As Nova Scotia’s nursing regulator, the Nova Scotia College of Nursing’s (NSCN) role is to ensure that all nurses providing nursing services for Nova Scotians are qualified to do so. The public can depend on NSCN to license those who meet registration requirements and demonstrate they have the knowledge, skills, and competence required to safely and ethically practice as a nurse.
Since our formation in 2019, NSCN has applied an innovative lens to our regulatory work seeking opportunities to streamline our processes and remove potential barriers. In 2022, NSCN continued to recognize the rapidly evolving changes to our health care system and needs of the public, specifically the shortage of nurses in Nova Scotia. To address this, we built on our innovative solutions to register and license nurses quickly during the early days of COVID-19, and comprehensively reviewed our registration and licensing processes to ensure they are relevant, flexible and positively contributing to the supply of nurses.
NSCN recently implemented a new first-in-Canada approach to registration and licensure that will establish a fast and predictable pathway to licensure in Nova Scotia. Registered nurses who demonstrate good standing and good character and are licensed in Canada, the Philippines, India, Nigeria, USA, UK, Australia, or New Zealand, are eligible for registration and licensure in Nova Scotia with no additional requirements other than passing the entrance exam.
“In the past year, NSCN demonstrated our nimbleness to respond to the evolving needs of the health care system and environments in which we work,” says Sue Smith, CEO & Registrar at NSCN. “We challenged ourselves to rethink our approach to registration and licensure while ensuring our decisions were guided by safeguards that prioritize public safety.”
The new licensure process for international nurses registered and licensed in the seven designated countries took effect on May 1, 2023 and reduces the overall processing time from up to two years to a matter of months. Applicants will apply and have their application assessed by NSCN directly, removing the need for the National Nursing Assessment Service (NNAS) for applicants from these identified countries. The process for nurses registered and licensed in Canadian jurisdictions took effect on March 29, 2023 and reduces the processing time to 24 hours.
“The majority of NSCN’s international nurse applicants come from the seven designated countries listed. A significant amount of data from 10 years of NNAS Advisory Reports, and review of nationalized curriculums, entry-level competencies and success rates of entry-to-practice exams has allowed us to confidently make this decision,” explains Smith. “When a nurse meets the registration and licensure requirements in one of these seven countries, it means they have demonstrated they have the necessary education, preparation and foundation to safely practice in the RN scope of practice similar to what is required in Nova Scotia.”
As of June 20, 2023, NSCN has received more than 14,000 applications from nurses in the seven designated countries with 440 applications in progress and 74 licences issued. From other Canadian jurisdictions, 647 applicants have been licensed and are ready to practice in Nova Scotia.
“While our new approach significantly decreases licensing time, it does not cut corners or reduce requirements. Every applicant must still meet the same registration requirements. We have not changed that. We have however, changed our approach to the type of evidence we assess to determine an applicant has met our requirements,” says Smith. “We anticipated there would be a lot of interest, but this is beyond our expectations. We are pleased that this will allow for more nurses to be licensed to practice in Nova Scotia and to be eligible to be employed as nurses in our province.”
To manage the influx of applications, NSCN has taken on temporary full-time staff and the Registration Services team is working hard to process applications and manage the information received to date.
NSCN continues to collaborate with health system partners to support nurses as they transition to practice in Nova Scotia. In early May, NSCN held a special stakeholder roundtable with the intent of developing an International Nurse Task Force. The task force includes partners such as the Office of Healthcare Professionals Recruitment, Nova Scotia Immigration, Nova Scotia Health, IWK, Department of Health, Continuing Care, Long Term and Seniors Care, Nova Scotia Housing, Department of Advanced Education, Nova Scotia Housing and long-term care employers. The task force is responsible for developing sector-specific workgroups to look at immigration, recruitment, employment, settlement, housing and education to ensure there is a coordinated effort to leverage the unprecedented number of applicants.
Nova Scotia Health has a program, Nova Scotia’s International Community of Healthcare Workers Engagement (NICHE), whose role is to provide wraparound support for international healthcare workers coming to Nova Scotia. On behalf of NICHE, NSCN sent out a survey to the international nurse applicants in our process to help them access the comprehensive immigration, settlement, and employment supports in Nova Scotia. So far, more than 9,000 applicants have responded to NICHE.
“We are thrilled to work with our health care system partners to ensure that these nurses have the support they need – it is a group effort. NSCN continues to deliver solutions that align with government’s direction to all health system partners in the province to think differently and move quickly. We are certainly doing that and continue to be innovative in our approach to enable nurses to deliver safe, competent, ethical and compassionate care to all Nova Scotians,” says Smith.