“Compulsory overtime” | A cancer that is killing the health network

We need to talk about “compulsory overtime” (well yes, again the mozus of TSO). Despite the sustained efforts of nurses and numerous groups and associations in recent decades, too many institutions still see OSI as a crutch, instead of seeing it for what it really is, a cancer. Every week nurses mobilize against this poison^⁠1but they refuse again and again to listen to us.

Natalie Stake-Doucet
clinical nurse

Nurses have been calling for an end to OST for over 20 years. The nurses hold on, fight tirelessly to be able to provide care in minimally acceptable conditions. The sit ins one after the other, then the nurses, creative and united, develop other means of pressure while the threats and sanctions also evolve. We are often told that “women can’t be held together”, but I have rarely seen such a sustained battle over such a long period of time as that of the nurses against the OSI.

But the fight is running out of steam. Why ? Because the nurses are leaving. I’m going to tell you a truth today that everyone knows, but is rarely named: every TSO is a step out.

Quebec has more nurses today than at any time in its history. The Legault government, like almost all governments of the past 20 years, refuses to believe that the problem is anything other than a “shortage”. We just want to inject more bodies into the network. The campaign to recruit nurses abroad is not an original or new solution. That’s pretty standard in the political cycle^⁠2. So we repeat ourselves, because politician after politician refuses to dwell on the real problems: the lack of dignity and humanism in the management of the network. As in all recruitment campaigns in the past, our nurse colleagues from other countries will also be tired.

Without legal basis

Because you see, there is a limit amount of OSI a nurse can endure. Each time we impose an OSI, we push a nurse out. At best, she leaves by resigning, at worst, she leaves because of illness. OSI makes us sick. We will never need to impose TSO if there is a natural disaster, a big accident or any force majeure event. In these cases, nurses have amply demonstrated their solidarity and commitment. But for political reasons, for reasons of indifference, of deficient management, there it becomes more complicated to convince a nurse to abandon her family, to stop providing for her basic needs like eating and sleeping. It takes violence.

We invented a whole mythology around the TSO. It is claimed that it is an “ethical” obligation or that it has some legal basis.

But the TSO was an administrative measure, without legal or ethical basis, which was born after Lucien Bouchard’s outpatient turn. It was said that it was “temporary” to allow the network to breathe the time that we adapt to this monstrous reform. It was the first “dose” of this deadly drug for the network, and addiction quickly set in.

It is still claimed today that we “need” the TSO rather than recognizing that the TSO is one of the main causes of the so-called “shortage” of the network. That’s the language of dependency. The network needs OST the same way an alcoholic needs another drink. The craving is created by an addiction that has devastating consequences.

The path to nursing hemorrhage is paved with TSO.