Home Health Covid, the protest of those who work in the emergency room: “There are still 4 thousand doctors and nurses missing. Insufficient recruitment and deserted tenders, so hospitals risk closing services”

Covid, the protest of those who work in the emergency room: “There are still 4 thousand doctors and nurses missing. Insufficient recruitment and deserted tenders, so hospitals risk closing services”

by admin

While Italy and Europe face the beginning of the fourth wave, the protest of those who work in the emergency room of Italy, the gateway to hospitals, returns: after almost two years of Covid, the category of doctors of the emergency-urgency departments denounces the lack of 4 thousand doctors and nurses, 30% of the staff needed to make them work, with problems of exhausting work shifts, overcrowding, waiting ambulances. For the first time the association representing them (Sime) takes to the streets. He denounces the risk that the surge in infections will force services to be closed, as happened in the most dramatic phases of the pandemic. He claims that the payroll incentives, recently earmarked by the government for 90 million euros, are welcome but absolutely inadequate to counter the “ongoing desertification of the departments, which directly affects the skin of patients and the quality of work and life of doctors”. The event will be held on its own Wednesday 17 November in Piazza Santi Apostoli in Rome, from 12.30 to 15.

The protest arises from the certainty that what has been done so far is not enough. Most of the competitions which have been banned to reinforce the wards are gone deserted in all Italian regions, many of the professionals have given up their jobs, one Scholarship out of ten of the specialty it was not even awarded in the 2021-2022 academic year. For lack of interest of recent graduates, since 18% of the students then left. “I knew of the difficulties when I chose this area, I don’t rule out leaving it as other colleagues do,” he says for example Alessandro Salzmann, who specialized just last Tuesday in Campobasso. “These are all the symptoms of a seriously ill system in which everything is difficult and heavy,” he says Mariapia Ruggieri, emergency doctor, head of the Emergency Department of the San Giovanni Addolorata hospital in Rome. Let’s take stock with Fabio De Iaco, head of the academy of Simeu directors and director of the Martini Emergency Department in Turin.

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The government allocates 90 million and you go to the streets, why?
It is not a demonstration against but for: we are not a trade union or a lobby, but a scientific society of professionals in the emergency area. Second point, the incentive is a positive signal, also because for the first time it inserts a differentiation between those in the emergency room and all the others, but completely insufficient: in fact, it is 100 euros net in paychecks, which is certain money. , but they are the equivalent of a private visit from any colleague who can do up to 50 a month while we only work for the national health system. After all, many young people, in the face of an entry salary as a first-rate manager of 2500 euros a month, preferred to stay away from the massacres of the emergency room and also had the convenience of doing so: the young doctor who goes to do the vaccinations or the Usca takes 60-80 euros for six hours of work, without nights and without the stress of the emergency area. Do the calculations yourself, the figures are not comparable. But it’s not a question of money: give us less, but put us in a position to work.

But why are you manifesting right now?
Because in the face of the fourth wave we risk closing services.

What do you mean?
The increase in infections will probably have a slightly lower clinical intensity than the previous ones because it mostly concerns unvaccinated people. But he arrives in a situation that is profoundly different from the previous ones in which people stayed at home, heart attacks and tumors also disappeared because those who were sick did not come to Ps. Now everyone is arriving, including those with minor medical conditions who may turn elsewhere. Basically we have returned to a pre-covid condition, with 24 million accesses in the Ps, and it is not changing despite the fact that Covid is rising. It’s like I have a football team that has to play on two fields.

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Where have all the doctors promised during the pandemic gone?
Our data show that in the last year, compared to 2 thousand exits, we only had a thousand entries. On average, we were able to replace a doctor for every two exits, plus the absences that were already previous. That is, it is true that some assumptions have been made, but they are completely insufficient compared to the exodus that took place. To this I add that the Covid contracts that have been talked about so much in the vast majority of cases are made with people who do not have the necessary qualifications to work in an emergency. These are young graduates, splendid and moving, but who cannot be put on duty in the emergency room tomorrow morning because they do not have the skills. In addition, the doctors hired are brokered by employment agencies and cooperatives that cover some of the Ps and take 125 euros an hour: that money does not all go to the doctor because there is a substantial portion that remains with these companies. It means that it is uneconomical to encounter those situations.

What would it take to intervene in support of the Emergency Department?
A total rethinking of the emergency-urgency system in the medium and long term. To be able to participate in the reconstruction of the health system. A new relationship between training and hospitals: we want a group of postgraduates to enter hospitals at this time, who instead are kept outside the hospitals and are only in the university. And that those postgraduates can be usefully employed in the assistance also in Ps under the guidance of the directors and on the basis of their skills that it will be precisely the directors who will establish, from time to time, to understand up to what level they can be pushed to work. If I get a recent graduate I cannot put him in Ps, because if a cardiac arrest patient arrives in the red room in cardiac arrest due to polytrauma, I cannot think that there is a recent graduate but I need an absolutely expert doctor.

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And how do you get it?
These levels of competence are established on the one hand by specialization: those who have it can do it, on the other hand in this phase as we have to run for cover we must also be able to legally establish levels of competence so as they progress these young colleagues who must be enabled to work in hospitals can be assigned to ever greater functions. I realize that it is complex, but it is the only solution we can see, otherwise we do not know how to do it except, I repeat, close the services.

What are the effects for citizens?
Citizens pay for it in terms of time available to the patient by the Ps staff: it is logical that if I have 50 patients in one shift among those who come in and out, I will have less time for each one than I have in charge 25 Because the problem is that we are constantly losing energy and resources but the patients always remain the same and indeed increase. But we keep replying: it is evident that somewhere we are subtracting something. We are finding that the quality of care is dropping in some areas. We see it every day, when we do the morning briefing with those who stayed for the night, we see what remains in the emergency room and we realize if the answers, let’s put it this way, are not adequate as we would like and should.

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