Tribune. The Ukrainian terror following the backwash of the Omicron wave erases the hospital reality. The French public hospital no longer makes the front page of the newspapers. However, while nearly 110,000 patients have died of Covid-19 in hospital, and others have seen their care delayed, the difficulties of functioning persist, even worsen.
Because the hospital of 2022 is no longer that of 2019. Thus for years, the reduction of hospital staff was a constant concern of hospital management. Personnel costs are still the hospital’s leading expense item (58% to 66%, depending on the type of establishment).
But if, until 2020, the directions drastically regulated these expenses, with roadmaps of economic performance, now they have to run following caregivers in hospital disenchantment. Positions are vacant, beds, services are closing for lack of staff everywhere in France.
Stop-gap management
Thus, between 2015 and 2019, according to the annual social reports, the Public Assistance of Paris Hospitals (AP-HP) reduced non-medical care staff by 1,790 full-time equivalents (FTE) (from 50,150 to 48,360). AND P). At the same time, hospital activity was maintained or developed in certain sectors. The ambulatory shift of the lightest patients continued, leaving hospitalized only the heaviest patients, increasing the work of caregivers accordingly.
In 2016, at the AP-HP, a reform of the organization of working time imposed alternating hours and a reduction in working time, grabbing fourteen minutes every day to save three days of RTT per agent at the end of the year. . The increased workload (doing the same thing in less time) and the risk of degraded work did not seem to worry. Yet staff turnover was accelerating. Out of 100 nurses recruited in 2018, only eighty-three remained in post as of December 31, 2019, and sixty-nine a year later.
Still to contain the workforce, the AP-HP complied, like other hospitals, with national recommendations and imposed the assignment of twelve patients to each nurse. The hospital establishments performance support agency (ANAP) has enacted this standard (even worse, ANAP recommending a ratio of one in fifteen), even though in many countries, the safety ratios are d one for four to one agent for eight patients.
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