Restrictions on access to night emergencies at the Bordeaux University Hospital “have allowed us to reduce the passage by approximately 20 to 25%”, said Friday July 1 on franceinfo Philippe Revel, the head of the service. 120 emergency services have already reduced their activity due to lack of staff. The upcoming holidays will probably not help the situation. The Braun report, commissioned by the government, simply recommends partially closing emergency rooms at night when there are not enough staff. This allows “easier working conditions and therefore more time to take care of the patients who are present”, he explained. According to him, “we will have to generalize it, because it is important that we can think about the reorganization of our emergencies”he says.
franceinfo: What conclusions do you draw from this experience?
This has allowed us to reduce by approximately 20 to 25% the passage to the emergency room at night on the Pellegrin site and thus to modify the functioning within the department, providing more resources for patients who really need of our care during the evening. Easier working conditions and therefore more time to take care of the patients who are present. For patients who did not come directly from emergencies, this avoids hours of waiting, for an opinion that does not justify this long wait.
What types of emergencies do you refuse?
Patients who indisputably need medical care, but who should normally be taken care of by another circuit, in particular by general medicine, city medicine, or by other health professionals, but who, find a solution, come to the emergency room anyway. That’s what we want to rearrange.
What services do you refer them to?
At night, there are a few on-call systems like SOS Médecins or other professionals who are stationed in the Bordeaux metropolis until midnight. Afterwards, there are a lot fewer patients who come after midnight. So we offer them solutions and, if necessary, for the less serious, we tell them to contact their doctor the next day. But they still got that medical opinion. And so, somewhere, they have a first piece of information to treat themselves.
Is there no risk of missing a life-threatening emergency by carrying out a diagnosis by telephone?
No, because the Samu medical regulation teams are fully trained to make this assessment and based on a certain amount of information that we collect on the phone, we are able to determine the seriousness of the condition. of the patient and to engage his sector.
The Braun report recommends generalizing this filtering to emergencies. Is it possible, do you think?
Yes, we will have to generalize it, because it is important that we can think about the reorganization of our emergencies. It is necessary to be able to create several levels of support. There are emergencies as such, but there is also, precisely, what can be done outside emergencies by care in town, by other professionals. Now is the time to implement this reorganization.
In your services, do you face many departures of nursing staff?
Yes, a lot. Both doctors and paramedics.
“We have had a leak of our employees for six months, which forced us to initiate these reorganizations because we no longer had enough people to run the service from May.”
Philippe Revel, head of the emergency department at the Bordeaux University Hospitalat franceinfo
We have finalized our summer organization plans. We should have continuous operation. We are still very worried about the downstream beds, that is to say the ability to be able to hospitalize patients in the middle of summer. We remain very vigilant and the organization we are proposing is very fragile because all it takes is for there to be other departures, illnesses or unforeseen stoppages, and that would put us in difficulty again. We are in a situation that is stabilized, we are on the wire and we will do everything not to fall.