from Maubeuge to Calais, emergency services on the verge of implosion
The triple epidemic of influenza, Covid and bronchiolitis is undermining already weakened emergency services. In the Nord and Pas-de-Calais, caregivers are ringing the alarm bells.
Caregivers face an endless day. While they have been ringing the alarm bells on the state of hospitals in France for several years, the past few weeks have marked an additional stage in the difficulties they face.
As the seasonal flu epidemic spreads, Covid-19 contaminations continue and bronchiolitis still requires the hospitalization of many children. At the same time, the general practitioners’ strike has been extended until 8 January. Add to this explosive cocktail the end of year celebrations, a period when emergency room visits increase significantly, and the result falls: hospital emergency rooms are overflowing.
In an article published a few days before the transition to 2023, we report the distress call from a caregiver from the Lille University Hospital emergency room. He explained that patients could wait until 7 p.m. on stretchers in the hallways. Attendance records were indeed recorded in late 2022, management said.
At the same time, several hospitals in the Nord and Pas-de-Calais such as Roubaix, Tourcoing or Saint-Philibert have triggered the white plan to deal with accumulated activity in their establishments. In Hazebrouck or Armentières, the directions declared their hospitals in tension, the last step before the activation of the white plan.
As Emmanuel Macron prepares to deliver a solemn speech on Friday January 6, 2023 around the current crisis in the health system, we have asked caregivers in various emergency services in the region to take the hens of the situation. , which they judge”catastrophic”.
The nurse-anesthetist we interviewed will remember his New Year’s Eve for a very long time. While working that evening with the SMUR team in Lens, attached to the SAMU in Arras, the comings and goings between the homes of patients and the emergencies of the hospital center follow one another. “We had a patient to place in intensive care but there was only one place left in Lille. When we called them, 5 people were already waiting to occupy this bed”, says Jean Letoquart, CGT delegate. He is also the Communist First Deputy Mayor of Avion.
“We had to put up a poster at the entrance to warn people that there was an 8h30 wait before having a doctor, he explains. I can tell you that no one left when they saw the sign.”
Every hour spent in the emergency department actually decreases the quality of care.
Jean Letoquart, anesthesiologist and CGT delegate at CH de Lens
In the early morning of the 1uh January, 40 people wait in the corridors on stretchers. “We put extension cords to connect the monitoring devices and bring them to the patients, we manage like that”. He assures him: “we come close to drama each time because each hour spent in the emergency room actually decreases the quality of care”.
An influx of patients to manage, coupled with too few staff to ensure the proper functioning of the service. “In Lens, it should be 24 full-time equivalent doctors (FTE) to run our emergencies, but there are only 9, laments Jean Letoquart. And it is not a series of sick leaves but programs that cause this situation.
We are suffering, we are short of staff. On a team of 6, we often shoot at 4 for about 70, 90 or even 150 entries over 12 hours. Which means that the quality of care, the quality of what we can provide in terms of diagnosis is compromised.
At the hospital center of the city, the sling of the caregivers triggered before the triple epidemic which weighs a little more each day on the emergency services of France. On December 8, 2022, at the call of the CFDT and the CGT, a renewable strike was launched to warn of the deteriorating working conditions and the lack of staff.
Nearly a month later, and after a break during the end-of-year holidays so as not to further clog the emergencies, the strike has just been renewed. “We absolutely need a second nurse in the emergency room”, explains the CGT. A key position to streamline the service, because these nurses “are those who somehow sort“. Or today, the union ensures that it blocks. “If a child is in 5, 6 or 7th position, we would like to prioritize them but the staff cannot do it”.
During the Christmas holidays, the emergencies of the CH of Calais were recorded on average between 120 and 150 daily passages, against 80 and 110 the rest of the year. “The management has made gestures but has difficulty understanding this precise point, which is nevertheless essential”, end the union. Discussions should continue during the week.
In Artois, the Béthune Beuvry hospital center covers a population base of 300,000 people. The emergencies “have been saturated for three months”says Christophe Blondel, local secretary of the CGT.
During the festive period, service counts “a hundred people in the emergency room, with stretchers all over the corridors”. He describes a situation that reaches its climax. “We see patients with oxygen cylinders in the corridors because we cannot connect them to the network and there was no longer a chair available”.
According to the SAMU-Urgences France union, 31 people died alone on stretchers in the corridors of emergencies in France during the month of December, “in conditions that should not exist”indicates Marc Noizet, president of the union and successor to François Braun in this position, appointed Minister of Health in July 2022.
When you have 30 or 40 more people in the hallways, the nurses, orderlies and doctors say they can’t keep an eye on everyone.
Christophe Blondel, local secretary of the CGT at the CH of Béthune-Beuvry
Did any of these deaths take place in Béthune? “Not the last few weeks, ranswers Christophe Blondelbut we have already had deaths on stretchers in the emergency room”. According to him, “When you have 30 or 40 more people in the hallways, the nurses, orderlies and doctors say they can’t watch everyone anymore.”
A situation that weighs on the morale of health professionals. “The caregivers feel like they are mistreating people, they can’t take time with patients, he explains. The workforce is not changing. We have a very big problem keeping staff and it is difficult to recruit”.
In October 2021, the CH de Maubeuge welcomed its first patients in the brand new brand new hospital located on the edge of the city. “This new establishment has been reduced to hospital beds, assures Guillaume Rosey, CGT secretary. So the people taken care of in the emergency room must wait for the patients who are in the beds to free up these beds to be transferred to the specialized services.
A downstream congestion which, according to him, has been lengthening the waiting time in the emergency room for several months, without forgetting the triple epidemic which is currently raging. “Friday evening, before the New Year weekend, there were around fifty patients in the emergency room for around ten hospitalization beds available at the hospital. For more than the majority of these patients, they nevertheless required hospitalization. “.
After a difficult weekend for the teams, the trade unionist shared on social networks a photo of the tents currently installed in front of the entrance to the hospital in Metz. In question, the influx of patients following sick leaves in cascade at the nearby hospital in Thionville. Guillaume Rosey added a message: “This winter, we fear the same disaster elsewhere.”
We asked him if he suggested a similar situation could happen in the parking lot of the hospital where he works. “Impossiblehe replies straight away, because we are already unable to run our services with the current workforce. Absenteeism is increasing and management is pulling the rope”. He takes as an example the case of a nurse who alerted him a few days ago. “On his provisional schedule of hours was displayed 60 in 6 days. However, the law only authorizes 48 hours over 7 days”, he laments. Before concluding : “Opening tents with additional staff is not a luxury that we can afford today in Maubeuge”.