The General Directorate of Health asks nursing staff who are positive for covid but asymptomatic (or very weakly symptomatic) to come to work. This measure illustrates the tension in hospitals, due to a strong epidemic wave and a lack of staff. What if we paid more attention to those on the front lines of saving lives?
In a mailing sent on December 31, 2021 to the healthcare staff of the AP-HP (Assistance Publique – Hôpitaux de Paris), the management invites people positive for covid, but asymptomatic, to come to work if necessary. ” You are Covid-19 positive and asymptomatic and you feel able to work. Due to the particularly serious epidemic situation and the difficulty of our teams in coping, it is possible to hold your post at the request of your health manager or your head of department. », Indicates the email that we consulted.
Certain strict rules are imposed: wearing a mask and observing barrier measures at all times; avoid moments without a mask ” in the presence of other colleagues (coffee break and meal) “; keep a distance with colleagues ” if you can’t avoid these moments “; open windows ” as far as possible “.
The AP-HP applies a national instruction from the General Directorate of Health. In a DGS-urgent (document sent to professionals), dated January 2, 2022, we can read that this is a ” exceptional exemption from isolation for essential activities in the health and medico-social sector “. This is limited to asymptomatic cases, or paucisymptomatic (very weak symptoms), with a complete vaccination schedule.
This decision may come as a surprise, as it is a type of measure that seems to apply only in the event of exceptional tension. This is where awareness must come in. Because, precisely, this instruction is the image of what happens in hospitals.
“Incredible” tension in hospitals
” This completely illustrates the incredible tension in hospitals today. », Describes the infectious disease specialist Nathan Peiffer-Smadja, head of clinic at Bichat hospital. For him, it is a measure ” necessary ” for'” avoid more damage in patients “, Adding that” we must keep the hospital for the patients, at all costs “.
The speech of the moment, consisting in evoking a wave of infections, but moderate in the hospitalizations, does not reflect the ground very well. The Omicron variant is certainly less virulent, but more contagious, which makes it statistically dangerous in the risks of critical states.
Result, to date, deprogramming of care and surgeries are taking place, and they are increasing. ” Make no mistake: we are already postponing a lot, including things that cannot be postponed. So if we postponed even more, there would be more deaths. “
“I don’t see how we could get there otherwise”
nurse questioned by numerama
So, yes, in hospitals, the decision to mobilize positive staff (or to requisition those from other services where deprogramming takes place) is not rejected by the staff, far from it. ” The fact that the isolation instructions are gradually being lowered is creating a mess that is not possible. But, at the same time, I don’t see how we could do it any other way », Confides a nurse, with Numerama, in a university hospital of big city, which has not yet called upon asymptomatic caregivers, but who is considering it.
Nathan Peiffer-Smadja, for his part, also supports this need, but regrets yet another measure being made “ at the expense of caregivers, as usual “. All the more so as this increases the risks in the field: with some caregivers positive for covid, compliance with the measures must be absolutely perfect, must not suffer from the slightest error.
Do not infect colleagues or patients, which could make the situation worse. With such an instruction – ” we do it, but it’s serious to do it »Specifies the infectious disease specialist – caregivers are walking on eggshells, which only increases their burden.
Under-staffed, low morale: a “staff hemorrhage”
But how do you come to this, adopting a risky but necessary step? Nathan Peiffer-Smadja warns about a “ staff hemorrhage “. The closing of the beds is only the tree that hides the forest: the problem is that there are not enough staff. The workforce is shrinking, and recruiting is increasingly difficult, during an epidemic wave historically at the height of contamination.
Concern is mounting among nursing staff, Nathan Peiffer-Smadja tells us, because everyone has this questioning: in the absence of nursing staff, will closed beds be able to reopen, and when?
Being understaffed, in a context where the tense situation of hospitals is not sufficiently taken into account by the government nor sufficiently explained to the public, undermines the morale of nursing staff. No longer being able to take care of patients represents ” the leading provider of burnout “, Explains Nathan Peiffer-Smadja, who describes a situation” horrible “.
” All the caregivers will tell you that this is what breaks the minds of the teams. Because caregivers are on the front line. We are the ones who tell patients ‘we can’t take you’, we are the ones who take the anger, the sadness. “
This is one aspect of the pandemic, and of this 5th wave, that should be recalled much more frequently. The braking measures are there in response to these risks of tension which, today, are no longer risks, but a state of affairs. Public goals and collective behaviors must be oriented around hospitals – because that is where lives are saved.
