Supervised Internationally Educated Nurse Gap Training Program FAQs

SIEN stands for Supervised Internationally Educated Nurse. The CLPNM will use the title SPN (SIEN) to refer to any individual who is participating in the SIEN Gap Training Program. This is because all SIENs will hold student practical nurse (SPN) registration on the CLPNM’s student register.

An SPN (SIEN) is an internationally educated nurse (IEN) who:

• is pursuing registration as a licensed practical nurse (LPN) in Manitoba,
• has applied to the College of Licensed Practical Nurses of Manitoba (CLPNM)
• has completed a clinical competence assessment (CCA),
• holds student practical nurse (SPN) registration for the purpose of completing bridging education, and
• has been deemed by the CLPNM to be eligible to practise, under supervision from another regulated nurse (LPN, RN, RPN), for an eligible employer, while completing the requirements necessary to obtain graduate practical nurse (GPN) registration and write the national examination for the practical nursing profession.

You will know if an individual is eligible to be offered employment as an SPN (SIEN) if their record on the public register includes the following notation:

• “This SPN (SIEN) is eligible to apply for SIEN employment with a Manitoba RHA or Personal Care Home. This registrant is not yet eligible to practise as an SPN (SIEN) until the employer enters into an agreement with the CLPNM.”

Another way to confirm is to ask the applicant to show you both of the following documents.

• A letter from the CLPNM advising them they may be eligible for work as an SPN (SIEN). This letter will include information on any competency gaps that have been noted during the individual’s clinical competence assessment (CCA) so you can assess whether your facility/program has the resources necessary to supervise the individual’s practice.
• An undertaking agreement which they have signed. A signed undertaking agreement is evidence that they agree to participate in the SIEN Gap Training Program and meet all requirements of the program. Note that the undertaking agreement will have an appendix for the employer to sign as well.

By presenting you with a copy of their CLPNM letter and signed undertaking agreement, the individual is providing you with evidence that they can begin looking for work as an SPN (SIEN).

Note that the individual cannot start work until both of the following two steps have occurred.

• The employing organization has also signed an agreement that has been returned to the CLPNM.
• The CLPNM has modified the individual’s record on the CLPNM Public Register identifying that the individual may practise as an SIEN.

The individual is not eligible to begin work until the employer agreement is returned to the CLPNM because the CLPNM must be satisfied that the employer is aware of the individual’s unique competency gaps and is able to provide the necessary amount of support and supervision.

Once the individual has met all requirements, which include providing the CLPNM with a copy of a signed employer agreement, the individual will be advised that they can begin work as an SPN (SIEN) with the approved employer.

At this point, the individual’s SPN registration on the CLPNM Public Register will be modified to include the following  notations:

• “The SPN (SIEN) must practise under the supervision of a Licensed Practical Nurse, Registered Nurse, or a Registered Psychiatric Nurse and may only practise when participating in a CLPNM- approved program of learning.”
• “The SPN (SIEN) is authorized to practise only at (name of employing facility).”
• “The SPN (SIEN) is NOT authorized to practise in nursing agencies, private homes, or in a self-employed capacity.”
  
  

Some individuals may have additional conditions, depending on their unique CCA results. If applicable, these too will be noted on the CLPNM’s Public Register.

Each SPN (SIEN) is an individual, with unique nursing experience outside of Canada. In most cases, SPN (SIENs) will not have prior exposure to Canadian nursing culture and communication expectations. Beyond that, the nature and extent of each individual’s competency gaps will be unique.

Employers should note that all SPN (SIENs) will have at least some competency gaps when compared with an entry-level Manitoba LPN. This is because an individual assessed as having no competency gaps would have been eligible for graduate practical nurse (GPN) registration and to write the national examination for practical nurses.

Before hiring an SPN (SIEN), be sure to ask an applicant to see the letter sent to them by the CLPNM following their clinical competence assessment (CCA). This letter will provide a summary of the entry-level competencies that were deemed to be met and not met during the CCA. This will allow you to ensure that the individual practises in an environment that provides an appropriate level of supervision and support. All applicants to the CLPNM who have been deemed eligible for the SIEN Gap Training Program have been advised that sharing this letter with any prospective employer is an expectation and a requirement in order to participate in the program.

To allow eligible internationally educated nurses (IENs) to earn while they learn more about practising the profession of practical nursing in Manitoba.

The SIEN Gap Training Program will provide opportunities for IENs who have been deemed eligible by the CLPNM to practise in a paid and supervised capacity within the scope of practical nursing in Manitoba while they are waiting to complete the requirements to become an LPN.

Normally, an IEN pursuing LPN registration would complete one or more clinical practicum experiences through Manitoba’s bridging education program for IENs, referred to as the Practical Nursing Qualification and Recognition (PNQR) program. Individuals who are eligible to participate in the SIEN Gap Training Program still complete some courses through the PNQR, but their clinical practicum placements will be replaced by their supervised and paid work experience, through the SIEN Gap Training Program.

In essence, the supervised work experiences that the individual receives, as part of the SIEN program, forms part of their bridging education.

Yes, SPN (SIEN) positions are expected to be paid positions. Although they practise in a supervised capacity, they are members of the health care team and are to be paid by the employer.

Shared Health has negotiated a salary and classification with the Manitoba Nurses Union (MNU), on behalf of the regional health authorities, including personal care homes who participate in the MNU Central Agreement. Any private personal care home who chooses to hire an SPN (SIEN) is encouraged to work with their own Union to negotiate a classification and salary scale. To be eligible to hire an SPN (SIEN), the CLPNM would expect that the classification and salary scale aligns with the wage that has been negotiated by Shared Health.

Yes, any person authorized to practise as an SPN (SIEN) will hold registration as a student practical nurse (SPN) with the CLPNM with conditions limiting their practice This means they are a member of a regulated profession, and their practice and professional conduct is subject to regulatory oversight.

Any individual deemed eligible by the CLPNM to practise as an SPN (SIEN) will have completed an orientation on the legislation and standards of the profession (jurisprudence education).

Although they are regulated, SPN (SIENs) do not yet meet all the requirements for registration as a licensed practical nurse (LPN), and therefore must still practise under supervision from another regulated nurse (LPN, RN, RPN).

It is important to note that SPN registration, on its own, does not authorize an individual to begin work as an (SPN) SIEN. Each individual who is deemed eligible for the program will have a series of requirements they need to meet before they become authorized to begin work.

SPN refers to Student Practical Nurse. SPN (SIENs) are a subset of SPNs.

All practical nursing students in Manitoba, including those enrolled in Manitoba-based Diploma in Practical Nursing programs, require SPN registration with the CLPNM while they are completing their education. This is unlike other nursing professions in Manitoba.

SPN registration is one of four types of registration that the CLPNM grants, along with graduate practical nurse, licensed practical nurse, and temporary practical nurse registrations.

As SPN (SIENs) are participating in a gap training program, they are considered students and require SPN registration. However, they are also a unique kind of student who is eligible for paid work while they learn. 

The only eligible employers, at this time, are regional health authorities and personal care homes in Manitoba who have submitted a signed employer agreement to the CLPNM.

Yes.

You will know if an individual is eligible to be offered employment as an SPN (SIEN) if their record on the public register includes the following notation:

“This SPN (SIEN) is eligible to apply for SIEN employment with a Manitoba RHA or Personal Care Home. This registrant is not yet eligible to practice as an SPN (SIEN) until the employer enters into an agreement with the CLPNM.”

Note that SPN registration on the CLPNM’s Public Register is not sufficient on its own to confirm that an individual is eligible to practice as an SIEN.

See Questions 2 and 3 above for more information about confirming eligibility.

The employer must agree to:

• offer the individual the opportunity to practise a minimum of 360 hours of supervised clinical practice, and track the SPN (SIEN) hours worked by the individual
• provide the individual with time off work so that they can participate in bridging education courses, when they are offered
• ensure that the individual is placed within a suitable practice environment,
• ensure that the individual’s practice is supervised
• arrange for at least quarterly evaluation of the individual’s practice, including a final report, and submit evidence of evaluation to the CLPNM (the CLPNM will provide a template for evaluation)
• provide support to the individual to address any practice concerns that are within the resources of the employing organization remediate
• report any concerns regarding the individuals practice, which are beyond the organization’s resources to remediate, or any concerns regarding the individual’s conduct, to the CLPNM
• cease SPN (SIEN) employment when the CLPNM advises the individual no longer meets the eligibility requirements for the SPN register (ie: the individual become eligible for graduate practical nurse registration) See question 15 for more information.

A suitable practice environment is one:

• where the individual will not practise alone on the unit, in the place of other nurses, or in a charge nurse capacity
• where another regulated nurse (LPN, RN, or RPN) is available to provide the required level of supervision
• where regular feedback, support, and guidance from other team members are available to the individual
• that is an appropriate match to the individual’s level of experience, recognizing candidates may have a wide range of practice experiences outside Canada
• that has experience working with and supporting IENs’ integration into Canadian health care environments, or that is willing to provide orientation to all staff to support integration of IENs into the practice environment, and
• that is able to provide orientation to the individual.

As noted above, some competency gaps are to be expected. This is the reason the individual holds student registration, is practising in a supervised capacity and is not yet on the full LPN register.

As an SPN (SIEN) employer, you will be asked to provide to the CLPNM quarterly evaluations of the SPN (SIEN)’s practice throughout their participation in the program. This is where you can note your observations regarding the individual’s practice.

In addition to regularly scheduled evaluations, employers are also asked to report immediately to the CLPNM any practice concerns that go beyond the competency gaps noted in the individual’s clinical competency assessment (CCA) if: 

• the resources required to address the practice concerns are beyond those that the employer can offer, or 
• the practice concerns relate to professional misconduct.

When an individual has competency gaps that are consistent with the findings on the individual’s CCA, or even gaps that go beyond those findings, but which can be easily remediated within the practice environment, the CLPNM does not need an immediate report. Those observations, and the individual’s progress towards addressing those gaps, can be included in the quarterly evaluation.

An SPN (SIEN) must practise a minimum of 360 hours of supervised practice, as part of their program requirements.  Orientation time on the unit can count towards the required number of supervised practice hours.  Time spent in a classroom environment would not count towards the required number of supervised practice hours. Classroom learning, even if provided by a staff educator, would be considered part of the theory/lab component of the individual’s learning.

Any employer who signs an employer agreement with the CLPNM will receive a copy of the standard evaluation form from the CLPNM. The CLPNM refers to this form as an Employer Practice Report (EPR).

Once the individual has completed all bridging education directed by the CLPNM, as well as, at least, 360 hours of supervised practise as an SPN (SIEN) they are now eligible to apply for registration as a graduate practical nurse (GPN) and therefore are no longer eligible to practise as an SPN (SIEN). They may, however, continue their employment with the same employer as a GPN.

It is the CLPNM that makes the determination of when the SPN (SIEN) has successfully completed the program. Once the CLPNM receives evidence of the SPN (SIEN) completing the required education and evidence of undertaking at least 360 practice hours, the CLPNM will advise the individual that they are no longer eligible for the SIEN program and that are instead eligible for GPN registration.

Please contact the CLPNM Registration Department by email or reach us by phone at 204-663-1212 or 1-877-663-1212 toll free.