‘Sans les travailleurs de la santé, il n’y a pas de soins de santé’ : dans le cadre d’un sommet d’urgence sur la COVID-19, les chefs de file du domaine de la santé exigent la prise de mesures immédiates

Transcription

SPEAKERS/INTERVENANTS

Dr./D^r Abdo Shabah, Anick Losier, Dr./D^re Katherine Smart, Tim Guest, Any Guillemette, Touria Izri, Lisa Grant, Jamie Mauracher, Stephanie Taylor, Clara Descurninges

Dr./D^re Katherine Smart

Thank you everyone. And good morning. Before I can begin my remarks, I would like to acknowledge that I'm speaking to you this morning from Whitehorse in the Yukon, on the traditional territories of the Kwanlin Dün First Nation and the Ta’an Kwach’an Council. I make this land acknowledgement with the recognition it must come with action towards real change that honors indigenous peoples as the caretakers of this land we now call Canada. Thank you so much for joining us this morning for the debrief of the emergency COVID summit we held last night in partnership with the Canadian Nurses Association. Given what we've been seeing unfolding in so many parts of the country, there was no question that we needed to come together as healthcare professionals to chart a course of action for responding to this crisis. Our frontline workers are no longer on the brink of exhaustion. They are exhausted. And given that they are not currently getting the support they need, they are also not seeing any hope or light at the end of this very long tunnel. This is clearly unacceptable, pure and simple. The burden of COVID has been placed on the shoulders of the healthcare workforce for far too long. Last night, we heard from over 35 organizations representing nurses, doctors, respiratory therapists, personal support workers, psychologists, education workers, and mental health professionals amongst others. We have a lot of work ahead of us, we urgently need to see action. But we also need to start planning now for the long term. Because once the pandemic is part of history, we will have a legacy of workforce issues. Problems that we have all known existed long before COVID and now are much more serious. Right now we need to see immediate relief to workers and COVID hot zones. This was clear last night we need mobilization and action. We also need governments to start to own the problems and act swiftly. They have a responsibility to citizens to health care professionals and they need to show leadership through action no longer just talk. I want to be clear that the level of burnout amongst healthcare workers is at a level no one has ever seen before. This was a clear consensus last night. There is a pervasive sense of hopelessness driven by a broken system, not by a lack of individual resiliency. Healthcare workers do not feel heard or respected. They work in a system that has been ignored and the responsibility to solve this crisis has been offloaded to them. We need governments to listen to what frontline workers are telling them. We know what needs to be done to bend the curve. 19 months into this pandemic, there is no light at the end of the tunnel. That is why it is so important that we mobilize now and take action. Longer term we need to start actual planning so we can avoid facing such a level of crisis again. But for now we are asking for all levels of governments to come together to stop talking and act to actually bring our healthcare system back to life. Thank you. Merci.I will now hand over to Dr. Abdo Shabah who is our CMA board member in Quebec and will address you in French

Dr./D^r Abdo Shabah

Alors, bonjour à tous et à toutes. Avant de commencer, je voudrais souligner que je me trouve présentement à Montréal, en Territoire Premières Nations non cédées. Je suis aussi conscient que cette reconnaissance de Territoires doit s'accompagner d'action en faveur d'un réel changement pour reconnaître les peuples Autochtones en tant que gardien de la terre que nous appelons aujourd'hui le Canada. Je vous remercie de vous joindre à nous pour un retour sur le Sommet d'urgence sur la COVID-19, que nous avons tenu mardi soir en collaboration avec les infirmières et infirmiers du Canada. Avec ce que nous sommes témoin de nombreuses régions dans le pays, il ne faisait aucun doute que tous les professionnels de la santé devaient se réunir pour définir un plan d'action en réponse à cette crise. Les travailleurs de première ligne ne sont pas à risque d'épuisement, ils sont déjà épuisés et ils ne voient aucune mesure qui pourrait apporter de l'espoir ou de la lumière au bout du tunnel. En fait, c'est inacceptable, purement et simplement. Les travailleurs de la santé portent le fardeau de la COVID-19 sur leurs épaules depuis trop longtemps et hier soir lors d'un sommet tenu d'urgence sur les services de santé à travers le Canada, les représentants de plus de 35 organisations d'infirmières, infirmiers, médecins, personnel de soutien, psychologues, le monde de l'éducation de la santé mentale, ainsi que d'autres organisations de la santé du pays ont pu prendre parole. Nous avons beaucoup de travail qui nous attend. Nous avons besoin de mesures urgentes. Nous devons aussi commencer, maintenant, à planifier le long terme parce qu'une fois que cette pandémie sera derrière nous, nous aurons encore davantage de problèmes de main d'œuvre. C'est un problème qui existait bien avant la pandémie. Aujourd'hui, nous avons spécifiquement trois demandes. Tout d'abord, nous demandons des actions à remédier à la pénurie de personnel. Nous devons nous pencher sur le recrutement, la rétention, la charge de travail et la sécurité des soins et offrir un répit immédiat aux travailleurs dans les endroits les plus touchés par la COVID-19. Puis, nous demandons à tous ceux et celles qui occupent des postes décisionnels, des gouvernements aux conseils scolaires de s'engager immédiatement à mettre en place des mesures de santé publique plus ferme. Finalement, et de façon plus urgente, nous devons offrir notre soutien en fait, en santé mentale aux travailleurs de la santé qui œuvrent dans les pires conditions, qui gardent notre système, aujourd'hui encore en vie. Dix-neuf mois de pandémie et il n'y a toujours pas de lumière au bout du tunnel pour les travailleurs de la santé. Il est temps pour nous tous, de nous unir, de nous mobiliser et nous en avons besoin plus que jamais.

Merci. Thank you. Miigwetch.Je cède maintenant la parole à Monsieur Tim Guest, président de l'Association des infirmières et infirmiers du Canada.

Tim Guest

Good afternoon. I would like to echo the remarks of Dr. Smart in thanking you for joining us for this first joint debriefing. I would also like to acknowledge that I'm honored to live and speak to you today from Mi’kma’ki, the ancestral and unceded territory of the Mi’kmaq people. It's been nearly two years since the first headlines of what we now know to be COVID-19. And since that time, health workers have been at the forefront, providing knowledgeable skilled and compassionate care to those in need. Now, as we're facing a growing fourth wave, and hospitals in many parts of the country are overwhelmed once again, health workers are past the point of exhaustion. We heard from over 35 health organizations, and every one of them agrees that action is urgently needed to support the health workforce if Canada's health system is to remain viable and sustainable for the future. As Dr. Smart outlined, the key actions that were identified by health leaders last night are critical to containing the fourth wave and leading an effective COVID-19 response. It is clear that the solution to this problem is multi pronged. First, we need immediate interventions that address the short term problems of critical burnout, fatigue and understaffing. We also urge all levels of government to immediately provide long term sustainable mental health supports targeted toward health workers. health care workers who feel safe and supported are more likely to stay in the profession and better and provide better care. At the same time, it is also necessary to look ahead to long term solutions such as developing a health Human Resources strategy in conjunction with an appropriate organization to support it, and better data collection to determine where the gaps are. Throughout this pandemic. We have heard by the public praise of the healthcare workers of the care that healthcare workers have provided. Now it is time to care for them. Governments and health organizations must urgently work together to support health workers because without health workers, there is no health care. Thank you.

Anick Losier

Merci beaucoup à nos invités. C'est le temps des questions, tel que mentionné, veuillez soumettre vos questions dans la fonction question/réponse en vous identifiant, de même qu'à qui la question est destinée. Ensuite, nous vous donnerons la parole pour poser la question directement.

Time for questions, you can submit your question to the q&a, please include your name and to whom the question is for. We will then unmute you. So I see that we have already some questions. So let me start with the first one from Jamie, Mo Hatcher. And I'm sorry, if I'm not doing injustice to your last name. What do you mean, when you say relief? What is the immediate solution? So Jamie, over to you.

Jamie Mauracher

Can you guys hear me okay?

Anick Losier

Yes, we can. Thank you.

Jamie Mauracher

Okay, wonderful. I'm just wondering if I can direct that to your president. And I'm just wondering, you're asking for immediate relief. But what exactly do you want that relief to look like? And how can we do this immediately when we're already facing a staffing crunch that that can't be fixed immediately?

Dr./D^re Katherine Smart

Absolutely. I think you've hit on the key point. And I think that was what you've highlighted is why there was such a sense of hopelessness last night. We have really utilized all the health care professionals in the system right now everywhere and there is No one else really is part of our problem. We are seeing things like mobilizing the Canadian Armed Forces and the Red Cross. And that is certainly one strategy to provide relief. Another issue that was discussed last night is removing some of the jurisdictional issues around licensure to allow more mobility of the healthcare workforce, so that we can take people from areas right now that are not as hard hit and remobilize them to parts of the country like Alberta and Saskatchewan that are really in crisis. So that's one short term solution. But I think what was really resoundingly clear is we are here because we have not had a human health resource plan. We have trained and supported to few doctors, nurses and other health care professionals. And unless we address that, in the long term, we are not going to have the solutions that we need. So we really are in an unprecedented crisis. There are no easy fixes. But there are those few things we could take action on now that would at least provide some relief during this phase of the pandemic.

Jamie Mauracher

Sorry, Katherine, can I ask a follow up?

Dr./D^re Katherine Smart

Please

Jamie Mauracher

I'm just I'm just wondering, is this at all realistic? Because I mean, we have been facing, you know, hallway health care and a shortage of staffing Well, before COVID. I know that you you know that. Is it realistic to fix this?

Dr./D^re Katherine Smart

I think the only way we're going to fix this problem is we actually see action and responsibility at the level of government. And that was part of our real frustration last night. I think healthcare professionals feel gaslighted by the government. You know, we have been telling them for years, these are issues, we've been working in an environment of austerity understaffing inadequate resources, but what we see is instead of politicians actually owning this government's owning this problem, they bounce the issue back and forth claiming jurisdictional issues between federal and provincial governments. They keep studying the problem and we don't actually see the problem solved through resources or collaborating with those of us in the field who can see what the issues are and have solutions. So I think the answer to your question is unless we see real actual commitment to action, no, this problem will not be solved. Could it be solved? Yes. How? Listen to those of us who know what the solutions are, actually take responsibility for the problem. Stop bouncing it between levels of government and resource the problem appropriately and in the long term. We could have the health care system that we all deserve.

Anick Losier

Thank you, Jamie. I'm going to en français to Any Guillemette de Cogeco 98.5. Amy, on va te « unmuter » pour un bon français et la question sera destinée à Dr Shabah.

Any Guillemette

Vous m'entendez bien ? Bonjour Dr Shabah. J'avais deux questions pour vous. En principal, j'aimerais ça que vous donniez des exemples, justement, comme on vient d'entendre, d'action à poser à court terme parce que ça peut être très long remédier à tout ça. Les gens sont fatigués maintenant, sont à bout de souffle maintenant, qu'est-ce qu'on fait en premier?

Dr./D^r Abdo Shabah

Vous avez une très bonne question, en fait à court terme, on a vraiment besoin de soutenir les travailleurs de la santé. Sans travailleurs de la santé, il n'y a pas de système de santé et le soutien devrait être sous la forme d'un soutien en santé mentale. Il faudrait qu'il y ait des programmes qui soient déployés par rapport à ces travailleuses et travailleurs qui sont épuisés. Du répit, dans les endroits les plus fortement touchés. On sait qu'il y a une pénurie, mais en même temps cette pénurie risque de s'accroître si on ne prend pas soin des intervenants qui sont sur le terrain. Il faut vraiment adopter des mesures de santé publique plus strictes, plus fermes, pour tout le monde et on dit tout le monde parce que, que ce soit des gouvernements jusqu'aux conseils scolaires ou des entreprises privées, pour éviter qu'il y ait une croissance au niveau des besoins au niveau du système de santé. Donc, ce sont des actions très court terme qu'on peut adopter. Évidemment, il faut reconstruire notre réseau en moyen long terme, mais ça, c'est une construction qui doit être des fondations de la première ligne, soit aux aînés, jusqu'à revoir un peu notre infrastructure aujourd'hui, au niveau des services à la fois hospitaliers et de soins intensifs.

Any Guillemette

En suivi, j'aimerais ça savoir quelle est votre évaluation de l'impact sur la qualité des soins, de cette fatigue extrême des soignants à force de faire du TSO du côté des infirmiers, les heures s'allongent aussi du côté des Doc. Il y a, j'imagine, un impact, est-ce que vous l'avez évalué?

Dr./D^r Abdo Shabah

L'évaluation tangible et ces impacts. Ces impacts sont trop récents pour être évalués à travers les différentes, de différentes façons. Par contre, ce qu'on sait à travers les différents sondages qui sont menés, c'est que l'épuisement il est là et cette fatigue, elle ne fait qu'empirer et la situation aujourd'hui est beaucoup plus grave que ce l'était au début de la pandémie où les gens avaient encore de l'énergie par rapport à des soins qui étaient à offrir à des gens dans le besoin. Donc, dans la situation actuelle, votre question est très pertinente, il faudrait mettre en place des mesures d'évaluation par rapport à la fatigue, mais je peux vous dire que cette fatigue, cet épuisement est palpable. Ça l'existait avant la COVID et ça ne s'est que détérioré durant la période de la COVID, malheureusement.

Anick Losier

Merci, Madame Guillemette. Maintenant, now we're gonna go to Eric Andrew key from the Globe and Mail and a question I'm trying to look very quickly I didn't see to who the question was addressed. But perhaps, Eric, you can let us know.

Touria Izri

Hi, thanks. Can you hear me? So this is directed to all three of you if possible. There are 1000s of medical workers across Canada who remain unvaccinated and in several provinces that's going to result in those workers being suspended without pay sooner rather than later as soon as October 15. In Quebec, I'm curious what you think can be done to encourage vaccination among the minority of your members who were not vaccinated and what preparations governments should be taking to prepare for the the increased labor shortage that this these suspensions could create?

Anick Losier

If I may, I'm gonna direct the question first to Tim Guest because he hasn't had an opportunity to answer and then perhaps we'll move to Dr. Smart.

Tim Guest

Thank you for the question. I believe the first thing that needs to happen is you need to understand why the individuals are hesitant to have the vaccine and actually have a conversation with them and provide them information to deal with that hesitancy. And we've believed that right from the start. We also believe that the vast majority of health workers have been vaccinated. But our biggest problem is we don't know because no one actually has the data.

Anick Losier

Thank you, Mr. Guest. Dr. Smart?

Dr./D^re Katherine Smart

I would echo what Tim has said. I think it's really important within all Canadians who are not yet vaccinated, including healthcare professionals to understand what's leading to that hesitancy. Once we know within individual organizations and provinces who the unvaccinated health care professionals are, then I think targeted interventions can be put in place to address their concerns and hopefully encourage them towards being vaccinated. I think it's never going to be possible to achieve 100% vaccination rates, you're always going to have people that choose not to be vaccinated. But I think that there is a lot of work we can still do to make sure that our messaging is culturally appropriate. It's accessible, it makes sense to people and that their concerns are addressed. And also to echo what Tim said, I think it's important to realize this is a very small number of people, that by far, the vast majority of healthcare professionals are supported vaccination and have already been vaccinated.

Anick Losier

Because the question was asked to all three of you, Dr. Shabah would like to give you the opportunity as well?

Dr./D^r Abdo Shabah

Well, it's a very relevant question. Thank you for asking. And I think there is no reason to with the actual system or the healthcare workers are already under stress, to have some other health care workers to become sick and we know that the vaccination is the keys so it's really to protect them and to protect all the patients that the vaccination the mandatory one that the one you were specifically talking about Quebec and there's the date of the timing of the 15th of October so this clearly is a public health recommendation should be maintained and we want to protect those health care workers and we should address as was mentioned previously, my colleagues as what are the reasons behind and try to convince them that being said, we need to protect the patients also and this is the most important part.

Anick Losier

Dr Shabah, est-ce que je peux m'imposer et vous demander de la répondre en français aussi?

Dr./D^r Abdo Shabah

Définitivement, alors par rapport à la question qui est la date butoir du 15 octobre pour la vaccination du personnel de santé. Il est critique que l'ensemble du personnel soit vacciné pour leur sécurité en fait. On ne peut pas tolérer qu'il y ait des professionnels de la santé qui tombent malades et surcharge notre système de santé ou contamine des patients qui de leur côté cherchent des soins sécuritaires. Donc, il est impératif que l'ensemble du personnel de la santé, tous ceux qui sont en contact, tous ceux qui sont dans ces services soient vaccinés pour protéger les patients et protéger le système.

Anick Losier

Merci beaucoup Dr Shabah. Next question, en français aussi, alors.

Touria Izri

Sorry. Just sorry, Eric. Sorry. Just a quick follow up and there was a there was a two part question. So this and then on the second part about what governments can do to prepare for the way in which suspended health workers will contribute to the labor shortage in the health system in Quebec. We estimate that 20,000 health workers, including 10,000, who interact with patients are will not be vaccinated by the deadline. What should governments what should health networks and hospitals be doing right now to prepare for, for that labor crunch?

Anick Losier

The Eric, just to clarify, would you like Dr. Shabah? Dr. Smart to answer this second part of the question?

Touria Izri

Maybe both if they if they both have thoughts on it, but maybe we could start with Dr. Shabah?

Anick Losier

Dr. Shabah.

Dr./D^r Abdo Shabah

Thank you very much for the question. I think there is multiple things that can be done to prevent further stress on the healthcare system. First of all, we need to recruit more healthcare workers, especially for the areas which are most in need. Some areas are more difficult than others. And also what we can do is to really bring quickly some kind of support to the healthcare workers that are staying on in the field. So I think by supporting those who are already vaccinated, that are trying to support the healthcare system, and by maybe we're adjusting and training new health personnel evidence, short term, this can have an impact. So we understand that this is something critical for the healthcare system. But we cannot afford to lose more healthcare workers because then becoming sick or affecting the patient. So we really have to stick to the public health principles. This is science, not politics. And we have to make sure that what the healthcare system is sustained and the patients are protected.

Anick Losier

Thank you, Dr. Shabah. Dr. Smart?

Dr./D^re Katherine Smart

I would definitely echo Dr. Shabah's comments. I mean, I think there's no question there's no easy solution to this issue. And right now we do have a manpower issue and losing more health care professionals is going to be challenging. But I also think we need to recognize that these vaccine mandates are necessary to keep the system functional in terms of safety of the professionals working in it. And most importantly, our health care professionals are part of the our patients who deserve to have safe health care. So I think there's likely going to be some short term pain for sure that governments are going to need to work collaboratively to mobilize and deploy and perhaps redeploy the staff they have to cover potential shortages plan for this in the long term. But I think we need to acknowledge in the long game of COVID these mandates are going to be critical to keep our public infrastructure safe and operational.

Anick Losier

Thank you, Dr. Smart. We'll keep you there because we have a question from CTV News in Edmonton from Touria. She wanted to hear from both CMA and CNA on the Alberta example Touria. Over to you, we'll start with Dr. Smart.

Touria Izri

Okay, good morning, Dr. Smart. Um, you know, obviously, Alberta is probably the hardest hit province in the fourth wave. I'm just wondering what you heard last night from health workers who work in Alberta, or were organizations that represent Alberta, just about the frustration and fatigue they're feeling at this point, you know, 19 months in, or perhaps 20 months in now into the pandemic?

Dr./D^re Katherine Smart

Thank you for that question. Certainly, we definitely heard last night the real level of despair amongst healthcare workers in Alberta. And I think one of the biggest themes we heard coming out of that province for really two things, one, the lack of politicians taking accountability for the state of the health care system and acknowledging where we are in Alberta and why we are there and actually committing towards action to bend the curve in that province. And secondly, was really feeling like there's a lot of gaslighting happening in Alberta. You know, we're hearing talks of oh, ICUs are at 84 - 90% capacity. But what hasn't really been acknowledged fully in a transparent way to the public is we know that many of those beds they're saying are available are not actual critical care beds. We know that when we look at what capacity they're at right now, it's really about 180% capacity of what's actually stopped critical care spaces. So yes, beds have been opened up, perhaps the monitors been attached to them, but there are not the staff available to care for those patients at the standard of care, we would expect typically in our ICU environment. We do not have critically care trained physicians or nurses available for those patients. So I think one of the real things we heard And the theme last night is health care workers want our leaders to be honest. They want them to acknowledge what they're hearing from frontline workers. They want them to tell the truth about the situation and be fully transparent to the citizens of this country, and especially in the provinces of Alberta and Saskatchewan, and take some ownership towards why we find ourselves where we are. Mr. Guest.

Tim Guest

Thank you. I completely agree with with Dr. Smart’s, comments, and don't want to reiterate what she's everything she said. But I would add a couple of specific points. We certainly have heard that the health workforce is extremely demoralized, in Alberta and they are on the brink of collapse, just like other places in the country. And they need to be supported. And we've also heard that they're afraid to walk in and out of work from their cars, that they feel that they're going to be accosted by the public. And we just can't have those additional stressors on a workforce that's already challenged to provide service. And so I would add, that that element is also a factor that we've heard is happening.

Touria Izri

Just a follow up, did you get a sense at all, that there was some relief that there are reinforcements that had arrived? Or is it that you know, at this point, help from the Canadian Forces or the Red Cross? I mean, it's, it's not enough to make a dent, we really need a fire break or something a little more drastic, I guess both of you can answer whether that came up.

Dr./D^re Katherine Smart

It did come up. And what I would say is I think, you know, certainly people are grateful that the help has been accepted and that there's been an acknowledgement that the healthcare workforce, as it stands in Alberta is not able to cope with what's happening. Obviously, the numbers of people coming to provide relief or not enough to offload the entire system. And I think part of the messaging that we were hearing last night is again, we need acknowledgement from the government that this is a band aid to the problem. The problem is that they are not taking action to bend the curve in terms of COVID in the fourth wave, unless we see political action aimed at more aggressive public health measures, including things like the firebreak to actually bring those case counts down. The health care system will remain in crisis. And you know, certainly that relief is welcome, but it is not the solution.

Anick Losier

Thank you, Dr. Smart. Tim Guest, Mr. Guest sorry.

Tim Guest

I would add that we did hear that there are municipal leaders in Calgary, Calgary as an example who who've come out and spoken about the need to do more. We've also heard about other organizations, such as school boards that are looking at actions that they need to do in order to protect students and the public and do their part. And the other thing that we heard from individuals last night is that we need to do more to encourage the public in those two provinces to be vaccinated. What we're seeing is that their vaccination rates are lower than the rest of the country and that is a factor and the more individuals that choose to be vaccinated and follow public health measures, the sooner we will be able to deal with this issue and get to the other side of it, but the longer we continue to pretend that there isn't an issue the worst that is this is going to get.

Anick Losier

Thank you, Mr. Guest. Nous avons une question en français de Clara Descurninges de la Presse canadienne. Clara, je suis désolée pour ton nom de famille. Alors, c'est au Dr Shabah.

Clara Descurninges

Oui, donc, je voulais savoir en terme de recrutement et de rétention et même de ramener du personnel de la santé, ce serait quoi vos recommandations à faire au gouvernement pour amener de gens à vouloir rentrer dans le système ou à y rester ?

Dr./D^r Abdo Shabah

Excellente question. En fait, c'est qu'on regarde un peu le court terme. Il faut vraiment essayer d'amener du soutien sur le terrain. Ce soutien, donc du répit dans les endroits les plus fortement touchés. Ça aide les gens un peu à comprendre qu'on tient à ce système-là puis il y a un investissement qu'on voudrait faire dans un système, qu'on voudrait le remettre sur les rails et ce soutien devrait être aussi en forme de santé mentale. Donc, tout ce qui est : on soutient en termes de santé mentale, c'est extrêmement important. Définitivement d'adopter des mesures de santé publique plus fermes. Ça amène les gens à se sentir en sécurité, d'être protégés au sein du système, mais au-delà de ça, c'est vraiment des investissements massifs dans le système pour essayer d'amener de nouveaux programmes, d'amener, de reconstruire la première ligne parce qu'actuellement, il faut se l'avouer, nous avons dépassé le système des solutions rapides. Les travailleurs de la santé, aujourd'hui, ne font que maintenir un système dont la fondation est fissurée depuis de nombreuses années, mais qui est aussi sur le point de s'effondrer. Donc, il faut, on y tient à notre système public, au niveau du système de santé et il faut un engagement collectif pour éviter cette situation malheureusement. Donc, toutes les mesures de santé publique et tous les engagements qu'on peut amener en termes financiers pour reconstruire le système, ça va être quelque chose qui va redonner confiance aux travailleurs pour revenir dans le système public.

Clara Descurninges

Question suivi, je sais que ça fait peut-être déjà un certain temps, mais disons des initiatives comme celle du gouvernement du Québec, qui voulait donner une prime aux infirmières pour rester ou revenir, ou faire de la rétention. Est-ce que c'est dans l'image de ce que vous chercher ou pas du tout ?

Dr./D^r Abdo Shabah

En fait, le soutien au niveau des travailleuses et travailleurs au niveau de la santé est toujours apprécié. Ce qui est donné comme soutien au niveau des infirmières, clairement, c'est un pas dans la bonne direction. Par contre, ce n'est pas suffisant. Quand on regarde les demandes au niveau des infirmières et infirmiers, du moins au Québec, c'est par rapport aux conditions de travail. Donc, on regarde au niveau des horaires, du temps supplémentaire obligatoire. Il y a également aussi au niveau du ratio patient, professionnel. Donc, il faut aborder le problème dans son ensemble et il faut trouver des solutions. C'est un pas dans la bonne direction, mais il faut en faire beaucoup plus et il faut investir massivement dans la réorganisation de nos services de santé et c'est ce qui va amener les professionnels à y croire davantage et à contribuer encore plus.

Clara Descurninges

Merci. 

Anick Losier

Merci, Clara. We turn to the Canadian Press with Stephanie Taylor. Stephanie, thank you for waiting and being patient. And I'm not sure what your question was addressed to but perhaps you can let us know. There. Can you hear me? All right. Yes, we may we can.

Stephanie Taylor

Okay, this I would say is it's likely for Dr. Smart and Mr. Guest. And when for the call of we need immediate relief. What is behind that is it the matter of there is just no more, there is simply not enough hands to do the work that needs to be done is the fact that those that can do the work are simply burnt out and themselves under a lot of kind of emotional physical strain like what is what is kind of behind this call at this point.

Dr./D^re Katherine Smart

We are hearing clearly that there is just not enough healthcare professionals to provide care and what that looks like you know, if you're wanting to kind of be go inside a hospital, what's actually happening is nurses are on shift where there is no one scheduled to take over from them at the end of their shift. So they're it's unclear to them what nurse is going to be coming in and looking after that patient. What that leads to is things like mandatory overtime, and people being asked to work things like 18, 24 hours at a time to continue to provide care, people being denied any ability to take any time off. So these are the things that contribute, of course to burnout when you are understaffed, unable to work reasonable work hours be mandated to stay past the end of a very grueling shift to have see no relief on the horizon. These things are not sustainable, and they've been going on for a long time with no real solutions coming. And then for the physician side of it, of course they depend on the nurses for the work they do. You know, Tim and I both commented throughout this, we are so grateful to be able to collaborate with each other, because we are integrated in the way we provide patient care. So physicians are also not able to deliver on the standard of care they would normally provide their patients when the nurses they're working with are not the nurses that are trained to be in those areas. And that's another huge issue. We heard nurses being redeployed from non-critical care areas to provide care they're not trained to provide. So you're having nurses from medical floors, neonatal ICU is being asked to provide care and advice to us to critically ill adults, this is not what they do. So there's a huge amount of stress that comes from being overextended in that way and then again, that moves on to the rest of the team who's now working with providers who aren't normally in those areas and don't have the skill set. So it's all those levels is really what we're hearing and that's why it is such a such a crisis is there's no end in sight. And I think the other thing we're really hearing is that these healthcare professionals don't feel that the government is really acknowledging where they're at. We're hearing a lot of platitudes a lot of over everything's okay over increasing capacity. But that's not what's actually happening for people that are living on the frontlines of this pandemic. And they want the government to acknowledge the truth of what the situation really is.

Anick Losier

I'm going to turn it to Mr. Guest.

Tim Guest

Thank you for the question. I would agree with Dr. Smart the primary reason why this has become such an issue for us is that we're hearing so much from the workforce, that they are nearing the end of their ability to cope. And, and their only resolution that they see to this is to leave the profession, and to go and do other types of work. We hear a lot in the media about needing to recruit and recruit and recruit, but we don't hear about what we need to do to retain what we have. And there the system has no ability to be viable going forward, if we don't retain first and then recruit after our focus has largely been in the wrong place. And I think I would also agree with Dr. Smart, we hear from the health workers that they hear what people say in the media when they're interviewed. And the story that goes to the public is nowhere near what their lived experience is. And they find that incredibly frustrating. And I think they want the public to really know what they're currently working in. The conditions are significant. They're working huge amounts of overtime. They have huge workloads, some of them twice what would normally be the case, they believe that they're giving some instances substandard care, which also wears on them. And they think the public deserves more.

Anick Losier

Thank you so much, Mr. Guest. Stephanie, did you have a follow up?

Stephanie Taylor

I did. You. Yeah. And you talk about multiple the there's a responsibility for multiple levels of government. But I'm wondering if Mr. Guest and Dr. Smart if you can speak to what role specifically you think the federal government has? Because as we see the crisis in Saskatchewan and Alberta? I mean, the provincial governments there took the directions they did they lifted public health orders, they sent the messages they did so I think a lot of people would see that largely, perhaps the responsibility falls to the provincial governments. In those cases, however, what do you think the federal government can do now?

Anick Losier

Mr. Guest, did you want to start?

Tim Guest

Sure. You know, and we heard a lot of examples about this last night, but I think the first thing that federal government needs to do is provide an adequate level of funding for the health system, they are a partner with the province in the delivery of health services in our country. And that's one of the areas where they can play a role. Another area that we believe that the federal government can play a role is with respect to data. We heard that example many examples of that in our discussion last night is that we have huge data gaps where we don't know how many resources we have, we don't know where they are, we don't know where the gaps are. And they can play a significant role in resolving that issue going forward, where we can have really solid national statistics about what our workforce is where we anticipate future problems to be and that we can have a better plan going forward to address it. So we don't find ourselves in this situation again.

Anick Losier

Thank you, Mr. Guest. Dr. Smart?

Dr./D^re Katherine Smart

Absolutely echo Tim's comments. And I think the other thing that's important to understand and what we were hearing last night is I think people are really tired of healthcare being the political hot potato that's passed between levels of government, you know, the federal government, blaming the provinces, the provinces, blaming the federal government, and no one actually stepping up owning the problem stating what it is and showing the leadership to move forward. We have seen the federal government before take action on issues of national importance, an example of which would be medical assistance in dying, or the federal government took the lead and provided a framework with the they could be doing the same thing in response to the COVID pandemic. I think that's really what people want to see is that leadership, you know, it's frustrating, we have pulled together this group of people, we've reached out to the government. And we what we aren't seeing is a desire or communication back from them in a willingness to collaborate with us around solutions. And I think what health care workers want right now is they want to be in those conversations at the federal level at the provincial level, we've made ourselves available, and we're really just waiting for the government's different levels of government, including the federal government to reach out to us to help us solve these problems. They've been given a new government a new mandate to move forward. And we know from our work that nine out of 10 Canadians feel that health care and solving the healthcare problem is of importance to them. And what we need now is the federal government to actually take that action.

Anick Losier

Thank you so much. I know we're over time and we're happy to stay as long as you like. Having said that, we have three more questions. Madame Guillemette si ça ne vous dérange pas, j'aimerais donner la parole à Lisa Grant, ensuite Caitlin Thomas du Montreal Gazette et ensuite vous revenir, est-ce que ça vous va? Je ne sais pas si… Wendy, if you can unmute Madame Guillemete de Cogeco.

Any Guillemette

Pardon oui, je n'ai aucun problème. Je voulais juste avoir la version française du fait qu'on se blâme les uns, les autres.

Anick Losier

OK, on vous revient là-dessus. Okay, over to the next person on my list here is Lisa Grant from 660 City News in Calgary. Lisa, over to you. And please let us know who you would like to answer the questions.

Lisa Grant

Good morning. This is for Dr. Smart. Do you guys hear me? Okay. Hi, I'm Hi again, Dr. Smart, how much more help is actually available through the military and Red Cross? What else have they got to give us?

Dr./D^re Katherine Smart

It's a great question. And I don't know those specifics in terms of numbers or who else could be deployed. So that would be an excellent thing to find out from the federal government. So I think that's one solution. I think the other issue is removing some of the barriers that we have to licensing in this country to allow other health care professionals to be mobilized. We've seen offers from Newfoundland that I think have finally been accepted. And there are had there been offers from other provinces as well, like Ontario, where things are better right now, where there are health care providers that are willing to redeploy to harder hit areas, but we have barriers around licensing that prevent that. So I think that's another place we can see some federal leadership is let's remove in this emergency some of these jurisdictional issues so that we have more mobility of our health workforce, that we're not bound up in bureaucracy when we need people on the ground.

Anick Losier

If I may, again, we'll pass the microphone to Mr. Guest.

Tim Guest

I would add that one of the things that we've heard a lot from workers is there's a pretend pretending situation that we have capacity in the system that we don't have. And there's really a need to right size, what services and capacity we can operate to match the resource that's available. And that would take us to a significant pressure off of the existing workforce, knowing that they're coming to work with reasonable workloads that they can expect to have someone to replace them at the end of their shift. And that they actually will be able to go home of continuing to have this situation where their work environment and their work experience is so unknown is creating such anxiety for them that we are at such risk of them leaving the health workforce in the situation becoming even more dire.

Anick Losier

Thank you so much, because I gave everybody else a follow up question. They said, Would you have another one?

Lisa Grant

I would please. How'd you know that was going to happen? Thanks very much. How do you guys feel about having to resort to this and unprecedented national summit, because some governments don't appear to be listening to health professionals and appear to be waiting for things to get worse before they finally take some action.

Anick Losier

Start with Mr. Guest and then we'll move to Dr. Smart.

Tim Guest

I think our colleagues expect us to act they've been telling us for a while that they don't feel that they've been adequately, adequately heard, and that there's been a need for us to pass their voice on. I also believe the public have an expectation for us to support them and to be their voice and to advocate for them to see this issue dealt with.

Anick Losier

Dr. Smart?

Dr./D^re Katherine Smart

You asked, you know how do we feel? I think we feel devastated to be in this situation. And the other thing was really hopelessness that what is happening in the world when we have governments unwilling to listen to the people doing the job, you know, how have we come to this point where there's such a disconnect from the people who actually know what is happening, that are there 24 hours a day, 365 days a year providing the service and being told by politicians that what they are seeing and experiencing every day is not what is happening. And that's why we felt the need to pull everyone together to come together with a united voice. And as Tim said, to really make clear two things: one to our health care colleagues, we see you we believe you and we are bearing witness to your suffering; and number two, we are coming together to advocate on your behalf to call out government to say we see you too and what you are choosing not to do, the truth you are choosing not to tell and we really call on all Canadians to back us, and let's move forward together to get the system back where it needs to be and meet the needs of Canadians in the way they deserve while supporting the health care providers who are there and want to provide the standard of care that they're trained to provide.

Anick Losier

Puisque c'est tellement une question importante, j'aimerais apporter Dr Shabah et nous donner une réponse en français et ensuite, Dr Shabah, on va demander à Any Guillemette de répéter sa question sur la patate chaude parce que je veux l'entendre dire et ensuite on passera à Caitlin Thomas.

Dr./D^r Abdo Shabah

En fait, est-ce que c'est pour la question par rapport à la responsabilité des différents paliers de gouvernement?

Anick Losier

Comment on se sent que d'avoir eu à aller aussi loin que de faire un sommet d'urgence sur la question qu'on a abordée hier?

Dr./D^r Abdo Shabah

Écoutez, les travailleurs de la santé travaillent aujourd'hui jour et nuit dans des conditions de plus en plus difficiles. Je dirais parfois désastreuse et ça depuis déjà 19 mois et aujourd'hui ceux qui travaillent en première ligne et en deuxième ligne voient des décès inutiles, des patients très malades et d'autres qui n'ont pas pu obtenir des soins et c'est inacceptable et c'est pour ça qu'il y a eu un sommet sur la santé. Plus de 35 organisations de travailleurs de la santé de tout genre se sont réunies pour discuter de la crise à laquelle nous sommes confrontés. Par rapport aux différents gouvernements, il faut cesser de se blâmer, de se lancer la balle parce qu'à ce moment-ci au pays, les travailleurs de la santé ne font que maintenir un système où la fondation est fissurée et sur le point de s'écrouler. On doit arrêter de politiser les soins de santé. Tous ceux et celles qui sont impliqués, au niveau comme professionnel, voient le système très vulnérable ou carrément affecté et les responsabilités de chacun des paliers de gouvernement doivent être assumées. Voilà, donc les travailleurs de la santé ne devraient pas se sentir abandonnés ou désespérés parce que sans travailleurs de la santé, il n'y a tout simplement pas de soins de santé.

Anick Losier

Merci beaucoup, Dr. Shabah. Madame Guillemette, est-ce que ça répond à votre question de suivi?

Any Guillemette

Oui, ça répond effectivement à ma question, merci beaucoup Dr Shabah. Merci.

Anick Losier

Merci Madame Guillemette. Now we have Caitlin Thomas from the Montreal Gazette. She says she's not able to unmute, but let's try. And she has a question for I think the group. Let's see if Caitlin Are you able to provide? You can try. Are you unmute? No, I can I can ask the question if you'd like our stricter public health measures necessary everywhere, for example, in Quebec, where there is a vaccine passport? If so, what kind of measures are we talking about? We'll start with Dr. Shabah, followed by Dr. Smart and and Mr. Guest.

Dr./D^r Abdo Shabah

Thank you for this important question. What I can, what you can say is that actually, measures that are put in place are critical to sustain the healthcare system. And it's important to keep the same effort and even make it greater in some areas in terms of vaccination efforts and exchange vaccination passport. With the opening of the economy, we have to be extremely careful and with the return of all the students back to school, in creating the spread of the virus might become even worse in the next few weeks. So we have to be extremely careful, we have to enforce those measures and we have to maintain the support to the healthcare workers in the healthcare system. So we're talking about the same thing: vaccination, public health measures and the vaccination passport, that all those measures should be kept and reinforced in all areas. For that to be able to sustain the health care system.

Anick Losier

Dr Shabah, est-ce que je peux vous demander de répéter en français, quel genre de mesure sanitaire plus stricte, nécessaire au Québec par exemple.

Dr./D^r Abdo Shabah

Les mesures aujourd'hui au Québec qui sont en place, sont requises, sont en fait, essentielles pour le maintien de notre système de santé. On parle de toutes les mesures qui ont été amenées par la santé publique, le port du masque, un peu la distanciation, tout ce qui est également du passeport vaccinal, de tout ce qui est au niveau de la vaccination. On amène de plus en plus, on voit une ouverture au niveau de l'économie et ça peut amener une croissance ou une augmentation au niveau du nombre de cas, le retour à l'école, l'ouverture au niveau des salles de spectacle, sont tous des éléments qui peuvent venir débalancer un système qui est très vulnérable actuellement. Donc, il est extrêmement important de maintenir ces mesures, de les renforcer et de soutenir le système de santé qui est actuellement bien à risque.

Anick Losier

Merci, Dr. Shabah. Dr. Smart over to you. Did you want me to repeat the question? Oh, sorry.

Dr./D^re Katherine Smart

Yeah, I think I'm okay, thank you. I think it's really important to acknowledge that the COVID situation is very different across the country, and I can appreciate for public health professionals, it is challenging because it isn't an evolving situation. So it's very clear that we have parts of the country like Alberta, Saskatchewan, New Brunswick, where things are really spiraling out of control and the need for stricter public health measures is key. In other parts of the country, things are going better with the restrictions that are in place. I think what we have learned from Alberta and Saskatchewan is that we have to be cautious when reopening and moving forward and not lift all measures at once. So you know, what do we need? We need absolutely vaccine mandates to get as many Canadians vaccinated as possible. We need a functional National Vaccine passport or certificate. You know, we've been talking about this for months. It's not complicated. It's unclear why that solution is not yet available for Canadians to make public spaces safer. We need to stay the course on many public health measures. And we need to be reactive to situations, that as they evolve to make sure we're increasing public health mitigation strategies in certain areas that aren't doing well. And keeping simple things like masking in place as much as possible so that we can prevent COVID from spiraling out of control and more parts of this country. So, I think we need to stay committed to public health. I think Canadians need to stay patient, that this is not going to be a situation an all or nothing situation. And we need to be fluid and adaptable as things evolve and change.

Anick Losier

Mr. Guest? Thank you, Dr. Smart.

Tim Guest

Thank you. I would add that I think the important thing that we've seen across the country is taking measured approaches to how we reduce public health restrictions. And understand that there's no negative consequence of them before we remove more making decisions based on science and not politics. And putting in place measures in a reasonable period of time when we see the numbers climbing, where we've seen significant problems or in jurisdictions where they have not acted fast enough. And then the issue has gotten out of control and where we're at currently what we're seeing in in Alberta, Saskatchewan now, you can look at other provinces that have taken a very different approach and, and have not had the same outcomes. And so I think we need to continue to follow science and make the best decisions that we can, of following the guidance of public health and acting very quickly.

Anick Losier

Thank you so much, Mr. Guest. I'm going through the question I don't think I forgotten anyone, going to do one last call. Last call is done. Merci beaucoup à tout le monde pour avoir participé. Thank you so much. In the chat box, we are putting the contact information should you have any more media requests for interviews, one on one or other questions. Both the teams at the CNA and the CMA are grateful for your participation today and happy to help throughout the day. Merci beaucoup à tous. Les coordonnées pour les équipes médiatiques de l'AIIC et de l'AMC sont maintenant dans la fonction « chat », si vous avez besoin de quoi que ce soit dans l'après-midi. Alors, je termine cette conférence de presse avec un remerciement à nos invités, Mr Guest, Dr Shabah et Dr Smart. Mr. Guest, Dr. Shaba et Dr. Smart, thank you so much for your insights and thank you for everyone for participating. Bon journée.