Emergency room overcrowding at hospitals in Montreal’s east end is the “canary in the coal mine” regarding the lamentable state of the city’s health network, according to the head of the intensive care unit at one of the struggling hospitals.
“Whatever is going wrong in the hospital is going to show up first in the emergency room,” Dr. François Marquis, chief of intensive care at the Maisonneuve-Rosemont hospital, said in an interview Wednesday.
Earlier this week, a group of emergency room doctors at the health authority in the city’s east wrote an open letter to the provincial government regarding the shortage of health-care workers. Exacerbated by the COVID-19 pandemic, the shortages are overwhelming emergency rooms, read the letter published by at least two Montreal news organizations.
Marquis, who was not one of the letter’s signatories, said his ICU normally has between and 20 and 25 beds but is operating at 50 per cent capacity because there isn’t enough staff.
“Right now, I’m struggling each and every day to keep 10 to 12 beds open, so the result is that many surgeries that will require a mandatory stop in the ICU are delayed,” he said, adding that he sometimes can’t discharge patients who improve because there are no beds available in the recovery ward.
The public outcry from doctors comes as the government is trying to catch up on surgeries that were delayed because of the pandemic.
“We’re not in recovery mode because we cannot start the recovery mode,” Marquis said. There’s one COVID-19 patient in his ICU and only a handful in other parts of the hospital, he added.
According to the doctors’ letter, half the nursing positions and three-quarters of the respiratory therapist jobs at Maisonneuve-Rosemont hospital are vacant. The doctors said staff shortages have led to bed closures in other parts of that hospital and at local long-term health facilities, putting more pressure on emergency rooms across the city.
Catherine Dion, spokeswoman for the health authority, said along with the staff shortages, it has given employees time off during the summer.
“After more than a year of sustained and uninterrupted work to deal with the health crisis, the (health authority) feels it is essential to allow its staff to take a well-deserved break during this essential summer vacation period,” Dion wrote in an e-mail Wednesday.
Part of the problem, according to the doctors’ letter, involves mandatory overtime introduced to prevent service interruptions. Forced overtime, they said, has pushed health-care workers out of the public system and into the private health network, which offers better hours and working conditions.
Jocelyn Vachon, president of the professional order that represents respiratory therapists, Ordre professionnel des inhalotherapeutes du Quebec, said there are several factors that have led to the shortage of his members. Workers are leaving the field entirely, moving from the public system to private surgery centres and fewer people are entering training programs, he said in an interview Wednesday.
Like nurses, respiratory therapists have faced mandatory overtime during the pandemic, often because colleagues got sick with COVID-19, Vachon added. He said the government should offer university-level training in respiratory therapy instead of junior college-level training to attract recruits and to ensure they are more competent and confident when they graduate.
Marjaurie Cote-Boileau, a spokeswoman for Quebec Health Minister Christian Dubé, said the doctors are right to be worried but the government is acting after years of neglect.
The government, Cote-Boileau said in an e-mail Wednesday, has limited the health-care system’s dependence on placement agencies and has capped the rates the agencies charge. It is also trying to reduce emergency room visits by investing more in home care and telemedicine, she added.
Quebec reported 75 new cases of COVID-19 Wednesday and no deaths linked to the novel coronavirus for a second consecutive day. The Health Department said the number of hospitalizations dropped by six, to 79, and 25 people were in intensive care, unchanged since Tuesday.
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