A Filipino Nurse, A Canadian Dream

Canada has been recruiting Filipino nurses for decades with the promise of stability and strong wages, but when Filipino nurses land in Canada do their expectations match reality?

Photo of Yrma (Filipino nurse) with the Philippines Flag's sun and the Canadian Flag's maple leaf.

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WINNIPEG, Canada. February 2005 – Yrma, 31, walked toward the exit of the Winnipeg International Airport after an exhausting 29-hour journey from the Philippines. She had arrived in Canada on a three-month tourist visa with the intention of challenging the Canadian Registered Nurse Examination (CRNE). 

Yrma was scheduled to challenge the exam just two days after arriving in Winnipeg. 

The Canadian Registered Nurse Examination was a seven-hour test that measured 148 different competencies necessary to practice nursing in Canada. According to a 2012 report by the Canadian Association of Schools of Nursing, of the 827 internationally educated nurses who wrote the exam in 2005-2006, only 61.55 per cent of them passed on the first attempt. In 2015, the exam was replaced with the National Council Licensure Examination (NCLEX-RN). 

“At the time, I wasn’t prepared for the exam because there weren’t any resources available for review. I wasn’t able to finish the exam because I was too sick and jetlagged at the time, so I knew I was going to fail. This upset me because I knew it would take longer for me to bring my kids over here,” said Yrma. 

Yrma’s two kids, a daughter (five years old) and son (two years old), were being looked after by their father in the Philippines.

WINNIPEG, Canada. May 2005 – Yrma sat alone in the spare bedroom a distant relative lent to her during her short stay. She wasn’t used to lounging around all day, so she often explored the city by public transit. She would ride the 77 bus that went from Transcona to Polo Park to become familiar with the city. While riding the 77, she noticed a building with the letter “H” on it and later learnt that it was Concordia Hospital. Curious about how Canadian hospitals compare to the ones in the Philippines, she got off the bus and went inside.

Upon walking through the main entrance, she came across a printed poster with the headline “Now Hiring.” Yrma filled out the application forms before returning home. She figured it wouldn’t hurt to try. She was surprised when Concordia called the following morning, asking her to stop by in the afternoon for a job interview.

Collage style image with a "77" Winnipeg Transit Bus in the foreground and Concordia Hospital in the back.

On the day of the interview, Yrma got caught in rush hour traffic. She had to run toward the hospital from the bus stop with only minutes to spare. In the interview, they asked her situational medical questions that reminded her of an oral exam. The interview questions didn’t faze Yrma because she taught this material regularly back home in the Philippines, where she was a nursing instructor. When the interviewers asked Yrma if she had any questions, she replied, “I want to know if I’m being hired because I’m going home in three days.” When they asked where home was, Yrma told them she was flying back to the Philippines. 

Later that day, Yrma received a call from Concordia Hospital offering her the job. She explained that she needed a formal offer letter for the job so she could process her application for a working visa. Concordia took the steps to send out a formal offer letter to Yrma while she was back in the Philippines so she could fly back to Canada on a working visa. While Yrma was back home, she received her results from the CRNE confirming her failed attempt. She reached out to Concordia to let them know of the news and was surprised to learn that they were still interested in hiring her. They asked if she would be interested in working as a Health Care Aide, and she agreed.

The recruitment of Filipino healthcare workers has been strengthening Canadian hospitals and medical facilities for decades. According to a study done by Statistics Canada in 2016, “Immigrants from the Philippines accounted for nearly one-third of adult immigrants in nursing and health care support occupations.”

CONCORDIA HOSPITAL, Winnipeg. December 2007 – After two years of living and working in Canada, Yrma was becoming impatient. She had been apart from her children all that time and couldn’t wait to have them fly over and be with her. When it came time to fill out and submit the forms for her permanent residence, Yrma did so with so much joy, but was later met with devastating news: she had been denied.

Because Yrma went through a visa change, she was required to work another two years to be eligible for permanent residence. 

Yrma decided to hop on a bus and reach out to the politician handling labour and immigration at the time. She travelled by bus in -30 weather to the other side of the city. After an hour of waiting, she had a chance to explain her situation but she left disappointed — the politician couldn’t do anything. Yrma was in disbelief. 

Photo of Yrma wearing a jacket on the right with her face missing from the image, with a Winnipeg Transit bus in the background during snow storm. Quote: "Hearing that the person responsible for the program couldn't do anything for me was so painful. This was the lowest point in my life," said Yrma.

Yrma was desperate for help and had no idea where to turn. She eventually discovered Immigrant Centre Manitoba, where she went as her very last hope. 

“I remember standing in line and feeling so helpless. I couldn’t stop thinking about my kids and how all these years apart will be for nothing. When it was finally my turn to speak with a representative, all I could remember was the confused look they gave me. My heart was broken, and I ran out crying. I’ll never forget the secretary who chased after me and sympathized with me,” she said. 

The staff member from the centre listened to her story and helped her fill out an application for express entry. Yrma made her way home, unsure of when she’d hear back from them.

One month after having her application processed through the agency, she was relieved to get the news that her application had been approved. She’d be reunited with her kids.

TANZA, CAVITE, Philippines. June 1990 – When Yrma, the oldest of three siblings, was in her final year of high school, she had ambitions of becoming a teacher just like her mother. Her parents, however, wanted her to take up nursing.

At that time, the Philippines followed a 10-year educational system where students would graduate in 10th grade, and enter university at the average age of 16. This system began changing in 2012 and is now in line with the Western educational system making it compulsory for students to complete additional years of senior high school up to grade 12. 

Yrma graduated from Tanza National Comprehensive High School in 1990 and decided to follow her parents’ wishes by attending a nursing college that they agreed to pay for. She attended DYCI (Dr. Yanga’s Colleges, Inc.) where she received her bachelor’s degree in nursing.

Her ambitions to become a school teacher remained, but her parents couldn’t afford to financially support her through another degree.

Nursing in the Philippines has a reputation of leading families to wealth because of the demand for nurses around the world, especially in the United States. The University of Washington wrote an article highlighting the country’s relationship with the Philippines since colonizing them in 1898 (Treaty of Paris).

The United States built nursing schools in the Philippines to help with the nursing shortages. This served as a good opportunity for Filipino nurses working in the United States to send money back home to their families.

BALIWAG, BULACAN, Philippines. July 2002 – Although Yrma completed her nursing degree like her parents wanted, she never lost her dream of becoming a teacher. She eventually earned her teaching degree and worked as a teacher for 12 years at both the elementary and senior school levels. 

“The happiest days of my professional life were teaching in the classroom. Being a teacher is a wonderful privilege and blessing,” she said.

Yrma landed a job at Baliuag University where she was hired as a clinical instructor for the nursing program. Her bachelor’s degree in nursing, along with her master’s in education made her the perfect candidate for this opening. During her two years teaching nursing students, Yrma first got the idea of working as a nurse abroad. She knew the working conditions abroad were much better compared to opportunities in the Philippines. According to a study conducted by Rowalt Alibudbud, MD, the average entry-level nurse in the Philippines will earn about 33,575 PHP (822 CAD) monthly in public hospitals. The Government of Canada’s website reports that the average hourly pay for Registered Nurses falls between 28-50 dollars per hour. Rowalt’s research also shows that Filipino nurses wanting to live in Manila, Philippines, may need to find an additional part-time job because the estimated cost of living in that city is about 50,800 PHP (1244 CAD) per month.

WINNIPEG, Canada. September 2005 – During her first shift at Concordia Hospital, Yrma met with the director of nursing, Ann Reichert, who suggested to Yrma that she try to become an LPN (Licensed Practical Nurse). The director explained that an LPN shares similar responsibilities as an RN (Registered Nurse), except LPN’s don’t conceptualize patient treatment plans and focus more on the tasks. 

“I was used to the small rural hospitals back in the Philippines. Walking into my first Canadian hospital for the first time was intimidating but exciting. I like to be challenged. I like change. I like doing things outside of my comfort zone. Concordia changed my life, and the lives of my children. I will forever be grateful,” she said.

Yrma took Ann’s suggestion and challenged the LPN exam. At this point, Yrma says she was in a much better mental state. She was well rested, and didn’t have jet lag this time around. She found the exam easy. Now that Yrma was licensed as an LPN in Manitoba, she was tasked with changing her visa from Health Care Aide to Licensed Practical Nurse. 

A few weeks after processing her request for her working visa to be switched, she was called by a government employee that her request was denied because the province didn’t need any more LPNs. Upon hearing the news, Yrma began to cry, realising her dream of starting a new life with her kids in Canada had come to an end. 

Yrma called Ann to let her know of the news and began sobbing over the phone as she thanked her for all the help and support. Ann reassured Yrma saying she’d do everything in her power to keep her here and make things right.

Yrma said that just when she was about to lose hope, her visa got approved. 

Photo of Yrma's son and daughter in front of a sun setting in the background. Quote: "My first thought was not about the job or future stability. All I could think about was being one step closer to being reunited with my kids," she said.

WINNIPEG, Canada. December 2009 – “The happiest day of my life was when my kids stepped foot in Canada for the first time. Even my co-workers at Concordia were so excited for me. They even bought them Christmas gifts.” 

Before Yrma’s kids arrived, she was renting a small basement bedroom to save up as much money as she could. “I saved everything because I had to spend money on plane tickets, winter jackets for the kids, and school supplies for after the New Year,” said Yrma. 

Her landlord surprised Yrma saying she’d need to find a new place because they couldn’t accommodate all three of them. 

“We didn’t expect to move out right away. That’s why when we moved into this tiny one-bedroom apartment, all we had was our clothes. We had to sleep on the floor for the first few nights but luckily my co-workers gave us some pillows and blankets to use. We’d order from the Chinese restaurant across the street and would reuse the Styrofoam plates and plastic utensils they’d give us,” said Yrma.

She struggled when the kids started school, having to rely on the help of the caretaker’s wife at their apartment complex to babysit the kids while she was at Concordia. It was a struggle knowing that this wasn’t the life she wanted for her children. It was normal for the three of them to be walking home from the grocery store and have other Filipinos from the neighbourhood offer to give them a ride home. She understood the gesture but didn’t want her kids to feel ashamed for walking home with groceries, so she’d kindly turn them down. On the outside, Yrma didn’t want to show her kids that things were tough and that she was disappointed with the quality of life she brought her kids into.

Image of a Facebook post Yrma posted on her account saying, "Thank you Lord for giving me two wonderful kids. I want to spend the night watching them sound asleep. I have waited for this for so long. What a wonderful feeling to be a Mom once again.

CONCORDIA HOSPITAL, Winnipeg. June 2010 – Yrma was settled into her role as an Licensed Practical Nurse (LPN) at Concordia. When new Filipino nurses were hired at the hospital, they would usually be assigned to Yrma, who helped get them on board. She understood the difficulties of being in an unfamiliar place. Yrma was grateful to Concordia for helping her with the visa and giving her a place to call home. 

Jolanta Hatt is a first-generation immigrant who moved from Poland when she was 18 (2004). She met Yrma during her practicum at Concordia Hospital because she was assigned to the surgical ward where Yrma was working. 

“Being a practicum student, you’re often a little timid and observant of the other nurses. I always remember noticing Yrma was super kind, while having that no-nonsense attitude. Like we’re getting things done. We have things to accomplish,” said Jolanta. 

Jolanta and Yrma continued working together, eventually becoming life-long friends. 

“I remember that initially, things were hard for Yrma, being a single mom to two younger kids. She still had this amazing work ethic and was just an amazing mother. She’d make the effort to show up for her kids’ extracurricular activities while juggling the schedule of a nurse,” she said.

WINNIPEG, Canada. March 2013 – Yrma realized that as the kids got older, things started to get more expensive. Her wage wasn’t going to be enough to support her family, so she needed to figure out a way to make some additional income. At the time, they lived in a tiny apartment and didn’t have a car to get around. It was all she could afford. Then a friend of Yrma’s introduced her to working as a travel nurse. 

St. Catherine University describes Travel Nurses as a solution for healthcare organizations facing staffing shortages. Essentially, practising nurses will work with private agencies around Canada that help them find work in high-need areas. This comes with added benefits for nurses like covered housing and meals, along with a higher hourly wage. Contracts can range from days, weeks, months, and can sometimes lead to opportunities for full-time positions. 

In January 2024, The Winnipeg Free Press reported that the Manitoba government has already spent $35 million this fiscal year on private agency nurses and is set to surpass the $60 million in 2022-2023. The demand for agency nurses is high due to nursing shortages across the province. Many nurses are attracted to the flexibility that agency nursing provides, but it costs the province more money. The Manitoba Nurses Union has been vocal about the issues surrounding agency nursing and has been calling for better conditions for nurses working in the public system.

Yrma worked for an agency that gave her extra shifts on some weekends and during Christmas break. She’d get to her shifts by carpooling with other nurses in exchange for making them all lunches. She soon upgraded to a slightly larger one-bedroom apartment and purchased a small car for her family.

Yrma’s brother and his family eventually moved to Winnipeg and joined Yrma and her two kids in the one-bedroom apartment. After one month of living here, Yrma and her brother’s family rented a house together for the extra space. Eventually, Yrma left Concordia to work as a travel nurse full-time. She primarily took on jobs in northern Manitoba and has since worked in every hospital in the province. 

Yrma said the money is good in travel nursing, but there are downsides, like the expectation to be an expert, often working alone, and having limited staff and resources available. Working in unfamiliar places also means the equipment and ways of doing things can be different.

WINNIPEG, Canada. February 2024  – Just one year ago, Manitoba health officials set out on a 10-day-trip to three cities in the Philippines in an effort to recruit internationally trained nurses to fill healthcare positions across Manitoba. Successful recruiting requires selling the location to potential candidates so they sign on. CTV News mentions the recruitment team focused on selling Manitoba’s diverse communities, beautiful lakes and summers, and the affordable cost of living. An article from CBC News mentions Manitoba officials offering incentives like paid travel to Canada and housing allowances. This trip resulted in more than 300 jobs being offered to Filipino health care professionals before the health officials headed back home. 

Controversy surfaced when records obtained by The Winnipeg Free Press reported that the Manitoba Government spent $460,189 to cover travel costs and advertising. This comes at a time when Manitoban nurses were being overworked and quitting their jobs because of the nursing shortage across the province. 

Global News reported on January 2024 that eight of the 300 Filipino nurses offered jobs from last year are set to arrive in spring 2024. Another 49 of these nurses are in the process of working with the province on arrival dates.

The Winnipeg Free Press reported on March 2024 that 35 recruits who passed immigration requirements failed the clinical competence assessments (CCA), which is required by the College of Registered Nurses of Manitoba. As a result, the job offers were withdrawn. Critics wondered why these Filipino nurses who were still interested in coming to Manitoba, couldn’t come as Health Care Aides with the possibility of working up towards becoming certified to work as nurses in the future.

Yrma smiles with her two health care aide friends wearing scrubs in the left photo and regular clothes on the right in Haida Gwaii, BC, Canada.
Yrma smiling (far left in the left photo and centre in the right photo) with her health care aide friends in Haida Gwaii, British Columbia, Canada.

SUNSHINE COAST, British Columbia. March 2024 – For Yrma, these immigration and certification challenges are well in the past. She now lives and works in the Sunshine Coast of British Columbia as a travel nurse. She’s happily working and exploring new places across the province she now calls home. Yrma shed tears of joy, while reminiscing about the comfortable life she now lives with her family.

“The last few years have been very, very, very, okay. When I open the fridge, it’s no longer only eggs. My kids are not wearing hand-me-downs anymore. We have no plans of ever moving back to the Philippines. Canada is now my home and I’ll forever be grateful to Manitoba. Every time I see the photo of me and my kids receiving our citizenship, it reminds me that it was worth it,” Yrma said.

For decades, Filipino nurses like Yrma have been instrumental in strengthening Canadian hospitals and healthcare facilities, but it isn’t easy for them. Filipino nurses moving to Canada often find living here deviates from the expectations they had before arriving. But, like in Yrma’s case, it can be a worthwhile struggle. For Yrma, the “Canadian dream” did arrive, but only after many setbacks and sacrifices.

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John Laracas

John (he/him) is a Canadian-Filipino who works best after midnight with a cup of tea by his side. He loves talking serif fonts, NBA Fantasy, and credit card reward programs.
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