Lpublic hospital is doing badly, the emergency services are doing very badly. Symptom and consequence of a deep hospital crisis, accelerated by the Covid-19 pandemic, the emergency room is on the verge of rupture. Due to a lack of hospital staff, one in five services is in danger of closing this summer.
There will therefore be deaths… All the scientific studies show that emergency room overcrowding is a factor associated with undue excess mortality. However, emergencies are the showcase and the front door of the hospital. The massive departure of caregivers and doctors has destabilized our establishments, with closures of beds and services, which makes the bottleneck of our emergencies inevitable.
Getting back into Covid crisis configuration
This deep, visceral disenchantment of hospital staff results from a dehumanized management of human resources, transforming the administration of our hospitals into entrepreneurial management, whose only compass remains profitability. Absurd criterion, since our receipts worsen the deficit of the Health insurance, and thus the accounts of the nation, while being based on the famous tariff with the activity (T2A), with deadly effects. We are clearly coming to the end of a cycle, calling for a fundamental structural reform, repeatedly announced by our various ministers, but never carried out or even initiated.
How to spend the summer without too much “breakage”? With the holidays of our hospital staff, the situation will worsen. In order to limit the damage, it is therefore necessary, as a matter of urgency, get back into crisis configuration, exactly as for the crisis due to Covid-19. Regional health agencies and hospital management must reactivate our famous crisis cells, by setting up organizations of bed management (bed management), through the daily census, at departmental level, of all available beds and real-time information on establishments in crisis. Yes this “dispatching” could be effective, but make no mistake about it, facing this new crisis will impose other sacrifices for a suffering and exhausted staff. The use of new deprogramming to free up beds thus becomes a conceivable option again.
How did we get here ? In my department, I always ask nurses, nursing assistants, health managers the reasons for their departure. Two types of arguments: first, the institution’s “factual” lack of attractiveness; then, the feeling of a lack of human recognition. Lack of attractiveness: housing difficulties due to above-ground rents disconnected from the income of our carers, resulting in longer and more expensive journeys. We must take this problem head on by reserving, by contracting with the town halls, affordable housing for our caregivers.
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