Nursing in Canada..

[picugal75]

I'm new here and finding it rather confusing to find my way around here and to post in the appropriate forum! I have several questions about nursing in Canada and found a lot of interesting posts but was unable to find where to start a new thread. Please move this to wherever its supposed to be. Thank you!

I am just starting the process of looking into moving to Canada. My background is slightly complicated. I'm Irish but I trained in the UK. I graduated in 1988 and have been working full-time since then so almost 21 years experience. The last ten has been PICU. I have been in the U.S since 1995 and have dual Irish/U.S citizenship. I am now looking at moving to Canada and have some questions. I have no family in Canada so location is undecided at this point. I am thinking Vancouver, Calgary, Edmonton and possibly Toronto. Does anyone have any information on PICU's in those cities? I work in a very busy 24 bedded PICU in a children's hospital in California at present. We have cardiac, trauma and everything else inbetween. I have worked in several PICU's all over the U.S so am used to moving. I am single so the ability to be able to buy a house on a salary is important. I would appreciate any help or suggestions that you could give. Also apart from Vanvouver I have not been to the other cities. I realise its cold up there but how much snow and blizzards are we really talking about particularly in Edmonton or Calgary? Thank you.

[picugal75]

Stupid question but how do I do that?

[Fiona59]

15 posts on various topics gets you PM privs.

[picugal75]

Thank you!

[NotReady4PrimeTime, RN]

Jan has been busy working nights and taking care of family stuff. She had no idea she was MIA and needed!!:bowingpur

There are PICUs in St John's, Newfoundland; Halifax, Nova Scotia; Quebec City and Montreal (2, an English one and a French one), Quebec; Ottawa, Toronto and London, Ontario; Winnipeg, Manitoba; Saskatoon, Saskatchewan; Calgary and Edmonton, Alberta and Vancouver and Victoria, British Columbia. Each of these places has its own brand of miserable weather. Me, I prefer the cold, snowy winters to the hot, smoggy, humid summers or the months of rain any day.

Now to get down to brass tacks... The 2 PICUs in Alberta have a bit of a rivalry going. Calgary has the brand new, shiny Alberta Children's Hospital with the brand new, sparkly, well-equipped PICU that frequently is closed to admissions. Calgary covers only southern Alberta, from roughly Red Deer south. They care for most ICU-type issues, but they send all their hearts and their transplants except bone marrow north. And they've poached one of our favourite intensivists...

Here in Edmonton we are a hospital-within-a-hospital and have a ratty old ill-equipped PICU that grows to accommodate whatever lands on our doorstep. We're supposed to be a 15 bed unit, but we stretch to 19 or 20 when we have to. We cover all of northern Alberta, parts of northern BC, all of the Northwest Territories, some of Nunavut and a bit of the Yukon. AND (drumroll please!) we are the cardiac centre for all of western Canada and any rejected cardiac patients from everywhere else. We have an ECLS team (RNs and RTs), a physicianless transport team and we provide training for the Berlin Heart to all of North America. (Dang I hate typing on a rubberized keyboard with gloves on!) We do roughly 15 to 20 heart transplants, 6 to 8 liver transplants and a handful of kidney transplants each year. Our adjusted mortality rate is about 4% on our close to 1000 admissions a year. Our burn admissions are not many - the burn unit takes kids as long as they aren't intubated or on pressors.

Although there's currently a hiring freeze province wide, there have been some exceptions made for our unit. We don't have any postings up currently but I know there are a couple of vacancies coming and our pool of qualified applicants is minuscule.

Our weather in the last few years has been a little unpredictable. The past two winters have been milder than usual. Still cold mind you, but not bone-numbingly so. Our snowfall really varies, as Fiona59 said. Some years we get a ton and others we get very little. Calgary, on the other hand, has REALLY unpredictable weather most of the year. It can be sunny and warm one minute and snowing or raining with thunder and lightning the next. They're prone to more late winter blizzards than we are. They can go from bare, dry streets and tee-shirts to 3 feet of snow and parkas in a heartbeat. Of course, they do have those lovely mountain views on clear days.

Real estate is more reasonably priced in Edmonton. The hot real estate market here cooled about 18 months ago and prices fell quite a lot. Houses in my neighbourhood are selling for $100k less than they were in 2007, after sitting on the market for months... There are deals to be had if you look for them. Calgary on the other hand just gets higher and higher and the vacancy rate lower and lower.

Issues. Edmonton has neglected its infrastructure badly for more than a decade and the roads are a crumbly mess. The city council chooses to spend money on artsy-fartsy stuff like a new museum, a Formula One race that loses money every year, rebranding the city every few years, a campaign to close the city centre airport and other noteworthy causes. Just lately they've gotten the message that the roads HAVE to be fixed and now I drive through three construction zones on my way to work. Sigh.

So there you have it in a (gigantic) nutshell. With another couple of posts you can PM me for more information.

[picugal75]

Jan! Thank you so much for chiming in. How will I know when I can pm someone? Is there any point in even applying to Alberta at this point If all jobs are on hold? I looked at the BC nursing site yesterday and this is going to be quite a complicated process with four countries involved. Do you know anything about the Picu in Vancouver? I'm going to go thru both sites this weekend and try and make a decision on location. I don't mind rain or cold but snow is not something I am used to. I've never driven in it and the thought of getting out of bed at 5am to dig my car out of a hole is not appealing! Any advice you could give would be appreciated. Thank you!

[NotReady4PrimeTime, RN]

Buy a house or condo with covered parking...

Seriously, the situation in Alberta is still in flux. It's quite possible that by the time your credentials are sorted out, that there will be positions open to external applicants again. (The process will take upwards of six months, no matter which province you choose.)

The PICU in Vancouver has some of my friends working in it. They send their complex hearts and their transplants to us. Their CV surgeon is comfortable with the low-risk cases (ASD, VSD, AV canal, coarct, BT shunt, PDA ligation, PA bands and that sort of thing.) but the difficult ones (HL/RHS, TAPVR, PAPVR, TOF, truncus, Ebsteins, TGA etc) are done by one of our three surgeons. They do about 300 cases a year between them. We're expecting to split the unit into med-surg and CV as soon as AHS frees up the omeny for renovations. We're supposed to be taking over the old CVICU and CV step-down unit now that the Mazankowksi Alberta Heart Institute is open. Our staffing numbers will increase significantly when that comes to pass. They've already hired the intensivists so the die is essentially cast.

You only need two more posts and then you'll be able to PM. To do that, look at your intended recipient's user name and next to their title (left to right) you should see a blue circle with an "I" in it, a piece of paper and pencil, an envelope, a green circle with a "+" in it and a magnifying glass. Click on the paper and pencil and you'll be taken to the private messaging screen. Pretty simple.

[picugal75]

Thanks for all the info. When they split your unit where do you think most of your staff will go? I was at UCSF when they split the units into a general picu and a peds cvicu and the staff voted 50-50 for each unit which was neat. These days I tend to prefer trauma myself over cardiac though it changes frequently. I'm having quite a dilemma trying to decide which location. If I picked Alberta and sat the CRNE there and passed, how difficult is it to transfer it to another province if I wanted to? Also how long does that usually take? Thanks for all your help.

[NotReady4PrimeTime, RN]

I'm not sure we're going to actually split the nursing staff. When I've asked about that I've gotten some really vague shoulder-shrugs. Planning is not a strength on our administrative team. What could very well happen is that we'll be assigned to one unit or the other for a block of time, say six weeks, and then rotate. I know there are people who have definite preferences (mine would be the med-surg side... trauma is included) but most would like to maintain their hard-won skills. I would hate to have us just being moved around willy-nilly from one unit to the other, which could happen. Hopefully NOT! I have some influence and will be strongly advocating for some formal plan... I guess we'll see.

As for the CRNE, as you've already learned, it's a national exam. Once you have a Canadian license it's not really difficult to move from one province to another. You apply for registration in the new province and send them your documentation. They look it over, take your money and issue you a license. When I moved from Manitoba to Alberta the process took about 6 weeks. For you it might take a couple of months because of the multiple licenses you've had that they'll verify. (I've only had two.) There's no prohibition against having more than one license other than the cost! Since I had no intention of returning to Manitoba I canceled my registration there and got a partial refund of my fees.

One more post and we can have PM discussions...

[picugal75]

That's good to know. I have lots of questions for you!

[NotReady4PrimeTime, RN]

Ding ding ding, post #15!

[NotReady4PrimeTime, RN]

Here in Edmonton we cover all of northern Alberta, parts of northern BC, all of the Northwest Territories, some of Nunavut and a bit of the Yukon. AND (drumroll please!) we are the cardiac centre for all of western Canada and any rejected cardiac patients from everywhere else. We have an ECLS team (RNs and RTs), a physicianless transport team and we provide training for the Berlin Heart to all of North America.

The PICU in Vancouver has some of my friends working in it. They send their complex hearts and their transplants to us. Their CV surgeon is comfortable with the low-risk cases (ASD, VSD, AV canal, coarct, BT shunt, PDA ligation, PA bands and that sort of thing.) but the difficult ones (HL/RHS, TAPVR, PAPVR, TOF, truncus, Ebsteins, TGA etc) are done by one of our three surgeons. They do about 300 cases a year between them.

So now we're getting kids from Peterborough, just 137 km from that Canadian children's hospital that gets all the recognition... http://www.thepeterboroughexaminer.com/ArticleDisplay.aspx?e=1695462

"An 11-year-old Peterborough girl is to get a "risky" heart procedure today that is the first of its kind, for a child, in North America. Grace Wood is to be in Edmonton's Stollery Children's Hospital this morning to replace a pulmonary valve, explained her father, John Wood, of Rochelle Ct., in a phone interview from Edmonton..."

We do a lot of these "firsts in North America", but if you ask anyone outside of western Canada to name a Canadian children's hospital, they'll instantly chime in with Sick Kids. Sad.

[Fiona59]

Heard it on the news this morning. An expected 4-8 hours in the OR and "she'll be back in school in a few weeks!!!" from the radio announcer.

Maybe it's time for the Stollery to start fund raising ads in Ontario, seeing as we get Paul Gross whining for the Sick Kids.