MONTREAL – Facing a shortage of hospital personnel willing to respond to Code White violent incidents involving patients and visitors at the McGill University Health Centre, the MUHC launched an internal recruitment campaign.

Historically, orderlies, security guards and nurses have been members of such response teams, but the MUHC is now recruiting secretaries, housekeeping staff and food preparers, as well, to subdue highly agitated or violent individuals during emergencies known as Code Whites.

Participation in the response teams declined after the MUHC in 2016 eliminated Code White premiums – so-called danger pay – under pressure from Health Minister Gaétan Barrette to slash operating costs.

The recruitment campaign for Code White volunteers comes after the publication of an investigative series in the Montreal Gazette that exposed security problems at the Montreal General Hospital (part of the MUHC). The problems include the near-strangulation of a nurse by a patient last September.

“Join today. Be part of the MUHC Code White response team,” says an internal ad with a picture of smiling healthcare workers joining hands in a circle.

“What’s in it for me?” asks the recruitment ad. “Receive specific certified Code White training to prepare you to safely use non-violent intervention strategies. Learn how to defuse an escalated situation in which there is the potential or actual danger of harm.”

Richard Fahey (pictured), the MUHC’s director of human resources, legal affairs and media relations, told the Gazette that the decision to get rid of Code White premiums was made to comply with Bill 30, adopted by the National Assembly in 2003. The legislation’s purpose was to reduce the number of healthcare bargaining units.

“As for the Code White premium, it was abolished in October 2016 as part of the standardization of premiums in compliance with the (provincial) collective agreements,” Fahey explained in an email. “The (premiums) had been created in-house at the MUHC and were illegal under the (provincial) collective agreements and Bill 30.”

The Code White premium worked out to $5.50 a day per worker. The MUHC saved tens of thousands of dollars a year by discontinuing it.

However, at least one Montreal hospital hasn’t abandoned Code White premiums. The Jewish General, which runs one of the busiest ERs in the city and has a psychiatry unit, chose to maintain it.

“The Jewish General Hospital provides the Code White premium where appropriate, according to collective agreements,” spokesperson Emmanuelle Paciullo told the Montreal Gazette by email.

On Sept. 15, 2017, two weeks after the ER nurse was throttled by a psychiatric patient at the Montreal General, the MUHC resolved to proceed with the recruitment campaign amid a rising number of violent incidents.

“We are looking for people who meet specific eligibility criteria and who are interested in being part of these (six-person) teams, on a voluntary basis, in areas including but not limited to: clerical staff, housekeeping, transport attendant and food service,” Dimitra Koinis, an MUHC human-resources counsellor, wrote in an email.

Koinis added “we are looking at launching this plan a.s.a.p.”

The MUHC launched the recruitment campaign officially more than four months later, on Jan. 26. On that day, interim executive director Martine Alfonso addressed the Gazette series, saying the MUHC takes staff security seriously.

Asked why it took four months to launch the recruitment campaign after the decision was made in September during a state of urgency, the MUHC responded:

“Many steps are involved in the recruitment of employees to this team: union and labour-relations approval, awareness to managers, bench-marking with other hospital practices, creation of communication plans, nomination of a coordinator of the teams and more,” the MUHC statement said. “All steps took place during the last few months to ensure a smooth recruitment process.”