2023-07-03 19:30:00
Minors hospitalized at the Joliette hospital for sometimes serious psychiatric problems are currently placed in the pediatric unit, where there are young children and sick babies. Stress, fear, feeling of incompetence: nurses can’t take it anymore and fear for their safety.
“It’s super dangerous,” laments a pediatric nurse on condition of anonymity, for fear of reprisals from her employer.
“It makes no sense, what is happening, reacts Marie-Chantal Bédard, the president of the local union (FIQ) of nurses in Lanaudière. We have employees in psychological distress, who are afraid of patients.”
Listen to the interview with Marie-Chantal Bédard, president of the local nurses’ union in Lanaudière via QUB radio :
no doctor
For several months now, the child psychiatry unit at Saint-Charles-Borromée hospital (Joliette) has been closed, for lack of a doctor on duty. Thus, children and adolescents who require psychiatric care are sent to the pediatric department while awaiting transfer to Montreal.
This delay can take up to a week, according to the nurses. One to three patients pass through this unit each week, according to the Integrated Health and Social Services Center (CISSS) of Lanaudière.
Here are examples of troubling situations reported by nurses:
A hospitalized child had threatened his parents with a bladed weapon. A child ran away from the unit and fled into the hospital. A patient had a razor blade in her cell phone. A teenager slashed his forehead following climbing on the windowsill.
“It took everything for them to be able to put stitches on him, he was super restless. They restrained him chemically and he slept until the next followingnoon, ”cites Ms. Bédard as an example.
“We don’t know what to do, how safe we are or not,” says another nurse. I ended up with a big, burly boy to take his vital signs. He had been hospitalized for homicidal thoughts… How much of a bubble can he have?”
“We are playing with fire”
The nurses also point out that the unit is not suitable for these patients, as medical equipment (such as syringes) is at hand and the doors are not locked.
Corridor of the pediatric unit of the Joliette hospital. Courtesy
“We are playing with fire. At some point, we’re going to get burned,” says Ms. Bédard.
Moreover, the union deplores the fact that these child psychiatry patients do not receive the help to which they are entitled, and that the nurses are not trained to respond to this clientele.
Nurses even say that children are not taken care of by any doctor on file while waiting for the transfer.
“No one came to see the child,” says a professional. I didn’t want to lose my license because I was caring for a child who didn’t have a doctor.”
The union says it has taken all kinds of steps with management, the Québec Ombudsman and the Order of Nurses of Quebec to rectify the situation, without success.
President of the Lanaudière nurses’ union, Marie-Chantal Bédard. COURTESY Marie-Chantal Bédard Courtesy Marie-Chantal Bédard
On this subject, the management of the CISSS had no spokesperson to answer the questions of the Journal.
Support in place
By email, it was replied that “support is in place on the unit to ensure the safety of the admitted patient and other patients on the floor”.
“All of the expertise is used to ensure that the user and his family receive the services they need,” we add. The CISSS did not want to confirm whether episodes of violence had taken place between patients and employees.
In addition, the CISSS indicates that a “rapid intervention team” was recently set up to better respond to behavioral problems. “As soon as a user with this profile is hospitalized, within the following hour, a mobilization of all sectors that can support this user is deployed”, we write.
An assertion denied by the union, which replies that no specialized team is in place.
Next fall, specialized training will be offered to nurses, adds the CISSS. A new child psychiatry unit is also currently under construction in Repentigny.
SITUATIONS REPORTED BY NURSES
A hospitalized child had threatened his parents with a bladed weapon. A child ran away from the unit and fled into the hospital. A patient had a razor blade in her cell phone. A teenager slashed his forehead following climbing on the windowsill.
“It took everything for them to manage to put him in stitches, he was super agitated. They restrained him chemically and he slept until the next followingnoon.”says Marie-Chantal Bédard.
Aid for young people in crisis must be reviewed
More crisis centers for children and adolescents must emerge in order to overcome the shortage of child psychiatrists that is hitting Quebec, believe Quebec psychiatrists.
“We find ourselves making up for the lack of psychosocial resources in general. We find ourselves in the emergency room with crisis situations because people have no other place to go,” underlines Dr. Annie Loiseau, child psychiatrist and spokesperson for the Association of Psychiatric Physicians of Quebec.
“It’s really a lack in Quebec, crisis services available quickly,” she said.
Shortage of doctors
Currently, 54 of the 241 positions available in child psychiatry are vacant in Quebec (22%). In Lanaudière, 5 of the 11 child psychiatrist positions are not filled, according to data from the Ministry of Health and Social Services.
In addition, the demand for services among young people has increased since the pandemic.
As for the situation in Joliette, Dr. Loiseau points out that several hospitals in remote regions must also manage these cases in pediatrics, for lack of a specialized department.
However, trained and specialized teams must be in place to ensure safe care.
“There shouldn’t be any cases of patients without a doctor, it doesn’t have to be,” she says.
When older adolescents (16-17 years old) show violence, it may also be better to place them in the adult psychiatric unit.
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