Foci of contamination which are multiplying in hospitals. And a little insidious music pointing the finger at the responsibility of caregivers. For dozens of health executives, members of the Inter-Hospitals collective (CIH), after months of efforts on the part of their teams, this is the last straw.
Usually discreet, the supervisors split a press release rejecting this status of scapegoat, designated by certain media and hospital management: “Despite the barrier measures that we have scrupulously applied for a year, with of personal protection always just in time, we endure the degraded conditions that we denounce for a long time. “
Latent guilt
In a hospital in the south of France, Marie (1), a pediatric health manager, deplores this latent guilt. “The management takes turns to see if there are not too many of us in the rest room and if we are well masked. I fixed gauges so that not everyone was on break at the same time. But you can’t completely dehumanize moments of decompression. We are already in non-stop vigilance. This surveillance is badly taken by ultra-dedicated personnel in the battle against the pandemic. The work force of its pediatric outpatient surgery department, closed three times in 2020, has thus been redispatched in the Covid units. “It was all done in a rush. The only executive in the sector, I found myself managing 90 people day and night, says Marie. I haven’t counted my hours. Right now the pressure is stronger than in the second wave on our hospital … I try to take the problems one by one. “
Sacrificial context
At the Pau hospital center (Pyrénées-Atlantiques), in mid-November, a cluster declared itself in geriatrics. “The caregivers were admirable,” says Florence Pinsard, who oversees long-term care (LTC) with 80 beds. They went back to their days off and the annual leave was canceled. We had 25 residents sick and 12 deaths, it was hard on everyone. Twelve staff were also affected. In this sacrificial context, it is out of the question to tolerate the slightest allusion to the lack of professionalism. Precautionary measures very often come up against the principle of reality. “There are 26 patients for three nurses, and the working conditions mean that it sometimes happens to make mistakes,” continues Florence Pinsard. But if an elderly person slips on the ground, we are not going to say to him: “Sorry, I am washing my hands, I am coming back”. When we feed them, there are postilions that we cannot avoid. “
Contradictory injunctions
Caught between a rock and a hard place, between management and their teams, contradictory injunctions are part of everyday life. Speaking is all the more difficult for these professionals working in the shadows. “We are invisible little soldiers,” said Marie, who was hit hard after months of surge. “We are there to be with the caregivers. I struggle when people want to close beds for us. I try to stay true to my values. “During the first wave of the coronavirus, a number of supervisors were able to benefit from greater latitude for action. “We were listened to more, analyzes Florence Pinsard. But we also felt abandoned at times. It was really hard to manage. I’m used to the mental load, but this was at the limit of what I could handle. “
Disillusion rises
Very attached to her public service mission, Fabienne Eymard, a health manager in pediatric orthopedics at the Public Assistance-Hospitals of Marseille (Bouches-du-Rhône), does not regret her professional choice. “Even if I only have a management bonus of 90 euros, which I am sometimes paid less than a nurse in my department, I like what I do. But you have to be lucid, a health framework, that does not make you dream. We are short of candidates. I accumulate unpaid overtime every day. A certain disillusion arises in the stories. Having to remind the teams on the days off, juggling the schedules becomes hell on a daily basis. “I spend 90% of my time contacting people to fill the understaffing. I am the firefighter on duty, ”emphasizes Fabienne Eymard. It’s even worse with the Covid. “Last Tuesday,” she continues, “for example, I asked the team that had just worked twelve hours to stay two more because the night nurse did not come. It’s not easy. I thought that we would have more time to think about treatment protocols or the construction of projects, but that remains marginal. “
Gain autonomy
To return to the basics, executives are now organizing themselves within the Inter-Hospitals collective. The issue of governance in their services, pushed out of the scope of the Ségur de la santé, is more topical than ever. The stake is crucial according to Axel Hoffmann, supervisor at the hospital of Cahors (Lot), which supervises resuscitation, and temporarily emergencies and SMUR: “We want to take part in decisions. Today everything comes from above. If we need to buy equipment, it’s the obstacle course. We would like greater autonomy in the services carried by a managerial duo, doctor and executive, but also for decisions to be taken with more collegiality in the hospital. By not taking into account only the financial parameters. “
(1) The first name has been changed.
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