It has been months, even years, that some caregivers alerted to a deterioration in the emergency situation.
In recent weeks, entire services have been forced to close for several days for lack of staff.
While a new demonstration is scheduled in Paris on Saturday,
20 Minutes
looked into the issue with four emergency responders working in different cities in France.
"The emergencies that close for two days, this is only the tip of the iceberg", breathes Emmanuelle Seris, emergency doctor in the Grand Est and spokesperson for the Association of emergency physicians of France (AMUF).
In Laval (Mayenne), Bailleul (Sarthe), Bastia (Corsica), in recent weeks, the emergency department has kept doors closed for several nights.
The symbol of a sinking hospital?
In any case, this is the speech of many emergency physicians who, everywhere in France, warn about essential services which can no longer respond to the influx of patients.
On Saturday noon, a new demonstration (at 1 p.m., Place Vauban, in Paris) is also organized by 80 unions, collectives and associations to defend the public hospital.
And especially emergencies.
Closures, understaffing and replacements
"In many hospitals, services are closing completely or partially, for lack of personnel, warns Collectif Inter Hôpitaux, which last Tuesday submitted to Olivier Véran's office a list of immediate measures to be taken.
SMUR lines and emergency services are sometimes suspended for several days.
Access to healthcare is now perilous over a large part of the territory.
"
The situations are obviously not the same everywhere.
But in the mouths of our interlocutors, who work in different regions, a sentence returns: "The guards are terrible".
“Usually a crowded ER is August or Christmas.
This is the first time I see this in November!
", Warns Mathias Wargon, head of the emergency department at Delafontaine hospital in Saint-Denis.
“Two thirds of the services are in great difficulty throughout France, summarizes Emmanuelle Seris, spokesperson for the AMUF. Either they close, or they try to hold on by accumulating tasks. So we work a lot of overtime. "A young emergency doctor, who works in the Paris suburbs and in the provinces, confirms:" some nights, there are three doctors instead of four ".
This tension is not new.
As proof, in March 2019, the Inter Urgences Collective warned of the increasingly catastrophic situation.
"But it is getting worse," describes the on-call intern, emergency doctor for a year and present on Twitter.
Some weekends, all positions are occupied by non-emergency workers.
They know the house, but it is not their core business.
However, time management, the daily "Tetris" to get patients into the available beds, is our competence.
Making a patient wait six hours for a sprained ankle is okay.
But if it's for chest pain, it can mean a heart attack that's caught too late.
"
More patients, and more serious
How to explain that emergencies wither away?
First of all, consultations are exploding.
Blame it on the fifth wave of Covid-19, which is already pushing certain services to trigger the White Plan.
# 5emevague ⚠️ With 80% of unvaccinated hospital patients: 26 patients including 4 in intensive care, an increasing flow of patients in the emergency room, the #Annecy Genevois Hospital Center is forced to launch its #PLANCBLANC 😷 # COVID19 # today. HauteSavoie @GuillaumeRozier pic.twitter.com/3m2FtuaswT
- SAMU 74 (@ SAMU74) December 1, 2021
Winter epidemics, especially bronchiolitis, which arrives early and strong, lengthens the list of urgent patients. "We are in the bottom of the wave in terms of medical demography," explains Bénédicte Vrignaud, responsible for pediatric emergencies at the Mother and Child Hospital in Nantes. SOS doctor is overwhelmed, general practitioners too. Many no longer take new patients. "
The latter therefore go where the reception is always assured: in emergencies. "Patients are arriving in greater numbers and sicker," adds Emmanuelle Seris. As they no longer manage to see their attending physician in time, certain pathologies worsen. The common cold becomes bronchitis. Hospitalizations accumulate and lengthen, and downstream, in the specialized services (cardio, stomato, rheumatology, etc.), there is also a lack of arms and beds. "So we store the sick in the emergency room", synthesizes Mathias Wargon.
In addition, some patients consult for non-urgent concerns or too often.
"We must appeal to civility, insists the pediatrician from Nantes.
Some come four times for a gastro.
We no longer tolerate waiting 24 hours for a medical appointment in a society where everything is obtained in one click 24 hours a day.
"" Given the counter-advertising, people know that they may wait 6 hours in the emergency room, it is never cheerful!
“, Nuance Emmanuelle Seris.
A hemorrhage that affects all professions
Faced with this influx, therefore, there are fewer and fewer caregivers. Resignations accumulate in emergencies, affecting first of all the paramedics. “In one of the two hospitals where I work, ten nurses, the most experienced, have left the emergency room since June 2021, recounts the Intern on duty. They were the pillars of the service, they trained the other paramedics, reassured the young doctors. "
In Nantes, in adult emergencies, patients can wait up to 24 hours… “We have great difficulties recruiting nurses, explains Bénédicte Vrignaud, from pediatric emergencies. We can sense the exhaustion of professionals with a very heavy workload. A disgust too. “Before, we had teams that lasted, you could make your career in the emergency room, insists Emmanuelle Seris. It was bearable. Now, there is a dehumanization at the management level, the expertise is no longer recognized, the paramedics have the impression of being pawns that we ramble from one service to another. "
And departures now concern doctors. "It started to crumble two years ago and resignations have accelerated in recent months," resumes this head of emergency. The Ségur did not take the measure of the needs. And we realized, through the pandemic, our own vulnerability and that of our families. So rather than exhausting themselves, many take the door. "Emergencies are also losing their heads of department, it is passed over in silence," adds Mathias Wargon.
Those who remain are filling in the gaps.
“Everywhere else, we can close the door,” resumes Emmanuelle Seris.
And protect yourself: the consultations are full.
In the emergency room, no.
There is physical fatigue, but also psychological fatigue.
When you see 30 hospital patients on stretchers, there is a value conflict.
"And to alert:" The house of cards, which was on the will of caregivers, is collapsing.
"
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