Due to the labor shortage, the Legault government authorizes candidates for the nursing profession (CEPI) to work in the delivery room as part of a pilot project. This practice was however banned in 2016, following a tragedy.
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Since January 11, CEPIs can work with women giving birth and their newborns at Sainte-Justine and the Jewish General Hospital. Quebec has given the green light to an “experimental project” supposed to last a year.
These are nursing students who have obtained their diploma, but who have not yet passed the professional examination of the Order of Nurses of Quebec (OIIQ) or obtained their license to practice.
The reason that pushed the State to take this path is clear: “The scarcity of labor in the delivery room has significant consequences on the capacity of the health and social services network to offer services of proximity in obstetrics”, is it written black on white in the government decree.
A decision that worries the Interprofessional Health Federation of Quebec (FIQ). “You have to understand that mother-child units, a bit like intensive care and emergency, are critical care units, so where there is a fairly rapid complication potential. To introduce new nurses to the profession, who have not even completed their process, they are candidates for practice, they do not have a full license to practice, in this type of Unity there is extremely worrying,” argues the vice-president, Jérôme Rousseau.
coroner’s report
This practice had been banned for more than six years. An “event” investigated by the coroner that caused the death of a woman who was giving birth prompted the OIIQ to ban the professional activities of CEPIs in the delivery room.
Generally, nurses who begin their career consolidate their learning in less critical care units, argues Mr. Rousseau. He recalls that the success rate of the CEPI last fall in the examination of the Order, a necessary step to obtain the license to practice as a nurse, was dramatically low (51%).
“It is confirmation that we are using young nurses in the learning process to fill critical staff shortages, while we are not addressing the needs. Once again, we’re going piecemeal: a hole, a peg, a hole, a peg, rather than looking at what the problems are in the health network to be able to find solutions to attraction and the retention of nurses”, insists the vp of the FIQ.
Not to mention the enormous pressure put on the backs of his aspiring nurses. “It’s so risky situations, nobody wants to experience complications, he adds. I don’t want to talk about misfortunes, but if a baby complicates and all that, and there is a death, it is extremely difficult to bear for a whole work team, as much for the nurse doctors, and when we is a few months into the beginning of a profession, it can literally mark, if we did not have the (necessary) support”.
Desired regulatory relief
Jérôme Rousseau would not be surprised that the Legault government is not content with a pilot project and will eventually extend this practice to all of Quebec.
In their memorandum submitted last June to the Council of Ministers, Christian Dubé and Lionel Carmant effectively underline having asked the OIIQ in vain to lighten the regulatory framework applicable to CEPIs in order to allow them to practice in the delivery room to counter the lack of staff.
The president of the Order, Luc Mathieu, had then indicated to the government ” [qu’] no new data [lui] leads to the conclusion that the legitimate concerns that led to the exclusion of the practice of CEPI with parturients are no longer justified. Therefore, [il] estimate[e] that it is premature for the OIIQ to immediately initiate a process of regulatory modification”.
Reached by our Parliamentary Office, the spokesperson for the organization specified that the Order had given its approval to the temporary holding of an experimental project subject to specific conditions and an evaluation by a team of impact researchers. the reintegration of these CEPIs with women who give birth.
-With the collaboration of Marie-Christine Trottier
Excerpts from the government decree on the pilot project allowing candidates for the nursing profession (CEPI) to work in the delivery room until December 31, 2023 at Sainte-Justine and the Jewish General Hospital.
■ A parturient (woman giving birth) to whom an institution participating in the project offers to receive services from a CEPI is free to refuse this offer.
■ A CEPI can manage, under supervision, a maximum of one parturient at a time in the delivery room
■ A CEPI does not practice with:
- of a parturient with an unstable high-risk pregnancy
- of a parturient under hemodynamic monitoring
- of a newborn whose neonatal resuscitation at birth is anticipated
- of a parturient with a complication during childbirth
■ A resource nurse is present on the unit at all times and supervises CEPI activities. This nurse must:
- Be present during childbirth
- Supervise CEPI during an atypical or abnormal fetal tracing
- Review the medical prescriptions in the user’s file at the start of the shift