Since the serious shortage of nurses which hit Nunavik last year, the numbers have increased slightly, but the situation remains worrying. The crisis also affects family doctors while new positions are difficult to fill.
At the beginning of 2023, the departure of several nurses created an alarming shortage of staff, so the Red Cross deployed a dozen reinforcement nurses to ensure rotations in Nunavik.
The shortage was particularly acute in the seven Hudson Bay villages managed by the Inuulitsivik Health and Social Services Center (CSI).
The population of 14,000 Nunaviks is separated between the coast covered by the CSI and Ungava Bay, which has seven villages overseen by the Tulattavik Health Center of Ungava (CSTU).
In Nunavik, the working conditions of healthcare personnel are different than in the rest of the province. There is no 24-hour operating room, no intensive care beds, no radiology exams or even full-time medical specialists on site.
Living conditions are also difficult in this large territory where the cellular network is not available everywhere. There is also no running water for 13 of the 14 villages. Tanker trucks must deliver water manually.
All regions of Quebec are competing for nurses, but if conditions were better in Nunavik, that would undoubtedly improve the situation, according to Dr. Geneviève Auclair, who works as a family doctor in Hudson Bay.
“People who leave because they are tired of lacking water, that could be the case,” she said. When there are a lot of irritants, at a given moment, it’s the straw that breaks the camel’s back. »
Cyril Gabreau, president of the Hudson’s Bay Nordic Nurses Union, affiliated with the FIQ, indicates that at this time last year, 26 positions were vacant out of 35. To date, 19 remain to be filled.
It reports 55 resignations last year and eight departures have already taken place since January 2024. Of this number, 46 have less than two years of seniority within the Inuulitsivik health center. “It is good to hire new staff, but we must put the means and actions in place to retain them,” he emphasizes.
Mr. Gabreau notes that there are hires, but unfortunately there are too many departures to compensate.
Few new positions filled in medicine
Dr. Genevière Auclair has also been head of the Nunavik Regional Department of General Medicine since 2015. She is responsible for recruitment for the entire region and she is particularly concerned about the lack of medical applicants this year.
The regional medical workforce plans (PREM) aim to distribute the workforce geographically. Five new family doctor positions have been allocated to Nunavik for 2024. Usually, all of these positions are filled, said Dr. Auclair.
“This is the first year that the application rate has been this low,” she declared. Currently, I only have one in five positions filled, I’ve never seen that. […] And yes that worries me because we need these people. We still depend on troubleshooting, especially the CSI. »
The emergency mechanism extends across the province and must be renewed each year, with the region having to prove its needs. “We then have a emergency bank with a pre-established number of weeks,” explained Dr. Auclair.
She specified that approximately 40 doctors are currently working in Nunavik. “Obviously this forty doctors is not enough because we are asking for around 200 weeks of troubleshooting per year from the CSI. This means that we need four emergency doctors every week all year round,” she calculates.
Work overload
Last month, only two nurses (out of five positions) worked in Salluit. “They spent 28-30 hours [d’affilée]. We always denounce that. This type of practice must stop. Imagine treating people after so many hours of continuous work, it’s a bit unthinkable,” denounces Mr. Gabreau.
He says similar situations are happening in different villages where nurses are understaffed and have to work long hours continuously. “This could put the population at risk,” warns Mr. Gabreau.
Dr. Auclair is of the same opinion. Sometimes, in a smaller village, a single nurse is on duty for several weeks at a time, she says. “What I’ve heard from patients and the community is that people are avoiding calling because they know there is almost no [de personnel] and they are tired. But is the patient in a good position to decide that it is a major emergency or not their problem,” she raises.
Nurses who staff emergency clinics are expanded role nurses. They can assess, question and examine patients independently, explained Dr. Auclair. If they are simple diagnoses, they will prepare the prescription. For more complex questions, they call a doctor.
The shortage of nurses is particularly critical in communities that are so small that there are no doctors on site. They are entirely dependent on nurses in expanded roles to provide 24/7 emergency service.
“I would say that we are not quite out of this crisis. For me, this is the worst shortage of nursing staff since I have been in the North,” says Dr. Auclair, who has worked in Nunavik for 16 years.
The president of the union believes, however, that the situation for nurses is tending to improve. He senses “a change in management” which gives him some hope. The work must continue, he says, in order to put more stable teams in place.
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