Science

“Actually, no one should break”: in the emergency room, summer on the tightrope – Sciences et Avenir

At the gates of Paris, in a posh suburb not spared from a shortage of nurses, a small emergency service is trying to “hold the course” and compensate for the “untimely” closing of its neighbors at the cost of repeated casualties to the crew.

“Vacation? I can’t take them, I have to plug the holes so the rest can leave”: Dr. Florian Bernas may well emphasize that his department is not “understaffed” and that for the guards this summer “the grid is full”, he does not hide the price.

“Everyone works a little overtime, but no one should break down. If we have even the slightest stoppage of work, I don’t know how we will do it,” said the 41-year-old doctor, head of emergency care in St. Petersburg. -Cloud (Hauts-de-Seine), which saw an average of 60 patients a day before Covid.

But “it’s more like 70 now” because the Foch hospital in Suresnes, four kilometers to the north, stopped accepting “bed patients” in early June. The “dropping” of serious cases caused by the departure of several practitioners is affecting neighboring institutions.

Antoinette, 100 years old, admitted to Quatres Villes in Saint-Cloud in Hauts-de-Seine, July 20, 2022 (AFP – Geoffroy Van der Hasselt)

Except that many of them are also in a precarious position. The recent “untimely closure” of Versailles and Poissy (Yvelines) does not make the task of Dr. Bernas easier. “The problem is picking up spades. Above 90 people are not seen a day, they leave earlier,” he says.

In order to receive patients into their cramped quarters without leaving stretchers lying in the corridors, the eight consultation boxes are often “separated” by screens. So much for privacy. Other wards house patients who no longer need to be in the emergency room due to lack of space “on the floors”.

The hospital management acknowledges this: “Normally we didn’t close beds in the summer,” but this year “we have fewer decisions.” In Saint-Cloud, “integrated medicine had to close the beds.” At Sèvres, geriatrics halved the airfoil. There is no other way out, because “we must take into account the development of personnel and give them leave.”

– “Fast to saturation” –

Nurse Ophelie in the emergency department of the Quatre Ville hospital in Saint-Cloud in the Haute-Seine, July 20, 2022 (AFP - Geoffroy van der Hasselt)Nurse Ophelie in the emergency department of the Quatre Ville hospital in Saint-Cloud in the Haute-Seine, July 20, 2022 (AFP – Geoffroy van der Hasselt)

Meanwhile, in the short-term hospitalization unit adjacent to the emergency room, “everything is full,” notes young nurse Ophelie Leroy, 23, who begins her morning round this Wednesday. On the “a little bit of everything” program: cardiac decompensation, respiratory failure, epileptic seizure, drug-induced hepatitis, falling at home…

After two years of such a regime, she is going to leave in October. “To move,” she clarifies, “but I need to change.” The exact opposite of her colleague Lea Coignon, 31, who “loves it when things move” and “feels really good in the emergency room,” where she usually works nights – 13 hours a month – to take better care of her 5-year-old son. .

“When I’m a day, I don’t have a family life,” explains this former caregiver, who nonetheless accumulates overtime – “over 300” last year – even if it means seeing her “a little less.” Three weeks of vacation are stretching their arms, but “maybe in August I’ll be called in to take care of,” she predicts. Of course, “it’s not necessary, but we think about other girls, we can’t leave them like that.”

Nurse student Elia (d) rests in the emergency room of the Quatre Ville hospital in Saint-Cloud in the Haute-Seine, July 20, 2022 (AFP - Geoffroy van der Hasselt)Nurse student Elia (d) rests in the emergency room of the Quatre Ville hospital in Saint-Cloud in the Haute-Seine, July 20, 2022 (AFP – Geoffroy van der Hasselt)

A much-needed solidarity because in this small service, “we quickly reach saturation,” says Florence Tun, 27, also a nurse. While at the front desk, she is responsible for first sorting between real emergencies and the rest.

“Some people come in with a diagnosis or think it would be faster to get an MRI,” she says. Sometimes the hospital is the only way out: “During the July 14 Bridge, people didn’t have their own doctor, so they came because they couldn’t find another way out.”

Fortunately, the staff of paramedics is almost complete. “I’m very lucky,” says Stephanie Dubus, 38, a health director who also has “no gaps” in her schedule “until September.”

But nothing is certain, “we must stay the course” despite the failures of nearby hospitals, she adds. “Then it collapses. We should try to prepare for everything.”

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