Regulator criticizes relaxed labour mobility rules, says some Manitoba nurses can't perform 'very basic' tasks
Some new Manitoba nurses missed 'critical checks for patient safety,' head of nursing college says
Manitoba's nursing regulator says some of the province's newest nurses struggle with basic tasks like taking blood pressure or administering medication, as the College of Registered Nurses of Manitoba speaks out against a recent ministerial order to remove what it calls a guardrail for patient safety in the interest of labour mobility.
On Wednesday, the college said in an April letter, Health Minister Uzoma Asagwara ordered it to remove a requirement stating nursing applicants registered to practise elsewhere — known as "labour mobility applicants" — needed to have a certain number of hours of practise in Canada in the last two to five years before being allowed to work in Manitoba.
College registrar Deb Elias says in 2022, Manitoba's former Progressive Conservative government waived the rule that nurses from other jurisdictions must prove they had worked recently.
That means a nurse can now live in Manitoba, but register in another province where it might be easier to get a licence.
Elias says it means some new Manitoba nurses missed "critical checks for patient safety," contributing to 35 complaints against labour mobility registrants that involved severe patient harm and two deaths, according to a February college report — something Elias called "deeply concerning and very morally distressing."
"The allegations are about really significant, gross nursing incompetence," she told CBC News on Wednesday.
"One example is applying a medication patch to an article of clothing, as opposed to skin where it should be — so it's very basic nursing practice issues that have significant effects on patient safety."
Manitoba's Labour Mobility Act states that any worker certified by a regulatory authority in another province is recognized as being qualified in Manitoba. But not all Canadian jurisdictions require the same clinical competence assessment.
From 2018 to 2022, Manitoba received an average of 168 labour mobility applications, but the number jumped to 637 — a near 300 per cent increase — in 2024, the college said in its February report.
Complaints also rose alongside the increase of labour mobility registrants, the report says. Labour mobility registrants were involved in about seven per cent of all complaints in 2023, but that number tripled to nearly 22 per cent the following year.
The college says 91 per cent of labour mobility registrants who were subject to a complaint did not meet its standard threshold of 450 registered nursing hours in the last two years, or 1,125 hours in the past five years.
'Looking for loopholes': college
Back in December, the college reinstated the rule for Canadian work experience, until the province stepped in.
In Asagwara's April letter to the college, the minister cited concerns about compliance with internal trade agreements and provincial legislation, the college says.
But Elias claims some nurses are "finding loopholes using the Canadian Free Trade Agreement in order to become registered elsewhere," she said.
"Then we have to register them here, so then they're put into practice and potentially put into situations that they're not adequately prepared for."
No registered nurses lost their licence due to the change the college made in December, the college said. However, Elias said she'd like to see any nurses who don't have the desired work experience in Canada complete more training before returning to work.
"It may delay them being a registered nurse for a period of time, but then when they enter the system, they'll be there for the long haul, providing safe care," she said.
Elias says some may think of the requirement as a barrier, but the college sees it as a guardrail for patient safety that's in the public interest.
She added that the college is not targeting internationally trained nurses, and that the issue involves "a small group [who are] looking for loopholes to get registered."
"We know people are eager to get to work, but being eager and being ready to practise are two different things."
'Have to be reasonable' in welcoming nurses: minister
Manitoba Nurses Union president Darlene Jackson says her organization agrees with the college, because without proper training, nurses are set up to fail.
"They are coming into our system unprepared for what a Canadian health-care system is," she told CBC News on Wednesday.
"We want these nurses in our system. We want them out there working, but we want them practising [safely]."
Health Minister Asagwara says all complaints are being handled, but it's unfair to judge all nurses in the same way.
"We have to be reasonable in how we welcome nurses … to the front lines of our health-care system," Asagwara said in a Wednesday interview.
"There are hundreds of internationally educated nurses who have come to Manitoba through that pathway, who are successfully working on the front lines of our health-care system and providing excellent patient care every single day."
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With files from Ian Froese