Photo: Graham Hughes The canadian Press
“What the workers live on the ground, it is totally different from what they hear at 13 h” during the daily press conference of the government, ” says Nancy Bédard, president of the Fédération interprofessionnelle de la santé du Québec.
The tragedy that strikes the network of the CHSLD in Quebec comes with many distortions in the chain of command between the ministry of Health, the CISSS-CIUSSS and the institutions themselves, denounced by several speakers at the forefront of the crisis.
“There’s a big difference between the directives of the ministry — or what the prime minister announced — and the way in which things are brought into the field,” says Nancy Bédard, president of the Fédération interprofessionnelle de la santé du Québec (FIQ, which has 76 000 members).
“What the workers live on the ground, it is totally different from what they hear at 13 h” during the daily press conference of the government, ” she said.
It is that between the department and the health care workers, there are the centres of integrated health and social services (CISSS, or CIUSSS), which are at the heart of the delivery of the material or of the management of the distribution of staff. There are also school principals.
Gold, this chain structural faces many difficulties posed by the current pandemic — in particular, the scarcity of equipment and lack of staff.
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But there is more, said Nancy Bédard speaking of ” confusion “. She gives as an example the “instructions not clear from the department” on the question of the resuscitation of patients in respiratory arrest, who leave, she said, ” a lot of blur on the shoulders of the healthcare professionals “. The Duty reported on Saturday that a CISSS to another, the guidelines were not interpreted the same way — a “standardized protocol” had to be routed.
Sonia Mancier, president of the FIQ-P (which represents 1500 workers in the CHLSD private institutes), evokes the case of an employer, ” which continues to move workers from one site to the other, because he has not seen a decree, which prohibited “.
Last Friday, the special adviser to the government for the situation of the elderly, Quoc Dinh Nguyen, said yet want to “prohibit the employment on more than one unit or more of an establishment” to prevent hiv-infected workers spread the virus. But for the time being, the ministerial order, the request to “avoid” this kind of transfer.
“It’s the same thing with the screening tests for the staff,” said Ms. Mancier : to this day, many women have not been tested in institutions ” where the FIQ-P is present.
For some CIUSSS, the process is very complex, it takes time to get in touch with the right person and having the answers that we seek
— Annick Lavoie
Another case raised by Nancy Bédard : the withdrawal of the nurses pregnant. “This is not normal that I have to intervene [with the authorities] every day on the application of the guidelines in relation to the nurses pregnant. […] Me, I can talk to the minister of Health. But there really is a lack of communication between the managers and the CISSS-CIUSSS, there is a gap between the order and what it means or how it is applied. It is a little bit no matter what. “
Director general of the Association of private institutions approved (ECHA), Annick Lavoie believes that the link between the 57 CHSLD members of its grouping and the CISSS or CIUSSS are ” variable geometry “.
“For some CIUSSS, the process is very complex, it takes time to get in touch with the right person and have the answers you seek. Also, the link is fast and well-organized. These differences that we see so many for the transmission of communications of the ministry that must go down as in the responses to requests for additional personal protection equipment [PPE]. “
President of the Fédération de la santé et des services sociaux (FSSS–CSN, which represents 30,000 workers in NURSING homes), Jeff Begley has noticed the same issues in the network. He speaks of a “very worrying situation” that he associates, in part, to the fact that NURSING homes are ” a grain of sand within the CISSS-CIUSSS “.
The ministry of Health reminds us that the CISSS-CIUSSS work in difficult conditions. “The context of scarcity can give to the CHSLD or other partners, the impression of not being prioritized for supplies. The same situation prevails for the human resources support : the needs are many. “
On Tuesday, the prime minister, Legault has not responded directly to a question asking him what he thought about the management of the CISSS-CIUSSS compared to the CHSLD. Rather, it has to be recalled that the lack of staff in these institutions is a known problem for a long time.