Montreal

How a Montreal hospital deals with ongoing staffing shortages

Managers at Montreal's Jean-Talon Hospital give a glimpse behind the scenes as they try to maintain patient services while juggling COVID-19 outbreaks, a lack of personnel and exhausted employees.

Scheduling team constantly juggling patient and employee needs with a severe lack of personnel

Florent Verjus manages scheduling for Montreal's Jean-Talon hospital. He says delaying mandatory vaccination for health-care workers may have bought some time but staffing shortages are still a daily challenge. (Ivanoh Demers/Radio-Canada)

Florent Verjus and his team at Montreal's Jean-Talon Hospital may not work directly with patients, but they play a crucial role in delivering their care.

Verjus, a former nurse, is the chief of services for the CIUSSS du Nord-De-L'île-De-Montréal. These days, plugging scheduling holes created by the labour shortage is a full-time job at the small, 180-bed hospital.

If the mandatory vaccination order for health-care workers had gone ahead as planned Friday, this weekend would have been "catastrophic," he said.

"We would've had some major issues ... so at least there are people coming back on the floor," he said.

"But I think it's just delaying the problem by a month."

Verjus estimates 15 more nurses, split between the emergency room, medicine and surgery departments, are needed to run the hospital at full capacity  — and that's just for this weekend.

He said staffing the ER is always his biggest challenge.

"On the evening shift we have 11 nurses, overnight we have  eight ... it's really an area where we're missing an enormous amount of staff," he said.

"And on top of that, it requires qualified staff. We can't just put anyone on emergency."

Jean-Talon Hospital is bringing in auxiliary nurses to help out, Verjus said, but there are weekend shifts like this one "where we're missing half the staff."

The art of persuasion

Verjus said he and his administrative team use a number of strategies to stretch their resources as much as humanly possible.

They ask nurses to work 12-hour shifts instead of eight, work rotating schedules (seven days on, seven days off) or offer a future day off in exchange for agreeing to work overtime when it's desperately needed.

Mina Di Tanna has worked the hospital's phones as a scheduling agent for 16 years. She's one of the people who handles the callback list and is well versed in the art of persuasion.

"Thank you. That makes me so happy," she told an auxiliary nurse over the phone after they agreed to help out in the ER this weekend. 

"Afterward, you're going to call me and say, 'Hey Mina, give me more shifts like that,' because I know you're going to love working in emergency."

Mina Di Tanna has worked the callback list at Jean-Talon hospital as a scheduling agent for 16 years, finding creative ways to juggle schedules and convince employees to work overtime or come in on their days off. (Ivanoh Demers/Radio-Canada)

Lili Campo is Jean-Talon Hospital's chief of medicine and palliative care. On a typical day, after a morning meeting with Verjus and the scheduling team, she makes the rounds looking for staff who are willing to fill in where the department is short personnel.

Campo said the pandemic has increased the pressure on her employees, caused burnout and exhaustion and made the staffing shortages worse because anyone showing symptoms of COVID-19 can't come to work. 

"Friday, Saturday, Sunday, Monday, those are the critical days for us," she said.

She said up to 80 per cent of her day can be spent negotiating with staff and working ahead on schedules, but she's happy to do everything she can to make sure the hospital's patients get the treatment and services they need.

"I'm still looking for three auxiliary [nurses] and at least five patient attendants for the weekend, but I've had at least two positive responses," she said.

"I'll continue my search... and the [people on the] callback list will continue their work — it's a team effort."

Labour shortage could worsen with vaccine requirement

In September, Quebec freed up millions of dollars for annual bonuses in an effort to attract more nurses and fill the over 4,000 vacant positions in the health network.

As of Monday, 22,446 health-care workers across the province weren't fully vaccinated.

Almost 8,000 of those have received one dose, but Quebec could still lose some 15,000 employees on Nov. 15, the new deadline.

Health Minister Christian Dubé said Friday it's too early to tell whether the financial incentives are working but he's satisfied with the results so far.

Lily Campo is the head of services for medicine and palliative care at Montreal's Jean Talon hospital. Campo says she spends about 80% of her time planning schedules and finding workers able to fill in and often ends up working overtime herself. (Ivanoh Demers/Radio-Canada)

He said Quebec is in negotiations with over 2,000 retired health-care workers and part-time employees who are considering full-time work.

Those workers have asked for certain working conditions, and he said he's pushing his office to finish negotiations as soon as possible, he said.

Dubé said each region is working on a contingency plan to replace unvaccinated workers next month and the province is making changes to improve working conditions across the entire health network.

For example, he said, Quebec is now letting workers in the public system choose their preferred schedule, but those from temporary staffing agency will not have that luxury.

with files from Radio-Canada's David Gentile and Émilie Dubreuil

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