Health professionals calling for long-term solutions with ERs running at double capacity across Quebec

Emergency rooms are operating well beyond capacity at hospitals across the province, and health care professionals and patient advocates say the government needs to act.

Winter clinics not helping overburdened emergency rooms, says Sainte-Agathe ER doctor

Emergency room nurses on two separate shifts staged sit-ins at Maisonneuve-Rosemont Hospital in east-end Montreal last weekend, to protest against being ordered to work double shifts. (Radio-Canada)

For most of the holidays, the emergency room in the Laurentians hospital where Dr. Simon-Pierre Landry works has been operating at nearly twice its capacity. 

Last Sunday, Landry came in on one of his few days off, and most of the rest of the staff at Hôpital Laurentien in Sainte-Agathe-des-Monts have been working overtime, too.

"We know that every year after Christmas, the emergency room will be super busy," Landry said. "We don't have a real plan in place."

The problem is not just in the Laurentians. Emergency rooms are running beyond capacity across Quebec, and health care professionals and patient advocates say the government needs to come up with long-term solutions. 

"It's almost all year long that we're in a state of overwork now," Landry said.

Last weekend, nurses fed up with being exhausted held spontaneous sit-ins at two hospitals in Montreal's east end.

They had been ordered to work double shifts — something their union says has become an all-too-frequent occurrence, especially during holiday periods.

"They often fall back on means that simply push the problem to later," said Denis Cloutier, the president of the union representing nurses in eastern Montreal. 

'It's becoming chronic and worrisome'

Emergency room nurses are exhausted "because their employer makes them do consecutive 16-hour shifts on a regular basis," said Cloutier.

The long hours and chronic staff shortages create a vicious cycle, putting more pressure on whoever is left in the ER, Cloutier said.

As a result, those nurses often end up on sick leave, or they transfer to less-demanding departments — or they leave the health care industry altogether, he said.

"It's becoming chronic and worrisome," Cloutier said. "We need to find a way to respond to the reality of emergency [rooms]."

CIUSSS tried to plan for holiday rush

Two sit-ins took place at Hôpital Maisonneuve-Rosemont on separate shifts Sunday, while a third was at Santa Cabrini Hospital.

When asked whether the nurses who participated would face consequences, Hugo Vitullo, the deputy director of professional services for the regional health agency overseeing Montreal's east end, the CIUSSS de l'Est-de-l'Île-de-Montréal, said "we're looking into that with our HR staff."

Hospital officials later determined that no disciplinary will actions taken against those nurses.

Vitullo said the CIUSSS did everything it could to plan for the holiday rush. 

"We have to have double the people to work, and that's a very difficult situation," he said. He said the agency has had to make up for staff calling in sick, as well. 

Nurses that worked the shifts before the sit-ins were asked to work a double shift, and some ambulances were redirected to other hospitals in the city. 

Nurses at Maisonneuve-Rosemont staged a sit-in over the long hours they were being made to work just last October, and there have been similar protests across Quebec.

The provincial labour federation representing most Quebec nurses, the Fédération interprofessionnelle de la santé du Québec (FIQ), has said workers' health and mandatory overtime will be major issues in the coming round of negotiations. The nurses' current contract expires at the end of March.

Dr. Simon-Pierre Landry, an ER physician at Hôpital Laurentien in Sainte-Agathe-des-Monts, says the government's winter clinic program, meant to steer flu and cold patients away from emergency rooms, isn't working. (Radio-Canada)

ERs clogged by flu and cold patients

Vitullo said hospitals' emergency rooms are also crowded by cold and flu patients who should be going elsewhere. 

"I guess it's a reflex from the population, but some people should change that reflex," he said. 

Landry, the ER physician in Sainte-Agathe-des-Monts, said it's unrealistic to expect people to change their ways. 

"Patients are worried and anxious," he said. "They will show up to the emergency room whether we like it or not. This is why we need to have better co-ordination."

Landry, who also runs a clinic in nearby Mont-Tremblant, said the government needs to give hospitals power to create partnerships with local clinics, so patients who don't need immediate treatment can be directed to those clinics.

He says the government's current solution — a winter clinic program — has not served its intended purpose of relieving pressure on emergency rooms because it is poorly designed.

The program allows certain clinics to stay open longer in the winter for patients afflicted with infections like the cold or flu, who often clog ERs at this time of year. 

But another government program provides subsidies to clinics to registered patients, Landry said, and clinics that take on other patients as part of the winter clinic program could end up losing some of that subsidy.

"Not a lot of clinics and not a lot of physicians have signed into that program," he said. 

For now, Landry said, the crush of patients waiting for care at the hospital emergency room in Sainte-Agathe-des-Monts-des-Monts is letting up, and staff are beginning to breath sighs of relief.

Quebec's Health Ministry did not return a request for comment Monday.

With files from Kamila Hinkson and Lauren McCallum