A 58 year-old nurse working at Quebec City’s Centre hospitalier universitaire de Québec (CHUQ) recently took her own life. It was the fifth suicide of a nurse at this institution in 18 months.
In a letter addressed to those nearest to her, the latest suicide victim, a 58 year-old nurse with 37 years working experience, reportedly attributed at least some of the difficulties that caused her to take her own life to management’s insistence that she return to work from medical leave before she felt capable of resuming work.
This became public when a nurse contacted the TVA television network to draw attention to the connection between the rash of suicides at CHUQ and the heavy workload nurses endure at what is Quebec City’s premier hospital.
That Quebec nurses are forced to work under trying conditions, due to inadequate resources, short-staffing and forced overtime, is common knowledge in Quebec. But provincial governments, Liberal and Parti Québécois (PQ) alike, have persisted with a policy of budget cuts, health care rationing, and privatization.
Interviewed by the Quebec City daily Le Soleil, a CHUQ nurse said that shortly before her colleague took her own life she saw her coming, tears in her eyes, from a meeting at which she had been ordered, over her protests, to return to work forthwith.
The nurse also told the Soleil she knew three other CHUQ nurses who had recently committed suicide. One was a few months from retirement, another was to retire in two years, while the third was just 21 and only beginning her career.
A subsequent investigation by the QMI news agency revealed that five CHUQ nurses had committed suicide during the previous 18 months.
Nursing has traditionally been associated with higher rates of suicide than the norm, no doubt because of the emotional stress that is associated with having to deal with the sick and dying on a daily basis
Under conditions where nurses are fatigued and/or feel unable to properly perform their jobs due to a heavy workload, the psychological stresses associated with nursing are greatly aggravated.
Of particular concern to Quebec nurses is the practice of forced overtime—a practice rooted in a chronic shortage of personnel.
Each week thousands of Quebec nurses are compelled to work extra shifts, depriving them of the personal and family time needed to physically and psychologically recuperate from their jobs.
According to statistics from the Ministère de la santé et des services sociaux du Québec (Quebec’s health ministry), the total number of overtime hours worked by nurses increased by 27 percent between 2004 and 2009, rising to 3.5 million overtime hours in the 2008-2009 fiscal year.
A study commissioned by the Canadian Federation of Nurses Unions and based on data provided by the Labour Force Survey found that during an average each week in 2008 more than 60,000 nurses in Canada worked overtime. In 2008, nurses logged 21,560,100 overtime hours—a 30 percent increase from 2005 and the equivalent of 12,000 full-time jobs.
During the same 2005 to 2008 period, absenteeism among Canada’s nurses increased 14.4 percent.
There is a close association between the two. Nurses who are fatigued by overtime fall sick or are forced, for their emotional well-being or because of pressing personal matters, to take time off. High absenteeism in turn leads to more forced overtime. Quebec had the highest overtime rate, with 35 percent of the province’s nurses working overtime on average each week in the 2005-8 period. And Quebec was tied with Newfoundland for the highest weekly absentee rate, with the equivalent of 11 percent of nurses absent one day per week.
Following the media report on the latest suicide at the CHUQ, many nurses came forward to describe the terrible conditions under which they work. Some reported that they were bullied by employer threats of disciplinary action into working overtime. Others pointed to evidence of psychological distress among some of their colleagues, including suicide attempts.
A recent study by the Canadian Federation of Nurses Unions found 86 percent of nurses consider their work environment as stressful and 85 percent consider it oppressive. Eight-six percent also contend that the health care facility at which they work is poorly equipped and 88 percent view it as poorly funded.
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The president of the nurses’ union at the CHUQ, Nancy Bédard, told Le Soleil that she witnesses her members’ distress on a daily basis. Yet the reaction of the local union to the exposure of the rash of nurse suicides at the CHUQ was to deny that they could be directly linked to the working conditions at the hospital. Said Bédard, “I can’t draw a connection, but I can tell you that the conditions in which healthcare professionals are plunged … can indeed create a state of psychological distress.”
As for CHUQ management, its communications director, Richard Fournier, insisted that no connection has or could be established between the nurses’ suicides and the work environment. He said that the nurses who had committed suicide were on sick leave due to “serious personal difficulties” and that most of them had “had a light or normal work load.”
The alarming levels of psychological distress, which can potentially contribute to suicide, among Quebec nurses can only be understood within the context of the huge cuts in health care spending and attacks on health care workers’ working conditions implemented by Quebec governments over the past two decades.
As elsewhere, the unions have played a key role in assisting big business governments in imposing these attacks. For example, it was the unions that proposed the PQ government of Lucien Bouchard use a scheme of voluntary retirements to slash health care spending in the late 1990s. Under this scheme, the government permanently eliminated tens of thousands of health care jobs, thereby diminishing the quality of health care provided Quebecers and significantly increasing the workload of nurses and other health care workers.
And in 1999, when nurses rebelled against their poor working conditions and the deterioration of health care and mounted an illegal strike in the face of savage antiunion laws, Quebec’s major union federations isolated their struggle, thereby ensuring its defeat. (See: Unions strangle Quebec nurses’ strike)
The unions’ role as agents of big business was once again exposed during the recent round of contract negotiations with Quebec’s current provincial government, the Liberal government of Jean Charest.
When the Liberals introduced, at the end of March, a budget establishing a framework for drastically reducing social spending, including the possible introduction of a user fee for medical appointments, the trade unions, which ostensibly represent the half million Quebec public sector workers, failed to organize any opposition. This silence was all the more deafening, given that the Liberal budget provoked a public outcry.
Then in June the union capitulated before the government’s contract demands: accepting a five-year contract with a total pay increase of only 7 percent, which is what the government had sought from the outset.
Alone among Quebec’s public sector unions, the Fédération interprofessionnelle de la santé (FIQ), which represents the majority of Quebec’s nurses, has balked at the sellout deal. Earlier this year, rank and file nurses at several Montreal area hospitals staged wildcat walkouts to protest their employers’ use of forced overtime.
While opinion polls have repeatedly shown strong support for the nurses, the Quebec government has arrogantly rebuffed the nurses’ principal demands—an end to mandatory overtime and to the increasing use of private, for-profit placement agencies to fill personnel shortages.
If the government is so cavalier, it is because it is confident that the unions, including FIQ, will isolate the nurses’ struggle, confining it within the straitjacket of a collective bargaining dispute and maneuvers with the big business politicians.
FIQ says it is ready to hold a strike vote at the end of September. But even if it makes good on this threat, the union bureaucracy will do so only with a view to pressuring the Liberal government to offer nurses a little more than other public sector workers, so that it can proclaim victory and shut down the nurses’ struggle.
No more than any of the other unions is FIQ prepared to challenge the government’s assault on health care and public services by making a strike the spearhead of an industrial and political mobilization of the working-class.
Such a mobilization is both possible and necessary. The deplorable working conditions nurses’ face are the result of a policy of dismantling social services and slashing taxes for the rich and big business that has been pursued by all governments in Quebec and across Canada for two decades and that goes hand-in-hand with big business’ assault on jobs and worker rights.
Now, under conditions of the greatest crisis of world capitalism since the Great Depression, the ruling class is intent on going still further. The pages of newspapers like La Presse, the Journal de Montreal, and Globe and Mail are filled with editorials and op-ed pieces declaring Medicare (Canada’s universal public health insurance system) “unsustainable.”
Quebec nurses must break out of the isolation being imposed on them by the trade unions and appeal to the working class as a whole to join them in a common fight against the big business program of dismantling public services and slashing jobs and wages.