Francis Charbonneau, Vice-President, Northern Sector, Union of Health Care Professionals for the LaurentidesThere are multiple factors that explain the crisis in the emergency rooms (ERs). Many people left because of the ministerial decree, the obligation to work full time, the obligation to work twelve hours, even when there were very few cases of hospitalization for COVID-19. The Laurentides region is very large and some places were comparable to Montreal in terms of cases of COVID-19, but if you go north there were places where there were no COVID-19 cases and yet the decree was applied wall to wall. It became the employer's easiest solution to deal with understaffing, instead of finding ways to keep staff in place with adequate working conditions. The employer abused the Ministerial Order and forced people to work longer hours than they were fit to do, which left many people exhausted. People have been leaving on sick leave, either on salary insurance or compensation from the Labour Standards, Pay Equity and Workplace Health and Safety Board Commission. Many people leave the ER to go to other settings that may be less understaffed. The other settings may be in the same facility; for example, home support which has a Monday to Friday daytime schedule, and perhaps one weekend out of six that you have to work. There are some who go to private employment agencies, or leave the health care system altogether. For patients, the ER is the gateway to the system. Once you're in the ER, if you're going to be admitted to hospital you have to be relocated, maybe to a medical unit. This requires that the medical units are able to receive patients. The same abuse of Ministerial Orders has happened in medical units, so they are also very short-staffed, so they reduce the number of beds, they close beds. Then patients end up staying in the ER. This creates a great deal of extra work. We are experiencing this situation in several places in the Laurentides right now. In Mont-Laurier, the situation in medicine and surgery is difficult. In Saint-Eustache, half of the intensive care beds have been closed, so patients who are more unstable and who require greater care, instead of going to the intensive care unit in Saint-Eustache, must go to the intensive care unit in Saint-Jérome. However, at Saint-Jérome, there is also a lack of personnel, and the number of beds has also been reduced to two-thirds of capacity. This means that two ERs can no longer send unstable cases to the intensive care unit because they are full. A few weeks ago, nurses from the ER and intensive care units at the Mont-Laurier Hospital held a sit-in. In this hospital, at night we need about six nurses to cover the ER and intensive care. Currently we have one or two. The evening nurses, every day, had to work mandatory overtime and stay on the night shift to provide care. After talking to the employer several times, asking for solutions to be put in place, and not being listened to, the only way they found to make it clear that they were exhausted, could not stand having to work overtime every day, was not to report for their evening shifts. It was their daytime colleagues who had to stay and work overtime to replace them.
We have submitted solutions to the employer since March, but he does not listen to us. One of the solutions is to take the jobs that are not attractive, because they are unstable, and stabilize them so that people will apply for them. These are positions where people have to work rotating shifts -- day, evening and night. This is not viable and it's often these positions that remain vacant in the units. Instead of stabilizing them, the employer has taken all the positions that were stable and vacant and turned them into rotational positions. Positions have to be upgraded to full-time. Part-time positions need to be turned into full-time positions that are stable, instead of having part-time positions so nurses have to increase their hours by accepting work that is offered during the day, evening, night. They don't know when they are going to be called to work and can be called in at the last minute. It's hard for families to organize their lives. The government has taken actions that have added fuel to the fire. For example, the government has given incentives for working during COVID-19, but it has put so many restrictions that it has created some very serious problems. For example, the government set a total amount of $1,000 per month that you could receive, but you had to work full-time, never be sick, never be absent for any reason other than your vacation and holidays. This caused people to work themselves to exhaustion, even working when they were sick, to get this amount. The incentive pay was stopped at the beginning of July and we saw people start to miss work even more because they were so exhausted. Now, given the crisis in areas such as in the ERs, and the medical, surgical and birthing units, the government has brought back the $1,000 bonus but only in those units. The other units don't understand why they are excluded when they too are suffering, so it creates a lot of dissatisfaction between the units. The government does not recognize everyone's work. Health care professionals continue to work very hard to provide care
to the population. It hurts us when we have to engage in actions like
sit-ins because we know that it disturbs patient care. But we have no
choice but to do so in order to bring attention to the need for working
conditions that will attract new people to the profession and sustain a
public health network and not have a private health network like our
U.S. neighbours. (Translated from original French by Workers' Forum. Photo: FIQ)
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The first thing the employer did was to call the Administrative Labour Tribunal to muzzle the
nurses and force
them to go back to work and not take this kind of action again. The
employer used
the legal route instead of sitting down with us to see how to find
staff and make sure that other sit-ins would not take place in the
Laurentides. The local health authority was afraid that people would
expose how bad it is everywhere. At the same time, it stated publicly
that its number one strategy was to be solution-oriented with the
union. In fact, the employer never met with us about the Mont-Laurier
ER, never wanted to put solutions in place and went straight to legal
action. This is not a solution.