Hospital workers have been called to protest across France this Saturday (December 4) over a shortage of staff, which has been aggravated by the Covid-19 pandemic.
Industry unions have issued the call.
As many as 20% or more of hospital posts remain empty, and the shortage is now starting to hit nurses, with 7% of positions now unfilled. Staff have left, resigned, gone on sick leave, or been suspended due to not having the Covid vaccine.
Healthcare professionals are required by law to be fully vaccinated, or face suspension.
At the Bourges hospital in Cher, Centre-Val de Loire, Dr Isabelle Meyer explained to FranceInfo that she was looking for doctors “everywhere”, and conducting interviews via video call to people based all over the world.
She said that the shortage of available physicians meant she had been forced to look to foreign doctors, army doctors, healthcare reserve teams, and even ask retired people to come back.
She said: “There are now only four of us, for 27 positions [in my department]. If we all worked 24 hours, we’d have to work 365 days a year just to cover it.”
Some workers at the hospital are even working 24-hour shifts three times a week.
The hospital’s Jacques-Coeur centre is especially struggling after personnel retired and no one was there to replace them.
Dr Meyer explained that younger doctors prefer interim roles that are better paid and with more flexible hours (as they choose their own), for example: up to €2,000 for a 24-hour shift over less popular days such as Christmas.
Finding enough staff has almost become its own full-time job, she said.
She said: “It's a real headache. There are gaps in the schedule every day...Someone who is sick, or an interim agency doctor might tell us that the next day, in the end, he can't come. It happens."
Last October, ambulances from the Samu were unable to leave for an intervention because of a lack of staff, she said.
Intensive care services have been struggling too.
Dr Olivier Michel, head of the Bourges hospital’s intensive care unit, said: “Out of a service that usually has 12 beds for the whole department, we only have 10 beds open, so two beds are closed.
“We don't have enough nurses to increase our number of beds in case we see more hospitalisations of Covid patients. A number of nurses are on sick leave, are absent, have resigned... Some have been suspended."
"In an institution like ours with over 2,000 staff, we still have seven nurses who have been suspended for not having been vaccinated. It's not much, but it adds up."
As a result, the hospital has had to shut 52 beds, including in the departments of geriatrics, cardiology, and intensive care.
Tension and the ‘plan blanc’
Last week, the hospital enacted the ‘hospital under stress (hôpital sous tension)’ system, after it saw an influx of patients suffering from winter illnesses, as well as Covid patients.
The ‘under stress’ protocol is designed to help an establishment deal with a crisis situation while maintaining continuity of care and preserving the safety of patients and staff.
It is the last level of alert before the ‘plan blanc’ status, which enables hospitals to cancel or postpone non-urgent appointments and operations in order to reroute staff and resources to the most urgent cases; and add emergency beds.
Covid has only intensified the problem, doctors say.
Agnès Cornillault, director of the Centre hospitalier Jacques-Cœur de Bourges, said: “Obviously, the hospital is in even greater crisis, because today, we are living with Covid.
“I have no doubt about the hospital’s capacity to adapt, but I do doubt its ability to stay resilient and resist another crisis. So many have given so much to weather the peaks of the crisis. As a result, people are exhausted and are questioning what they want to do next.
“We have had a real lack of time over these past few years to talk about what we’re doing. Everything is timed and under pressure. But we need to make sure we have time to think about what we’re doing.”
The hospital is expecting that it will need to transfer certain patients to neighbouring hospitals if an influx of Covid patients is admitted over the next days and weeks – but there is no guarantee of a place elsewhere either.
‘Non-vaccinated’ taking up intensive care beds
The ‘plan blanc’ has already been enacted in some hospitals in France already, including in Colmar and Mulhouse in Haut-Rhin, Grand Est.
The Colmar hospital raised the alarm on December 1, and has highlighted that its intensive care units are now full of unvaccinated people.
Head of emergency Dr Yannick Gottwalles, told France Bleu: “All Covid patients admitted to the ICU who are unvaccinated. The intensive care units are saturated with patients who would not be there if they had been vaccinated.
"We are coping with this and increasing our capacity because the fifth wave is here and we are not yet finished with this epidemic.”
His colleague, Dr Elisabeth Gaertner, head of the anaesthesia-intensive care unit at the hospital, said: “I am seeing patients aged 20, 37 or 40, who show no signs of other conditions, and who have to be intubated because they are arriving in great respiratory distress.”
The Mulhouse hospital currently has 77 Covid patients, of which 16 are in intensive care.
The occupation level of intensive care beds is currently at 37.3% across France as a whole, but capacity varies considerably between departments.
(Map: France Bleu)
It comes as the fifth wave of Covid continues apace in France, and the government is urging all eligible adults aged 18 and over to book their booster vaccinations as soon as possible.
The latest figures from Santé publique France (December 1) show that there were 49,610 new Covid cases confirmed in France in the past 24 hours, and 93 more deaths.
The rate of positive tests is now at 5.8%, and the first case of the new variant Omicron has now been confirmed, in the Paris region.