For Dr Caroline Brémaud, it’s a “cry from the heart”. On this morning of Tuesday, December 27, the head of the emergency department of the Laval hospital center (Mayenne) called on caregivers, the media, users and “all concerned citizens” to gather in front of the establishment, to try to alert to the “more than tense” situation within its emergency department. “We caregivers are overwhelmed, you patients are abandoned”, she denounces on Twitter, believing that the health system “is collapsing”. In a service calibrated for 90 daily passages, the triple epidemic of Covid, flu and bronchiolitis greatly weakens the teams of Dr. Brémaud, forced to treat, for a few weeks, “between 120 and 140 patients every day”. Last week, a peak of 158 patients in a single day even marked the minds of caregivers.
“The patients wait on stretchers, even on chairs. We don’t have time to take care of them. Quite frankly, they are not welcomed in dignified conditions”, summarizes the doctor, annoyed. Same difficulties on the side of the Samu, which would have experienced last week an acceleration of up to “1500 calls” in one day, against 400 usually. “Patients sometimes had to wait several hours for simple advice. My colleagues are exhausted, we see it very badly”. By the admission of the Minister of Health François Braun himself, the current triple epidemic, to which are added the Christmas holidays for caregivers, the fatigue of the teams or the lack of hospital beds, weighs heavily on services emergency “saturated”. “Our health system is particularly in tension at the moment, with the Samu who have an increase of 30 to 40% in the number of calls”, he indicated on December 23 during a night visit to the Samu of Paris.
“Everyone is mobilizing in a kind of sacred union which is remarkable”, he wished to greet, nevertheless predicting a situation “even more complicated next week”, and an “extremely difficult course to pass” . In a press release published the same day, the Samu urgences union in France (SUdF) highlighted a “dizzying” rise in Samu activity over the last fortnight, with a 55% increase in calls in the week of December 12 to 18, 2022 alone compared to the same date in 2021 – “the worst period” that caregivers have experienced “since March 2020 and the first wave of Covid”. Same assessment on the side of the emergency reception services, whose activity would have increased by 5 to 10% over the month of December. “The treatment times are increased by 10% and the number of patients simultaneously present by 10 to 15% compared to 2021”, details the SUdF.
“Concerned” patients
In an attempt to cope, department heads and establishment management are organizing themselves as best they can, digging into the workforce on leave or their last resources. At the CH de Laval, an agreement was thus signed with the Civil Protection of Mayenne, in order to take care “as well as possible” of the dozens of patients received in the emergency room. In addition to streamlining logistics by bringing blood samples to the laboratory, carrying out stretcher-bearing missions or facilitating the return home of patients, volunteers also monitor the bells of the sick, bring them food or drink, reassure the more anxious. “In fact, they do what we no longer have time to do. They bring a little humanity back into the care,” explains Caroline Brémaud. Monday, the day after Christmas, one of them, for example, took the time to hold the hand of an elderly patient, more than stressed by her visit to the emergency room. “We needed an attentive ear: we must not believe that the patients do not realize the situation. It worries them a lot”, testifies Rémy Besson, president of the Civil Protection of the department. In one month, he indicates that his team has already been mobilized “about ten days” to meet the needs of patients… And caregivers at CH Laval.
At the Rennes University Hospital, the emergency department and the Samu headed by Professor Louis Soulat are also counting on the help of Civil Protection and the Red Cross. “We, it is not for the reception of patients, but to reinforce medical transport”, tells the vice-president of the SUdF to The Express, while two emergency services are currently closed in the department. For 15 days, the emergency doctor has also called on medical students, who come to help their elders manage the 30% increase in the activity of Samu 35. In the corridors of emergencies, the results are not more optimistic . “Every morning, we have between 20 and 30 patients who sleep here due to a lack of beds on the floors”, deplores Professor Soulat, overwhelmed. Last week, his teams had to accommodate up to 50 patients at the same time. “It’s too much. They clearly do not benefit from adequate supervision”.
“We fill in the holes”
Same fight in the Paris region, where Pierre Schwob, co-president of the Collectif Inter-Urgences (CIU), evokes a “catastrophic” situation. At the Beaujon hospital, in Clichy, this nurse from the emergency department recounts, annoyed, the frantic pace caused by the 120 to 130 passages per day – against an annual average of 100 daily patients. “There is a lack of space, of emergency personnel, of oxygenation capacity for patients”, he describes. “I have about ten treatment boxes: when I have fifteen patients to treat urgently, where do I put the other five?”. On the evening of December 22, the caregiver claims to have had no other choice but to warn his management, via a “declaration of serious and imminent danger”. “In 24 hours, we were released an additional nurse, and medical students were sent to the emergency room to help,” explains Pierre Schwob.
If these reinforcements allowed the service, for a time, “to collect the influx of patients”, the nurse does not say he is relieved. While the director general of the Regional Health Agency (ARS) Ile-de-France, Amélia Verdier, called “solemnly” Friday, December 23 to the mobilization of liberal health professionals and private clinics to “relieve hospitals”, the nurse is worried about repeated absences and departures from his emergency department. In one year, he says that no less than ten caregivers would have left their post there, to join other services, deemed calmer. “In the meantime, we fill in the holes as we can. We call students, associations, liberals… But what is the next step?” he asks, regretting a situation that has become “unmanageable on a daily basis”.