Tribune. The circulation of the coronavirus is currently not controlled. Faced with this observation, President Emmanuel Macron proposed new measures aimed at slowing down the third wave, but also at strengthening our health system, in particular with the creation of 3,000 resuscitation beds. This would bring the number of resuscitation beds to 10,000, while more than 5,000 of them are already occupied by patients suffering from severe forms of Covid-19. While no one can dispute the need to strengthen the capacities of hospitals in resuscitation beds, we wonder about the practical implementation of this measure.
Indeed, the creation of 3,000 intensive care beds in the coming days implies that we will have around 4,800 to 6,000 new nurses, but also nursing assistants, physiotherapists, psychologists and additional doctors. This demand for personnel comes in a context of a shortage of medical and paramedical nursing personnel prior to the crisis, and in that of great fatigue among health professionals.
Professional skills
Beyond the quantitative aspect, which is already worrying, the question arises of the competence in critical care of these backup personnel, particularly with regard to nurses. Indeed, the professional skills essential to work in the very complex technical environment of resuscitation with patients whose progress is continuously monitored cannot be acquired in a few days. These observations lead the professional national councils of anesthesia-resuscitation, perioperative medicine and intensive medicine and resuscitation to recall three recommendations, already formulated in July 2020, so that our critical care system is effectively in a condition to better adapt in health crisis situation:
First, the recognition of the very specific skills of nurses in intensive care units which, today, are absolutely not taken into account and valued in France. While new beds are to be opened, these unrecognized personnel are wondering about their departure from the intensive care units.
“Today, the care reserve is still a project and we do not have caregivers” familiar “on a daily basis with critical care”
Second, the strengthening of the current nurse / intensive care patient ratio, which must be increased from 1 nurse for 2.5 patients to 1 nurse for 2 patients. This measure, justified by the very heavy care load, would make it possible, in the event of a crisis and the extension of our resuscitation, to have more nurses who are experts in resuscitation to supervise the personnel who have come as reinforcements. Today, the insufficient number of our expert nurses is an obstacle to the opening of new resuscitation beds.
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