LEAP case shows shocking treatment of IENs

Thankfully, ONA's Legal Expense Assistance Plan (LEAP) Team is here to help.  

“Canada is a young country and people come here from all over the world to seek a better life,” says LEAP Legal Counsel Vanessa Yanagawa. “They come with energy and fresh perspectives, and a file that came to LEAP regarding an IEN highlights one such story.” 

But it also highlights a much darker side, which prompted an investigation by the LEAP Team into the issues that IENs face, which are shockingly widespread. 

Devastating impact 

This particular case involves an IEN whose colleagues started reporting concerns with her practice after just a few shifts. During the probationary period, she was terminated.  

“A big part of what I do is write responses to the College of Nurses of Ontario [CNO] about allegations arising out of my client’s conduct,” explains Yanagawa. “My clients are often anxious and scared. Before we discuss their response, I always ask the same question: ‘What made you get into nursing?’ As soon as I ask this, I feel a sense of calm come over them. Nurses love to talk about nursing and what brought them into it. And I love hearing my clients’ stories.” 

This IEN’s story began the same way. She developed a passion for helping people while caring for a sick relative, and after moving to Canada, worked as an unregulated care provider before going through the CNO’s rigorous registration process. After doing so, she accepted a position at a large urban hospital.  

“During our discussion, she talked about how proud and happy she was to be in Canada,” says Yanagawa. “She left a lot in her home country, but she heard such great things about Canada, she knew it was the right choice. On the eve of her first shift, she described feeling like she was living her dream.” 

Unfortunately, that dream soon came crashing down, as she felt more assessed by her colleagues than mentored.  

“This experience had a devastating impact, and she started to feel isolated,” adds Yanagawa. “Despite the challenges, she still believed she could prove that she was the dedicated, hardworking and skilled nurse that she knew she was. Regrettably, her perseverance wasn’t enough, and her employment was terminated and reported to the CNO.”   

The experience was so traumatizing, the IEN considered returning to her home country.

Similar themes 

“Writing my submissions for this case, I felt terrible for my client,” explains Yanagawa. “Canadians are known to be warm and welcoming, and they embrace and celebrate differences. Why did this nurse have this experience, especially at a time when we needed more nurses? I started to wonder whether her situation was unique; my colleagues also noticed this.”  

The LEAP Team discovered that the increase of IENs can be traced to 2022 when the Minister of Health directed the CNO to register thousands more quickly. Shortly afterwards, the team noticed more IENs being terminated and reported to the CNO.  

They also concluded that IEN terminations had similar themes, most notably that they occurred shortly after they started employment in Canada, often during probationary periods. Issues reported about IENs included prioritization issues; difficulty with technology and administering medications; and time management.  

“As we started to see more and more cases come in regarding IENs, we developed a questionnaire and sent it to IENs reported to the College,” notes Yanagawa. 

The results were shocking, indicating that the experience of this particular member was not unique. IENs reported issues with orientation (insufficient length, inconsistent mentors/preceptors, disorganization) and colleagues (unsupportive, cliquey and unwelcoming).  

“I also conducted a lot of research on IENs in Canada,” says Yanagawa. “I discovered that the challenges often experienced by them included staff feeling unprepared to support them, IENs lacking customized orientations, and IENs being assigned inconsistent mentors. This research was dead on and reflected the experiences of our members.” 

Remarkable impact 

Thankfully, the story of our terminated IEN member has a positive ending.  

“The CNO conducted a full investigation into the employer report of this IEN,” explains Yanagawa. “After reviewing my submissions, it took no action, indicating they must have also noticed the increase in IENs being reported.” 

Now, instead of an investigation, the CNO typically offers what they call “remediation” to IENs reported early in their Canadian careers. That may include completing a course or meeting with a nursing expert.  

“This change to the CNO’s process has had a remarkable impact on our IENs struggling with their careers in Canada and they are thankful for the ability to work through the challenges in a non-punitive way,” concludes Yanagawa. 

“I love hearing their stories, and am humbled by their bravery and dedication to work in a new country. With the increasing research and processes to support IENs, I’m confident we can create an environment where they feel welcome and can quickly integrate, and where their diversity is celebrated.” 

Read more about how the LEAP Team helps members one the ONA website.