We are all aware, whether in Canada or in Quebec, that our health system faces many challenges related to the aging of the population, chronic diseases and the endless list of health service needs. To overcome these many challenges, resorting to investments and reforms is essential. However, the challenge linked to the labor shortage seems immeasurable.
In an interview with Radio-Canada, Quebec Minister of Health, Christian Dubé, recently mentioned that agency staff change care units during the week: “the patient may have to deal with two or three different nurses in the same week “. The question to ask the Minister of Health is: Is there a law or regulation that prevents managers and schedulers of our health facilities from scheduling nurses from employment agencies into the same care unit for a long period?
Your words, Mr. Minister of Health, are pure truth, but what you should know and recall in the same breath is that all these nurses from private agencies who change care services are trained and oriented by nurses from the public service who already have tired wings.
If there is a lack of integration of agency nurses into the public health system, it is quite simply because in the eyes of the government, they are temporary resources. They respond to a specific need to be filled.
In my sector, most agency nurses live in Montreal, but work in the Laurentians and Lanaudière. It is obvious for the resources of these two regions that a reduction in hourly rates or the upcoming and complete abolition of agencies will force these workers to return to work in Montreal. So what will become of regional health facilities deprived of these resources?
If you consider nurses to be pillars of health, I invite you to take note of the fact that sometimes pillars need support.
Bridge from practical nurse to nurse
Orienting practical nurses to nursing education is plausibly an invaluable initiative to build skills in the healthcare field. During school, nurses develop a professional identity which represents the basis of their practice. The launch of what is called the auxiliary nurse to nurse bridge has already begun by the Quebec government. However, the COVID-19 pandemic has crystallized the social representation of the nurse, freezing her in the role of a heroine or a guardian angel ready to go into battle through dedication and sacrifice.
In order to strengthen the practical nurse to nurse transition, it would be wise for health establishments and training organizations to find ways to facilitate this transition. Let’s first think about flexibility in working hours. For example, offering certain courses remotely is one of the best ways to reconcile work-study and work-family. In addition to the recognition of prior learning and financial support already put in place by the Quebec government, it is essential to make practical nurses aware of all the professional and personal advantages that come with being a nurse.
CLSC, walk-in clinics, pharmacists, etc.
We read and heard a few months ago that the emergency rooms of one of the CISSS des Laurentides hospitals could close due to a critical lack of nursing staff. Moreover, an order from the Superior Court of Quebec brought relief to citizens by maintaining the opening of emergency rooms at night.
Of course, this is a spontaneous solution, but imperfect and unfair, because it is possible to transfer staff from other care units to the emergency room. This means creating a shortage of personnel in the care units in order to maintain the operation of the emergency room. For a lasting solution, it is recommended to strengthen interpersonal collaboration.
In other words, encourage existing resources such as CLSCs and pharmacies (obviously in the presence of pharmacists) to operate at night in order to relieve emergency room congestion. Setting up services that relieve emergencies, such as nighttime walk-in clinics, can also offer the population more adequate care options and thus reduce the influx of patients to emergency rooms.
In short, Quebec’s health system suffers from a critical lack of manpower. It is the government’s responsibility to develop a clear and sustainable vision to address this in order to prevent health system problems from exacerbating. Positively strengthening nursing training, adopting an integrated approach and thinking about using different strategies could significantly reduce the pressure not only on emergency departments, but also on the entire health system.