'A terribly short-sighted decision': nurse criticizes Quebec's plan to reduce reliance on private workers
MONTREAL -- A pledge by regional health boards across the Montreal area to prioritize more favourable shift work for its own nurses and respiratory therapists and to stop training nurses from private agencies is being criticized by workers in the public system.
The move is in response to a Government of Quebec directive last week that aims to bolster the public system that is struggling with a shortage of about 4,000 nurses. The ministry is giving healthcare institutions in seven regions until Dec. 1 to come up with their own transition plans to ultimately reduce the use of private workers. Part of the plan is to hand over "unfavourable" night and weekend shifts to private agency workers.
The government will allow the renewal of private agency contracts for up to six months “to allow for a smooth transition.”
But one ER nurse who works for the Ouest-de-l'Île-de-Montréal CIUSSS is speaking out against the decision that he says will be detrimental to patient care.
“This is a terribly short-sighted decision,” said the nurse, whose identity was verified by CTV News but is not being published because he fears repercussions from his employer.
He said emergency rooms and ICUs have been able to stay open because of the support of private agency nurses, even before the pandemic, and they are “vital” to providing adequate health care.
“We already are so short of nurses in general. We can't afford to lose any nurses — public or private,” he said.
In a statement, the Ouest-de-l'Île-de-Montréal CIUSSS defended its decision, saying it has "embarked on a culture change based on stability and predictability of schedules" adding that they are betting that agency care professionals will will heed the call and contribute to the change.
"Currently, at CIUSSS de l'Ouest-de-l'Île-de-Montréal, 0.77% of the hours worked by nurses and respiratory therapists are filled by independent labour," spokesperson Hélène Bergeron-Gamache stated.
She said the new initiative "will ensure better working conditions as well as renewed solidarity and collegiality between professionals on the same team," adding that "user safety remains our priority, no compromise will be made in this regard."
NO MORE TRAINING PRIVATE NURSES AS OF NOV. 1
In response to the government directive, Lynne McVey, CEO of the Ouest-de-l'Île-de-Montréal CIUSSS, announced on Monday that the regional health board will stop training nurses, licenced practical nurses and respiratory therapists from private agencies as of Nov. 1, according to a memo obtained by CTV.
McVey said the decision is part of a “concerted approach” from 15 other heads of health and social services organizations across the Greater Montreal Area, including the north and south shore of Montreal.
Speaking on behalf of those organizations, she said, “The most coveted shifts will be set aside for nursing and cardiorespiratory employees from our organization.” The CIUSSS will also discontinue the renewal and signing of new mutual agreements with private agencies.
“Through our actions, we seek to restore confidence and attract nurses and inhalation therapists who have chosen to work in the private sector back to healthcare organizations,” she wrote in the memo.
“In keeping with the measures announced by the ministry, we will favour our own staff rather than private agency nurses and inhalation therapists.”
For its part, the ministry of health said it is moving ahead with the reduction of private labour now that some health-care workers have started to trickle back to work through its recruitment effort in recent weeks. Last week, Dubé said 408 nurses committed to returning to the public health-care system, including 25 who came out of retirement.
'HOW ARE ERs AND ICUs GOING TO STAY OPEN?'
The nurse who spoke to CTV News countered the narrative that private agency nurses aren’t already getting “the crappy shifts” in hospitals. He said when he used to work as a private nurse, he always got night or weekend shifts, and that trend continues today.
“We need those agency nurses. I worked with them last night and without them, I couldn't do my job,” he said. “They're highly trained. And without them, there's no way that we can function.”
“A lot of these nursing agencies, they work in ERs and ICUs. If you cut the legs off of these places, how are ERs and ICUs going to stay open? There's no way. It’s a very poorly brought up idea that shows that the higher-ups know nothing about what's going on.”
The effects of the nursing shortage are already being felt. On Monday, Lachine Hospital said it will have to close down its emergency room for 16 hours a day — from 4 p.m. to 8 a.m. — and completely shut down its ICU as of Nov. 8.
Last week, the Senneterre Hospital, in the Abitibi-Témiscamingue region, also raised alarm bells at the decision to close its emergency room from 4 p.m. to 8 a.m. as of Monday.
"These decisions will put the lives of many people in danger. We must provide not less, but more care. You cannot tell a patient with a heart attack that it is too late because it is 4:15 p.m.," wrote Dr. Paul Saba, president of the council of physicians at Lachine Hospital, in an open letter to Health Minister Christian Dubé.
The province's largest nurses union, the Fédération interprofessionnelle de la santé du Québec, said Tuesday it believes the private agencies are “taking advantage” of the crisis in working conditions in the public healthcare network and agreed with the province’s direction of banning independent labour.
However, it said in a statement to CTV that it had higher expectations that the minister would implement “concrete actions” to support the public healthcare network.
“Without a clear timetable and a formal commitment to get rid of [independent labour], it is more difficult to see the government's real intentions to stop using private agencies,” said the FIQ’s interim president, Nathalie Lévesque.
“The success of the process depends in part on solidarity among institutions and clearer, more formal commitments from the government."