Amid Green party leader Annamie Paul’s latest demands to convene a meeting of First Ministers to agree on an urgent action plan to address the humanitarian crisis unfolding in long-term care (LTC) facilities across Canada, and after the controversy, protests, and constant complaints about the conditions in Maimonides Geriatric Centre in Montreal, Global Green News talked with Jane (the name is changed upon the person’s request), one of the health workers in the center, on January 16th,2020, to discuss the situation at the center:
Current situation
Q First of all, how would you describe the situation in the center today?
There are many infected cases, but we also should consider that the center has over 300 residents. The cases are going up by approximately 2 cases a day. Everyone is working to contain the spread as much as possible. There is a wing specifically customized for Covid–19 patients, and they have personnel assigned exclusively to that area, so the staff does not move between zones, but I feel like the nurses are overworked. Also, because there are not enough nurses, the work is not being done as it should. Health care professionals need to do much work to analyze and adequately adjust the residents’ treatments globally. However, most of the patients deemed stable are monitored for day to day needs, and only a few of them receive proper follow up for chronic conditions such as hypertension or diabetes. Such a lack of thorough follow up is caused by the lack of staff.
Staff
Q A post on the Montreal Gazette website from November 25th, 2020, reads that: “two days after insisting that the COVID-19 outbreak at the Maimonides Geriatric Centre was under control, officials were scrambling on Thursday to control the contagion amid a rising death toll and a shortage of nurses”. Do you think the center is still suffering from a shortage of staff?
Staff is definitely not enough. Nurses used to work eight-hour shifts, but now they are working twelve-hour shifts. They are doing 7 to 7. They are overworked, and because of that, the work is now sloppier. Also, when they had the 7 to 3 shifts, there was always a day nurse available. A day nurse is a person who would actually allow you to have a follow up on your patient, but now because of the shortage of staff, the day nurse is only there for a couple of days a week, so one does not have access to her all the time, and it is hard for her to keep informed on what is happening to her patients while she is gone. Also, because the staff does not necessarily document everything in the progress notes, they would not always know what happened. Versus when the nurse was there five days a week, it was much more efficient.
Q So, how many active nurses do you have during the day?
During the day, there is one registered nurse for each wing, so 2 for the floor. The thing is, every time I would need to discuss something with a registered nurse, I could not find anybody. I can hardly find them.
Q– How many doctors are there?
There are two doctors assigned for every floor, but the doctors are only there once a week. So basically, there are no doctors on most of the days. There is, of course, always an on-call doctor for emergencies.
Q Officials in the center denied to the Montreal Gazette that staff was working in multiple wards or that some infected residents were transferred to Maimonides from other nursing homes. Any comments on that? Are nurses working multiple wards?
I do not think so because there is a high risk of contagion. Although the problem is, since the center is short-staffed, there is always a nurse who is replacing another nurse. So, when this happens, I am pretty sure they come from another ward. So, it is probably to some degree that nurses work multiple wards, but they stay on it when they are assigned to a floor. They wouldn’t move between floors. They also have the clinic testing, so, technically, staff should be getting tested. The clinics are open every day from eight to four so that one always has access to testing. However, every time I pass by, I see nearly no one getting tested. Some people I know in the center try to get tested once a week, but since it is not mandatory, most people would only test when they suspect they might have Covid. That is probably a reason why the staff has a high rate of infection.
Complaints about the care conditions
Q Some family members of those who live at Maimonides insist that staff shortages, especially among patient attendants, are more acute after hours and on weekends. One family member asked, “If they have enough [attendants], why are residents sitting in soiled diapers?” Are residents getting the care they should be getting?
It is hard to say. However, since there is so much work to be done, it is hard to track down the responsible nurse on the floor. For instance, there was one patient recently with multiple comorbidities and quite frail in his health condition, but he was not immediately taken in charge upon his arrival, and I could not discuss his condition with the auxiliary nurses who were available. When I need to discuss a matter, I can barely find anyone, and I have to try numerous times before I can find someone to talk with.
Vaccination
Q How many staff members were vaccinated?
80% of the nurses are vaccinated. Now, they stopped the process because they have run out of doses. They stopped at 80 %, so the cooking staff, for example, didn’t get vaccinated because they were not deemed a priority.
Q Is there anything else you would like to add?
Yeah, I must say that these are problems that we are facing here in the center because of the difficult situation we are in, but people are working their maximum here in the center and are giving their best. Sometimes when you hear reports in the media, I feel they are a little biased, and they forget to mention the real logistical and organizational problems we are facing, and they focus on blaming the staff. We must remember that this is a significant center, and it is, actually despite all the problems it is facing, doing better than many other private and public LTCs.
Update
On Wednesday the 27th of January, the leader of the Green party of Quebec, Alex Tyrell, commented to Global green news on the interview and said: ” This is the exact sort of thing that led to thousands of preventable deaths in long-term care facilities during the first wave of the COVID pandemic. Over the years, neoliberal austerity measures, cutbacks to healthcare spending, and a refusal to attract new nurses to the profession by improving working conditions has pushed our healthcare and long term care facilities to the breaking point. These problems will persist far beyond the pandemic if significant changes are not made quickly. As a society, we are failing to act. We are failing patients, healthcare workers, and the most venerable members of our society.”
The answers to the interview questions were not edited for content.
Global Green News have tried to contact the Media Relations department of the center, but did not receive an answer.
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