I was surprised, shocked, by the directive, said Denis Cloutier, president of the Union of Care Professionals of the East-of-the-Island-of-Montreal, in an interview with Tout un matin at ICI Première on Friday. If they do sit-ins, it’s because they [les infirmières] confronted with situations in which they feel they cannot provide quality care to their patients.
In recent months, public outings by nursing staff at the Hôpital Maisonneuve-Rosemont (HMR) in east Montreal have highlighted the annoyance of health network staff over overtime (TS) and particularly mandatory overtime (TSO).
According to data obtained by Radio-Canada under the Access to Documents Act, HMR is not the only hospital where nurses are recording TS and TSO.
Last year, the nursing and cardiovascular (Category 1) staff of about twenty hospitals across Quebec collectively experienced TS and OSI of more than 10% of their regular work hours.
Launch of the widget. Skip the widget?
end of the widget. Back to the top of the widget?
The average TS rate reached 7.46%, while the average OST rate was 0.28% for the 93 hospitals from which we had data.
According to the Ministry of Health’s online dashboard, the OSI rate for the nursing and cardiovascular staff reached 0.62% during the 2022 summer vacation.
The Montreal, Montérégie and Outaouais regions are particularly affected by the use of overtime.
As the President of the Fédération interprofessionnelle de la santé du Québec (FIQ), Julie Bouchard, explains in the negotiations, we want the complete abolition of mandatory overtime.
Julie Bouchard, President of the Quebec Interprofessional Health Federation (FIQ)
Photo: Radio Canada
Nurses across the network accumulated about nine million hours of overtime in 2021-2022, according to the Department of Health.
A recurring situation
The use of overtime is not new.
According to our data, prior to the pandemic (2019-2020), overtime rates among caregivers were also widespread. Three years later, the rates for the hospitals we got the data from have increased slightly.
As the Doctor of Nursing and teacher Nathalie Saké-Doucet reminds us, in the late 1990s, with the outpatient shift, we forced almost 6000 nurses to retire and this is where the TSO was born, which continues to be a major issue to this day.
Nathalie Saké-Doucet, Doctor of Nursing and teacher
Photo: Radio Canada
This extra time is concentrated where there are most issues with employee retention and workload. […] in emergencies, midwifery units and intensive care, adds Ms. Saké-Doucet.
Additionally, according to data from the Quebec Institute of Statistics, hospital nurses are among the workers who work the most overtime in Quebec. In 2021, the Quebec average was 4% for all occupations combined and 6.5% for teachers.
The obsession with retention
When he started examining health credits last week, Minister Christian Dubé did not hesitate to reply that the main problem in the health network is staff retention.
The 20,000 other graduates are worrying [chaque année] because they no longer want to work in the health network […] It’s much more of a bonding issue than an attraction issue, explained Christian Dubé.
“We can get young nurses in training, young nurses, orderlies […] because they form many of them. What we have trouble with is keeping them. »
— A quote from Christian Dubé, April 25, 2023, during the investigation into the budget of the Ministère de la Santé et des Services sociaux
Met during a Common Front (CSN, CSQ, FTQ, APTS) union demonstration, clinical nurse Mélanie Samson did not hesitate to point out the impact of overwork on her young colleagues.
Personally, I know some who have gone to other departments where there is less traffic. Others simply left the field, she says. Ms. Samson has worked in the emergency room at the Cité-de-la-santé in Laval for 12 years.
Mélanie Samson, Nurse, Cité-de-la-Santé de Laval
Photo: Radio Canada
The new management is trying to do zero TSO, there is a will, recognizes Union of Nurses, Respiratory Therapists and Auxiliary Nurses of Laval (SIIIAL-CSQ) President Dereck Cyr. But they don’t always respect the collective bargaining agreement in the media […] and right now there is about 15% to 20% OST in the ER every day.
Self-management of schedules
Minister Christian Dubé has repeatedly advocated the self-administration of schedules in recent months in order to hand over the TSO to TS.
Some hospitals, like CHUM, offer nursing staff the opportunity to express their schedule preferences and choose available overtime. 12-hour shifts are also offered in some departments.
In the case of the MSSS, it is specified that many institutions have started with an organizational commitment beyond the pilot projects. […] and already now we observe: a decrease in the number of occasional absences, a decrease in the number of OSI shifts and an increase in the satisfaction rate of employees participating in the project.
In addition to self-management of schedules, some also suggest mobility of staff from one department to another, particularly to the emergency room.
It is out of the question for the President of the FIQ to accept such a proposal.
Caregivers working in CHSLDs or FMGs do not want to be moved from one location to another because the safety of the care would be compromised, explains Julie Bouchard.
When asked this week if he feared a strike in the autumn, Prime Minister François Legault replied he hoped not.
What we want is to find a solution as soon as possible for the good of the people of Quebec, but also for the good of the workers, argued the prime minister.
I am thinking, among other things, of the health network. We no longer want the use of private agencies, we no longer want obligatory overtime, so that means a new organization of work. This will happen a lot in collective bargaining.