Withdrawing services and professional practice: what you need to know

Withdrawing services and professional practice: what you need to know

Some APTS members have been reassigned to work in CHSLDs and have had to withdraw their services from their regular clientele. This raises a number of issues in relation to professional practice. The current health and social emergency and the need to bring down terrifying death rates in care homes for older people are aggravating the structural disorganization of our health and social service system.

Our members typically go through a three-stage process: they withdraw their regular services, undergo reassignment, and return to their regular duties. Each of these steps poses its own challenges.

Putting services on hold

Before the usual professional activities are put on hold, it’s important to question whether the harm caused by withdrawing services is disproportionate to the benefits of reassignment. The people currently served still have needs, even though there is a pandemic. Some forms of physical or psychological care need to be provided at the right moment – if they are not, a patient’s condition may rapidly deteriorate. Patients may experience deconditioning as a consequence of inactivity, and this too is a risk that must be assessed.

Although recent ministerial orders allow health and social service employers to redeploy some of their staff to CHSLDs, managers still need to be made aware of the negative effects of withdrawing services from the regular clientele. In fact, a number of professional orders are suggesting that their members be proactive in this respect.

It can make sense for professionals to discuss this issue with their manager as a group, because their professional judgment is needed for the system to work properly. The right balance must be found between withdrawing and redirecting services, for the benefit of all.


Structural disorganization poses specific problems when it comes to reassignment. In the best-case scenario, our members are able to offer their professional expertise. In many cases, however, they are given generic tasks such as monitoring, collecting data, calling people to confirm negative outcomes for COVID-19 tests, etc. It is clear that better use could be made of their training and skills.

When professionals are assigned tasks outside their field of expertise, they are still professionals. This does not change. Their ethical obligation to protect the public still stands, although it may be reduced in some cases. Some professional orders have issued clarifications on this topic.

For instance, if a social worker who is distributing meals becomes aware of abuse or psychological distress, that person must use her or his professional knowledge to help the victim. It is important to make sure that reassigned professionals have the leeway to do this (e.g., putting a note in the user’s file).

Getting back to normal

Employees face physical risks when they are redeployed because of COVID-19, but they also face psychosocial risks when they go back to their normal tasks. Employees returning from a CHSLD reassignment may be exhausted and feel more vulnerable. Vacation time is important, as well as appropriate psychological support.

Major after-effects are also to be expected. Workloads may turn out to be a lot heavier because client files have been piling up and some cases have become more complex. Appropriate planning is required to attenuate risks of work overload and increased injury.

Employees must have the time they need to deal with this situation. Going through each file, contacting users, following up and making adjustments – all this takes time. Measures taken to attract and retain employees during the crisis must continue after the pandemic to ensure a smooth return to regular activities.

Getting back to normal activities (or whatever is the new normal) is something that has to be planned with the professional employees concerned. A contextual multi-factor assessment will help ensure a more effective transition to regular duties. The plan should also give our members the time they need to take charge of their respective caseloads once again.

Unlike working conditions that have been altered by the partial suspension of our collective agreement, professional obligations remain the same. Whether or not you belong to a professional order, you are committed to protecting the public. Your expertise and clinical judgment are key assets that are crucial in the current situation. They have to be protected and exercised at every stage of the process.

By Christophe Vaillancourt | June 18, 2020