Montreal gets its first clinic run entirely by nurse practitioners to help ease ER overcrowding

"It is one of the more organized initiatives in the province of Quebec," says Lina Spagnuolo, director of nursing of the CIUSSS in the east of Montreal, where the first clinic run entirely by nurse practitioners opened. Alyssia Rubertucci reports.

By Alyssia Rubertucci

A first of its kind in Montreal: a clinic opening up run entirely by nurse practitioners. 

“We’re not innovating,” said Lina Spagnuolo, Director of Nursing at the CIUSSS de l’Est-de-l’Île-de-Montréal. “But it is one of the more organized initiatives in the province of Quebec, and for that we’re very proud and our team of nurse practitioners is very motivated and dedicated to make this work.”

(Credit: Alyssia Rubertucci / CityNews)


It’s part of a set of solutions the provincial government’s health crisis management team put in place to help ease extreme overcrowding in the city’s ERs.

“It will prevent people from waiting for hours in the emergency room,” said nurse practitioner, Nadine Belony. “We often see patients there who present with a health problem that does not require to be seen in the emergency room.”

Nurse practitioner, Nadia Belony. (Credit: Alyssia Rubertucci / CityNews)


An example, Spagnuolo says, would be a child running a fever, with an earache or sore throat.

“Sometimes these patients, they don’t know where to go, so they come to the emergency department,” she said. “That’s a classical case that could be referred to our nurse practitioner clinic, in which case the nurse practitioner could diagnose, evaluate, and prescribe the necessary treatment.”

The first clinic, at the CLSC Olivier-Guimond in Hochelaga-Maisonneuve, will be able to treat 250 patients weekly.

It opened on Thursday, as ERs in Montreal were at 135 per cent capacity on average – the Jewish general hospital at 191 per cent.

It was established in less than a month, after Quebec health minister Christian Dubé, announced in early November the creation of these IPS clinics and a specific pediatric line within the province’s health hotline, 811.

Dubé said 811 on Wednesday received 5,000 calls, and another 5,000 more just for the pediatric hotline.

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“It’s just another resource and it will have an impact because these patients that are presently coming to our ER department, especially this week in the East, the numbers are very high,” Spagnuolo said. “So for sure it’s going to decrease the pressure in the ER and on our teams also in the ER that are very overworked.”

The nurse practitioners will be able to see patients with non-urgent health problems.

“She can diagnose illnesses, she can prescribe, administer medication,” Spagnuolo said. “She can do invasive procedures, she can do pregnancy follow-up.”

Lina Spagnuolo, Director of Nursing at the CIUSSS de l’Est-de-l’Île-de-Montréal. (Credit: Alyssia Rubertucci / CityNews)


But the clinic isn’t a walk-in. Patients will be referred by triage nurses from the emergency rooms at nearby hospitals or after calling 811.

Although new to most of Quebec, this initiative isn’t new to Canada or the rest of the world.

“When we compare, for example, in the other Canadian provinces, in Ontario, IPS clinics already exist,” said Belony. “So, for me, I find that Quebec, we were late.”

Around 40 front-line nurse practitioners in Montreal region were asked to work overtime there on a voluntary basis.

(Credit: Alyssia Rubertucci / CityNews)


The clinic is working to hire full-time positions, which will allow the clinic to be gradually open seven days a week. And two more of these clinics are due to open in Montreal by end of year.

“I think it’s going to be a project, which must really be long-term for the good of the population,” said Belony.

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