In an article from Montreal Journal of December 21, it is reported that the Minister of Health, Christian Dubé, is considering a bill to regulate the use of private health personnel placement agencies.
In the article, Mr. Dubé is quoted: “What I want to tell employees is to think twice before leaving [le réseau public] for agencies. The minister’s remarks imply that if we make life more difficult for the agencies, fewer nurses will leave the public network. It even seems to indicate that this bill could help “recover the employees lost in recent years to the benefit of the agencies”.
I must offer important nuances to the minister’s perspective reported in the article. I have been a nurse for more than twelve years now, I have worked in the French-speaking, English-speaking and regional networks. I am now a nursing teacher and researcher. This letter is one of opinion, but it is an opinion that is informed by years of expertise.
Our healthcare system is sick
First of all, it is absolutely true that placement agencies profit from the exodus of nurses from the network. These agencies are a symptom of our sick health care system. However, the agencies do not cause the nurse drain. This nuance is fundamental, because it makes it possible to identify the real source of the problem; the absolutely scandalous working conditions in far too many circles.
Suspensions for a toast to compulsory overtime (TSO), it is the dehumanizing management and toxic hierarchy that puts caregivers in a situation that forces them to make a choice between their health and their work. We’ve been saying it for years; we told Mr. Couillard, Mr. Barrette, Ms. McCann and now Mr. Dubé: we are leaving the network because the violation of our fundamental rights has been normalized there, without consequences. Before preparing a bill on agencies, why not work on a bill that makes institutions accountable for the use of the TSO?
Examples of solutions elsewhere
In France, for example, a manager must obtain a mandate from a judge before imposing TSO. It can be done quickly, in a few hours, but it requires the manager to have solid justifications before imposing any.
In British Columbia, the last collective agreement included an agreement to share responsibility for staffing; if a nurse was missing, the employer had to pay the nurses present an additional $5 an hour until a replacement was found. This agreement guaranteed that we worked hard to provide enough personnel, including surpluses, to avoid having to pay. The solutions for avoiding recourse to the TSO are multiple and several can come directly from the MSSS.
I continue to be amazed at the stubbornness to tackle everything but the root of the problem. It seems naive to me, or arrogant, to think that by making the working conditions in the agencies as worse as in the network, the nurses will remain in the unbearable conditions imposed on them, or even more absurd, that they will just come back. Because that’s kind of what this bill proposes, isn’t it? Need I remind you that we are humans, not furniture?
The nursing retention crisis we are currently experiencing will not be resolved by looking at a sheet of statistics. You can’t just change us columns in a spreadsheet. The nurses who left did not leave for the agencies, but left for their health. We will not return as long as our health is threatened.
Please, invest in addressing the factors that we have clearly identified that cause us to leave. Eliminate the need for agencies. Agencies are proliferating today because working conditions have been allowed to deteriorate, like a sore that becomes infected. It is by healing the wound, not by cutting the arm that we will save the patient.
File photo, Natalie Stake-Doucet
Natalie Stake-Doucet, nurse, teacher, doctor of nursing