We join our voices with those of our colleagues in the Outaouais to inform the population of the Hautes-Laurentides that we too experience critical situations in our emergency rooms on a daily basis. The Mont-Laurier emergency room is in crisis, but above all in survival mode.
An emergency which, by the way, also regularly receives ambulances diverted from Rivière-Rouge and Maniwaki hospitals. Did we have a choice? Did we have more resources to accommodate these patients? No.
The obsolescence of the Mont-Laurier emergency room has reached its peak! Already too cramped, it has coexisted for almost four years with intensive care due to lack of staff. A beautiful five-bed intensive care unit sits empty and gathering dust on the third floor. All this due to a glaring lack of nursing staff.
Emergency and intensive care require nurses with critical care expertise who are now rare commodities. Many have left for better working conditions in other sectors, where their critical care skills are not required. Nursing staff are exhausted by mandatory overtime hours, not being able to eat during their shift, always being understaffed and rushing to care for patients. Difficult to recruit in these conditions.
We are therefore short-staffed during several shifts, and often in need of an additional nurse when urgent transfers are required to hospitals in the South. Transfers require almost a full shift (7 to 8 hours) of a qualified nurse, and this occurs every week.
In addition, cases of mental health problems have literally exploded in the emergency room. Despite our incessant requests to set up a safe isolation room suitable for our agitated patients, nothing is done. Every week, this clientele in psychological distress is installed in front of the nurses’ and doctors’ station, on a stretcher right next to the trauma room and the intensive care beds where seriously ill patients try to rest. This is dangerous for patients [agités] themselves, other patients present and our treating staff. Patients want to leave intensive care quickly for fear of screaming patients in the emergency room, next to their room.
We deplore the lack of access to radiology. We have little access to ultrasounds, both urgent and elective. The magnetic resonance imaging (MRI) device project, which had been promised to the Hautes-Laurentides by a minister ten years ago following relevance studies, was abandoned. Medicine has evolved, and technologies such as MRI should be accessible to everyone; our patients have to travel hundreds of kilometers to access it. Some decline and refuse the exam, due to lack of means to get there. Others are sometimes even hospitalized to have access to this service. Very sick patients, that’s what we treat. However, we must always do more with less.
Several of us have chosen to no longer work in the Rivière-Rouge emergency room, because we believe that we could no longer provide safe care there without jeopardizing our practice licenses. An emergency room requires a minimum of staff and different professionals who have the skills of this work environment, which was certainly not available at all times.
We anticipate that, in the near future, this will be more than precarious in the emergency rooms of Hautes-Laurentides, because the next generation is not there, among all professionals (nurses, respiratory therapists, technicians in radiology and laboratory, attendants, administrative agents, social workers), because the recruitment and retention conditions are not there. We work in a dilapidated environment, with an increasing demand for services to be provided to an aging and increasingly sick population.
The representatives of the CISSS are aware of this and have tried to stop the bleeding that threatens the hospitals of the Hautes-Laurentides as best they can. The health network has never been as precarious as it is now. Solutions often come from the bottom up. The public has the right to know, and politicians have the power to change things.
* Also co-signed this letter: Rosalie Castonguay; Alexandra Tourangeau; Pierre-Marc Bilodeau; Judith Leroux; Richly Tran; Pierre-Olivier Roy and Michaël Lefrançois. All are also emergency physicians in Mont-Laurier.