For Prakash Kulkarni, moving to Canada was like a dream come true. With thirteen years of experience as a registered nurse in India, Kulkarni received his work permit after applying to bring his skills to Nova Scotia which, like much of the country, continues to experience a workforce shortage of health care professionals.
He arrived in Bridgewater, N.S., in 2023, and the community has since become home for Kulkarni — but this didn’t happen right away. Moving from Chandigarh, India, which has over 1.2 million people, to Bridgewater with its population of about 9,000, was a big change.
“Integrating into the community was a very challenging task for us,” says Kulkarni, who came to Canada with his wife, two children and his father.
For example, as a Hindu, Kulkarni was unsure where to go for his spiritual needs. Even the process of enrolling his children in local schools was an added stress. However, as a participant in Nova Scotia’s International Community of Health Care Workers Engagement program (NICHE), Kulkarni received support for issues like this as he settled into his new life. The program, which aims to streamline the process for international health professionals immigrating to work in Nova Scotia, also seeks to increase the retention of its participants by helping them and their families to settle in the community.
Prakash Kulkarni with his family at a recent event highlighting Scotiabank's support of the NICHE program.
Through NICHE, supported by Scotiabank, newcomers like Kulkarni receive guidance on things like setting up a bank account, connecting with childcare or even finding cultural networks so they can enjoy food from their home country. Kulkarni says NICHE helped familiarize him with his community, including recommending attractions like beaches he could enjoy with his family.
Scotiabank is supporting the NICHE program, investing $500,000 over four years through ScotiaRISE, the Bank’s $500-million commitment and community investment strategy aimed at promoting economic resilience among disadvantaged groups. The funding will be directed specifically towards program initiatives aimed at retaining newcomer health care providers and making them feel at home in Nova Scotia.
One in every five immigrants who land in Canada will decide to leave within 25 years, and more than a third of those leave in the first five years, according to a report by the Conference Board of Canada. The report, called The Leaky Bucket 2024 and supported in part by Scotiabank, found that Atlantic Canada faces the highest onward migration. In Nova Scotia and New Brunswick, immigrants outside Halifax and Moncton are more likely to leave than those who settle in these cities.
The COVID-19 pandemic brought the country’s shortage of health care workers into focus, but the issue goes beyond that. According to the Canadian Institute for Health Information, while the overall supply of nurses has increased, the number working in direct care roles has not kept up with the demands of the country’s aging population. From 2013 to 2022, the number of nurses working in direct care roles per 1,000 older adults in Canada (age 65 and older) decreased from 59 to 52. Realizing that international recruitment was one crucial way of addressing the shortage, Nova Scotia and other provinces started programs to accelerate the recruitment of international health professionals.
There are several programs aimed at supporting newcomers to Canada at various points of their journey, but this fragmented approach can sometimes leave gaps and may be difficult to navigate for newcomers. NICHE was started in 2021 by Nova Scotia Health to provide support to newcomer health care workers in a more holistic way. The program is proudly supported by the QEII Foundation, Atlantic Canada's largest healthcare foundation.
Recruitment teams at NSH attract and hire internationally-educated health professionals matched to service needs across the province. Since NICHE began in 2021, about 700 internationally-educated nurses have been hired to work at NSH.
Health professionals work with preceptors and mentors until they have fully adjusted to the Canadian health care system, which means learning new policies, guidelines, practices and ways of working in various health care settings across the province. As needed, NICHE also facilitates language supports during this transition period. Many internationally-trained health professionals were educated in English but may have a different primary language.
Internationally educated nurses at orientation for the NICHE program.
“Newcomers bring such valuable experience to our communities in Canada, which is why Scotiabank is proud to support the NICHE program,” says Nicola Ray Smith, Regional Senior Vice-President of the Atlantic Region for Scotiabank.
“It is vital that these health professionals and their families feel supported and at home in Canada and the communities they are serving.”
Historically, many health professionals coming to Canada initially take a less advanced job relative to their experience in their home country. That’s where NICHE’s ongoing professional development program can be crucial in ensuring newcomers get immediate support and are supported long-term to grow their careers and lives in communities across Nova Scotia.
Many newcomers who settle in a community may end up leaving if there aren’t suitable employment options for their spouse as well, an issue which NICHE also works to address.
For example, Kulkarni came to Canada with his wife, who was a registered nurse in India but had not yet received a work permit in Nova Scotia. His wife joined one of NICHE’s transition-to-practice programs, where a preceptor helped identify what orientation she will need in order to begin practicing independently.
Annette Elliott Rose, Chief Nurse Executive & Vice President Clinical Performance & Professional Practice at Nova Scotia Health, says that the NICHE program has already accomplished a lot and garnered national recognition.
“It has a profound impact. There’s great pride in Nova Scotia around welcoming internationally educated health workers to communities and to practice,” she says.
Kulkarni’s story is a good example of how newcomer health professionals can successfully put down roots and feel at home in the communities they are working to keep healthy.
He has remained close with his cohort of nurses from when he arrived, including other newcomers from India, the Philippines and other countries. On Christmas Eve last year, the group got together for lunch, bringing dishes from their respective cultural backgrounds.
Kulkarni has become a permanent resident and, to his surprise, he also qualified for a mortgage.
He now lives in a house with his wife and two children in Bridgewater, an hour outside of Halifax, a community he says he wants to live in for the rest of his life.
“I’m in love with this place,” Kulkarni says. “Thank you, Nova Scotians, for welcoming us and giving us this opportunity serve you. It's a great privilege to work as an employee of Nova Scotia Health.”
