Blaming the pandemic is very convenient to explain the low success rate of apprentice nurses on the first attempt of the examination of the Order of Nurses of Quebec (OIIQ). But also a bit short. At 51%, this is well below the usual averages of between 71% (also in the pandemic) and 96% since 2018, when the exam became entirely made up of choice answers. Could this not be the result of the combined failure of supervisors, trainers and the Order, at least in part?
The case is not trivial. The commissioner for admission to professions was also quick to launch an investigation. But in the immediate future, what do we do with these failed apprentices that the public network needs so much? The Ministry of Health and Social Services is formal: this will have a real impact on the number of qualified nurses available. The latter candidly hopes that while waiting for the resumption of the exam next March, they will continue to practice under supervision as CEPIs (candidates for the practice of the nursing profession), as permitted by regulation.
We can reasonably doubt it. Some will play it safe, reduce or even cancel their shifts to reserve more study time. This is because the number of exam attempts is limited to three. For those whose September exam was the third attempt, a failure sounded the end of a personal dream, while giving a serious blow to Jarnac to the public network which relied on these same CEPIs for long months to keep afloat.
In an emotional letter published in these pages, CEPI Andrée-Anne Guenin wondered about the value of such an exercise in times of severe shortages: “I do not consider that I made the free and informed choice to hang up my stethoscope. They are forcing my hand today. She is not asking for a free pass, but a new chance and support from all the actors in the network to deserve her place.
The protection of the public is a cardinal value; we understand the Order not to lower its standards. However, there is reason to wonder about the place of CEPIs in our network. Called as reinforcements in a ship in the middle of a storm, they responded wherever they were called, without ever flinching. Even when the tasks were light years away from what they would be called upon to do as professionals, which no doubt contributed to their collective failure.
We will remember a disturbing passage from Coroner Kamel’s report on the death of Joyce Echaquan. This had been left to the sole supervision of an overwhelmed CEPI, in contradiction with the rule that a CEPI must be supervised at all times. In light of these series of failures, it is clear that we have probably asked too much of the CEPIs, who are today paying a high price for abuses and shortcomings of all kinds made possible by a health crisis, which , let’s say it, goes far beyond the pandemic framework.
The Order, as well as the education and health networks, has to examine its conscience. The CEPIs are an essential link in our porcelain network. You can’t do business with them on a massive scale and then hypocritically conclude that a large number aren’t doing the trick. They deserve better, and so do the patients.