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alerting geriatricians about care for the elderly

Catherine Pflieger, 45, belongs to this generation of nurses for whom “entering the public hospital was a great honor”. She says it with great pride. It was twenty years ago and it looks like another century, when the public service and its agents are going through a historical and existential crisis. “At that time, there were more applicants than places. Out of a hundred people, five nurses were taken! » Times have changed, and Catherine Pflieger, who has become a health executive, walks the corridors of the geriatric center of the Mulhouse hospital center describing the difficulties that now seem insurmountable in recruiting discouraged, disillusioned and, for some, suffering caregivers.

In theory, in the various geriatric departments, there should be at least 180 nurses for the 1,200 beds intended for sick or dependent elderly people, hospitalized or accommodated on the heights of the agglomeration of 275,000 inhabitants. But the “target number”as they say in the administration, has become inaccessible, and everyone smiles sadly when Catherine Pflieger mentions it in a hospital meeting room. “Today there are thirty-seven vacancies among nurses. And it will get worse: we will have at least forty-three unfilled positions in January 2023.”

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Nathalie, 59, nursing assistant at the geriatrics center of the GHR in Mulhouse and South-Alsace, makes a resident's bed on July 18, 2022. She has worked in the department for fifteen years.

Added to this is absenteeism, with 14% of nurses currently on sick leave, a high figure, a sign of the exhaustion of the troops after the battle of the Covid, particularly difficult in a region on the front line of the first wave, in 2020. “This means that almost a third of our human resources are missing. Up to 50% in some more distant nursing homes”laments the head nurse, forced to juggle and tinker to ensure continuity of care.

The consequences are both immediate, serious and lasting: for lack of carers, the management had to temporarily condemn around thirty beds within the geriatrics centre. More alarmingly, throughout the Mulhouse sector, 177 follow-up and rehabilitation care beds (SSR) are now closed, out of a total of 603 – as many patients who cannot be taken care of, while doctors would like.

Lack of political anticipation

Yves Passadori, head of the geriatrics center of the hospital group in the Mulhouse region, July 18, 2022. Yves Passadori, head of the geriatrics center of the hospital group in the Mulhouse region, July 18, 2022.

In the small meeting room, a poster in Gothic letters reminds us that the “medical home for the elderly” was inaugurated in 1973 by Michel Poniatowski, then “Minister of Public Health and Social Security”. The minister has been dead for twenty years, the walls have been repainted, but the rooms have remained the same, cold in winter, hot in summer – on 4e floor, under the roofs, the temperature exceeds 30 ° C in heat waves and the stocks of Chinese fans which stir the air in the corridors do nothing about it. Yves Passadori, 66, one of the great veterans of French geriatrics, head of department in the Haut-Rhin for twenty years, listens to the health executive decline the figures of public impotence. The doctor does not hide his emotion: “I have never experienced such a situation. It is very worrying. We can no longer close the gaps, and all the centers are closing beds. »

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