The Quebec health network depends more and more on workers from elsewhere. Last year, one in five new nurses and one in six new doctors came from immigration. How do they view our healthcare system, so hard hit by the pandemic? Portraits of ups… and downs.
After ten years in Quebec, nothing – or almost – could convince Aïssatou Sidibé to return to work in France. This 38-year-old nurse “found her X” when she landed at the Montreal Heart Institute in 2011.
“In France, there is, on average, one nurse for 15 patients”, estimates this nurse born in Paris. “In Quebec, it’s more like one nurse for 5 or 6 people,” she notes.
“We prioritize quality of care over quantity. »
This is also what pleases Elsa Deleage, a 31-year-old nurse who landed at the Hôtel-Dieu in Lévis with seven years of experience in her luggage. In post since November, she finds the pleasure – and, above all, the time – to make “relationships” with the children she takes care of in the pediatric wing.
“That’s what I like about my job,” she explains. “In Marseille, I no longer had that, since there were not enough staff. Here, I even have time to teach parents. »
There is also more equipment in Quebec hospitals than in France, notes the nurse. “In France, you always had to go begging from other services for a pump or something else. It’s a little less bad here. »
Papers and TSO
A major shock awaited the two French nurses when they arrived in Quebec: compulsory overtime, a Quebec management specialty far from being in vogue in France.
“I had never done it in France,” recalls Aïssatou Sidibé. “It sure came for me, the day I was told I had to do this…”
“In France, it’s always on a voluntary basis, unless no one shows up to provide care,” says his colleague from Lévis. “They can force us to stay until they find a replacement. Never for eight hours straight. »
Another significant irritant: the amount of paperwork to complete.
“I have the impression that they are behind the La Timone hospital where I worked in Marseille”, indicates Mme Deleage. “Everything is done in writing, on paper. It was a big surprise. To the public, in France, everything has been computerized for five years. »
Sometimes unable to decipher the writing of colleagues, often forced to fill in the same information on one, two, three forms, Elsa Deleage believes that computerization would save “a lot of time” for nurses. “It’s very tedious to do everything in writing. It gets repetitive. »
“It’s not very good for the forests”, laughs the Dr Firouz Abdollahi on the line.
Waiting lists
Even in Iran, this pediatrician’s phone sometimes displayed numbers from 514 and 450.
“Friends living here called me to get my opinion for their children,” recalls the Dr Abdollahi, who has twenty years of experience in a hospital center in Tehran.
When he landed in Montreal in 2017, he understood why his friends were taking this shortcut. Quebec shared a similarity with the Iranian public health system: waiting lists.
“There is a public system and a private system in Iran,” he explains. “The first is overwhelmed, but accessible to the poorest in exchange for a small franchise. The second is uncongested, but reserved for those who can afford it. »
This 52-year-old family doctor, who now works in a CLSC in the metropolis, observes the same weakness in Quebec. “In Montreal, it can take four years to have a family doctor. To get second- or third-line care, it may be a little more complicated. »
This expectation almost sent Aïssatou Sidibé back to France. This nurse, so happy when she treats her patients, became disillusioned when she had to reverse roles and found herself in the shoes of a patient with a uterine fibroid.
Without a family doctor or possibility of treatment for several months, she seriously considered returning to France for treatment – where the law requires having a family doctor, she specifies.
“When I fell ill, I said to myself that I was going to return to find my doctor and my gynecologist”, explains the one who is now cured – after treatment received in Quebec.
“I think it’s really a health system that gives a very good service despite its irritants”, assesses the Dr Abdollahi. The Quebec network is also more generous: the salaries have no common measure with those in force in Iran or even in France, “the European country which pays its nurses the least”, recalls Elsa Deleage.
Shortage of staff
Mohamed El Boughanmi has been caring for Quebec seniors as a beneficiary attendant for three years — first in a private residence, then in a CHSLD in Lévis. Residences for seniors are rare in his native Tunisia and are mostly private. Elderly people usually live with their families: it is their loved ones, and not State servants, who look after them and accompany them until death. In his opinion, the public system of care for the elderly has its merits in Quebec.
“The families are busy, the children work and don’t really have time to take care of their parents,” observes Mr. El Boughanmi.
“Here, the elderly are in the hands of angels”, image the attendant about him and his colleagues. “It allows young people to get on with their lives. »
He notes that the lack of staff in the care setting multiplies the overtime. “Now is the time to give more to be one with our patients. We are forced to replace colleagues infected with COVID, ”he believes.
Elsa Deleage sees it differently. With her evening shift at the hospital, she hardly sees her husband and two children on weekdays.
“It’s difficult to reconcile work and family in France,” she says. “I feel like it’s kind of the same here. »