2023-08-25 15:45:13
By visiting the emergency department of the Libourne hospital center, we pass in front of many patients who wait on stretchers, in the corridors, with a resigned expression. “Sometimes we can no longer move, comments Anaïs Girard, head of the emergency department of Libourne and Sainte-Foy-la-Grande. And this morning, it’s not a busy morning… ”She explains, this Friday, during the support visit from the Regional Health Agency (ARS) following a complicated summer episode, that a doctor who takes care of her morning can have up to 35 patients to see. Doctor Etienne Grandidier knows something regarding it, following having finished his 24-hour shift, he will be with patients once more from midnight this evening, due to the lack of doctors.
An undersized service
“We manage to ensure the recommended timeframes to take care of vital emergencies”, tempers the head of the emergency department, while underlining the difficulties for other care such as those of certain elderly people who stay more than 24 hours on stretchers. And this summer, the center was put to the test since activity there increased by more than 10% compared to 2021, due to the closure of the Sainte-Foy-la-Grande emergency room. “The service is old and sized to accommodate 100 people per day, but we took care of up to 140 daily this summer, says Anaïs Girard. We look forward to working in more suitable premises. But for the moment, there are no funded projects to modernize the premises.
While normally the pace slows down following August 15, that has not been the case this year. Fortunately, the center was able to count on caregivers from other departments of the hospital who came to lend a hand. “Our referral sector is vast, there is northern Gironde but also part of Dordogne and Charente, with no other emergency centers nearby, apart from the Bordeaux conurbation,” underlines the head of the pole.
A bell for all regulation
Access to the emergency room is via a bell and then it is a reception nurse who directs the patients. “The bell is to limit attacks on staff,” explains the head of the center. Depending on the seriousness of their cases, patients are then directed to the various emergency departments. “Normally, hospitalization in the emergency room should be limited to 24 hours, but it’s a little longer at the moment,” adds Anaïs Girard. In the reception area, there can be up to twenty patients at the same time and it is too small, which poses problems of confidentiality. “Normally, only regarding fifteen patients stay following midnight and this summer, we had up to thirty,” she adds. The pole is trying to innovate to deal with the difficulties and has, for example, created an emergency downstream unit to offer “decent conditions of care to prevent patients from remaining on a stretcher”, points out the head of the pole. .
The service remained open all summer “with degraded staff”, specifies Anaïs Girard. Like many establishments, the Libourne hospital is experiencing great recruitment difficulties. In the emergency department, there are 17 full-time equivalent doctor posts, but 30 would be needed to operate under normal conditions. “We are in great difficulty, people are running out and leaving the ship, says doctor Etienne Grandidier, emergency doctor. And, the territory is devoid of general practitioners. “In addition, new recruits rarely want to work full time “because it’s too hard”, justifies Anaïs Girard. The establishment has a training plan to support general practitioners who wish to become emergency physicians, five of whom are currently following this program. “Without this initiative, we would only have 12 doctors”, warns the head of the pole.
If the numbers of paramedical personnel are less complicated, almost balanced for nurses, the challenge is to keep them within the teams. Crèche for staff, training plan, proposals to improve skills are among the tools deployed to try to retain them. Regulation, with the creation of a Samu Nord Gironde, is desired by the teams, who note that the Samu Gironde is overwhelmed. “These are difficult conditions, but we are committed to giving meaning to what we are doing”, relativizes Anaïs Girard, who points to the unfailing investment of her teams, who are nevertheless exhausted, as she made it clear to the ARS.
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