From Gatekeeping to Collaboration: Supporting Internationally Educated Nurses in Rural and Northern British Columbia

AimTo examine the experiences, motivations, and perceived inequities of internationally educated nurses (IENs) residing in northern British Columbia and to identify systemic, geographic, and regulatory barriers to workforce integration.BackgroundAlthough IENs are critical to Canada's health workforce, many face prolonged licensure processes and limited access to education and employment, particularly in rural and remote communities.DesignGuided by Equity Theory and organizational perspectives, this mixed-methods study explored how perceived inequities influence motivation, engagement, and workforce participation.MethodsData were collected through three focus groups and interviews (n = 13), an online survey (n = 79), and a key partner workshop with regulators, assessors, educators, a union and health system partners (n = 16).ResultsFour themes emerged: resourcefulness, rural life, mental health and identity, and challenges within the registration process. Participants demonstrated resilience and strong professional commitment but reported delays, financial strain, and limited access to local training and navigational support. Survey findings echoed these barriers. The key partner workshop translated findings into partnership-based strategies to improve educational access, regulatory collaboration, and rural workforce pathways.ConclusionEffective IEN integration requires coordinated, equity-oriented partnerships across regulators, educators, and employers. Strengthening these collaborations can improve licensure access, support retention, and enhance healthcare capacity in underserved regions.