After working in some of the busiest emergency room departments in the southern United States for the past 15 years, the 41-year-old Pictou County native wants to be closer to her family.
“It’s good to be able to do this work, but I have done it for a long time, and a career is one thing, but I miss my family,” she said from her apartment in Clearwater, Florida. “I’ve got gotten older, my parents are getting older and I want to be closer to home.”
At a time when Nova Scotia is crying about nursing shortages, MacDonald thought it would be easy to return to her hometown, but so far the process is moving at a snail’s pace through all the red tape.
She graduated from high school in Pictou County and moved to Texas where she received her paramedic training from San Jacinto College in Pasadena in 1998. In 2000, she decided she wanted to be a nurse so she received her Associate of Applied Science in Nursing in 2000 from the same college.
In 2014, she received her Bachelor of Nursing from the University of Texas, graduating with honours. After getting this degree, she was sure her work experience and education would make it an easy ride back to Pictou County.
“I worked in a Texas trauma centre where I was emergency charge nurse and clinical educator for 11 years and then I took a job as a flight nurse and I went to Arizona and New Mexico and flew for a year and half. I wanted a change because I hated the heat in the desert so I had an opportunity to work at the Tampa General Hospital in its emergency department.”
Tampa General is a Level One trauma centre that handles everything from cardiac and stroke problems to weight loss surgeries. It is also the fourth busiest transplant hospital in the United States.
There are currently 78 beds in its emergency room and ER staff generally sees 350 people a day and things move at a steady pace.
“Your wait time is usually less than 40 minutes,” MacDonald said. “Flu season hit us really hard and we had three- and four-hour waits. That was huge.”
But instead of packing her bags, she is spending money on applications and waiting for approval from the National Nursing Assessment Service in Philadelphia to tell her that she is cleared to work in Canada.
She understands the NNAS is set up so that a nurse interested in Canada, who has earned their education from any other country, must prove they meet all of the Canadian standards. This requires her to submit proof of education and work experience from every place she worked or studied.
But since the time she applied in late-November, she has been told several times by NNAS that the University of Texas is not sending them the right information.
“I sent everything to the NNAS three times now and they send it back saying the U of T information is not adequate and they need something else,” she said.
However, instead of them contacting the U of T directly, NNAS has a policy in place that requires the applicant to be notified that the information is not right instead of going right to the source.
“I asked them, ‘why don’t you just call of U and T and get what you are looking for,’ but they won’t. Instead, I get a letter in the mail and they tell me to get information and send it back in again.”
Sometimes it is the smallest of things that could be worked out with just a quick phone call that frustrate her the most. For example, she just received another letter in the mail from the NNAS saying her employer paperwork was rejected because it didn't state that she spoke English.
“So I have to send it in again. I don’t speak anything but English. Frustrating.”
So far she has paid $650 for the initial application to NNAS and high priority mailing costs every time she sends it back for approval. She must also pay $25 for each application to the State of Texas Board of Nursing as well the Board of Florida Nursing for verification of licensure. If she isn’t approved by December 2015, she will need to apply for an extension on her application.
But even after approval from NNAS, she still can’t back her bags for home.
“The NNAS application is not to give you permission to practise in Canada, it will give me permission to apply to College of Nursing in Nova Scotia to write their entrance exams,” she said.
In comparison, she said, if she had received her education in Canada and wanted to work in the United States, the process would be much easier.
“The United States makes it simple. Nurses from Canada come to the board here, they pass the board exam and start to practise. Everything down here is done online through a national web page where everyone is verified. All registration is done on time and online. I know 10 or 11 nurses from Canada working down here now.”
She said it’s frustrating because it is in the news every day how Nova Scotia has a nursing shortage. She is willing to work through the process to get home, but the process is so cumbersome that sometimes she wants to give up.
“There are times when I say this is ridiculous. I can put all of this money and fuss into this and they can still say I am not OK. Your life is on hold.”
What the NNAS says:
The National Nursing Assessment started operating in August 2014 as a single entry for any internationally educated nurse who wants to work in any Canadian province but Quebec.
The process sets one common standard across the country for all those in the nursing profession, said NNAS executive director Ann Marie Atkinson.
“This is one consistent standard process,” she said. “Quality control wasn’t there before. The object is to streamline the process for applications.”
She admits that it can take up to year for a file to be completed and the biggest holdup is getting all the proper documents.
“That is often what takes so long and it is out of the control of the NNAS,” she said. “We need better transcripts from international institutions and documentation from licences, employers as well as have language proficiency testing done. Sometimes it can take a year, sometimes less.”
As of now, Atkinson said, the NNAS has several thousand accounts and so far, it has produced several hundred advisory reports.
‘So it is flowing well,” she said. “We monitor it through regular monthly reports, but if there is a nurse who feels she is caught up in due process, she should contact me or NNAS. I think from an organization perspective, it is a new organization and things are working towards our expectations but we are always looking for feedback and trying to improve our ways.”
Why is there a nursing shortage in Nova Scotia?
Janet Hazelton could see the writing on the wall many years ago.
“The issue with what we are experiencing now is what we always knew what was going to happen,” said the Nova Scotia Nurses Union president. “After four years ago, the government of the day decided there would be a hiring freeze and, two years ago, they didn't hire anyone so we are paying for it now.”
There will soon be a large number of nurses looking to retire and many young nursing graduates who are offered little incentive to stay in the province, especially in rural areas. According to provincial stats, three of every five nurses in Nova Scotia are eligible to retire in the next 10 years.
“These young new grads want to work and live in Halifax,” she said, adding that 30 years ago nurses would graduate from a diploma program in New Glasgow or Antigonish and make a life for themselves in these areas, but that isn’t the case today.
“They also want to travel. They are going everywhere. It’s good for them but a big challenge for us. If you go into the Aberdeen or St. Martha’s you will meet nurses from New Glasgow, and I have been nursing in Truro for 27 years, but that is not how the industry works now. Lots are going to Australia now.”
She said there is no incentive for graduates to stay in the province since government has done away with graduate tax breaks of up to $15,000. University graduates were eligible for the tax rebate for six years after graduation, but Nova Scotia has done away with it because it claims it has done little to entice people to stay in the province.
