Nursing shortage, a public health problem

For several months (even years), we have not counted the articles, chronicles and other investigative files describing the appalling working conditions of nurses and other caregivers in the health network. The causes of the current “shortage” of nurses have been known for a long time: misuse of compulsory overtime (OST), work-family-study balance practically impossible, dehumanizing management of the network, wages not competitive with in the private sector, etc. Thus, the salary and administrative adjustments recently proposed by the CAQ government are a step in the right direction. However, this measure takes only one part of the equation into account and omits a key factor influencing service delivery, namely the general health of the population.

Let us first mention that several other possible solutions have been stated many times by stakeholders in the field and other experts in the field: gradual abolition of OST, moratorium on private health placement agencies, reduction in patient ratios by nurse, permanent salary increases for all front-line employees (not just nurses hired full-time), etc. However, the general improvement in the working conditions of nurses remains difficult to apply in the field given the current lack of manpower. It is the snake that bites its tail, and no one really knows which end to grab the beast without being bitten in turn.

Like the “shortage” of labor observed in the entire Quebec labor market, that suffered by the health network is the result of two distinct phenomena: a drop in the labor supply. combined with an increase in the demand for labor. However, the solutions outlined above only tackle the supply of health care work, ie the number of hours worked by caregivers within the public network.

What about the demand for healthy work? We hear very little about it, for one simple reason: the demand for healthy work stems mainly from the general state of health of the population eligible to receive care in its territory. With an aging population, many will be tempted to argue that the increase in demand for health care (and therefore, for healthy work) is inevitable and that it is futile to tackle it. However, there is nothing further from the truth.

In October 2011, the Canadian Institute for Health Information (CIHI) released a report which stated that, contrary to popular belief, the aging of the population has contributed only very modestly to the growth in the use of medical devices. medical resources in health networks across the country. Indeed, another CIHI study published in January 2011 showed that the demand for health care in the country was mainly caused by the increase in the prevalence of chronic diseases and not by the aging of the population per se, one of them. not necessarily explaining the other. Obviously, an aging and sick population certainly puts more pressure on public health networks than an aging, but healthy population.

What to do then?

The COVID-19 pandemic has collectively opened our eyes to the importance of public health and prevention in order to reduce the occurrence of infectious diseases and their respective costs. However, it seems that this finding has not yet led the government to make improving the overall health of the Quebec population one of its priorities for action. Of course, improving the health of populations is not easy. Such a task requires that we question our ways of working, eating, consuming, and arranging public places, as well as the organization of the health network and access to care.

These challenges are nonetheless essential, as they contribute to our populations aging in good health, far from overcrowded hospital rooms and constantly crowded emergency rooms. Healthy aging is not a luxury; it is a necessary and accessible reality for most of us if we collectively give ourselves the means. Otherwise, we will be doomed to endure an eternal “shortage” of personnel.

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