Caroline has suffered from generalized anxiety disorder since she was 6 years old. During her nursing studies at university, she benefited from an accommodation measure, namely additional time to take her exams. The shock was great when he arrived on the job market. Lack of staff, overwork, the “harsh reality” caught up with her. “I came home to work, I was panicked,” says the nurse at the Sainte-Justine University Hospital Center (CHU). I wasn’t sleeping anymore. I even lost weight. »
It was last summer. The candidate for the practice of the nursing profession (CEPI), who prefers to keep her real name quiet for fear of being stigmatized, almost gave up everything. But the Sainte-Justine team “rescued” her – she says so – before she sank beneath the waves. She received help from a program to support the transition between school and the job market, intended for nursing recruits who are experiencing difficulties or who suffer from an “invisible disability” such as a disorder. anxiety or attention deficit disorder.
CHU Sainte-Justine launched its program in 2022 after noting, in the midst of a staff shortage, an increase in resignations among recruits. “Several people in a short time mentioned “I sleep more”, “I can’t manage myself”, “I’m not able to come to work”, says Mélanie Guilbeault, head of development and professional expertise at the nursing department. . That’s what alerted us. »
The Sainte-Justine team tried to understand this new phenomenon. She realized that the number of students with so-called emerging disabilities (learning, mental health, attention, neurocognitive disorders, etc.) has exploded in Quebec universities in recent years.
“These people benefit from accommodations that allow them to reach their full potential and obtain a diploma, which is wonderful, but after that, when they arrive in the workplace, they lose their accommodations,” explains Karine Charbonneau, one of the two nursing advisors responsible for the program. However, the expectations for them are “the same” as for employees who have no difficulty.
Invisible disability or not, stress is often at its peak among CEPIs when they arrive at work. In addition to preparing for the famous exam of the Order of Nurses of Quebec, they cut their teeth in the field by taking care of their patients alone.
Accommodations
Over the past two years, around thirty recruits have received support from the program. Caroline was able to meet weekly, in complete confidentiality, with a nursing advisor — who is not called upon to evaluate her CEPI work — in order to establish strategies to reduce her anxiety.
An accommodation measure was also put in place: CEPI was able not to take a break during her shifts to “advance her tasks as much as possible,” without receiving comments from her bosses. However, she had to agree to reveal her mental health disorder to her superiors.
“There is a lot of pressure when you start [sur le fait] that you have to take your breaks, explains Caroline. You are supposed to be able to organize your affairs so that you are able to take your breaks. It had to be socially accepted by the boss. »
The break is in fact “an evaluation criterion” which is used to determine whether a CEPI is “capable of organizing itself well”, confirms Karine Charbonneau. “It’s also something healthy to take a break, so you have to take it,” she continues. But when the person tells us that it causes them more anxiety to take their break than to review their files, at that point, we have to adjust. »
Thanks to the program, recruits with attention disorders can now write their notes and review their files in a place other than the nurses’ station, a noisy environment where there is coming and going. “At that time, it takes a room which is on the unit where [la CEPI] will hear the bells and where she goes [savoir] if the patient needs it, but which is still less chaotic,” says Valérie Russo, the program’s nursing advisor. She emphasizes that the priority remains patient safety.
Raise staff awareness
Convincing the hospital teams of the relevance of the program was not so easy, according to those in charge. Employees expressed “certain reluctance”, indicates Karine Charbonneau. “Nurses said: ‘I didn’t have that when I arrived. Why could she have a little more?” We saw how much stigma there is,” she continues, recalling that her hospital is no different from other workplaces.
Training was given to teams to make them aware of the reality of their colleagues with invisible difficulties or disabilities. “Our key messages are really [d’avoir de] flexibility, to adapt to the person, to take into account their particularities,” says Mme Charbonneau. Orientation periods for these recruits may be extended as necessary. “We are more patient,” she notes. If we feel that the person is progressing and that they are safe [pour les patients], we remain in support with her. »
For Caroline, this additional help lasted a few months. The young woman, who passed her Order exam, is now taking her breaks. She is fine. “I needed that push in the back. If it hadn’t been for that, I don’t think I would have been able to continue working. I would not have been able to pursue a career as a nurse. »