A Tataskewayak Cree Nation nurse, who is desperate to work in Manitoba, has been barred from practising after failing an English exam that advocates argue is prejudiced against First Nations people.
Two years ago, Tamra Keeper passed the National Council Licensure Examination for registered nurses after receiving her nursing degree from the University of Manitoba in 2017.
With her successful test result in hand, Keeper applied to the College of Registered Nurses of Manitoba to become licensed to work in the province.
MIKE DEAL / WINNIPEG FREE PRESS Tamra Keeper has taken the test unsuccessfully five times in the past two years; she came within half a point of passing on her last attempt.
The mother of two was eager to begin her career in the midst of the COVID-19 pandemic. She hoped to focus on mental health and provide support to her community, also known as Split Lake, about 900 kilometres north of Winnipeg.
“I believe in supporting my community, and being a helper,” Keeper told reporters at the Manitoba legislature on Wednesday, where she was joined by members of Manitoba Indigenous Nurses Inc. and First Nations health organization Keewatinohk Inniniw Minoayawin Inc.
However, despite receiving her training in Manitoba and speaking English as her first language, Keeper was told by the college she had to pass the International Language Testing Source exam because more than two years had elapsed since she completed her education.
According to the college, people who complete their education in English within two years of applying are automatically deemed to be proficient. However, applicants outside that two-year period must take a test.
Keeper said only a few months had passed between the time she passed her NCLEX-RN and applied to the college.
“I’m not too sure what happened in those four months that made my English not proficient,” she said. “The only language I speak is English… it seems ridiculous in a way.”
In a statement, the college’s communications manager, Martin Lussier, said available evidence shows language proficiency “can improve or worsen over time.”
“Based on an in-depth review with a language proficiency expert and testing providers, the college was able to validate that a two-year period represents an appropriate balance point to manage risk and provide applicants with the time needed to complete the registration process,” Lussier said.
Keeper has taken the test unsuccessfully five times in the past two years; she came within half a point of passing on her last attempt. Meanwhile, she watched as nurses worked shorthanded throughout the pandemic and the college received ministerial approval to temporarily waive language requirements for some internationally educated nurses.
“It’s been two years of me trying to be an RN in Manitoba. It’s been very costly for me,” Keeper said.
Keeper said she’s considering taking a job in Saskatchewan, where she won’t be required to prove her English skills and will receive support to get licensed.
“If I want to pursue my RN career right now, that seems like the only option,” Keeper said.
KIM chief executive officer Dr. Barry Lavallee said the exam requirement appears to be a “a racial barrier to eliminate access of First Nations nurses.”
MIKE DEAL / WINNIPEG FREE PRESS KIM chief executive officer Dr. Barry Lavallee said the exam requirement appears to be a “a racial barrier to eliminate access of First Nations nurses.”
“By denying First Nations nurses a licence, all Manitobans are affected,” the family physician and expert in Indigenous health said. “So this really is an unnecessary barrier that must be eliminated.”
Lavallee said the test is biased towards people of European descent.
“My expertise is addressing racism, Indigenous-specific racism in health care. This to me smells like white supremacy, affecting a policy or sort, that actually denies access to people of colour, including particularly, First Nations people,” he said.
NDP health critic Uzoma Asagwara raised the matter in question period and called on Health Minister Audrey Gordon to intervene.
“We have Indigenous people who have trained in English, and live and work in English being subject to testing that can and has delayed their registration. That’s wrong. We need every nurse we can get,” Asagwara said.
Gordon did not speak to reporters after question period, but in the house she said: “We are continuing to work with our colleges of registered nurses of Manitoba, as well as other colleges across the province, to ensure that registration is streamlined not just for Indigenous nurses, but for all nurses who want to practise here in our province.”
The college, meanwhile, has been engaged in a learning journey including reflection and education on how registered nursing regulation can support reconciliation in Manitoba, Lussier said.
“Though this work is just getting underway, we would welcome the opportunity to discuss the concerns raised at the press conference today that the college’s language proficiency policy is creating a biased or inequitable environment for Indigenous nursing graduates in Manitoba,” Lussier said.
