'I’ve come to understand the significant contributions of Filipino nurses to the health of Canadians’ 

May is Asian Heritage Month in Canada and this year’s theme is Continuing a Legacy of Greatness. This  theme has touched me in in several ways, calling me to reflect on my life as a Canadian-born Filipino, my family, and my work as a registered nurse. These are my personal reflections informed by my own lived experience.

• From left, Aniela dela Cruz BN'98; Lucy Reyes, MN'91; Mr. Zaldy Patron, Philippine Consul General; and Kathy Howe, Executive Director of the Alberta Association of Nurses. 

Being generation two in a three-generation Filipino immigrant family

I come from a three-generation Filipino immigrant family. My family’s migration to Canada dates back to the late 1960s and early 1970s, when Canadian immigration policies began to shift. In 1971, multiculturalism became government policy. The then-Prime Minister (P.E.) Trudeau described that no singular culture could define Canada; that as a country, we recognized multi-cultural communities as an essential element in Canada. This was not only one of the turning points for the many Asians who were disenfranchised in Canadian society, but also the backdrop to the lives of many Asian-Canadians and families today.

Being generation “two” in my immigrant family, I experienced the economic and social hardships, the challenges for me and my siblings living and navigating Canadian society while our parents wished for us to maintain our cultural heritage, language, and values. We didn’t live a life of privilege in Canadian society, but our parents showed us how to work hard, endure challenges, live with humility, and to serve others. Resiliency is the greatness they have given me, my siblings, my children, nieces, and nephews.

Asian-Canadian contributions throughout history

The history of Asian people and communities in Canada spans over 200 years, starting with the first Chinese artisans who arrived in Canada to establish a trading post in the late 1700s. Since then, Asian peoples have become an important part of Canada’s multicultural society.

 Many Canadians are familiar with the building of the Canadian Pacific Railway (CPR) and the contributions of tens of thousands of Chinese immigrants to this work. But we must also remember the injustices, health, and social inequities that many Asians have experienced in Canada — a result of public policies that historically marginalized Asian immigrants and Asian-Canadians. The histories of Asian-Canadians are many, including, the poor treatment of Chinese workers during the building of the CPR , being denied the right to vote in provincial and federal elections until the first half of the 20^th century, the Japanese internment during World War II, and the Komagata Maru incident of 1914, to name a few. 

Being aware of such stories and histories is not meant to promote division and tensions amongst people in Canadian society. It is a chance to recognize the contributions, challenges, as well as resiliency of Asian-Canadians over time - past, present, and future. Canadians of Asian heritage are diverse, and we must recognize and celebrate the diversity, strengths, and resilience of people in Asian communities.

Filipino nurses’ role in health of Canadians

I am also a registered nurse in Alberta. Since my undergraduate nursing education, I have come to understand the significant contributions of Filipino nurses to the health of Canadians since the 1960s. There are scholars across Canada who are writing and preserving the histories of Filipino nurses in Canada, and I encourage people to read these complex histories. As a Filipino-Canadian nurse, I feel it is important to understand and recognize the important work of Filipinos who have historically been women. Many left families behind to work in the Canadian health system under formalized work arrangements with the Canadian government and to fill nursing shortages in Canada.

Many nurses also migrated to Canada from the United States, via work arrangements with the U.S. government. The histories demonstrate a complex interplay of factors – domestic nursing shortages, shifts in Canadian immigration policies, globalization, economic factors, recognition of international nursing education, and many other push-and-pull factors that shape migration of nurses worldwide.

The internationally educated RN and challenges they face

Stories of pioneer Filipino nurses in Canada are remarkable and remain relevant today. I recently had the pleasure of meeting many pioneer and current Filipino nurses in Calgary during National Nursing Week. In contemporary times, the internationally educated registered nurse (IEN) continues to face systemic challenges in becoming licensed to work as a registered nurse in Canada. Data shows a significant disparity between the number of IENs in Canada and IENs actually working as RNs. Many factors today mirror historic factors that shape the experiences of the IEN in Canada.

IENs today have to apply for a Canadian RN practice permit through a regional regulatory body for nurses. The process involves first the need to verify the IEN’s credentials and education, and to compare their international nursing education to Canadian standards through the National Nursing Assessment Service (NNAS). Once this step is completed, a report is forwarded to the respective regulatory body that the IEN is applying to become an RN. The regulatory body then assesses the NNAS assessment findings and makes recommendations for the IEN to write the National Council Licensure Examination (NCLEX) exam, an English proficiency test, a provincial RN Assessment program, partial or full completion of a “bridging” program such as the Bridge to Canadian Nursing Program in Alberta, and other requirements. Many fees accompany this process in Canada.

I’ve met many IENs from the Philippines who are now in Alberta, and who have shared stories with me about their journey in becoming registered to practise in Canada. Many come from U.S.-modelled nursing education programs in the Philippines due to the colonial relationship between the U.S. and the Philippines. These stories have striking similarities. For those who are able to access bridging programs, many still face costly tuition fees, high cost of living  in cities where bridging programs are located, and other challenges related to migration and settlement in a new country. For those unable to access bridging programs, it is often due to significant waitlists, unaffordability, and inaccessibility of programs. Through it all, the IENs I’ve met have demonstrated perseverance and resiliency in their journeys; for IENs who are still seeking to practice in Canada, hope is another attribute they share.

As we near the end of Asian Heritage Month, I encourage all Canadians to learn about the diversity of Canadians who are of Asian descent, the contributions that Asian-Canadians have made to Canadian society, and the resiliency that many Asian-Canadians have. This brief essay is only a small reflection of my experiences as Filipino-Canadian, and I hope to continue the Legacy of Greatness – resiliency - with others.