“In the emergency room, we are facing a difficult situation. With the holidays, this situation is even more tense. “And it is Elisabeth Borne who recognizes it. According to the Prime Minister, calls to emergency services have increased in France by 20 to 30%. Except that opposite, emergencies are struggling to meet patient demand.
One of the causes is well known: under the effect of a triple epidemic, emergencies are facing a massive influx of patients. On this Christmas Eve, the flu continues to “progress strongly in France (+ 84% of visits to the emergency room in one week), like covid-19 (+ 2.8% of hospitalizations in the last seven days ). Bronchiolitis is regressing (-24% emergency room visits in one week) but remains at a very high level. Result: “We have between 120 and 140 patients per day in the emergency room of Lorient, even up to 145”, remarks Dr Christelle Mauconduit, interim head of the service.
Hemorrhage among caregivers
The overactivity in the hospital cannot be explained by the medical alone. There is also the human. While the needs are there, the massive flight of caregivers continues, accelerated by the health crisis. Exhausted by years of scarcity and lack of resources. With consequences: due to lack of staff, nearly 20% of beds are closed, according to the Samu-Urgences de France union. Fewer beds but more patients: enough to create traffic jams in the emergency corridors and lengthen the waiting times before treatment.
Finally, there is the context of the holidays. The holiday period is a source of population movements and family reunifications which can be the cause of a significant postponement of consultations in the emergency room. And, on the caregiver side, there is the departure of staff on leave.
White plan activated
Faced with overloaded emergencies, many hospitals have launched their white plan. Including in Britain. In Morlaix, it has been activated since November 30. On the same day, the Regional Health Agency asked all health establishments in Ille-et-Vilaine to do the same.
White plan also activated at Lannion and Brest-Carhaix hospitals. It allows you to change schedules, trigger overtime and modify staff organizations. In Vannes, we have even just moved to level 2 of the system, making it possible to consider intervention deprogramming.
Landerneau emergencies closed at night
But this is not always enough. In Landerneau, the lack of staff is such, at Christmas, that the hospital announced that it was forced to close its emergency reception service, from 11 p.m. to 8:30 a.m., from Friday December 23 to Monday January 2, 2023. Maternity care will be provided.
“Despite the search for all possibilities, the organization cannot be maintained”, writes the ARS in a press release. The establishment recently faced the successive departure of eight emergency physicians. For the holidays, this will therefore be a minimum emergency service: open during the day but, at night, “centre 15 will direct patients to the place best suited to their needs”.
Regulation in Vitré and Redon
Other Breton establishments avoid closing but are forced to apply regulation to entries, to compensate for the lack of arms. Thus, only patients requiring very urgent care have been accepted, since the end of November, in the emergency departments of Vitré and Redon, between 8 p.m. and 8 a.m. The other patients are redirected to surrounding establishments, and in particular to Rennes. It is the 15 which is responsible for distinguishing those who are part of the first category.
Elsewhere in Brittany, emergencies remain open to all but it will probably be necessary to wait long hours before seeing a doctor. “Very long”, even, according to the ARS, in the adult and pediatric emergency services of Ille-et-Vilaine.
Long hours of waiting
“The partial closure of the emergency department of Landerneau will have repercussions on the activity of the emergencies of La Cavale Blanche, Carhaix and the Morlaix hospital center”, warns, for its part, the CGT CHRU Brest-Carhaix. “However, in these three emergency services, the situation is already catastrophic. »
“The lack of nursing staff, uncompensated absenteeism, sustained activity and the maintenance of certain non-urgent scheduled activities are the cause of these degraded organizations which not only generate a loss of opportunity for patients but also endangering the lives of others of the population dependent on the emergency care of the Brest-Carhaix CHRU ”, denounces the CGT, which has just filed a report with the public prosecutor of the Brest court.
Call 15 before going to the emergency room
Faced with the expected influx, the establishment management is organizing and chanting a watchword. In Ille-et-Vilaine, the Fougères Hospital Center, which had to regulate access to these emergencies two weeks ago, asks “the population to call 15 before moving”. In Quimper, the management of Chic also reminds the population of the “need to call 15 before going directly to the emergency room”.
In Saint-Brieuc, we are now going further, from December 24. “Access to adult emergencies at the hospital center will be by systematic call to 15, excluding vital emergencies,” announces Ariane Bénard, the director of the hospital. Concretely, patients will continue to be received. But if they have not called the regulation before coming, they will be redirected. “We went up to 246 passages in one day when the average is normally 170”, justifies the management.
In Lannion, as at CH Max-Querrien in Paimpol, we remind you that emergencies should only be considered as a last resort. “Before, you have to turn to the attending physician or the on-call medical center, open without an appointment, on Saturdays, from 2:30 p.m. to 9 p.m., and on Sundays (and public holidays) from 9 a.m. to 9 p.m. »
letelegramme Fr Trans