Coup de grâce
- EM
- 12 déc. 2019
- 2 min de lecture
Our public academic hospital, the Assistance Publique – Hôpitaux de Paris, is dying, right now, just in front of us. The strike in public transport, started a week ago, is stricking the “coup de grâce”.
Over the past 20 years, we managed to strive for maintaining the level of care, both quantitatively and qualitatively, despite progressive but unstoppable shrinking of human resources in the hospitals of AP-HP (at least regarding the caring staff, including doctors, nurses, auxillary nurses, speech therapists, (neuro)psychologists, physiotherapists, …).
In such tense situation, any additional unexpected adverse event comes with a risk of complete collapse.
That’s more or less what’s happening.
You have to figure out that, as a consequence of the extraordinary increase of living costs in Paris and close suburbs, a vast majority of nurses and auxillary nurses are living far away from Paris, sometimes very very far away. More than one hour and half by train. Because of the strike, they need to wake-up at 3 am, to find a plan B to reach our hospitals at 7 am, to work full day until 3 pm, and then to go back home not before 7 pm. And they have to face this 7 days a week. And days and nights. Not surprisingly, despite they are highly dedicated to their job, despite we have no doubt about their true commitment in patients’s care, they started to give up, and to stay at home or to take a sick day. Managers had no leeway, given the chronic understaffing.
And without any nurses in the operative theater, without any nurses and auxillary nurses in the wards, we have no other options than stopping to operate. That’s what happened yesterday and today, and that’s what will happen tomorrow and next week.
But guess what ? For the first time since so many years, I do feel optimistic and I let myself dream for a short while.
The reason is quite simple: there is a sudden and collective awareness that we have hit the bottom and that, necessarily, whatever it will be, a better future is ahead of us.
The AP-HP is dead, long live to the AP-HP !
And now the real question: how to restart from zero and rebuild an efficient hospital that would take advantage of the high expertise of the caring teams ? how to convince money owners that the talents of people inside of the AP-HP make it worth to put money on the table, even if this is an investment without any other return than the satisfaction to contribute to a just cause ?
A topic for another post …
Et comme le rappelait le facétieux Vialatte, « Et c'est ainsi qu'Allah est grand »
I continue to think that understaffing is not the biggest issue, it’s the easiest explanation for malfunction.
Public system need to understand that theY have to move to an asymmetric personnel policy. This means that you have to encourage, economically and professionally, the personnel who wants to work more.
Due to workers unions in France, they will not accept this fact “the same for everybody they say”. I remember when in the EU some countries, France among them, wanted to go further in many political and economical fields but this was blocked by other countries and no progress was made. Then it was decided to do a “two speed” system and to progress only with the countries that wanted and…