"A Nurse is not a Nurse is not a Nurse": The Social Construction of Skill Among Internationally Educated Nurses Through the Lens of Feminist Economy and Disablement

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dc.contributor.advisorVosko, Leah F.
dc.contributor.authorVega, Temoc Thania
dc.date.accessioned2025-04-10T10:56:36Z
dc.date.available2025-04-10T10:56:36Z
dc.date.copyright2025-01-17
dc.date.issued2025-04-10
dc.date.updated2025-04-10T10:56:36Z
dc.degree.disciplinePolitical Science
dc.degree.levelDoctoral
dc.degree.namePhD - Doctor of Philosophy
dc.description.abstractThis dissertation examines policies from 2000 to 2024 regarding the assessment of internationally educated nurses' (IENs) skills, including credentials and work experience needed to enter Canadian nursing. I show that federal and provincial initiatives, like the National Nurses Assessment Service and fair access legislation, have made the process stricter, longer, and more expensive. As a result, many IENs are pushed into lower-tiered healthcare jobs, such as personal support work, characterized by high job insecurity, low wages, and increased risks of disability, including injuries, illnesses, and mental health distress. I argue that IENs' downward occupational mobility extends beyond a policy failure or racial biases; it is intricately connected to the racialized and feminized segmentation of care work, underpinning Canada’s development as a settler-colonial capitalist state. It is a continuation of a gatekeeping mechanism where (a) white nurses enhance their power and privilege—like better pay, benefits, and social status—by upholding masculinist and colonial beliefs about skill, often marginalizing labour associated with poor, non-white women, and (b) settlers access a pool of easily exploitable labour to fulfill the nation’s social reproductive demands. Unlike past racially explicit exclusions, the current policy uses “managed” integration, marked by selectivity (higher scrutiny) and assimilation (limited to those who approximate Canadian nursing standards). This segmentation is masked by race-neutral policies focusing on public safety and upholding international applicants' rights to fairness. Despite the advantages of racial segmentation processes, I illustrate how the downward occupational mobility of IENs adversely affects their health and the welfare of impoverished communities in their home countries, particularly the Philippines, and is closely linked to neoliberal privatization and declining care standards in Canada. By integrating insights from critical policy analysis, feminist political economy, critical race theory, and critical disability studies, I develop a framework to (a) examine the ideological and socioeconomic interests integration policy supports and (b) advocate for a fundamentally different approach to healthcare organization, specifically, one that challenges the hierarchical classification of skills (i.e., distinguishing between high-skilled and low-skilled jobs) as the mechanism that determines workers' unequal access to compensation, benefits, job security, legal protections, and social status.
dc.identifier.urihttps://hdl.handle.net/10315/42865
dc.languageen
dc.rightsAuthor owns copyright, except where explicitly noted. Please contact the author directly with licensing requests.
dc.subject.keywordsFeminist political economy
dc.subject.keywordsCritical disability
dc.subject.keywordsCritical race
dc.subject.keywordsWomen studies
dc.subject.keywordsGender studies
dc.subject.keywordsAnti-racist
dc.subject.keywordsNurses
dc.subject.keywordsNursing
dc.subject.keywordsSocial construction of skill
dc.subject.keywordsSkill
dc.subject.keywordsHealth care
dc.subject.keywordsMigration studies
dc.subject.keywordsImmigrants
dc.subject.keywordsFilipinos
dc.subject.keywordsPhilippines
dc.subject.keywordsDisablement
dc.subject.keywordsSocial determinants of health
dc.subject.keywordsPublic policy
dc.subject.keywordsCritical policy analysis
dc.subject.keywordsLabour market integration
dc.subject.keywordsHistorical materialism
dc.subject.keywordsForeign credential recognition
dc.subject.keywordsInternational credential recognition
dc.subject.keywordsDownskilling
dc.subject.keywordsDeskilling
dc.subject.keywordsDownward occupational mobility
dc.subject.keywordsSkill mismatch
dc.subject.keywordsSkill matching
dc.subject.keywordsDisability
dc.subject.keywordsRace
dc.subject.keywordsGender
dc.subject.keywordsNecropolitics
dc.subject.keywordsSocial model of disability
dc.subject.keywordsHealthcare
dc.subject.keywordsLabour mobility
dc.subject.keywordsInternational division of labour
dc.subject.keywordsRacial segmentation
dc.subject.keywordsGender segmentation
dc.subject.keywordsDivision of labour
dc.subject.keywordsSocial reproduction
dc.subject.keywordsCare chains
dc.subject.keywordsCare drain
dc.subject.keywordsJob flattening
dc.subject.keywordsPrecarious employment
dc.subject.keywordsPrecarious jobs
dc.subject.keywordsOccupational health and safety
dc.subject.keywordsNeoliberalism
dc.subject.keywordsPrivatization
dc.subject.keywordsInterprofessional collaboration
dc.subject.keywordsPersonal support workers
dc.subject.keywordsHealth care aides
dc.subject.keywordsOccupational segmentation
dc.subject.keywordsProcedural fairness
dc.subject.keywordsEntry-to-practice
dc.subject.keywordsOccupational standards
dc.subject.keywordsNursing education
dc.subject.keywordsRegistration practices
dc.subject.keywordsRegulatory bodies
dc.subject.keywordsCollege of Nurses of Ontario
dc.subject.keywordsNational Nursing Assessment Service
dc.subject.keywordsFair access
dc.subject.keywordsBridging programs
dc.subject.keywordsNCLEX-RN
dc.subject.keywordsOSCE
dc.subject.keywordsOffice of the Fairness Commissioner
dc.title"A Nurse is not a Nurse is not a Nurse": The Social Construction of Skill Among Internationally Educated Nurses Through the Lens of Feminist Economy and Disablement
dc.typeElectronic Thesis or Dissertation

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