The Rural Internationally Educated Nurses Pilot Project

By Catherine Baxter and Lori Fontaine
March 2019
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What you need to know

Recruitment and retention of Registered Nurses (RN) in rural Manitoba communities continues to be a challenge. Knowledgeable, skilled, and competent RNs are essential to the delivery of high-quality health care. When inadequate numbers of qualified professionals are available, the delivery of health services may be impacted.

Internationally Educated Nurses (IENs) comprise an important component of the nursing workforce in Canada. While previous research studies have examined the challenges IENs encounter entering and integrating into the Canadian nursing workforce, few studies have examined the experiences of IENs working in rural communities.

Why this research is important

In 2015, Prairie Mountain Health (PMH) and Southern Health—Santé Sud (SH-SS) were experiencing a shortage of Registered Nurses. To address the shortage both Regional Health Authorities (RHAs) entered into a collaborative partnership with Manitoba Health, Seniors and Active Living, the College of Nurses of Manitoba, and Red River College (RRC). The engagement of key stakeholders resulted in the development of the Rural Internationally Educated Nurses (IENs) Registered Nurse (RN) Pilot project. The pilot’s four phases began with the recruitment of 16 interested and eligible IENs. Phase two involved the delivery of bridging education at Red River College. Phase three saw the relocation, orientation, and employment of the IENs in each of the two Regional Health Authorities, and the final stage comprised an evaluation of the pilot project. The evaluation of the IEN pilot project provides valuable insights into factors that support the integration and retention of IENs into the rural Manitoba nursing workforce.

How this research was conducted

The first phase of the evaluation took place one year after the IENs had assumed employment in each of the Regional Health Authorities. Data on key performance indicators were collected from Red River College, the College of Registered Nurses of Manitoba, and each of the two Regional Health Authorities. In addition, 13 of the IENs completed written questionnaires, and of these, 12 agreed to participate in qualitative interviews. Eleven of the managers who supervised the IENs also agreed to participate in a qualitative interview. The final phase of the evaluation, a three-year follow-up, will be conducted in the summer and fall of 2019.

What the researchers found

All 16 of the IENs who participated in the pilot were successful in gaining licensure as Registered Nurses in Manitoba. Upon completion of the Red River College bridging program, 15 IENs accepted employment as RNs in one of the two Regional Health Authorities. One year later, all 15 IENs continued to live and work as RNs in both acute and long-term care facilities within each of the health regions. The IENs identified that the supports they received from colleagues, managers, and other IENs were important in easing their transition to the workplace. Connecting to others within the community and experiencing a ‘fit’ with rural life were central considerations regarding their intention to stay in the community long-term. The managers described the positive contributions the IENs had made to the nursing workforce. Buddying the IEN with experienced nurses, ensuring adequate orientation time and recognizing individual differences amongst IENs were strategies used by managers to cultivate confidence and support the integration of the IENs into rural nursing practice.

How this research can be used

Effective policies to assist IENs to integrate into the rural nursing workforce, as well as, retention strategies to encourage IENs to remain in rural communities are essential elements of health workforce planning. This research will contribute to our understanding of IENs experiences living and working in rural Manitoba and will help inform policy development.


Financial support for the evaluation of the Rural IEN Pilot Project was provided by Manitoba Health, Seniors and Active Living.

About the Researchers

Catherine Baxter

Catherine Baxter, RN, PhD

Catherine Baxter is a Registered Nurse and an Assistant Professor in the Department of Nursing, Faculty of Health Studies, at Brandon University.

Lori Fontaine

Lori Fontaine, MA

Lori Fontaine is a Policy Analyst at Manitoba Health, Seniors and Active Living (MHSAL).


  • health workforce planning
  • Internationally Educated Nurses
  • recruitment and retention
  • rural nursing

Editor: Christiane Ramsey

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