Quebec's efforts to hire nurses from abroad falling short

After failing to recruit hundreds of orderlies internationally, François Legault's government is now dangling the same solution to the nursing shortage.

If the past is any indication of the future, the chances are slim that Quebec will see thousands of professional nurses coming to the rescue of the health-care system.

Liberal health critic André Fortin is calling on the government to act quickly to analyze the failure of the foreign orderly recruitment program and to correct its shortcomings.

"We can't make the same mistakes a second time," he warned.

As of Dec. 17, there was a shortage of 3,871 nurse technicians and clinicians in the Quebec network, according to data from the Ministry of Health. On top of that, there's an additional 1,708 auxiliary nurses sought for a total of 5,500 positions to be filled.

Among the solutions proposed by Minister of Health Christian Dubé, there is talk of recruiting internationally. However, according to figures obtained by The Canadian Press through the Act respecting access to documents held by public bodies, Quebec has managed to attract between 359 and 399 nurses per year for the past five years.

During the period from Sept. 1 to Jan. 20, a total of 145 nurses were convinced by the Recrutement Santé Québec service, whose mission is to facilitate "the recruitment, reception and integration of health and social services professionals who have graduated from outside Canada and are fluent in French."

These few hundred care professionals come mainly from France but also from Belgium, Morocco, Cameroon, Tunisia, Lebanon and Benin.

Once these nurses have been recruited, the question is how to keep them. Quebec professional health-care union federation (FIQ) feels this is far from guaranteed.

"We can't go looking for nurses internationally and bring them here under the current conditions," said FIQ President Julie Bouchard, listing issues such as workload, mandatory overtime and patient ratios that "don't make sense."

According to her, the government must take the next steps correctly.

"We will improve working conditions, we will stabilize the care teams, we will introduce a law on ratios, we will plan the workforce, and then we will know exactly how many nurses are missing and how many we can go abroad to find and allow them to be well in Quebec," said Bouchard, who speaks for around 80,000 nurses, nursing assistants, respiratory therapists and clinical perfusionists.

Sylvain Brousseau, president of the Canadian Nurses Association (CNA), agrees: "Going to look for people abroad is not the solution because they don't stay either," he said.

"We should ask ourselves why? It's the work environment that requires a radical change to make it more humane," said Brousseau, who is also a research associate at the Centre intégré de santé et des services sociaux de l'Outaouais and a regular researcher at the Knowledge Institute of the Montfort Hospital in Ottawa.

Whether they are immigrants or of Quebec origin, nurses are all seeking to improve their lot.

Dubé's office maintains that "international recruitment is one of the solutions to find more staff in our health network" and promises to continue its efforts in this direction. The minister also said that he intends to make the health network "an employer of choice."

For Bouchard, the recipe is quite simple.

"The work of care professionals must be revalued. If we improve their working conditions significantly with better salaries, then we will create a pendulum effect, and that's when the government will be able to say that it has become an employer of choice," said the FIQ president.

Québec Solidaire health critic Vincent Marissal also believes that the current working conditions risk scaring off potential candidates.

"If you are a Senegalese or French nurse and you do a little Google search (with the words) 'health,' 'Quebec' and 'hospitals,' there is something to worry about or even frighten you with the news that will come out," he said.

PROMISING INITIATIVE

In February 2022, then immigration minister Jean Boulet, along with Dubé, announced a $65 million investment over two years to find 1,000 nurses elsewhere in the world.

The initiative seems promising so far, according to data provided by the Ministry of Health. It is reported that 1,533 candidates have been attracted to the profession. However, they must first "complete the additional training prescribed by the Ordre des infirmières et infirmiers du Québec (OIIQ)" and pass the entrance exam to the profession to obtain their right to practice.

For the OIIQ, president Luc Mathieu said that the process of recognition of competencies has been greatly improved as a result of the partnership developed with the Immigration, Francisation and Integration Ministry.

According to Mathieu, some less affluent countries that are also short of nurses try to slow down the exodus of their professionals by refusing to provide certain documents or by dragging out the file.

Brousseau raises the ethical problem of robbing already weakened states: "I have no problem with people coming of their own free will, but I do have a problem with people taking resources from countries where they themselves are in short supply," he said.

From a very down-to-earth point of view, Bouchard also pointed out that Quebec may not be ready to welcome a large number of new arrivals because the word "shortage" does not only mean labour, but also housing and daycare.

This report by The Canadian Press was first published in French on Jan. 31, 2023.