WHEREAS it is difficult to recruit Registered Nurses to rural Alberta; and

WHEREAS the College & Association of Registered Nurses of Alberta (CARNA) requires successfully recruited foreign trained nurses to undergo a document review and will not accept document reviews completed by other provinces; and

WHEREAS obtaining the original document from foreign countries can take months if the prospective nurse is not physically present in his/her country of origin; and

WHEREAS all Canadian educated Registered Nurses must successfully write the Canadian Registered Nurse Examination which gives them a license to practice independently; and

WHEREAS foreign trained nurses who pass this same exam must still complete 225 hours of supervised and satisfactory nursing prior to receiving a license even if they may already have several years of excellent experience;

THEREFORE BE IT RESOLVED that the Alberta Association of Municipal Districts and Counties urge the provincial government to work with the College & Association of Registered Nurses of Alberta to accept satisfactory document reviews completed by other provinces and to license foreign trained nurses when they successfully complete the Canadian Registered Nurse Examination.

Registered Nurses are an integral part of a health care team. As is the case with physician recruitment, the recruitment of Registered Nurses to rural Alberta is difficult. Unfortunately, even when successful in recruiting foreign nurses, there are hurdles that these prospective nurses must overcome prior to practicing in Alberta regardless if they are already practicing in other provinces.

In Alberta, Registered Nurses are licensed by the College & Association of Registered Nurses of Alberta (CARNA). All Canadian educated Registered Nurses must successfully complete the Canadian Registered Nurse Examination which gives them a license to practice independently. If a foreign nurse successfully completes this same exam, CARNA requires that they still complete 225 hours of supervised and satisfactory nursing prior to receiving a license, even if they already have several years of excellent experience elsewhere.

Foreign educated nurses are also required to undergo a document review by CARNA prior to receiving their license. CARNA will not accept a document review completed and accepted by another province even if these nurses are successfully practicing in that province. In some cases, obtaining the original document from foreign countries can take months if the prospective nurse is not physically present in his/her country of origin. 

The additional requirements hinder the recruitment process and Alberta’s competitiveness to recruit these foreign nurses. To alleviate this, the Province must work with CARNA to reduce these barriers.

Please note that a similar resolution was presented at the 2012 AUMA Convention by the City of Brooks and was carried.

The AAMDC has no active resolutions directly related to this issue.

Alberta Health recognizes the recruitment and retention of nurses in rural Alberta is critical to the delivery of health care services.  Alberta Health Services (AHS) is responsible for recruitment of nurses to provide services across Alberta, including rural and remote communities.

The thorough assessment of health professionals, including registered nurses (RNs), is critical to keeping Albertans safe.  The College and Association of Registered Nurses of Alberta (CARNA) is mandated by legislation for establishing, monitoring, and enforcing high standards of qualification for RNs in Alberta.

Under the Agreement on Internal Trade, regulatory colleges such as CARNA are required to register applicants who currently have full registration in another Canadian jurisdiction without further requirements.

• CARNA may be in contravention of this agreement by requiring foreign trained nurses registered and practising in another Canadian jurisdiction to undergo a documentation review to verify their credentials and, in some cases, requiring these applicants to undergo a period of supervised practise or an assessment.
• The Labour Mobility Unit of Alberta Enterprise and Advanced Education and Alberta Heath are collaborating to address this issue with CARNA.

Assessing competence includes not only knowledge, which can be tested in an exam, but also skills that need to be observed by an experienced clinician. 

Domestic trained nurses receive extensive supervised practise during their studies.  CARNA requires foreign trained nurses to pass the CRNE and complete 225 hours of supervised and satisfactory nursing in order to ensure the registration of competent, effective, and safe RNs.

• Internationally educated nurses coming directly to Alberta from out-of-country can access CARNA’s online International Applicant Self-Assessment to determine if they are eligible to practise as an RN in Alberta and what documentation they require.
• A National Nursing Assessment Service will be piloted in the near future which will be a central service to authenticate and validate documents of all foreign trained nurses coming to Canada.

While the AAMDC currently waits for a response from the College Association of Registered Nurses of Alberta on this issue, the response from the government leads the AAMDC to deem this resolution as Accepted. The government’s response shows that this resolution flagged a potential issue in that these practices may be considered a contravention to the Agreement on Internal Trade. The AAMDC will follow up with the province to determine what results from the work of Alberta Health and Alberta Enterprise and Advanced Education to resolve this issue.