I am a USA trained RN with over 5 years of experience. I have and BSN Degree and a Master degree to work as a NP. I got married this years and move to the Ottawa area. I started the process to transfer my license over to Canada from USA last October 2015. I called the CNO and I was told to contact NNAS for educational evaluation first.
The NNAS are a USA based third party company that reviews education for the Nursing Boards in Canada. Their reviewing criteria are unknown to me even after I asked them, they stated that it is confidential and they will not disclose this information to me. They told me that it takes about 6 to 8 weeks to process paperwork that is sent to them by mail. I had to call them multiple times, they could not find my paperwork, my school had to send them the same paperwork several times before it was finally found and processed.
They requested paperwork is for verification of employment, verification of education (which includes transcript, course description or syllabus of each course), Verification of Nclex exam with a notarized paper for the Nclex to release my actual Nclex grade to them. Plus, I had to pay them $650.00 US dollars for them to start the process.
The report was completed 8 months later around the beginning of July 2016. They issued an evaluation to the board of nursing that was unfavorable to me. They deemed my education as not equivalent to that of Canada. Although they ask for specific classes to be evaluated at the end of their report, I was given a 38% equivalence rate. I asked them to explain this to me and honestly they could not explain it because to me, it's confidential. I was told this percentage is not uncommon for USA trained RN. Mind you my husband studied nursing in Canada, we studied in same books by the same publishers, and the only difference is that they had Canada in front of all their books.
The NNAS claim that they look for certain words in the syllabus to see if I meet those criteria. I explained to them the syllabus gives you a brief description of the class and the contents that you are expected to have mastered. The remain exact topic studied needs to be followed through by going to the delineated chapters of each nursing book as outlined by the syllabi in order to provide a fair assessment of the topics that was mastered. Then I was told that they do not have the time to go look in every book, it should be in the syllabi or they assume that I never learned it.
I ended up have to go the dean of my school in order to request for them to send NNAS all my nursing education courses' syllabi. Then, I called NNAS again, and they did not receive the paperwork that was FedEx to them by the school. I was very disappointed by the work of NNAS because I went a prestigious Catholic University in USA, graduated with a 3.4 GPA, received two grade based scholarships and a job offer before graduation.
I was advised by my family to call NNAS. So I did call, I asked them why they issued this report that is not fair to my level of knowledge, training, and application of nursing sciences?
Then, I realize that although they requested these listed classes.
1 - Medical surgical for adult
2- Maternal and infant
3- Care of children
4- Psychiatric
5-Geriatrics
6- Community health
7- Anatomy and Physiology
8- Pathophysiology
9- Pharmacology
They actually look for other component of the nursing program not covered under these classes such as community nursing, health assessment and lab, simulation classes and competencies, ethics, professional role, nursing research, therapeutic interventions and lab, professional nursing, medication calculation and more.
So now, August 2016, I am still waiting 10 months later for another report that the NNAS agreed to re-issue because they realized that the prior report was not appropriate before I can get to step 2 which is applying to the CNO. The CNO actually is much quicker than NNAS, and I truly believe that they would do a better job by themselves or allow USA RN to either practice based the Nclex scores or allow us to take the exam again since it is the actual measure of competency for entry of practice for both Anglo-Canadian provinces and US States.
Does anyone have any recommendation for me?
Because I am here in I cannot work because I am waiting on NNAS…
How can we go about changing this process into a both safe and seamless process?
I was hoping this was a joke. I want to pretend I'm surprised but when I think about how this whole thing is set up, my surprise lessens but my blood pressure increases.
Many issues here:
1) If Canadian entry-to-practice expectations are uniform in as much as the NNAS assessment can determine whether one meets the education requirement for applicants wishing to practice anywhere in Canada (except Quebec), why should there be a separate OSCE/proof of knowledge, skill and judgement exam for IENs in different provinces? (now that we have this 'streamlined approach)
2) Why the ridiculously high cost? Sure, they may not have received the Ministry funding that was received for the start-up of the IENCAP in Ontario, but that doesn't justify this cost because the wheel has already been invented. I agree it looks exactly the same as IENCAP. Slight tweaks for provincial legislative differences are all that is necessary and therefore applicants need not be paying the costs of initial set-up from the ground up. Interestingly enough, CARNA explicitly disassociates themselves from the fee for the exam, however this is the only exam they will accept for IENs and therefore they endorse it.
3) For an assessment done by people who have only had one day of training, $1900 is absolutely unreasonable. It's just as bad as NNAS; $650 for an assessment of nursing education that is done by non-nurses! The problem is, IENs will continue to pay and say nothing, because they are at the mercy of licensing bodies that essentially determine the fate of their career and in some cases this determines the fate of their lives.
My guess is that the Touchstone Institute (company!) will move across Canada, capitalizing on the industry that has been made of is IENs.
For those new to the forum, it may or may not be an important side note that that the CEO of Touchstone (the company that determines whether an IEN has to go back to school or not) is also a professor at York, the Ontario university with the IEN bridge program.
1. I believe that if the forecasts in the Villeneuve and MacDonald report 'Toward 2020 Visions for Nursing' are correct, then Canadians are working towards centralizing the IEN assessment process. In addition, the Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications is working towards improving the consistency and portability of assessment results across Canada. Centralizing assessment services through use of two service providers such as NNAS (for education assessment) and Touchstone Institute (for competency gap assessment) would be one way to help ensure consistency between provinces.
2 &3. The cost is high because it needs to help cover the paychecks of at least twelve examiners and 12 actors, as well as at least one administrative staff and the rental of facility where the exam will be conducted.
1. ...Centralizing assessment services through use of two service providers such as NNAS (for education assessment) and Touchstone Institute (for competency gap assessment) would be one way to help ensure consistency between provinces.
2 &3. The cost is high because it needs to help cover the paychecks of at least twelve examiners and 12 actors, as well as at least one administrative staff and the rental of facility where the exam will be conducted.
The problem is, NNAS is proving to be a failure. It certainly accomplishes the goal of centralization, but does not accomplish the goal of actually assessing nursing education. Licensing bodies are aware of this, yet they continue to push forward with it.
Touchstone is incredibly difficult to deal with. Their customer service is just as awful as NNAS's. The fact that they might gain monopoly on competency gap assessments is frightening. When I contacted them regarding some concerns about transparency etc and stated that they need to be accountable due to having received government funds, they stated that they received government funding for other exams that they do but not for IENCAP. The Ministry also seemed to have no clue about monies going to anything related to IEN assessments. I don't believe this to be true, however if it were, it would mean IENCAP isn't 75% government subsidized. I still can't wrap my head around the cost. After paying to rent the facility and for admin work prior to the exam (which is already set up for the most part), each staff member would be getting paid almost $6000 per day.
I hope that as they centralize this entire process, they also centralize how results are interpreted. So that an applicant who was educated in India and received "non comparable" and an applicant educated in the US who receives "non-comparable" are treated the same in terms of next steps post NNAS Advisory Report. I seriously wish they would have on-the-books consultation sessions with some of us! We could contribute some good ideas to help improve this whole system of assessment.
Just wanted to give a bit of background on IEN competency assessments in Canada, the names of the competency assessments vary by province, they are Substantially Equivalent Competence (SEC), Clinical Competence Assessment (CCA), Internationally Educated Nurse Competency Assessment Program (IENCAP), Nursing Community Assessment Service (NCAS).
Touchstone implemented the IENCAP in Ontario 2013, but the other provinces implemented their competency assessments years earlier, some like Alberta, implemented their SEC assessment in 2007. All of the competency assessments were/are done by an external providers. In BC the SEC assessment was done at the IEN assessment service centre at Kwantlen Polytechnic University (until Dec 2016) BC started using NCAS Jan 2017, in Alberta the SEC was done at Mount Royal University (until June 2013), in Saskatchewan the SEC is done at Saskatchewan Polytechnic, in Manitoba the CCA is done at University of Manitoba, in Nova Scotia the CCA is done at the Registered Nurses Professional Development Centre.
If you look at the websites for various assessment centres you will see the fees range $1,500-2,500 (for the centres that post their fees). The duration of the assessments vary depending on what competencies need to be assessed but seem to take two to three days, sometimes five days.
I believe that in the future, either Touchstone's IENCAP or BC's NCAS may be implemented as the national IEN competency assessment, as they are both one day assessments, rather than multi-day assessments.
I hope that as they centralize this entire process, they also centralize how results are interpreted. So that an applicant who was educated in India and received "non comparable" and an applicant educated in the US who receives "non-comparable" are treated the same in terms of next steps post NNAS Advisory Report. I seriously wish they would have on-the-books consultation sessions with some of us! We could contribute some good ideas to help improve this whole system of assessment.
Maybe IENs can write letters addressing their concerns and asking for consultation sessions with their MPP and their MP in order to share ideas and help improve the system.
I agree, there needs to be a critical mass of letters/complaints though I think in order for this to be noticed. I have contacted both of the above. I think though, since we are in such a precarious situation and the outcome of this has such a huge impact on our livelihoods, it's hard to advocate for ourselves. As well, those from countries where advocating for yourself only gets you in trouble or where it's just not a cultural norm to advocate for yourself are not likely to advocate during this process, and that is probably representative of the majority of applicants. I think it would be easier if the situation wasn't so precarious for many of us. But you are right, it needs to be done.
I think that although canned or 'party line' responses are all we receive, it is still important to write to CNO (or other licensing body), Office of the Fairness Commissioner and even Canadian Nurses Association (just to keep them apprised of the situation) when writing in regards to NNAS. I have also copied RNAO on letters to CNO just so RNAO is apprised of the situation and CNO knows they are apprised. As an advocacy organization, even though they are not involved in licensing, I think it's important for RNAO to understand the experiences of IEN's in Ontario. They also need to know how the companies they have contracted to do their assessments operate.
@Rn_Pro, I understand about being reluctant to draw attention to oneself by advocating when one's livelihood is at stake. Maybe an advocacy group can be created after IENs are licensed. I think a sub-group of Canadians who were educated in the US and experienced difficulties in becoming licensed in Canada may be easier to involve in a group letter.
This is an IMMIGRATION ISSUE... at least they are not being denied licensing and no road blocks are being put in place to stop them from getting a license just like anyone else...if a Canadian nurse was married to a US citizen , she/he would have had no issue moving there and exercising her/his profession! As bad as Trump is, it's still not as bad as an AMERICAN NURSE MOVING TO CANADA!
Not an immigration issue. A visa issue. TN visas are for non-immigrants. They are being denied entry into the country where they are employed.
I posted this just to raise awareness to other Canadians working as nurses in the US, as they may want to begin the application process to obtain a license in Canada if they haven't already--given that their ability to work in the US may start to become limited.
For what it's worth, you are right, it would be easier for a Canadian married to a US citizen, since the US hasn't implemented anything like NNAS. But, this change which made it harder to become a nurse in Canada has nothing to do with our Prime Minister; it was the provincial regulatory bodies that decided to come together and "streamline" the application process, making it near impossible to become licensed. It was only a matter of time before the Trump presidency began impacting on the livelihoods of Canadians.
For what it's worth, you are right, it would be easier for a Canadian married to a US citizen, since the US hasn't implemented anything like NNAS. But, this change which made it harder to become a nurse in Canada has nothing to do with our Prime Minister; it was the provincial regulatory bodies that decided to come together and "streamline" the application process, making it near impossible to become licensed. It was only a matter of time before the Trump presidency began impacting on the livelihoods of Canadians.
Actually, the changes were/are driven by a joint effort between the provinces, territories and the federal governments via the Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications.
I'm sorry RN_pro if i am going to sound bitter and upset (which I actually am) but IT IS an immigration issue. Every time you say the word visa (B1, F1, TN, ...ect), you are talking immigration. Every time you leave your country and enter another one, you are considered a foreigner, and so dealing with "immigration"=governement=politics. Plus these nurses are actually working in the US, which means they are not there just to visit. At least they can! even if they call themselves non-immigrants. Imagine the boards of Nursing in the US made them go through everything they are making us go through, would they even be talking about a visa? I doubt it...
I was having a conversation with a "senior" nurse in Ottawa who was laid off her job and replaced by an IEN RPN. She pretty much told me "we don't need you, you need us! Canada doesn't have to accommodate you even though you are coming from the USA...you have to be considered just like every other immigrant...Plus Canada doesn't need nurses. The government is cutting off the budget and many nurses are paying the price! They are being replaced by cheaper labor, including immigrants who would accept a lesser pay. What about all the Canadians that are losing their jobs and the ones at school who will be looking for one? I actually think that CNO should stop "recruiting (I am using her exact word) immigrants!..." and so on...I was very surprised and upset to hear all this from a Canadian nurse. Can you imagine if we were having thinking and having the same speech about them?
I and many like me didn't just wake up and decide to move to Canada. If it wasn't for my husband and my baby, i would GLADLY stay in the US. Trump is a joke, and many of his decisions are very biased but they do not prevent me from working and providing for my family. I can understand Canada doesn't need nurses, but at least give us the chance to be licensed just like anyone else, especially people coming from accross the boarder, speaking the same language, studying from the same books and who have to same standards of care. Why the special treatment for US nurses? Well we not only have 99.9% the same curriculum, but we are both north American, and if Canada was to be in war (God forbid) USA would be the first to step in for them. If France had a shortage of nurses, they would accept applications from their neighbors who spoke the same language, had the same curriculum and had close to the same culture as theirs before looking at any other applicants. I am saddened that Canadians think US nurses are not "competent" enough for them; but are they competent enough to be accepted in the US without any issue? I don't think it's fair at all. I am sorry they are having trouble with their visas, but at least they are not being denied a license...
dishes, BSN, RN
3,950 Posts
1. I believe that if the forecasts in the Villeneuve and MacDonald report 'Toward 2020 Visions for Nursing' are correct, then Canadians are working towards centralizing the IEN assessment process. In addition, the Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications is working towards improving the consistency and portability of assessment results across Canada. Centralizing assessment services through use of two service providers such as NNAS (for education assessment) and Touchstone Institute (for competency gap assessment) would be one way to help ensure consistency between provinces.
2 &3. The cost is high because it needs to help cover the paychecks of at least twelve examiners and 12 actors, as well as at least one administrative staff and the rental of facility where the exam will be conducted.