The jokes fuse in the room which serves as a collective office for the doctors.

It is 8:30 a.m., the night shift is handing over to the day shift after a "fairly busy" shift.

That does not prevent caregivers from teasing each other about the next outings between colleagues or the dark circles that dig some faces.

"The good atmosphere, it keeps everyone. The same guard with people who make the face or who shoot themselves in the legs, it's not the same", underlines doctor Thomas Stadler, 29, who ends his service .

This recently graduated practitioner is one of the twenty doctors hired since 2019. At the time, after several departures, the service had only seven holders and relied on temporary workers.

Episodes of strikes had shaken the emergency room and all of the 17 interns had declared themselves on sick leave for professional exhaustion.

Entrance to the emergency room of Mulhouse hospital, January 16, 2023 © SEBASTIEN BOZON / AFP

To restore stability in this service, which receives 60,000 patients a year, it was necessary to attract and retain staff.

Not easy for an establishment located outside a large metropolis and close to Switzerland and its wonderful salaries.

"We activated two levers", explains Marc Noizet, the head of the service, recruited to get out of the crisis.

"We accompanied practitioners who wanted to train in emergency medicine. And we welcomed young people in their final year, when they come out of thesis. They feel good here, they all signed a contract behind", underlines the doctor, also president of the association Samu-Urgences de France (SUdF).

The "French Tri"

In less than four years, the emergencies have expanded and now have 28 doctors.

A real success for this hospital, the first in France to have been massively confronted with the Covid-19 pandemic, in the spring of 2020.

Review of the night in the emergency room of Mulhouse hospital, January 16, 2023 © SEBASTIEN BOZON / AFP

More recently, like other establishments in France, its emergencies were swallowed up at the end of December by a triple epidemic of Covid-19, influenza and bronchiolitis.

The service has also adopted a new method to orient patients in an efficient manner, the "French Tri" (French Emergency Nurses Classification in-Hospital Triage), recommended by the French Society of Emergency Medicine. .

Doctor Marc Noizet, head of emergencies at Mulhouse hospital, examines a patient shortly after admission, January 16, 2023 © SEBASTIEN BOZON / AFP

This color code assigned to the medical file according to the degree of urgency, replaced the old system of distinction by painful zone or organ, which did not always make it possible to correctly give priority to serious cases.

“We ask questions, we sort according to the clinical condition of the patient and his history”, explains Isabelle, reception and orientation nurse (IAO), 56 years old.

His position, "strategic", is reserved for experienced caregivers.

“If we send someone who has a heart attack to the waiting room, thinking that it is gastro pain, it is problematic”, underlines Pascal Erhard, 58-year-old Smur nurse.

Obsolete IT

Despite this progress, all is not rosy in the service, which is faced with the same difficulties as all public establishments: the hospital has closed around a hundred beds, not counting those which are not usable, given the shortage of nursing staff on the floors.

"It's a puzzle," says Dr. Sophie Nguyen.

This experienced practitioner multiplies "daily" phone calls to find beds for her patients.

"There, I have an 84-year-old man, completely dependent. There is no reason for him to stay in the emergency room, but I can't find any service that accepts him," she said, hanging up the phone.

"I've been on it for an hour. During that time, I don't heal".

Doctor Marc Noizet, head of emergencies at Mulhouse hospital, responds to an emergency call, January 16, 2023 © SEBASTIEN BOZON / AFP

To increase the time devoted to care, Marc Noizet would like to simplify the administrative procedures incumbent on doctors.

He readily admits that he spends more time in front of his computer, filling in patients' medical files, than with the patients themselves.

"IT wastes a lot of our time, the tools are not ergonomic. With tablets and voice dictation, I would do everything near the patient's bed. But IT is very expensive, we end up with systems who are 20 years old", he regrets.

"It's a real subject."

© 2023 AFP