Despite the urgency, we must wait. Due to a lack of caregivers, patients at the Bordeaux University Hospital have been welcomed, since Wednesday evening May 18, by “two Civil Protection volunteers” and “a security officer“, explained on franceinfo, Tuesday, Gilbert Mouden, nurse anesthetist and union representative. And the Bordeaux University Hospital is not the only one in this situation: “IThere are beds in every hospital that are closed for lack of staff”said on Thursday, Rémi Salomon, Chairman of the AP-HP Establishment Medical Commission. “This concerns about a hundred emergency services out of the 690 in France”believes for his part Patrick Pelloux, president of the association of hospital emergency physicians of France, in an interview with West France.
With the approach of the summer holidays, these closures of emergency services are worrying. Franceinfo takes stock of the reasons that push hospitals towards the rupture of care.
Because the hospital is facing a burnout epidemic
Several emergency services are forced to close because of numerous sick leaves. Apart from the case of Bordeaux, Chinon (Indre-et-Loire), the “Teams are exhausted”testified Wednesday Guillem Bouilleau, the head of the emergency reception service and the Smur of Chinon, on France Bleu Touraine. “There is only one nurse left who feels able to work. The situation is indeed catastrophic. All the others have collapsed little by little like a house of cards.”
“It started with crying, then a psychological and physical breakdown of some caregivers, then it spread.”
Guillem Bouilleau, head of the Chinon emergency reception serviceFrance Blue Touraine
At the Orléans University Hospital (Loiret), emergencies only received vital emergencies from March 28 to May 13, because 76 nurses and nursing assistants were on sick leave for burnout, reported Sunday The JDD (paid item). According to France 3 Centre-Val de Loire, all staff were able to gradually resume work on Friday. In Nevers (Nièvre), in mid-April, all of the midwives in the maternity ward were also on sick leave for professional exhaustion, forcing the Nivernaises to give birth in the surrounding departments for a few days.
Same observation in the Vosges, in Gironde, or in the Pyrénées-Atlantiques. “There is exhaustion and a lack of recognitionnotes Rémi Salomon. So, after a while, people say: ‘I prefer to preserve myself, preserve my family life, my personal life. I can’t keep wearing myself out like this.”
“There is a phenomenon of ‘great renunciation’ with staff who are totally disillusioned and who no longer adhere to the collective and federative idea that is the public hospitalanalysis Patrick Pelloux in West France. The system has been destabilized and the staff have been a little abandoned after having worked a lot.”
Because the flight of caregivers is structural
Since the fall of 2021, the flight of medical and paramedical personnel in all hospital departments, including emergencies, has been difficult to contain. In question: a crisis of vocations and the exhaustion of the remaining caregivers, who must ensure their work after two years of the Covid-19 pandemic and numerous departures from the public hospital. “There are beds in every hospital that are closed for lack of staff. And so there are 10%, 15%, 20%, sometimes more, closed beds”, believes Rémi Salomon. According to a flash survey conducted by the Directorate General for Healthcare (DGOS) published in December, the hospital lost, for the month of October alone, 784 nurses (including 568 in the public and 216 in the private sector). , then fell Le Figaro (paid item).
“There is a lack of staff in work organizations where people are made to work at full capacity on 12-hour shifts, or even 24 hours for some doctors. They are brought to exhaustion or departure”is indignant on franceinfo Gilbert Mouden, nurse anesthetist and Sud Santé Sociaux staff representative in Bordeaux.
Reminders on days off, night work, stressful situations… Difficult and poorly paid working conditions are regularly denounced to justify the departure of staff members. Despite the salary increases of 183 euros net per month, allowed by the Ségur de la santé, for a nurse, a night call brings in only 10.70 euros gross more on his salary, according to the HRD of a public hospital joined by franceinfo. “It’s ridiculous ! is indignant on franceinfo Rémi Salomon. Constraint is not sufficiently remunerated. This is the first step the next Minister of Health must take.”
If, for many years, the phenomenon affected more rural or unattractive areas, it now concerns the whole of France. “We lack emergency doctors and we have difficulty retaining them”analyzes François Crémieux, head of Marseille Public Assistance-Hospitals (AP-HM) in Release. “In Marseille, it is the competition with the liberal sector and the lucrative clinics that destabilizes the teams the most, while there is no shortage of health professionals. Timone’s emergency room shouldn’t be in trouble!”
Because, for lack of doctors in town, patients turn to the hospital
Finally, if emergencies are particularly affected, it is also because they take care of all patients, including those who should not be knocking directly on their doors. In particular patients without an attending physician. “City medicine, liberal, is in crisis: there are not enough general practitioners, so people are turning to emergencies”explains to France 3 Centre-Val de Loire, Matthieu Lacroix, spokesman for the emergency doctors on strike in Orléans.
An observation shared by Rémi Salomon. According to him, if we want to ensure continuity of care this summer, we will have to “that all caregivers, in town and at the hospital, participate” to collective effort. “HAS some places, it will be necessary to shorten the holidays”he warns. But this effort should not only bear on the shoulders of hospital caregivers and general practitioners, warns Patrick Pelloux. “We must oblige all doctors, including private clinics, to participate in the permanence of care.”