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A precarious journey : experiences of nurses from the Philippines seeking RN licensure and employment in Canada Hawkins, Margery Edith


Increasingly, registered nurses (RNs)from lower income countries are seeking RN licensure and employment in Canada. Despite efforts to support their integration into the workplace, a significant number do not complete the registration process. To explore this phenomenon, using ethnographic methods informed by postcolonial feminism and relational ethical theory, I set out to learn from nurses educated in the Philippines about their experiences seeking RN licensure and employment in Canada. These nurses make up the greatest percentage of internationally educated nurses (IENs) in Canada and have a long history of migration to learn from. My goal was to understand how the experiences of these nurses shaped and were shaped by social, political, economic, and historical contexts and mediating oppressions at international, national, and local levels. Over the course of a year, I engaged 47 nurses in individual and focus group interviews. They had come to Canada with diverse immigration histories and work experiences. To enhance understanding of their perspectives I also collected data from secondary participants, such as nurse educators and immigration counselors, and reviewed immigration and regulatory documents. My analysis revealed that decisions at each stage of the nurse migration journey, which began in the Philippines and progressed to Canada, were not made in isolation. Rather, decisions were influenced by structures embedded within prevailing ideologies of neo-liberalism and neocolonialism and intersecting relations of gender, race, and class. Such structures and processes have the capacity to constrain agency and put nurses in jeopardy of marginalization, exploitation, and powerlessness. In this context, issues considered cultural might be better understood as partial and dynamic implications of broader social inequities. Consequently, it is imperative to extend our gaze beyond everyday practices of individual nurses, programs, and institutions and critically expose root causes of such inequities. Moreover, it is vital that the voices of IENs be included in health care planning and policy making.

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