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Interviews Denis Cloutier, President, Union of Health Care Professionals for Montreal EastThe crisis in emergency rooms (ERs) is very real. It is directly related to the lack of nursing staff in the emergency rooms. The staff shortage and having to work continuously understaffed throughout hospitals, even more so in the ERs, causes more and more serious difficulties for nurses. The most well known is the use of mandatory overtime, which has driven many to work elsewhere, for other employers where the shortage is less severe. There is a shortage of nurses everywhere. More and more nurses have gone to the private sector in recent years, which, with COVID-19, has made the staffing shortage worse. The conditions are very bad.
One of the main factors that has caused so many nurses to leave is the Quebec government's Ministerial Order 007. This order, which was in effect from March 2020 until about a month ago -- almost a year and a half -- allowed for overriding collective agreements, for nurses to be moved at the whim of employers, for their workload to be increased, while nurses who came from the private sector were not subject to this order. In the past there was a balance between the public network and the private agencies that has been broken. Agency nurses were few in number. They were paid more than public sector nurses but they were sent where no one wanted to go. However, in times of shortage, to attract agency nurses, the Integrated Health and Social Services Centres and the Integrated University Health and Social Services Centres have guaranteed them working conditions far superior to those of the public sector nurses. Working under-staffed, being forced to work overtime, became far too common in nurses' work, which pushed more and more of them to leave. Mandatory overtime was already a management tool before the pandemic and it became even more so during the pandemic and it is still a management tool as the pandemic is subsiding. There is also a backlog of surgeries, medical care, etc. It's not just COVID-19 that we are dealing with.
Mandatory overtime is not something that was negotiated with the union. It is a professional obligation related to the Code of Ethics of the Quebec Order of Nurses that is being overused. It is not the union that allows a boss to hold an employee against his or her will. We would never agree to that. We think that the government should stop talking about this situation as something exceptional. In Maisonneuve-Rosemont, the employer imposed mandatory overtime 52 times in one weekend a few weeks ago. In the past they have tried to compensate nurses with bonuses for working in the ERs, but there is a limit. When you steal time from people it becomes inhumane. A full-time job now means being forced to work two or three overtime shifts in a single week. It becomes unbearable. I don't believe in private employment agencies in the public system. I don't believe in this cohabitation. Employers say that private agencies are there to help us. This does not help us. If there were no private placement agencies all nurses would be working in the public network. We have to favour the collective, the collective as a group of employees, and the collective as citizens of Quebec by having an equal public network everywhere so everyone has the same conditions. I don't see a place for the private sector in this. Another problem is the competition between hospitals. Hospitals are competing for staff, competing for the same nurses. Competition is difficult. I represent Maisonneuve-Rosement Hospital and Santa Gabrini Hospital. It's hard to compete with the University of Montreal Health Centre which is brand new, which is on the metro line. Why would a nurse go to work in a hospital that is not modern if she or he is going to suffer all sorts of inconveniences? Employers are in competition with each other and those who are favoured with brand new buildings, or geographically, will always be able to recruit while others are systematically short of manpower. Can we accept that there should be such inequality in health care from region to region or facility to facility? The Ministry has never wanted to deal with this problem. The Ministry must coordinate all of this. In terms of hiring, the Ministry could coordinate a better distribution of the workforce. Many things would be possible, but the Ministry does not intervene in anything. It washes its hands of any accountability. (Translated from original French by Workers' Forum. Photos: FIQ)
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While we were working with COVID-19, all the nurses in the network
faced challenges; shifts moved around, full-time work imposed,
overtime imposed, etc. Meanwhile, the nurses employed by private
agencies did not have these conditions. So we ended up with
situations that were even worse this year. Because of these imposed
conditions, it is very difficult to recruit new nurses or to convince
in-house nurses to go work in the ER, for example. 
The
Ministry must get involved and compensate nurses for the inconveniences
they have suffered. Compensation for mandatory overtime work could take
the form of days off. The Ministry does not acknowledge that
this is forced labour. It acts as if nurses are voluntarily accepting
the mandatory overtime work so it does not raise the issue
of compensation. Many nurses would want to work in the ER if they were
offered stable positions and a work schedule without mandatory
overtime. This way of managing is unacceptable. It
makes the nursing profession overall less and less attractive for the
future. It is a challenge. The greatest difficulties are in the ERs and
that is why it is the place that people leave first.