The Minister of Health François Braun evokes for a few weeks a project of "refoundation" of the profession. At the end of a seminar held at the ministry on Friday, he planned to bring it to fruition in September 2024.

Mr. Braun is due to visit a nursing school in Val-d'Oise in the afternoon to take the pulse of students and their trainers.

The minister reiterated his desire to reform the "decree of acts", a legal text that strictly regulates the acts of care that nurses can practice. In particular, he wants to introduce the notion of "missions", which would make it possible to give a slightly less restrictive definition of the profession.

The College of Nurses fully supports this project. "It is clear that the skills" attributed to nurses "will go towards more autonomy," explained this week the president of the Order, Patrick Chamboredon, at a symposium organized by this organization.

With the aging of the population, "many things will be played out in patients' homes, and in the Ephad", without a doctor being available immediately, he stressed.

Daniel Guillerm, the president of the National Federation of Nurses, is also in favor of a "reflection on the contours of the professions" of caregivers.

"Today, in a heat wave, if a nurse finds a dehydrated patient at home, he has no choice but to send him to the hospital," because he does not have the legal competence to provide the necessary care, he said.

"This is abuse," given the regular overcrowding of hospitals, he added. Especially since simple care could be enough in some cases.

Many brakes

In fact, nurses have already recently made progress towards more autonomy and responsibility.

For example, the Rist law of 19 May 2023 enshrines the know-how of nurses for the treatment of healing wounds and authorizes them to prescribe the necessary additional examinations and health products.

It also allows advanced practice nurses (APNs, who have two additional years of study and more autonomy in care) to receive patients without a prescription, if they practice alongside doctors - for example in multi-professional health homes.

There are still many obstacles to extending the autonomy of nurses, first and foremost doctors' organisations © SEBASTIEN BOZON / AFP/Archives

But there are still many obstacles to extending the autonomy of nurses, first and foremost doctors' organizations.

"We do not want the pretext of (care) teams to be a reason to slip notoriously medical tasks, which require long years of study and practice, to people who would be a little less experienced," explained recently Dr. Sophie Bauer, president of the Union of Liberal Doctors.

The review of the Rist Act has given rise to fierce battles in Parliament, where doctors' unions have succeeded in preventing, in extremis, thanks to the support of the Senate, that independent advanced practice nurses, practicing outside any medical structure, can receive patients without a prescription.

And among salaried nurses, some look with great suspicion at the major maneuvers that are coming around the decree of acts.

Without a text clearly setting out what a nurse can do – and by default what she cannot do – "there is a risk of worsening subordination to doctors" in hospitals, says Delphine Girard, nurse and national head at the CGT Health and Social Action federation.

"The shortage of medical and nursing staff cannot be compensated by new distribution of tasks and missions" between caregivers, she adds.

© 2023 AFP