First Nursing Clinic | The only two full-time IPS slam the door

“We have lost the feeling of belonging and confidence in the organization,” write the two resigning nurses in a striking letter

(Quebec) One of the flagship solutions of the Legault government’s crisis unit to relieve emergency room congestion is failing in eastern Montreal. Two nurses slammed the door of the new IPS clinic due to issues affecting “the quality and safety of care”.

In November 2022, emergency rooms in Greater Montreal are bursting at the seams faced with the resurgence of a wave of respiratory viruses. The situation is such that Minister Christian Dubé orders the creation of a crisis unit to find rapid solutions.

Among the three main measures announced: the creation of specialized nurse practitioner (IPS) clinics which will be able to handle less urgent cases.

The CIUSSS de l’Est-de-l’Île-de-Montréal quickly raised its hand, so much so that the very first IPS clinic in Montreal was inaugurated in record time, three weeks later, at the CLSC Olivier-Guimond .

Minister Christian Dubé visits it and speaks of “a small success”.

However, a year later, the picture has darkened. The only two IPS in full-time position resigned last week from the CIUSSS de l’Est-de-l’Île-de-Montréal, we have learned The Press.

“We were faced with issues that had an impact on the quality and safety of care. These issues having not been taken seriously are unfortunately the reasons which led us to make the decision to leave the establishment, write the resigners.

The missive, which was addressed in particular to senior management, was sent to The Press by the Union of Healthcare Professionals of the East Island of Montreal, affiliated with the Fédération interprofessionnelle de la santé du Québec (FIQ). We contacted the two ex-employees, who did not want to grant us an interview.

“It is with immense sadness that we learned the news […] because somewhere, it is a project in which we believe a lot,” explained the president of the union, Denis Cloutier.

The CIUSSS also says it received “with regret” the resignations of the two nurses. “The two positions left vacant by these resignations are currently being posted and will be filled as soon as possible,” writes Christian Merciari, deputy CEO of the establishment.

“There is a slowdown in clinic activities while the positions are filled,” he added. However, services are still offered to the population and the CIUSSS IPS team “has mobilized to provide availability and cover the transition period”.

These resignations come as emergencies are once again under pressure with the return of respiratory viruses and the days of strike which have disrupted the network.

In the East, the occupancy rate in the emergency rooms of Maisonneuve-Rosemont and Santa Cabrini hospitals was 135% on Wednesday.

Harsh criticism

In the nurses’ letter, the criticism of the establishment where they worked for several years is harsh: “Being in the past IPS proud to work for the CIUSSS [de l’Est-de-l’Île-de-Montréal]we lost the feeling of belonging and confidence in the organization,” they write, adding “having always believed” in the project despite the “obstacles” of recent months.

At the center of their grievances: the lack of equipment to assess patients, “almost non-existent” clinical support, the “difficult” management of the team of employees and “the lack of stability of the staff”.

They particularly deplore having seen managers, auxiliary nurses, administrative agents and several IPS come to lend a hand “sporadically” and that “all the auxiliary nurses who worked at the clinic” came from private employment agencies.

The two IPS also note a “gap between management/ministry requests and the reality on the ground”.

For example, they highlight “the lack of representativeness of IPS in meetings concerning decision-making related to practice at the IPS clinic” and “the requirement to cover unfavorable opening hours” given their small number .

The nurses write in full that they have “submitted verbal and written solutions” to their managers “on numerous occasions”. They wish, through their letter, to allow “an improvement in the situation at the IPS clinic” and make the “environment attractive” and “safe”.

A “recent creation”

The CIUSSS, for its part, emphasizes that IPS clinics “remain recent creations”. The establishment explains that its teams will work to “improve this young model and ensure access to services”.

He recalls in passing that “the creation of this clinic occurred in a context linked to overflows in emergency rooms”. This took place in a “context of staff shortage” and the situation “always requires adjustments”.

For Denis Cloutier, the “priorities were not put in the right place” to ensure the long-term success of the IPS clinic, which was “left a little to its own devices”, too few positions having been created at the start of the project. The union demanded the creation of four to six full-time IPS positions.

Mr. Cloutier criticizes the decisions of the Legault government which seem to be taken to respond to crises, according to him, like last year with the unit created by Minister Christian Dubé. “What happens, anyway, to this crisis unit? “, he asks.

“What was the objective? Respond to media pressure or really improve access to the front line? It seems that it is really in reaction to what is happening and that a couple of months later, there is no follow-up,” laments Mr. Cloutier.

According to the latest budget presented by Minister Eric Girard, Quebec plans to create 23 new IPS clinics within five years, including 6 in 2023, to increase access to the first line. The creation of these clinics will require total investments of 395 million by 2027-2028. Six IPS clinics were created in 2022.