A nurse has been fired from a Canadian hospital following an outcry over a video showing a dying indigenous woman screaming in distress and being racially insulted by staff.

Quebec Premier Francois Legault has also ordered a thorough investigation into the incident saying the nurse’s remarks were “unacceptable” and “racist”.

Joyce Echaquan, a 37-year-old Atikamekw woman, arrived at a hospital in the Quebec City of Joliette on Monday, complaining of stomach pain.

The mother of seven had previously suffered similar issues and told staff she had a heart condition. Echaquan started live-streaming her experience on Facebook as her pain escalated, and staff at the hospital appeared indifferent to her pleas for help.

In the footage, Echaquan could be heard groaning as nurses call her “stupid as hell”. “Are you done acting stupid? Are you done?” asked one nurse in French as Echaquan moaned in pain.

“You made some bad choices, my dear,” another nurse said. “What are your children going to think, seeing you like this?”

“She’s good at having sex, more than anything else,” the first nurse said.

Leaders of the indigenous community said the video exposes the grim realities of systemic racism that have long gone ignored throughout the country.

“Discrimination against First Nations people remains prevalent in the healthcare system and this needs to stop,” the Assembly of First Nations national chief, Perry Bellegarde, said in a statement.

While condemning the nurse’ actions, François Legault rejected the notion that Echaquan’s death was representation of a broader problem of racism within Quebec, despite a public inquiry concluding the opposite.

“I really don’t think we have this kind of way of dealing with First Nations people in our hospitals in Quebec,” he said.

Marc Miller, federal Indigenous services minister, extended his condolences to the community who were traumatized by the “gut-wrenching” video.

“This is the worst face of racism,” Miller told reporters. “This is someone who is at their most vulnerable. And they are dying, having heard racist words expressed towards them.”

Canadian Prime Minister Justin Trudeau  called Joyce Echaquan’s video “worst form of racism”.