A black book to denounce the “miserable conditions in which we are forced to work”

Pocosa met Caroline Dufour, one of the nurses who compiled testimonials from emergency room health workers in Gatineau and Hull. These testimonies were gathered in a black book to denounce the “miserable conditions in which they are forced to work”. Pocosa publishes here this black book and gives the floor to Caroline Dufour who agreed to testify to explain the approach of the group at the initiative of this precious collection …

Where did the idea of the black book originate?

Over six months ago, with the help of management, a committee was established whose aim was to “find solutions to problems”… But nothing has changed, things are progressing too slowly. We are still waiting for changes.

The initiation of the movement to decry extreme working conditions (following the testimony of Émilie Ricard) caused us to reflect on how we could contribute to the process. We made a request in our establishment, the emergency department in Gatineau, for those willing to share their experiences. The response was astounding and we ended up receiving more than 50 testimonials in less than a week! It is only fair to report that in the last 3 years, we have also sustained many cuts…not only in nursing positions but also in support staff. Our goal was to gather evidence in which to present to management by our newly established committee. We did exactly that, and the feedback we received after presenting the status of our working conditions was “ You are all too emotional, the last week has been difficult”.

What argument did management use to refute your criticism?

There were not so many arguments as such, but more denial. In fact, what we understand is that they really work in a risk management mode, in relation to staff with a minimum quota per patient. A quota, that is not even respected! You cannot find replacement staff at 10pm, in a system that already functions with personnel already pushed to their limits.

On the floor, we agree to fend for ourselves. At night, we often accept a staff ratio of more than minimal. It’s really stressful: we know we will not be able to get support in the middle of the night and we never know what cases will happen in the emergency room. We have only 2 nurses in shock room, one in the triage and a nurse assistant head to receive critical cases. A chance that girls help each other and support each other.There is evidence based research that supports the fact that patients are worse during the night… but it is also the quarter where the staff is the more scaled down.

Let’s get back to the black book… Following the response, or there lack of, from the managers the committee received after presenting the testimonials we gathered, we decided to create and share our black book. The aim was to circulate and reach as many as possible. It came to no surprise that, in a short time, our movement caught the attention of the media. It was extremely demanding. In addition to our work, we had to answer questions, give interviews and in a nutshell, respond to our new founded fame created by the media. There is also the issue that many of the personnel are apprehensive as several had already received sanctions in the past or paid a lot for the 1998 strike. It’s hard to mobilize, but we want to struggle for the quality of care and the working conditions of nurses are paramount to guarantee this quality, so we continue.

We are cognizant of what is happening in Hull to create alliances, thereby gaining strength in numbers. The staff there organize sit-ins during their lunch hours and several sit-ins at night, when there was a shortage of staff. There was also a T-shirt that was produced that says “nurses exhausted = high risk of errors” (in the front) and “safe ratio” (in the back)!

A few nurses have been wearing the t-shirts, but it was frowned upon by our managers whose response was to says “it was not even true”. As there are not so many statistics as such that prove how much the pressure has increased, if only at triage, and our warnings are not even considered…and yet…I am an assistant head nurse and I can see how much the nurses’ tasks have become excessively demanding and that we are working with insane quotas. I spend my time running to support those in tears and to take on some of their tasks to help them. Working conditions such as these do not make sense.

We reached out to our union to see if they could help us organize “sit-ins” as we have no clue where to start. We were given some advice as it is considered an “illegal” protest. We also realized that it is not our responsibility to deal with understaffing. It is really the obligation of the nursing coordinator to call the union at change off shift to report understaffing be documented.

You have to know, the situation becomes chaotic! There are a lot of nurses leaving to work up north, as the working conditions are better and they have more autonomy to practice. It is becoming increasingly impossible to provide gratifying care here.

We must be diligent in keeping statistics and proper documentation of these working conditions in order to promote change. Our aim is to publish a black book which includes all of the Quebec hospitals.  We are only at the beginning…