Immigrant nurses in B.C. say language proficiency tests a barrier to practice

Some internationally educated nurses in B.C. saythelanguage proficiencyrequirement to become a registered nurse is an unnecessary barrierforcing them to give up their career and look for other jobs. Amid the strain of the pandemic on other nurses, they say they feel frustrated,unable to help.

Anne Ignacio and her parents, all internationally educated nurses (IENs),immigrated to Canada from the Philippines almost a decade agowith hopes of continuing to work in their profession.

But after multiple attempts at passing the English proficiency exam, she saidthey had to make the difficult decision to switch careers.

"The required scores for the English exams, I find it ridiculous," Ignacio said. "They require an overall score ... and they also require you to meet a certain score for each category."

IENscan take one of two language tests the Canadian English Language Benchmark Assessment for Nurses(CELBAN), or the International English Language Testing System (IELTS), which costaround $300 to $400 each to take.The results ofboth testsexpire after two years.

Ignacio, who worked as an operating room nursefor two years before coming to Canada,saidshe would score above the overall minimum in the IELTS,but come up short by half a mark in one of its categories.

After seven attempts, she saidshecouldn't afford to take any more tests.

"That's when I decided if nursing is not working out for me here in Canada, then I will just have to pursue another program," she said."My job at the time, I only made $13 an hour and it wasn't full time work."

'It would be better if we would have ended up where we expected'

Ignacio's dad,Ramon, who has over20 years of experience as a dentistin addition to anursing degree, now worksfor an organization that helps patients with developmental challenges.

Her mom, Maria, who also has degrees in nursing andhospitality management, works in a housekeeping role at a retirement home.

"Still in the health care field-ish, but it would be better if we would have ended up where we expected with our profession," said the younger Ignacio.

She said before they left, they attended an immigration seminar where "they said there's a lot of opportunities for nurses and doctors because Canada is constantly needing professionals in the health care field."

Leilani Leonardo said she immigrated to Canada in 2011with the same understanding.

Leilanisaid she worked for four yearsas a labour and delivery nurse, and an operating room nurse, at one of Manila's tophospitals.

She said shetook the language proficiency test twice before learningshe also needed to complete four more years of schooling.

"I just gave up," she said. "The whole system is so convoluted and it's really expensive ... and I had bills and expenses."

But after almost 10 years, Leonardo saidshe has decided to pursue her nursing registration again, now that her children are older and life is a bit easier to manage.

"I'm really excited and I'm hopeful. I managed to save up a little bit and I'm ready to do it again to at least prove that I can do it."

Petition for change

Sara Jackson, who has been teaching English as a second language tointernationally educated health care professionals since 2000, said she's seen students try for years to meet the high language requirementsand eventually give up to pursueanother career.

"It was heartbreakingbecause they were just stuck," said Jackson,also a registered nurse. "The system is not designed to break people but it does."

In 2019, she said she decided to put out a petition to lower the required IELTS and CELBAN scores forIENs.

"I have sent this petition to every nursing regulatory body across Canada and to the Ministry of Health," she said.

In an email statement to CBC, the British ColumbiaCollege of Nursing and Midwivessaid they work with the Ministry of Health and the National Nursing Assessment Service (NNAS) which evaluates the educational and professional credentials of IENsto regularly update and streamline the registration process.

"We are working collaboratively with the Ministry of Health, NNAS, and other partners to continuously ensure that our processes protect the public and ensure that nursing standards are met," they said.

B.C.'s Ministry of Health said they are aware of concerns over test accessibility, costs, score requirements and delays, especially for immigrants.

"In response to processing delays due to English Language Testing requirements by National Nursing Assessment Service, effective July 8, 2021, applicants can defer their language assessment until they apply for licensing registration in B.C.," the ministry said in a written statement.