Home Health Nephrology goes to Medicine at the Livorno hospital. Here’s why and what changes

Nephrology goes to Medicine at the Livorno hospital. Here’s why and what changes

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Nephrology goes to Medicine at the Livorno hospital.  Here’s why and what changes

LIVORNO. Like every summer, from 15 June to 15 September, the hospital’s activities will be reduced. In the past – the Tyrrhenian has told this several times – a decrease in elective surgical activities was foreseen, with the notorious operating rooms “closed for holidays”. This year the cut will concern Nephrology: from tomorrow, June 15, the 11th pavilion will remain open only during the day for dialysis activities. The hospitalizations will be moved to Medicine, to the 2nd pavilion, whose beds – in a small part – will be reserved for nephrological patients.

Luca Carneglia, director of the hospital, why this reduction in Nephrology?

“In reality it is not a reduction, on the contrary we will increase the dialysis service. Today there are two daily shifts, while in the summer they will become three ».

What about the rest of the department?

«The increase in the dialysis service will involve an absorption of nursing resources. To this it must be added that this year we will not close the 6th prime (surgery in day surgery) because we have to keep a high step on the surgical waiting lists. It is a department that in recent years, in the summer, stopped its activity ».

What does this have to do with Nephrology?

“The two needs, combined with the fact that staff have to be guaranteed the possibility of taking the summer holidays, will lead to a reorganization of the department”.

Explain it to us …

“Today in the 11th pavilion there are 10 hospital beds, which will be reduced to 6 and transferred to the 2nd pavilion, in multidisciplinary medicine, which also hosts Pneumology, Neurology, Internal Medicine and this summer will also host Nephrology”.

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What does the organization gain?

«I repeat: dialysis is expanding. And then we make better use of nursing resources: in the 11th pavilion two nurses (minimum contingent to activate a ward) look for 10 beds, while at the 2nd they can look at 16 beds according to the parameters of the law. If we had removed two nurses from the 2nd we would have renounced 16 beds ».

Many will say that Nephrology is shutting down...

«Not so, I don’t close the Nephrology, I transfer it for a few months. I transfer beds from one ward to another. I would add that we have also moved back the peritoneal dialysis activities from the 9th (Infectious Diseases) to the 11th to facilitate the organization, bringing everything together at the 11th and redesigning the configuration that existed before Covid ».

However, the accounts say that there will be 4 fewer places for nephrological patients …

“These are patients who need to have a diagnostic framework and the solution of sending them to the medical area rather than surgery is the best. I must say that Nephrology has always given a hand even in the emergency room, taking even non-nephrological patients when needed ».

So do you think there will be no need for those 4 seats cut?

«We start with 6 nephrological places but with the possibility of extending them at any time. It is not one decrease for nephrological patients. At the 2nd, if two more places are needed, they will be found ».

But the number of beds on the 2nd will remain 115: therefore those of Medicine will drop. In the end, between the 4 of Nephrology and the 6 removed from Medicine, 10 beds are lost …

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«At the moment, Medicine is managing well. The total seats remain 115 because physically it is not possible to put extra beds ».

Someone argues that this move is the prelude to a closure or a downsizing of Nephrology planned by the ASL …

“There is no idea of ​​closing Nephrology. I have no indications of preparing such a ground, nor would I want to. We need this expertise. The skills in the hospital must increase if anything, this is my will, increase the offer, not reduce it ».

But who decided the operation on Nephrology?

«It is an initiative of the hospital management aimed at a reorganization that – I repeat – will allow us to meet everyone’s needs. In this way we are able to keep the 6th first open, to guarantee the third round of dialysis and the nephrological places ».

Couldn’t they hire two more nurses? It is the most natural objection that the unions will be able to make …

“There has already been a confrontation with the trade unions”.

Let’s move on to Surgery: how will the activity go on?

«This year we have the possibility to activate additional shifts: the contract provides that in certain cases the staff can carry out activities beyond the established time; for the surgical activities the Region has put funds and the staff has agreed to adhere to this offer for which we will continue to operate. There is also the advantage that we will have the contribution of two nurses and an observer for the whole month of June and July who will come from Pontedera, where work is being done in the operating theaters. This will allow you to activate an extra room every day. For this I thank the nursing department ».

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Basically how many operating theaters will be functional?

«The Surgery will work in 8 rooms plus the emergency room in the morning, therefore 9 in total. And 4 in the afternoon ».

Like in winter …

“More than last winter.”

Will the 6th first never close?

«In the last few summers the day hospital and day surgery, practiced on the 6th prime, were suspended. This year the ward will become week surgery: it will close only on Sunday and Saturday afternoon ».

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