Jeffery Hale: The hatch from the inside

Jeffery Hale: L'éclosion vue de l'intérieur

Jeffery Hale: L'éclosion vue de l'intérieur

The Jeffery Hale is the main focus of an outbreak of the COVID-19 in Quebec outside of Montreal, with almost three-quarters of its 130 residents infected, with 39 deaths.

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May 9, 2020 4: 00

Updated at 12h19

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Jeffery Hale: The hatch from the inside

Jeffery Hale: L'éclosion vue de l'intérieur

Jeffery Hale: L'éclosion vue de l'intérieur

François Bourque

The Sun

Jeffery Hale: L'éclosion vue de l'intérieur

Jeffery Hale: L'éclosion vue de l'intérieur

Marc Allard

The Sun

The phone of Caroline Légaré rang in the middle of the night of 31 march. “Your father is not doing well”, he announced an employee of the Jeffery Hale.

The family of Jean-Pierre Légaré, 89-year-old, knew from the winter that his general condition was deteriorating. He was weakened from his last hospitalization for influenza.

It was agreed that in the event of a new infection, we would refer not to the hospital. He would end his days on the fourth floor of the CHSLD Jeffery Hale.

The previous evening, Dr. Judith Germain had telephoned already to prevent that he was a bit of a fever and that there was the COVID-19 to the floor below.

The state of Mr. Légaré is aggravated during the night. “It was phenomenal,” describes Caroline Légaré.

We had warned her of the risk, but it has kept coming for the last moments, respecting the instructions of protection.

During his previous visit on 14 march, his father was sleeping and she had not dared to wake him up. She regrets it. The visits were forbidden, except for the last few hours of life.

His father died on 31 march. Because of the COVID-19, it has not lingered in the room after the death, such as the often close in normal times.

Mr. Légaré was the first victim of the coronavirus at the Jeffery Hale, the main stage of hatching out of Montreal with almost three-quarters of its 130 residents infected, with 39 deaths.

That happened to come to this? The explanations are many, has found The Sun.

Customer fragile, lack of staff, the character of the sneaky virus, maintenance visits, movements of employees between floors, use a delay of the mask. A lot of effort, dedication, and good will, but a balance sheet demanding.

Friday, march 13, Lise had a bad feeling when she gave a kiss on the head of her husband, before leaving her room. “I had the impression that it was the last time that I kissed her,” she said.

The next day, the visits were prohibited on all floors of Jeffery Hale, except to the palliative care unit, on the 3rd floor, where there were exceptions for the relatives of those end-of-life.

Lise was worried about. She understood that family members travel to the bedside of residents on the verge of dying. But she feared that visitors from contaminating the health care staff.

“One of the problems at Jeff,” says Lise, is that the staff goes from one floor to another” — which on the 4th floor, where her husband died only one of the COVID-19, a night of mid-April.

Jeffery Hale: L'éclosion vue de l'intérieur

“One of the problems Jeff, it is that the staff goes from one floor to the other,” said Lisa, whose husband died only one of the COVID-19, a night of mid-April.

Provided by the CIUSS, Mélissa Giguère

Staff put at risk

Of orderlies and nurses worried about also during this period of march 13 to march 28, prior to the official start of the outbreak.

The visitors were more in the rooms, often without mask or coat of protection, evidenced by Nathan (fictitious name), a health-care worker.

He remembers having counted up to seven visitors in a room at the end of march and was seen walking in the hallways, the living room of families, the dining room. “It is clear that we are being put at risk,” he perceived.

And then there were the comings-and-goings of residents in rehabilitation functional rehabilitation transition Unit (UTRF), who continued to go out for dinner as a family.

“The measures were drastic for a part of the population”, but not for these people at risk. “It was just no sense”, think the president of the union representing the nurses, Patricia Lajoie.

A first notice of the outbreak was issued on march 17, for the rehabilitation unit. It was not, however, the COVID-19, but the Syndrome of gait influenza (SAG) related to the seasonal epidemic of influenza.

The first case of COVID-19 at the Jeffery Hale will be detected a few days later, on Friday, march 20. The diagnosis will be confirmed on the 23rd of march. It was an employee who had worked in palliative care in the 3rd.

Fifteen employees will then be sent in isolation to the home, and users will be confined to their room, as provided for in the protocol during outbreaks of influenza or gastro.

Employees note that a man and a woman who died this week in palliative care, showed symptoms similar to those of the COVID-19 (cough, fever, difficulty breathing). They will ask, in vain, that these patients are screened.

Dr. Hubert Marcoux, who works in palliative care, is formal : “These patients are not died of the COVID”.

One of them had been tested positive to the influenza and died. A lady died of pneumonia, and a third died of pancreatic cancer doubled in delirium.

The “fear of the unknown” to cause reactions. The similarity of the symptoms has been able to create the “confusion” analysis Dr. Marcoux, who finds it “unfair” that managers have been blamed for it.

It is not the only one. In a letter co-signed by two dozen colleagues and members of the teams of care, Dr. Catherine Gagnon is the defence of the management.

During this last week of march, the setpoint of the washing of the hands is tight, but employees still circulate between the floors, the mail has been distributed, and few new residents have been admitted, which meant the transportation of furniture. The last admission was made on 27 march.

Jeffery Hale: L'éclosion vue de l'intérieur

The dg deputy Jeffery Hale, Brigitte Paquet, and Dr. Francis Piuze

The Sun, Erick Labbé

Masks late

Quebec feared at this time of a lack of personal protective equipment, said Dr. Francis Piuze, who work in palliative care, and ensures the “co-management” since the beginning of the pandemic. “We don’t have all the ammo that we’d like to have” we he said in an interview.

The masks were then distributed sparingly.

“Everything was under lock and key. It was necessary that you go see the head nurse on the floor, and she gave it to the seed,” notes Yvan Blouin, coordinator of the health and safety of the trade Union of workers of the CIUSSS of the Capitale-Nationale (CSN).

The instruction was to use them with patients who had symptoms of the COVID-19, so only a minority of the employees wore.

Wearing a mask became systematic only at the time when the outbreak was confirmed at the end of march.

Dr. Judith Germain showed concern in an email sent to the CIUSSS on march 25.

“Here, it has not had a fit test, so we can’t approach these patients in a safe manner”. A “fit test” allows you to adjust the mask so that it is watertight in the face of the droplets that spread the COVID-19.

Dr. Germain will not obtain the CIUSS a terse response : “The guidance will be released when the time is appropriate”.

Disappointed, she returns the e-mail cynical. “I read in your response : you may be entitled to shields when the enemy army will have invested your walls”.

“The Saturday night which many will remember”

Things will switch over on march 28. “It is the Saturday night which many will remember,” says Dr. Piuze, who is in isolation at him and follows at a distance the operations.

In a few hours, a second and a third employee to test positive on the third floor and of the users show symptoms. “The fire was taken.” This will be the “pandemonium,” described Dr. Piuze

The Jeffery Hale came to pass at the stadium “outbreak”.

When we realized, “we closed the doors, but a part of the evil was done”. The enemy had already entered. “As the wind rushes when the doors are still ajar”, describes Dr. Piuze.

In an attempt to contain the spread, the direction order of “walling off” the floors and insulate the teams.

“We have given instructions to be extremely clear so that there are no more possible movements. All efforts are made to make sure of it”, reports the deputy director-general, Brigitte Paquette.

But there are 450 employees engaged in the care of the Jeffery Hale. It is a

big machine. “Is it to have a perfect score of 100 %, I can’t guarantee it,” concedes Ms. Paquette.

Sometimes, one has no choice but to send reinforcements. “We will not let someone without basic care, in a protective soiled or without hydration. […] We are going to look at the lesser evil”, argues Dr. Piuze. Employees are then transferred with “all possible precautions”.

The Jeffery Hale held out at the beginning, because the outbreak originated in the 3rd where there is a greater ratio of staff because of the nature of the care (palliative and rehabilitation).

It has also been able to repatriate employees of in-home services and other community missions of the Jeffery Hale.

The Jeff has, nevertheless, been close to breakdown in service in the middle of April. Eight doctors sign a call for help. Despite all the efforts of our staff, we request reinforcements to maintain a level of care that is “acceptable”. Twenty doctors, nurses and attendants will respond to this call.

First confined to the 3rd, the virus pierces the 4th from the 30th of march, and then on the 5th, the 6th and the 2nd. In mid-April, all floors of accommodation are affected.

Dated as of may 5, the photo gave this : 2nd floor, 12-positive patients, 8 deaths; 3rd floor, 3 positive, 8 deaths; 4th floor, 6 positive, 7 deaths; 5th floor, 7 positive, 7 deaths; 6th floor, 13 positive, 9 deaths.

At the time of going to press, only 35 of the 130 residents of the Jeffery Hale had not been met.

“Enclosed in his body”

Mrs. R., aged 91, was in the Jeffery Hale since 2010, which far exceeds the average stays in NURSING homes (around 18 months). “Nine years locked in his body,” says his daughter.

His family had chosen Jeff because it was “the best place” : “food special”, “dedicated people”, quality of care, animation, etc

Things have worsened with the reform Bar, and the scarcity of the workforce, she noted.

She believes that her mother “was well cared for until the end”. “What killed the families, it is the lack of information”, after that the visits were prohibited.

She has finally found a woman of the evening who brought the phone to her mother so that she could talk to him in the hollow of the ear before sleeping.

Mrs. R. has withstood the first wave of COVID on the 5th floor. It has been tested negative for the good Friday 10 April, but began to decline on the following Sunday. She died on 29 April, a month after the first resident of the Jeff.

It was offered to her daughter to come in for the 24 to 48 hour period. She declined the invitation. At 65 years of age and being fragile, she did not want to put themselves at risk for a visit that would not have made sense, “dressed as Sputnik, without being able to touch him, squeeze her in my arms, it is inhuman”. She was asked to do more with FaceTime.

The mother of René Dufresne is 89 years old and weighs 89 pounds. His kidneys and his lungs are fragile, and it is of high pressure. The wire from the hatch to the Jeffrey Hale, Mr. Dufresne was worried that the coronavirus is make it up to her on the 6th floor.

Two weeks ago, she was tested positive. “When they said it, I said to myself, it is going to stay three or four days.” It seems since in the process of overcoming the disease. He is in stable condition. It is no longer bedridden and able to walk a little.

René Dufresne fingers crossed. And hope that his phone will not ring in the middle of the night.

“Dying in a good mood”

They came out smoking in the evening of that Wednesday of may. Him cover yellow. It in green.

He was admitted to palliative care a few months ago. Cancer of the pancreas.

As it does not have the right to go out alone, “his” nurse accompanies it. He stressed how he is treated well.

It has been tested for the COVID. Nothing. He shrugs his shoulders and smiles. He has chosen to “die in a good mood”.

He occupies his days to follow the news and was immersed in the tv series Outlander. One nurse’s story of war transported into another era-and who faces the unknown.

Other nurses come out smoking in their turn, and then the charge among those who came in support two weeks ago.

All playful and animated by a force that we can barely imagine. But behind the facade, there is another reality.

“You get used to living with death,” says one of them. It does not support, it is have seen patients die alone”, because he was unable to make it come to time of close.

The man lit another cigarette. And then another, “his nurse also. As if nothing more was rushing in this spring of all emergencies. With residents in the least, the burden became less heavy.

Since the outbreak, two patients with the Jeff were able to return to the house and 14 have been cured of the COVID.

A nurse tells of a lady believed to count down the last week has started to do better. It is still standing.

The residents are very elderly and ill, to succeed and to survive and want to stay awake. As to better enjoy life.

Raising my eyes, you can see their light in the night of the Jeffery Hale.

READ ALSO: How to mediate conflicts and values?

READ ALSO: 150 years of compassion

Jeffery Hale: L'éclosion vue de l'intérieur

At the time of going to press, only 35 of the 130 residents of the Jeffery Hale had not been met.

The Sun, Patrice Laroche

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TIMELINE

  • 13-14 march: Ban visits in the accommodation section (99 beds), except to the palliative care unit for humanitarian reasons
  • 20 march: An employee who has worked on the third floor is declared positive. First case official COVID-19.
  • 28 march: official Start of the outbreak (3 patients, and more) ; “segregation” of the story for the doctors and the staff
  • March 30: First case of COVID-19 in “accommodation”
  • 31 march: First death of the COVID-19
  • April 16: All floors of the Jeffery Hale are affected by the COVID-19
  • May 7: 39 deaths, 95 users positive, 94 employees positive
Jeffery Hale: L'éclosion vue de l'intérieur

Infographic The Sun

Le Soleil

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