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

Aim To 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. Background Although 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. Design Guided by Equity Theory and organizational perspectives, this mixed-methods study explored how perceived inequities influence motivation, engagement, and workforce participation. Methods Data 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). Results Four 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. Conclusion Effective 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.