New Montreal specialized nurse practitioner clinics seeing fewer patients than expected

Four new specialized nurse practitioner clinics (IPS) opened this year in Montreal to ease emergency room overcrowding — but they're seeing fewer patients than expected.

Radio-Canada found that only about a third of the expected patients are being treated each week. The four clinics were expected to see about 650 patients a week, but an analysis reveals the number has been only about 200 on average.

People mainly visit the clinic for fractures, ear infections, stitches and respiratory infections. But emergency rooms are still seeing thousands of patients every week.

One issue raised by nurses and doctors is the fact that there are still too few nurse practitioners in the province to fully staff the new clinics.

"It is very far from the objectives at the moment. And we're moving nurse practitioners who could have stayed in the clinics [where they work]. Instead of creating additional silos, we should have strengthened the current partnership between nurse practitioners and doctors," one doctor told Radio-Canada.

The Quebec Order of Nurses (OIIQ) says it remains sceptical of the the specialized clinics' capacity to reduce ER crowding but that it "salutes the government's will."

"The success of this approach is linked to the condition of being able to count on a sufficient number of NPs," a spokesperson said, adding the province could do more to encourage nursing students to pursue a career as a nurse practitioner. 

The president of the Union of Care Professionals of the East-of-the-Island of Montreal, Denis Cloutier, is not surprised by the difficulties in recruiting.

"There is a whole dynamic with the doctors who work in family medicine to be able to release these nurse practitioners to go to work in the [specialized] clinics — this is the first obstacle," he says.

East Montreal facing shortage of nurses

Since 2021, nurse practitioners can, among other things, diagnose illnesses, prescribe diagnostic tests, prescribe medication, determine medical treatments and carry out pregnancy followups without the supervision of a doctor.

There are more than 1,000 of the nurses in Quebec.

The operation of the new clinics is closely linked to the availability and volunteering of nursing staff, said Danny Raymond, a spokesperson for the CIUSSS du Centre-Sud-de-l'Île-de-Montréal. A dozen nurse practitioners offer availability on a voluntary basis and in rotation.

At the Laval CISSS, the clinics are staffed with two nurse practitioners, one nurse clinician, an administrative officer and two interns, according to a spokesperson.

In the last budget, the province set aside almost $400 million over the next five years to fund 23 new clinics.

The president of the Association of Specialized Nurse Practitioners of Quebec (AIPSQ), Christine Laliberté,  says she is hopeful the new clinics will manage to stabilize.

"In the future, we are planning to open permanent positions and see people there on a regular basis to maintain opening hours and the services offered," she says.

LISTEN | How will Montreal's first specialized nurse practitioner clinic work?