Intensive care at Fleury Hospital | “The situation has become dangerous”

The D^D Isabelle Lepage is an omni-intensivist at Fleury Hospital. Until last March, she was also head of the intensive care unit at this community hospital, one of the few to serve a vulnerable population pool in northern Montreal.

Now she is also a whistleblower.

The D^D Lepage hesitated for a long time to contact The Press. She didn’t want to undermine the reputation of her hospital. She wasn’t really sure, either, that it was constructive to publicly denounce everything that was wrong there. And, like some of her colleagues, she feared reprisals.

But there, she considers that she no longer has a choice.

There, that’s going too far. “The supply of services to patients and the context of care are in such a fragile state at Fleury Hospital that the situation has become downright and undeniably dangerous,” she denounces.

It is that there is now medical discovery of intensive care at the Fleury hospital. For seven days in September, there were no doctors on this unit to care for unstable patients.

Two doctors who were part of the small intensive care team have resigned in recent months, exhausted by the heaviness of the task. A third, the D^D Lepage, is on maternity leave.

As a result, there are only two doctors left in intensive care. When these are absent and an alternative solution cannot be found, unstable patients must be transferred urgently to the Sacré-Coeur hospital.

Of course, you can’t put a patient in critical condition in the ambulance, and thank you, good evening. It must be stabilized before proceeding with the transfer.

“This window of time where the patient will not receive optimal care is particularly problematic and dangerous,” said Dr.^D The page.

The transfer may also influence the choice of care provided to patients. Chronic lung patients, for example, may need to be intubated for ambulance transport. “In intensive care, they might not have needed such invasive care. »

I ask the D^D Lepage if the situation could lead to the death of certain patients. “Patients are definitely at risk of having complications,” she replies. We risk having deaths in sub-optimal contexts like that, of course. »

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“No, it’s not dangerous to come to Fleury”, however assures me the D^D Stéphanie Raymond-Carrier, director of professional services at the CIUSSS du Nord-de-l’Île-de-Montréal. “I wouldn’t want the people who will be brought here by ambulance to have the perception that they will not have the necessary quality of care. »

A contingency plan has been developed to ensure patient safety, she explains. In times of medical discovery in intensive care, it is the emergency physician who takes care of the patients. Beds are opened at Sacré-Coeur to immediately accommodate patients transferred there. “I’m not telling you that this is the ideal plan, but it is the safest plan that we were able to implement in the circumstances. »

Despite all its efforts, the CIUSSS has so far been unable to replenish the intensive care team, admits Dr.^D Raymond Carrier.

I spoke to a doctor who has worked at Fleury Hospital for several years, who refuses to be identified. It confirms all the information reported by the D^D The page.

Fleury is a modest community hospital serving the neighborhoods of Ahuntsic and Montreal North. His small team had a mission. A vision. Its management knew its staff, its floors and its patients well.

And then came reform. The management of medical services has been centralized within the CIUSSS du Nord-de-l’Île-de-Montréal. “There is no longer any management at the Fleury hospital. There are almost no managers left. No senior manager. The whole management is at Sacré-Coeur”, denounces the D^D The page.

The D^D Raymond-Carrier points out, however, that a coordinator was appointed to Fleury a few months ago, precisely after this “malaise” was transmitted to the management of the CIUSSS.

But for the D^D Lepage is not enough.

The offer of care is crumbling, she argues. The microbiology and pneumology departments have been repatriated to the Sacré-Coeur hospital. “There are crying needs in health care and we are in the process of emptying this offer of services there. It is absolutely saddening. »

The concerns of doctors are minimized by the CIUSSS, she continues. ” It’s discouraging. People end up burning out and quitting for those reasons. In the last few weeks alone, three GPs have resigned and two have requested leave.

In addition, five out of ten department heads have resigned over the past year and a half: in microbiology, pulmonology, general surgery, intensive care and emergencies. They left because of management’s lack of listening, consideration and cooperation, according to the D^D The page.

These local representatives “left for all sorts of reasons. There were those who were unhappy with the current situation, that’s for sure. But others, it was for personal reasons “, nuances the D^D Raymond Carrier.

The latter admits that tensions exist. The CIUSSS has even hired an outside firm to try to soften the angles with the Fleury doctors.

But the D^D Lepage does not budge. “There is a certain tolerance from the management to a diminished quality of care. Is it acceptable to sacrifice quality of care and patient safety in this way? I think not. […] In my opinion, our patients deserve better. »