Your First Job as a Nurse in Canada: What No One Tells You

When I think back to how I started in nursing in Canada, I wasn't thinking about strategy. I was thinking about getting hired.

I'm an RPN now — working casually at Sunnybrook in Toronto, and as an ADOC and Educator at a LTC facility. But my start looked nothing like that. It started with visiting nursing, PSW shifts, and years of applying to hospitals that kept saying no.

What happened between then and now is what this post is actually about.

I Didn't Get It Right the First Time

I didn't pass my RPN licensing exam on the first attempt. I passed on the second.

And like a lot of new grads without hospital placement experience or connections, I didn't start in a hospital. I started as a visiting nurse.

It wasn't hard to find work there. Visiting nursing agencies are almost always hiring, and it's one of the fastest ways to start earning. At the same time, I was applying to LTC homes — but the pay at many of them was lower than I expected, so I kept hesitating.

Eventually, through my girlfriend at the time — now my wife — I heard about a newly opened retirement home that was hiring. That's where things started to shift.

Starting Somewhere Is Easy. Moving Up Is Not.

I got in as a casual RPN.

Which, in practice, meant one or two shifts a month — if that.

So I talked to the manager and started picking up PSW shifts to fill the gaps. Visiting nurse work on the side, PSW shifts at the retirement home, slowly building toward more RPN hours. Eventually the RPN shifts increased and I moved into a part-time role.

At the time it felt like progress. And it was.

But what I didn't fully see then:

It's easy to get into certain sectors in nursing. It's much harder to move out of them later.

I Worked Hard — But Not Always Smart

There was a stretch where I worked three consecutive 8-hour shifts without proper rest. Twenty-four hours, essentially. I didn't even know at the time that wasn't allowed.

I was just trying to prove myself. At the time, it felt like the only option.

I applied constantly. Indeed, hospital career pages, city job postings. I went in person to hospitals around Toronto looking for HR, dropping off resumes. If I had to guess, I visited each hospital at least four times.

There were no clinical extern positions back then. No easy entry points. My clinical placements had been in LTC, not in hospital settings. No connections. No shortcuts. Just repetition.

How I Finally Got Into a Hospital

Eventually, I got an interview. And this part still feels a bit surreal.

I was working at the retirement home when a patient was transferred to us from a hospital. I received the handover from the nurse who brought them over — a routine interaction, the kind that happens dozens of times a week in this industry.

That same nurse showed up as one of my interviewers.

I didn't have connections. But without realizing it, every professional interaction I'd had — every handover, every phone call with a hospital nurse — was building an impression. That one stuck.

Part effort. Part timing. Part luck. That's honestly how it happened.

(Note: The way you handle communication during handovers can define your professional reputation. If you're struggling to understand colleagues or physicians in a multicultural environment, check out my practical tips for training your ear: [How I Trained My Ear to Understand Different Accents as a Nurse in Canada])

What the System Actually Looks Like

If You Can Get Into a Hospital — Do It Early

This is the one I'd emphasize most. Hospital positions generally offer higher base pay, evening and night premiums, and more room to grow. More importantly, hospital experience opens doors. It's far easier to move from a hospital into LTC or a clinic than the other way around. If a hospital offer is on the table, take it seriously.

Municipal Jobs Are the Next Best Option

City-run LTC homes — Toronto, York Region, and others — often pay close to hospital rates and come with solid benefits and pensions. The trade-off is the workload. In many LTC settings, one or two nurses are managing 30 to 50 residents, medications, wound care, documentation, and PSW supervision. It's demanding work.

Agency Work Pays — But It's Not a Foundation

Higher hourly rates, flexible scheduling, easy to get shifts — agency work can make sense as a short-term move, especially when you're trying to stay financially stable. But without guaranteed hours or benefits, it's hard to build on long-term.

The Part Most People Don't Say Out Loud

If you start in LTC or a retirement home, it's easy to stay longer than you planned — not because you want to, but because the work becomes familiar, the schedule becomes comfortable, and hospital offers don't come easily.

I've seen nurses stay twenty, thirty years in the same setting. There's nothing wrong with that if it's a deliberate choice.

But if your goal is to get into a hospital, you have to keep pushing for it early and consistently. The longer you wait, the harder the gap becomes to close.

One Last Thing

Your first nursing job in Canada doesn't define your whole career. But it shapes your options more than most people expect.

Start wherever you need to — that part is reality. But once you're in, keep your eyes on where you want to go.

Where you start is flexible. Where you stay is what matters.

Where did you start your nursing career in Canada? I'd genuinely like to hear how it went.

Where did you start your nursing career in Canada? I'd genuinely like to hear how it went.

[Next Steps for Your Career & Income]

• Option 1: The Long Game. Wondering why I emphasize getting into a hospital early? Check out the actual pay gap between RN and RPN roles: [Nurse Salary in Ontario (2026): RN vs RPN Pay Guide]

• Option 2: The Fast Money. Considering agency work for higher hourly pay? Here is the realistic truth about the trade-offs: [Agency Nursing in Canada: What to Know Before You Start]