Maryse Tremblay is used to critical situations. The 52-year-old nurse treats patients whose lives are often in danger. She must monitor them closely and react quickly if their condition deteriorates. She works night shifts in intensive care at Maisonneuve-Rosemont Hospital.
In her 33-year career, Maryse Tremblay has never fallen in combat. But a month and a half ago, she lost her footing. And she almost collapsed.
Omicron had just struck and was threatening her five weeks of annual vacation—she always takes it in the winter for downhill skiing. “When I found out, I was in shock,” says Maryse Tremblay, sitting at the kitchen table in her Montreal condo. I no longer felt like living. I had suicidal thoughts. »
It was then that she realized she was at her wit’s end. The nurse had been working full-time since the start of the pandemic. Between June and November 2021, she voluntarily added three overtime shifts every two weeks to her regular job – there was a shortage of staff. She also had to work compulsory overtime (TSO) on occasion.
“When you work 4 p.m., you “tachycardia”, you’re very nervous, says the experienced nurse, with graying curly hair. It’s something. »
On a day in August when she was working mandatory overtime, her patient “coded” and went into cardiopulmonary arrest at 9:45 a.m., when she usually goes to bed. Maryse Tremblay hasn’t forgotten anything. It must be said that she notes everything in a small notebook.
The COVID-19 pandemic has breathless Maryse Tremblay, who nevertheless does half-marathons (she alternates running and walking). Patients with COVID-19 are unstable. “These are all patients on the verge of being intubated,” she summarizes.
After having launched a cry from the heart to her superior and in the media with her union, Maryse Tremblay obtained her vacation. When The duty met her at home, she was finishing them, snug in a mauve fleece sweater. His ski therapy seemed to have worked. She’s back to work.
Burnout rate at 30%… before the pandemic
Maryse Tremblay is far from the only caregiver to suffer from burnout. Three months after the start of the pandemic, in 2020, 52% of healthcare workers already suffered from this syndrome, according to a Quebec study conducted among 467 professionals (nurses, doctors, etc.), managers and administrative officers. of the network.
These burnout employees had, at least once a week, “the feeling of being drained physically or emotionally” or “felt more detached from the patients and the care they were giving”, explains the DD Judith Brouillette, head of the psychiatry department at the Montreal Heart Institute and researcher at the University of Montreal, who led the study. “Before the pandemic, if you look at Canadian studies of nurses or doctors, burnout rates were 30%,” she says.
According to the DD Brouillette, professional exhaustion is a “red flag”, which does not necessarily lead to a work stoppage. In his study, however, 24% of participants had high symptoms of post-traumatic stress disorder, 23% anxiety and 11% depression three months after the onset of the crisis.
What about today ? The data collected as part of the study does not go that far, but those of the government testify to the fragility of the staff (see box).
One thing is certain, employers have every interest in surveying their staff on their psychological health, “naming” the problem and finding solutions with employees, according to the DD scramble. “Organizational support” (beyond the employee assistance program) is a “super protective” factor, she points out. The capacity for resilience, on an individual scale, too. “Psychological health is a shared responsibility,” she says.
Healthcare institutions are well aware of this. At the Charles-Le Moyne hospital in Longueuil, human resources tried to alleviate the inconvenience for caregivers during the fifth wave.
Part-time positions have been upgraded to full-time “over a short period,” says Jeremy Palomares, clinical-administrative coordinator of medicine, surgery and specialized units at the CISSS de la Montérégie-Centre. “We did not cancel any holidays, because people needed to rest and recharge their batteries with their loved ones. »
Caregivers from the operating theater have also been reassigned as a team to intensive care. “When we told employees in the block that we were going to need to reassign them, the first reaction was: ‘Oh no, we’re going to be moved again, we’re going to be split up,’ says Jeremy Palomares. I asked them, “What are you afraid of, being displaced or being separated?” They replied: “We don’t want to be split, we want to work together.” »
An impact that varies according to seniority
Thanks to their seniority, the nurses with the most experience were able to remain on their teams, unless they volunteered to be relieved. From then on, it was mainly the youngest who were deployed elsewhere, explains the president of the Fédération interprofessionnelle de la santé du Québec (FIQ), Julie Bouchard.
“For some, there was no period of training, of adequate adaptation,” she laments. For “days, weeks”, these nurses lived with “the fear of making a mistake, of not providing care correctly and of jeopardizing their license to practice”.
This “major” issue weighed heavily on the psychological health of nurses, she says. “It’s not true that, as long as you’re a healthcare professional, you’re good at working anywhere. Expertise is very important. »
The Dr Paul Fillion knows something about it. Sent as a volunteer to CHSLDs in Montreal during the first wave, this retired emergency physician was completely overwhelmed by the experience. “It got to me, to see the chaos that reigned in the system. To find myself alone in a department. A nurse would have done better. We were doing what we could. I had a hard time telling myself that it was no big deal. »
For days, weeks, these nurses lived with the fear of making a mistake, of not giving care correctly and of jeopardizing their license to practice.
Recently arrived in Montreal, this resident of the Outaouais has also lived this experience in the solitude of forced confinement. “You see people who are in need, you would like to do something and you can’t. There’s nothing worse than feeling like you don’t have the tools you need. Anxiety and insomnia got the better of her motivation. After two months, he dropped everything and returned to the Outaouais.
However, the Dr Fillion had seen others. As a volunteer doctor for the Red Cross, he treated the victims of cholera in Somalia, those of the earthquake in Haiti in 2010. “Cholera was dangerous, but we were organized,” he says. During the first phase of the pandemic in CHSLDs, it was “the unknown”, the “chaos”. There, as in Haiti, a feeling of helplessness pushed him to his last psychological entrenchments. “Over there, it’s powerlessness in front of people who had lost arms, legs… It wasn’t the same here, but it was the same feeling: not being able to help people the way we thought to do so. »
Worst memories of the M pandemicme Bouchard also go back to the first wave. Before taking the helm of the FIQ in December 2021, she led the local section of the union in Saguenay–Lac-Saint-Jean. There, she was particularly marked by the outbreak at the CHSLD de la Colline, in Saguenay, where 21 elderly people died.
She describes “the post-traumatic shocks of the nurses who worked there”. “We are used to dealing with death, but with so many patients dying, it is extremely difficult. Especially when you’re the only person they’re going to spend their last hours with. »
As a result of this experience, some nurses who worked at the CHSLD de la Colline at the time decided to retire sooner. Among those who have returned to work, many have “reduced their availability”, reports the union leader. “They never want to work in such a difficult environment again. Full time is no longer possible for them. »