Emergency doctor says Quebec emergency room “on the brink of collapse” needs help

More and more emergency rooms in Quebec are struggling to take care of patients as hospitals are dealing with severe staff shortages caused by nurses tired of pandemic working conditions.

Across the province, several emergency rooms were forced to shorten their business hours, doctors warned of possible medical errors, and patients faced longer waiting times.

Doctors who work for CIUSSS de l’Est-de-l’Île-de-Montréal say the emergency room of the troubled hospital at the eastern end of Montreal is on the verge of collapse.They warned that the service might be shut down An open letter Zhou Yilian wrote to the Ministry of Health.

“Over time, we have seen things get worse and we are on the verge of collapse,” said Dr. Bernard Mathieu, an emergency physician at Maisonneuve-Rosemont Hospital who wrote this letter.

The signatories blamed the worsening working conditions that have intensified the pandemic on shortages-such as “large” forced overtime, competition from private nursing institutions that provide better pay and working hours, and insufficient wages.

“It’s something that makes people very angry, very tired, and then what happens is that you give up. You can’t be like this all summer,” Matthew said.

Province-wide issues

The unstable situation at Maisonneuve-Rosemont Hospital, Mathieu said, half of the hospital’s nursing staff and three-quarters of the respiratory therapist positions are vacant, which is just a drop in the bucket compared to other parts of the province.

As of Tuesday, the average occupancy rate for emergency rooms in Quebec is 106%, and there are several emergency rooms in the Monterrey area on the south coast of Montreal that have occupancy rates approaching or exceeding 200%. For several weeks, alarm bells have sounded in the form of closures, reduced working hours and capacity notifications.

In June, By St. Paul HospitalThe emergency room in the Charlevoix area near Quebec City announced that it is reducing working hours due to a lack of nurses.The hospital staff had to Juggling shifts and postponing holidays Keep the department open.

A few days later, Gatineau HospitalDue to a shortage of care, the emergency room in the Outaouais area was completely closed for a few days-a grieving family blamed the condition of their loved ones Received treatment two days before her death in hospital.

As of Tuesday, the average occupancy rate for emergency rooms in Quebec was 104%, and several in the Monterrey area approached or exceeded 200. (Radio Canada)

Quebecers have been asked to avoid emergency rooms in the past two weeks Maisonneuve-Rosemont and San Cabrini Hospital In eastern Montreal, due to the capacity constraints of Granby Hospital and Brome-Missisquoi-Perkins Hospital, CIUSSS de l’Estrie-CHUS requires people to “choose wisely” where they receive treatment.

CISSS des Laurentides also requires people with non-emergency health problems to “choose other solutions” instead of going to the emergency department because of the high occupancy rate, especially at Saint-Eustache Hospital.

On Monday, the Coaticook emergency room in the eastern township said that due to lack of personnel, it will only be open during the day from July 14 to August 16.

Staffing issues, high demand

Dr. Richard Fleet said there are many reasons for the current overcrowding of emergency rooms, including people seeking care after avoiding hospitals during the peak of the pandemic, and Surgical activities returned to pre-pandemic speed.

Laval University emergency room doctors and emergency medicine research chair said that this increased demand creates a “perfect storm” for the risk of medical errors without adequate staffing.

For Dr. Judy Morris, president of the Quebec Emergency Medical Association, the influx of patients has not changed much. “This is indeed a change in the capacity of the system.”

She said this puts “a huge amount of pressure” on the remaining employees.

“They have to work overtime. They are tired or discouraged. They want to leave on their own, which is natural because their working conditions are so difficult.”

An emergency nurse takes care of a patient at the Cité-de-la-Santé Hospital in Laval, Quebec. As of Tuesday, the hospital’s occupancy rate was 116%. (Dave Saint Amante/Canadian Broadcasting Corporation)

Mathieu from Maisonneuve-Rosemont said that since the beginning of the pandemic, nurses have left more quickly than they arrived at the hospital, partly because of exhausting working conditions, which created a vicious circle for other nurses who needed to make up for vacancies.

“We have more than 100% of occupations, and we have less than 50% of employees available…There is no rival,” he said.

The elastic band can only stretch so far. Morris said that throughout the pandemic, emergency room nurses are being drained due to retirement, private institutions and even pressure, which has caused many people to take sick leave.

Need specific solutions

Doctors in Maisonneuve-Rosemont are urging the Minister of Health Christian Dubé to immediately pass a government decree to reduce the use of private care facilities, allowing these workers to fill job vacancies only when it is difficult to fill, and other requirements regarding working conditions, recruitment and retention of staff .

Morris said that in order to get enough people to return to the hospital, strict incentives are needed, such as salary increases, flexible arrangements, and non-compulsory overtime. “It makes it very interesting to work in hospitals in those acute care settings.”

Fleet is also the research director of a leadership and innovation project called Living Lab Charlevoix, which aims to Implement solutions to improve first aid in rural areas, Said his team of medical students proposed some citizen-based solutions.

Dr. Richard Fleet, the research director of a leadership and innovation project called Living Lab Charlevoix, said that his team of medical students has come up with citizen-based solutions to improve conditions in Quebec emergency rooms. (Valerie Markou/CBC)

These include hiring retired nurses to mentor senior students, creating a project to assess the quality of work life, and a pilot project that brings together nursing students and residents of nursing homes.

As far as Dube is concerned, he admitted that several hospitals in the province “have run out of time” and vowed to resolve these “various short-term problems” in the summer to ensure “a more favorable decline.” [the] Health Net. “

Morris emphasized that Quebec must take immediate action in order to avoid the wave of emergency room closures, delays in surgery, and likely to resume and reduce unnecessary activities.

“We lost too many team members,” Morris said. “We are really in trouble now.”

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