From the Carcassonne hospital center (Aude), Nathalie Cantié, nurse on the cardiology and emergency care technical platform, has noted for several weeks that a new patient population has been consulting within the establishment. “Summers” arrived in the region for their holidays, and resulting, according to this elected CFDT staff, a 15% increase in hospitalizations since June. The 50-year-old, twenty years of practice at the Carcassonne hospital, evokes this 70-year-old patient who became unwell in his swimming pool, in full sun at 5 p.m. The heat causes “additional charges on emergencies, with repercussions on services”she explains.
The Carcassonne hospital center is one of 127 French health establishments whose emergency services are in great difficulty, according to a list compiled by the Samu-Emergencies of France union (SUdF) what franceinfo was able to consult. According to this list, approximately 90% of hospitals in tension lack medical staff, when 47% face a lack of caregivers, nurses or administrative staff, among others. Faced with the new heat wave that is hitting France – in parallel with the seventh wave of Covid-19, several caregivers in these care centers in crisis are worried.
At the general hospital center ofOloron-Sainte-Marie (Pyrénées-Atlantiques), Angélique Lebrun, CGT secretary, ensures that she does her union half-time during her rest time this summer: due to the “needs” currently, she has found full-time work as a nurse’s aide in long-stay service. In this unit, a nurse is currently in charge of 37 beds, “and we tour with nurses from other departments”, warns the trade unionist. Its service welcomes patients who can no longer stay in nursing homes, people in palliative care as well as patients with physical or mental disabilities. But “how to take care of the elderly if we do not have the necessary staff?”, asks the nurse’s aide.
The director of the hospital center, Frédéric Lecenne, explains to franceinfo that the main difficulty for the hospital is that of the lack of doctors. “For the month of August, we have almost 30% of doctor ranges not yet covered.” In the geriatrics department, half of the beds will be closed next week due to the lack of a doctor. “For three weeks, we have reduced our total bed capacity by 20%”, says the director of the hospital.
“The priority is the line of mobile emergency and resuscitation structures. When the doctor (emergency physician) goes out, there is still the paramedical team and an anesthesiologist but there is no longer a doctor in the emergency department at the hospital.”
Angélique Lebrun, nursing assistant and CGT secretary at the Oloron-Sainte-Marie hospital
at franceinfo
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The establishment operates with more than 60% of replacement doctors, and the situation in the emergency room is particularly critical. “We should have 11 doctors, there are currently two”, due, among other things, to work stoppages. According to Angélique Lebrun, the activity in this service, which was to close in May, was able to be maintained thanks to “to the solidarity of the substitute doctors who have taken vacations”. Since then, the emergencies of Oloron-Sainte-Marie have been running “a lot on degraded modes”, illustrates the caregiver. For example, there was a doctor the night of July 11 to 12, but no doctor the night of July 7 to 8.
“Since 5 p.m., the emergency corridor has been full”, reported, on July 11 in the early evening, Agnès, nursing assistant in the adult emergency room of the Bordeaux University Hospital. The establishment, like the hospital of Oloron-Sainte-Marie, is one of the 127 care centers whose emergencies are particularly in tension. “There is a doctor with an intern. With the beds which are closed on the floors, we cannot move the patients”, describes the 51-year-old caregiver, an activist with Force Ouvrière. In her profession, absenteeism reaches 17%, she says. “The fatigue is felt, I don’t know how we’re going to hold out in the summer.”
“I think we’re going to lose some patients.”
Agnès, adult emergency nurse at Pellegrin Hospital, Bordeaux University Hospital
at franceinfo
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“At midnight, the emergency room doors are almost closed, except for vital emergencies”, continues Pascal Gaubert, Force Ouvrière secretary at the Bordeaux University Hospital. He adds that city doctors came to lend a hand in the service from 5 p.m. to midnight, for lack of staff. The trade unionist fears the evolution of the situation over the next few weeks, between the leave of caregivers, staff affected by Covid-19 and this wave of strong heat which is beginning. “It’s the summer of all dangers.”
In the Pellegrin emergency room in Bordeaux, caregivers and patients are directly affected by the high temperatures from the outside. The service has no air conditioning, only fans. “Imagine, we are around 34°C there, relate Agnès. I get out of work, I’m sweating.” During the heat wave in June, “We had to go and ask for fans, humidifiers to cool the patients.” But with this new episode of high heat, Agnès fears seeing patients become dehydrated in the emergency room, not to mention a possible influx of people affected by the heat wave. “I think we are heading towards disaster”, she lets go.
Angélique Lebrun, from Oloron-Sainte-Marie, shares this concern. “We are very vigilant” and the hydration of patients, especially the elderly, is closely monitored. However, “It’s very hot” at the hospital, points to the nursing assistant and CGT secretary. In his department, only the room where elderly patients have lunch has air conditioning, “otherwise they are just small portable air conditioners”. Frédéric Lecenne, director of the hospital, confirms this increased vigilance to further hydrate the most vulnerable patients. “The risk is to see dehydrated elderly people. We have also provided ventilators in many services”, he adds.
“In 22 years of activity as a nurse’s aide, this is the first time that I feel so worried about the summer. I fear that there are deaths.”
Angélique Lebrun, nursing assistant and CGT secretary at the Oloron-Sainte-Marie hospital
at franceinfo
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In the event of an influx of patients suffering from the heat wave, will these caregivers already on a tight flow be able to meet the demand for care? “Management has started anticipating. Staff will be recalled. And staff will return,” reacts Nathalie Cantié from the Carcassonne hospital center. “We will have to free up overtime, call on volunteers to come back, postpone holidays”, develops Pascal Gaubert from the Bordeaux University Hospital. At the Oloron-Sainte-Marie hospital center, the management will call, if necessary, on volunteer agents to return and overtime.
The seventh wave of Covid-19 adds further complexity to the situation. Several caregivers assure that at this stage, the resumption of the Covid-19 epidemic remains “manageable” across their services. Pascal Gaubert is however convinced of this: “If the wave were to hit, we would be in dire straits.”
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