Nursing candidate was unsupervised day of Joyce Echaquan's death, coroner's inquiry hears

Nursing candidates at the Joliette Hospital are regularly left unsupervised, contrary to what is required by their professional code, a coroner’s inquest heard during the third week of testimony into the death of Joyce Echaquan.

WARNING: This story includes accounts of offensive language

Dr. Jacques Ramsey, left, and Quebec Coroner Géhane Kamel, right, are co-presiding over the inquest. (Marie-Laure Josselin/Radio-Canada)

Nursing candidates at the Joliette hospital are regularly left unsupervised, contrary to what is required by their professional code, according to testimony heard at the coroner's inquest into the death of Joyce Echaquan.

That was also the case for the aspiring nurse who had Echaquan under her care the day she died at the Centre hospitalier régional de Lanaudière.

A nursing candidate has completed a degree in nursing and is awaiting a permit to be issued by the provincial order of nurses.

Echaquan, a 37-year-old Atikamekw woman, was subjected to racist insults from nursing staff on Sept. 28, 2020, and livestreamed a video that sparked outrage across the province. A coroner's inquiry is being held to determine exactly what happened to her.

Three nurses who tried to resuscitate Joyce Echaquan testified Tuesday morning.

One said the nursing candidate working that day had several serious cases on her watch and didn't have the support needed, given her level of experience.

"She should not have had such an unstable patient," said the nurse, whose identity is protected by a publication ban.

She said nursing candidates are often given the same responsibilities as nurses who have decades of experience.

Dr. Jacques Ramsey, who is co-presiding over the inquest, pointed out that nursing candidates must be assigned a full-time supervisor to mentor them, under the Quebec Nurses Act.

One nurse said that's the way things were done when she started 10 years ago. But with staffing shortages, nurse candidates are routinely given tasks normally reserved for nurses, and don't have a person they can turn to to ask questions, she testified.

Delay in transfer to resuscitation room

The nurses said they were "surprised" when Echaquan was brought to the resuscitation unit. 

The nursing candidate had called to ask for Echaquan's transfer because the patient was in restraints and required monitoring.

Joyce Echaquan died at the at the Centre hospitalier régional de Lanaudière in Joliette, Que., after being admitted for stomach pains. (Facebook)

But when Echaquan arrived, she was barely breathing, said the second nurse who testified Tuesday.

"We weren't expecting an unstable patient, we were expecting a patient in restraints who needed observation."

This distinction brought on an 11-minute delay, before resuscitation efforts began. Her death was confirmed 45 minutes later.

"We did everything we could to save her," one nurse said. 

Racist comments

The third nurse who testified on Tuesday, who no longer works at the Joliette Hospital, said she had heard racist comments from her colleagues before, including from the nurse who was caught on video by Echaquan.

The nurse on the video, who told Echaquan she was "better off dead" and called her a "f--king idiot," had reportedly also made comments about a young Syrian patient at triage, a few years earlier.

During her testimony Tuesday, the nurse said she had called an interpreter to help her ask questions of the Syrian patient and his parents in Arabic.

After 30 minutes, the other nurse, from the video, reportedly told her "you took way too much time with them — they don't deserve it, they're not from here."

"I couldn't believe a nurse had said that," she told coroner Géhane Kamel. She immediately reported the incident to her superior but never heard back.

Testimony from three patients heard Tuesday afternoon also indicated that very crude, offensive language was overheard the day Echaquan died.

Two parents who were each accompanying their child reported hearing nurses labelling "Indian women" as being "loose" and only good at having children.

Carol Dubé, Joyce Echaquan's husband, has been been taking copious notes inside the courtroom during the inquiry. (Marie-Laure Josselin/Radio-Canada)

Another patient was hospitalized in a bed near Echaquan, on the morning of Sept. 28. Annie Desroches cried throughout her testimony, as she recounted how Echaquan had lent her her cell phone so she could call her son.

Desroches said when Echaquan started screaming out in pain, nurses told her impatiently to calm down. One nurse reportedly said "we're going to shoot you up [with painkillers] and you'll sleep like a rock."

"When you're a nurse, you're supposed to protect and comfort patients to make them feel better," she said. "None of this is acceptable," she concluded. The nurse in question denied having said this during her testimony last week.

Coroner addresses criticism

Before the beginning of proceedings on Tuesday, Coroner Géhane Kamel addressed criticism surrounding her impartiality in an opening statement.

In a column by La Presse journalist Isabelle Hachey last week, former Quebec Court of Appeal Justice André Rochon said he felt Kamel's tone was hostile toward some of the medical staff who testified. Former coroner Denis Boudrias also questioned her objectivity.

Quebec Coroner Géhane Kamel defended herself Tuesday, saying she has remained impartial as she looks into the circumstances of Joyce Echaquan's death. (Ivanoh Demers/Radio-Canada)

Kamel said the goal of a coroner's inquest is to explain the circumstances surrounding a person's death and to prevent similar situations from happening.

She said that goal was threatened by the "evasive and opaque answers" she was getting from certain witnesses. Kamel said she remains entirely impartial but did apologize if her comments bothered anyone.