Since May 18, access to adult emergencies at Pellegrin Hospital has been regulated to deal with a lack of staff.
The condition of people who are not referred by the 15 is assessed by civil security volunteers, in conjunction with the medical regulators of the SAMU.
The device is intended to be made permanent, so that one can no longer present oneself spontaneously before a call to 15.
Free entry to the Pellegrin emergency room in Bordeaux, 24 hours a day, has ended since May 18, as in more than a hundred other emergency services in France.
From 5:00 p.m. on weekdays (and 10:00 p.m. on weekends), Civil Security volunteers guide those who present themselves spontaneously at the entrance.
A “degraded” mode of operation denounced by the SUF, FO and CGT inter-union which called on the staff of the Pellegrin University Hospital to mobilize on Tuesday, in front of the hospital roundabout to request additional staff.
“The system was put in place overnight and we have public security volunteers, for whom we have a lot of respect, who work today at the public hospital to sort patients, indignant Gilbert Mouden ,
nurse anesthetist at Smur and Sud-santé representative at Bordeaux University Hospital.
For us, this is not acceptable”.
Received under a medical tent
This Monday, around 6:30 p.m., Civil Security volunteers welcome a young man who complains of burns after prolonged exposure to the sun.
Installed in a medical tent, in front of the Emergency room, he was examined by a nurse who quickly reassured him about these lesions, first degree burns.
He sends him as a precaution, to walk to the burns management service, a few tens of meters away.
In the tent, a telephone makes it possible to make the link with the 15, whose premises are on the site of the CHU.
A configuration that poses “problems of medical secrecy”, for Gilbert Mouden.
The nurse continues with the case of Brandon, 19, who, a good student, contacted the 15th before presenting himself, a letter from his doctor in hand.
During an interim mission, the young man was the victim of a chemical vapor projection in the eye.
"I had red eyes that were watery and itchy," he says.
Today, my doctor told me that I had to go to the emergency room to rule out keratoconjunctivitis.
“He quickly enters the service for support.
"The nights are better"
Like Brandon, many patients have been told to call 15 before coming to the ER.
“There are 30 to 40 fewer visits per day at the moment (part of which is explained by a low period), notes Philippe Revel, head of the adult emergency department at the CHU de Pellegrin.
The teams appreciate not being always on the run and being able to provide quality care.
The nights go better.
"There are fewer entries at night but we have recently noted a lot of entries between 8 a.m. and 9 a.m., I think people will adapt to the degraded system", points out Gilbert Mouden, who fears that he will not There is no turning back on this upstream regulation.
“The tent and Civil Security are there for those who have not heard or understood the message, explains Philippe Revel.
I hope that in a few weeks or months, everyone will know that before going to the emergency room, you have to dial 15. And, at that time, we will no longer need this security and, I think that this is the future of our emergencies.
An evolution of the operation which risks weighing on the regulation of the Samu, which already receives between 1,200 to 1,500 calls per day.
"It's an additional workload because you have to regulate these people who come spontaneously to the emergency room," worries trade unionist Gilbert Mouden.
For the head of adult emergencies, this regulation makes it possible to focus on the most critical patients, while managing the others more efficiently.
“Before they waited between 6 to 10 hours, he explains.
There, they are offered a possibility of better quality care (direction to the general practitioner, SOS Médecins or medical advice) than waiting in an overcrowded hallway.
“We are not magicians”
Elderly people who live in EPHAD where the referring doctors are insufficient, patients who cannot find treating doctors, many retiring without being replaced and others who wish to consult a specialist, find themselves in the emergency room.
“But in the emergency room, they will not see a specialist, especially at two in the morning, points out Philippe Revel.
Care pathways need to be reorganized.
We are not emergency room magicians, we have no more answers than city medicine”.
If emergencies find themselves overcrowded, it is also because they are “at the end of the chain” and perceived as a last resort accessible to all patients.
Between 55,000 and 73,000 people are seen each year in the emergency room of the Pellegrin hospital.
“We have temporary staff in the emergency room, we have 40 medical students at the Samu to hold the regulation center of 15 and volunteers at the entrance, lists Gilbert Mouden.
How far are we going to go in degrading the healthcare system?
“Many caregivers are worried as summer approaches, a period of intense activity where the emergencies of the CHU must in particular relieve those of the establishments installed on the coast.
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