Six solutions to counter the nurses shortage

Marie-Eve Cousineau

17 septembre 2020

On the eve of a potential second wave of COVID-19, the healthcare system remains "very fragile". The statement of the Minister of Health and Social Services Christian Dubé is without appeal. There is a lack of nurses and nursing assistants in the network. But what to do to counter the short-term staff shortage? Here are six possible solutions, compiled by Le Devoir à partir d’entrevues avec des experts du monde de la santé.

Encourage full-time work

About 60% of staff in the health network work part-time, according to the government. "If we had all these beautiful people working at 75% or 90% of a complete task, that would already help", underlines Roxane Borgès Da Silva, associate professor in the department of management, evaluation and health policy at the 'Montreal university.

According to Roxane Borgès, Quebec must put in place incentives to encourage nurses to work full time rather than part time. "The government should make a commitment to those who work full-time that they will not work compulsory overtime," she said. Staff would thus have better control over their work schedule, personal agenda and family life.

Change of tone and message

On March 21, the Legault government adopted a ministerial decree allowing health establishments to modify the working hours of staff, as well as to suspend or cancel leave already authorized. Part-time employees in particular were forced to work full-time. "The government has taken a very directive tone," said Damien Contandriopoulos, a professor at the School of Nursing at the University of Victoria in British Columbia. That's a very bad idea. »

Nurses, he says, have left the network or even the profession. Many are exhausted. "The government must recognize that its approach was wrong," he continued. He must tell the nurses “tell us what you want, we will offer it to you”. He must drastically change his message of appeal to the good heart, to the dedication of nurses.

Retirees and students to the rescue

As in the first wave, the government needs to expand its labor pool in anticipation of the fall, according to Carl-Ardy Dubois, director of the University's Department of Health Management, Evaluation and Policy. of Montreal, who authored the report "COVID-19 and the Healthy Workforce. Clear the land and lift the institutional locks".

Retirees, graduates in the health field, new graduates: as many people as possible must be mobilized, points out Carl-Ardy Dubois. “On the other hand, in the case of retirees, is there a lot left to mobilize for the second wave? " he asks.

Currently, 1,134 retired nurses and 700 retired nursing assistants lend a hand in the field, according to their respective professional order. “We hope that others will be added,” says Carole Grant, president of the Order of Nursing Assistants of Quebec.

New cohorts of graduates will also come as reinforcements. According to the Order of Nurses of Quebec, 3,473 candidates for the practice of the profession will take their professional exam this week, which has been postponed twice since the start of the pandemic in March. In addition to this number, there are 155 candidates for the professional examination for specialized nurse practitioners.

As for future nursing assistants, they must first resume their courses. Vocational training centers have suspended their training to accommodate the approximately 10,000 students in the accelerated beneficiary attendant program in CHSLDs, says Carole Grant. “These accelerated attendant training students are now done,” she said. We can think that the training of auxiliary nurses has started again. This varies from region to region. »

Appeal to newcomers

Environ 500 candidats, issus de l’immigrationApproximately 500 candidates with an immigrant background apply each year for recognition of equivalence to the Order of Nurses and Auxiliary Nurses of Quebec. These are more numerous since the pandemic. “Candidates may be ready to work during the 2nd wave, says the president of the Order, Carole Grant. Sometimes, the refresher training is not very long. The Order of Nursing Assistants of Quebec is one of the Quebec professional orders that welcomes the most newcomers to its ranks.

Take care of current employees

At the height of the first wave, more than 10,000 health network employees were absent from their jobs. They had contracted COVID-19, were in administrative isolation or did not show up for work for various reasons.

« L’enjeu va être de pouvoir mieux protéger les employés, dit Carl-Ardy Dubois. Ça veut dire des équipements de protection individuelle disponibles et ne pas faire la même erreur de mobilité de la main-d’œuvre. »

Du soutien psycho-social doit aussi être offert aux troupes en « état de fatigue », selon lui. « Il ne faut pas seulement avoir une ligne d’appel », précise Carl-Ardy Dubois. Des initiatives doivent être mises en place localement, estime-t-il.

Des incitatifs pour le temps supplémentaire

La Fédération interprofessionnelle de la santé du Québec dénonce depuis longtemps le temps supplémentaire obligatoire, qui est devenu, selon elle, « un réel mode de gestion ». Damien Contandriopoulos croit qu’il faut combler les quarts de travail autrement.

« Le temps supplémentaire obligatoire, ça n’existe pas en Colombie-Britannique, dit-il. Jamais une infirmière va se faire imposer un deuxième shift après en avoir fait un. La façon de fonctionner n’est jamais coercitive. Elle est beaucoup plus axée sur les incitatifs. »

Le syndicat des infirmières de la Colombie-Britannique confirme que le temps supplémentaire obligatoire est limité à des situations d’urgence « comme l’écrasement d’un avion de passagers ». « Certains employeurs peuvent offrir du temps supplémentaire au taux triple lorsqu’ils sont désespérés et ont offert les quarts en temps supplémentaire régulier, sans trouver personne pour les combler », indique le syndicat dans un courriel.

Damien Contandriopoulos estime que cet incitatif peut en valoir le coût à long terme. « Les agences de placement privées, ça coûte aussi énormément cher. »