Marc Beaufigeau is a cardiovascular surgeon at the Saint-Pierre clinic in Perpignan. A specialty which, until then, had been spared from deprogramming. But, for the past two months, he has also been faced with the postponement of certain operations. A situation which does not result directly from the Covid but from an accumulation of factors: pressure from caregivers, resignation of nurses, patients who no longer dare to consult and delays in appointments.
As a cardiovascular surgeon, can you describe the situation you are facing?
Since the start of the Covid crisis, there have been delays in the detection of the disease. In oncology, some patients arrive for screening and are already in the palliative stage. That is, they are no longer curable. In a developed country, this is not normal. Me, it’s special, because I’m in a cardiovascular specialty where pathologies are considered urgent and priority. So we hadn’t shifted much so far. But, for two months, it begins. I have two or three deprogrammings a week. I have a patient who is deferred for the fourth time.
How do you explain it?
We are facing a huge resignation from caregivers. In the teams of nurses, there is an exhaustion, a real suffering at work. They are exhausted. In the private sector, we have not taken care of a lot of Covid patients, but there is a change in the way of working, in organizations. We’ve downsized and there’s no more flexibility. Yet they do a tremendous job. It is an extremely hard and badly paid job. They are called once home to come back because there are not enough arms left. In twenty years of work, I had never seen that: two evenings in a row, nurses call me in tears, telling me that they can’t take it anymore. But they are our guardian angels, without them we will not succeed.
What is the consequence of this pressurization and resignation of the nursing teams?
Today, we closed hospital beds at the Saint-Pierre clinic because there are not enough nurses to operate them. We are not deprogramming because of the Covid, we are deprogramming because we don’t have enough nurses. When you close a floor, you have to rethink the whole organization, the patients are mixed. On the same floor you can have a patient on cancerology, cardiology… Normally, nurses have training to have a field of specialty, now they go from cock to donkey. We are also asked to increase turnover. We manage to do major operations such as colon surgery on an outpatient basis. Obviously we don’t do that with all patients, we see who is able to bear going home the same evening. Nurses have to cope with this turnover which leads to enormous administrative burdens. They spend 40% of their time in front of screens. But it is a national situation.
And the patients in all this? The pressure on health is known to everyone, how do they react?
The Covid has been the accelerator of a problematic situation. We see the arrival of acute illnesses taken care of at a much more serious stage. Instead of going through the consultations where they were told: “We’ll operate on you in a week or two because it’s urgent”, now they come directly to the emergency room.
What message would you like to convey to patients?
It is absolutely necessary to continue to come to see us, to be tested. We are going to be human, to take charge as best we can. We will adapt and we will be tailor-made. There will surely be a bit of a wait, but you have to consult and not wait.
“15 to 20% of beds closed in Saint-Pierre”
Julien Coulomb, director of the Saint-Pierre clinic, confirms this Friday evening that around thirty hospital beds, or 15 to 20% of the total capacity, are closed. Hospitalization beds, dedicated to stays of at least one night at the clinic, are to be differentiated from ambulatory beds, where patients leave the same evening after their intervention.
They are still running at full speed. A situation due to the triggering of the white plan “level 4, a national directive which asks establishments to deprogram non-emergency patients. We can no longer operate as much as before”, assures Julien Coulomb.
But also by a significant phenomenon of stops linked to Covid: “Either because the members of the team are positive, or because the child is sick and you have to pick him up from school”. In Saint-Pierre, the director of the clinic specifies that he has not given instructions to keep positive but asymptomatic caregivers in post.
Finally, he confirms that nurses are particularly under pressure. “Absences force us to change schedules. At the last check-in we had 10% absent for illness, that is to say that I do not count those who are not there because of their holidays. I am very admiring the dedication of the teams”.
(SOURCE: THE INDEPENDENT)