So long home, hello Canada

Nursing BC, Apr 2001 by Griffiths, Helen

Overcoming Cultural Differences

For Kulvir Minhas, who came from India, immigration was less of a problem. Her mother, who was already resident in Canada, sponsored her. Registration, however, was more complicated. For nurses from outside of Canada, RNABC requires transcripts and other records documenting their education and work experience. But Minhas had broken a government bond in order to join her family here. She had not kept a three-year commitment to work at a hospital in India and would have to pay the equivalent of $1,000 for the release of the records. It was money she didn't have.

So instead of coming to Canada as a nurse, she became a care aide. During this time she gained insight about things that many Canadians take for granted. For example, she was not familiar with the idea of sharing her workload.

"When I first started, I thought that I had to do it all," she says. "Even if I had a partner, I felt like I had to finish the work and it was all on me."

After working for more than seven years, the physical aspects of her care aide job took their toll. Shoulder pain was enough to motivate her to reconsider applying for registration with RNABC. She passed the English language tests (TOEFL and TSE) and was accepted at Kwantlen College's Graduate Nurse with English as Additional Language Program.

Gail Hills is a faculty member in the program. Unlike Minhas, many of Hill's students enter college having had little exposure to Canadian culture. Often, the only Canadian they will have spent time with to this point is their English teacher.

"What I have come to understand," says Hills, "is that their greatest challenge is the enculturation ... And they are still working on it when they graduate. So while a grad from a collaborative program's learning curve might be how to be more organized and make independent decisions, a grad from our school may be struggling with getting by without an instructor at their side to interpret the environment for them."

Interpreting the environment is a big part of the job for Hills and her colleagues. She gives the example of a time when the instructors suggested to students that they arrange a potluck lunch for staff as an icebreaker at the start of a clinical rotation. The students weren't in favour of this as they felt staff hadn't been very welcoming to them. Hills says, "We had to explain to the students that staff were stressed out and the presence of students might have seemed like an extra load, but by bringing the food, it shows them you value the time they spend with you."

In another example, Hills had given the students a case study to work on in groups. She had to leave the room to attend a meeting, but on return she found one of the students working on her own. "She hadn't learned to work in groups," says Hills. "So once again I had to interpret for her what was going on and the impact it might have for both her and the other students."

Finally, in a class discussion about computerized patient records, a colleague of Hills' asked students about the possible impact on patient care if there were concerns about who could access the information. She was hoping to hear comments such as, "Patients might be afraid to seek care due to fears of breached confidentiality, and meanwhile their condition might worsen." Instead she received responses such as, "It would be good because patients may not want to reveal certain information, and we might not know they were HIV-positive."