionals” Nursing in Ontario Ruth Wojtiuk, Professional Practice Lead

November 26, Working in Ontario To work as a nurse in Ontario requires registration with the College of Nurses of Ontario (CNO) 2

November 26, ONTARIO A preferred destination for Internationally Educated Nurses ,900 new registrants - General Class: 4,947 RNs and 4,953 RPNs. RN – Internationally Educated % (643) RPN – International Educated % (1189) An RN increase of 3.2 % over 2011 An RPN increase of 10.5% over

November 26, CRNE/CPRNE Pass Rates RNs educated outside of Ontario: 35.3% RPNs educated outside of Ontario: 60.4% CNO – Nursing Registration Exams Report 2012 With CARE: RNs/+ RPNs educated outside of Ontario: 80% CARE – Centre for Internationally Educated nurses – 2012/13 Annual Report 4

November 26, CARE Centre for Internationally Educated Nurses An expert inter-professional team of Case Managers help immigrant nurses successfully move from pre-registration to achieving registration and nursing employment in Ontario. Community based, Not for Profit Organization funded by Ontario Government and the Government of Canada 5

November 26, CARE Centre Program Model Case Management 6

November 26, CARE Centre Membership Criteria Eligibility letter from the College of Nurses of Ontario (CNO) Permanent resident, landed immigrant, convention refuge, Canadian citizen, Live- in Caregiver (with proof of PR application) CLBA level 7777 or ELTS 6.5 7

November 26, CARE IENs REGISTERED (148% OF TARGET) 146 CARE IENs EMPLOYED (99% OF TARGET) 8

November 26, IEN Challenges 9 REGISTRATIONCOMMUNICATIONEMPLOYMENTINTEGRATIONSETTLEMENT

November 26, Changes to the Registration Process 1.Additional assessment methods to determine academic equivalency (OSCE) 2.Safe practice timeframe reduced from 5 to 3 yrs. 3.Additional jurisprudence exam. 4.Fluency tests reduced to 3 (CELBAN, IELTS, TEF) 5.New – 2 yr. deadline to meet requirements 10

November 26, How Does CARE help  CNO Navigation  Assessment for knowledge gaps  Development of customized plan  Examination Preparation and Review 11 REGISTRATION

November 26, How Does CARE Help “Issues of language skills are more complex than whether or not IENs can speak English; because health care has many expressions and phrases that may be ambiguous or confusing to outsiders…” College of Nurses of Ontario Project Report – 2007 Learn From My Experience  on-line foundations for CLBA 5 & 6  nursing specific workplace language/communication courses  enhanced communication for OSCE  soft skills  IELTS preparation Accessible - face to face, video conferencing and on-line 12 COMMUNICATION

November 26, Employment Trends Rising Employment for RPNs In 2011 Ontario experienced an overall increase in nursing employment of 0.6% over RNs Employed in Ontario – 2011 of 0.5 % over RPNs Employed in Ontario of 3.4 % over Source: CNO Membership Highlights

November 26, How Does CARE Help One in 10 nurses working in Ontario today was educated outside of Canada. Many foreign- educated nurses are underemployed or have turned to other jobs because of obstacles and barriers they faced while attempting to practice here. Internationally Educated Nurses: An Employers Guide (2012) - Baumann. A & Blythe.J  Pre-registration Employment  Enhancing Employability  Observational Job Shadowing  Employment Strategies Workshops  Reference Letters  Alumni network  Professional Development 14 EMPLOYMENT

November 26, How Does CARE Help An increased demand for a workforce that provides culturally, and linguistically, relevant quality care, makes it imperative that care is delivered by a diverse team that can address the complex needs of clients entering the Ontario care system. College of Nurses of Ontario Project Report – 2007 Learn From My Experience Experience + Confidence+ Support  Case Management Support  Observational Job Shadowing  Sector Specific Communication Courses  Professional Development  Alumni Networking 15 INTEGRATION

November 26, How Does CARE help To be accepted into the new society, normally newcomers have to change their thinking, behaviour, habits, social norms, and their former way of life. We can help them by understanding their struggle and assisting them in their settlement. Victoria Immigrant & Refuge Centre– Annual Report 2010  Case management - Holistic approach/philosophy - Cultural orientation - Role modeling  Referral relationships with settlement agencies and community resources 16 SETTLEMENT

November 26, Collaboration Strategies 17 WINWIN GoalsChampion 2 – way

November 26, Collaboration CARE Centre collaborates across service, academic and employment sectors to support IENs. HFO – cross referrals pre & post CNO application Language and Communication for Nurses (LCN) - in acute and long term care settings. i.e Yee Hong Centre for Geriatric Care Revera Home Health - developed and implemented a Community Nursing Readiness Assessment tool. Hamilton Health Science Centre - IEN/ESL Nurse Integration Program OHA/NHSRU’s series of workshops for employers of IENs, following the launch of their website with resources to facilitate IEN integration. WIL Employment Connections - Employment Strategies for Nurses program Observational Job Shadowing opportunities for IENs CIIP – pre and post arrival support 18

November 26, What do IENs say about CARE “The support I received was most important. It was this constant guidance and splendid support that really helped me to get through. And through the network of the CARE Project I met others who were like me and had the same goals as me.“ "From my point of view the CARE project is like a lighthouse giving me direction and helping me pass the exam...I was put on the right path in being able to achieve my goal of working as a nurse in Canada.“ "Without the program I don't know where I would be today. I would probably have eventually received my registration and found a job nursing, but not for a long time. Without the CARE program, I would not have my license today and I would not be working." 19

November 26,