Begona Fernandez |
Madrid (EFE).- Hospital emergencies have reached the maximum number of patients treated this week and the demand begins to drop, although new upturns are expected in February. Faced with sanitary pressure, many hospitals have initiated the drainage strategy and reduce their scheduled activity to accommodate emergencies.
“Having a frail 80-year-old patient in a corridor for three days respects neither his dignity nor his privacy and this is a hospital management problem and this policy must be ended,” the president said in an interview with EFE of the Spanish Society of Emergency and Emergency Medicine (SEMES), Tato Vázquez, which estimates 20% of emergency patients who remain awaiting admission in corridors and boxes.
And this reality, he specifies, “puts in check the quality of care in matters of dignity and makes life very difficult in the search for spaces, since you have to do real Tetris to place the beds.”
Emergency spaces are finite “and if the corridors and boxes are busy, we cannot meet the demand,” he stresses.
It is more important that a patient with pneumonia have a bed than another with a hernia
An excess of demand that came to register this month between 20 and 25% more patients in hospital emergencies throughout Spain and a maximum peak of 45% in some communities.
Vázquez, head of the emergency service at the Hospital do Salnés (Pontevedra), understands that emergency saturation can be prevented: “I think it is more important that an elderly patient with pneumonia have a bed than another with a scheduled inguinal hernia” .
For this reason, he proposes developing a “different calendar” and that the scheduled activity that is not a priority can be framed in unusual periods, such as vacations. “And if there are not so many scheduled admissions, there will be beds available for admissions from emergencies,” he emphasizes.
More verbal and physical attacks on professionals
Some health systems estimate that a hospital admission should take four or six hours, but the reality is far from these forecasts, since there is a conflict between the demand for emergencies and the scheduled admissions and, up to now, managers have given priority to the latter.
Emergency services such as the La Paz university hospital in Madrid or the A Coruña university hospital have even had 20% of patients in the corridors and that is “outrageous” for the patient and for the professional. In fact, the The tension that is created in those corridors is generating an increase in verbal and physical attacks against both doctors and the rest of the staff.
Vázquez affirms that this is not justifiable, but understands that “when your 80-year-old father has been in the corridor for two days, people have a certain tension.”
«And if the patients pending admission do not leave and continue to enter, there comes a time when the system explodes. It is a matter of communicating vessels », he adds.
In the emergency room we have never stopped, the strike is symbolic
“The strikes called these days in Primary Care dot us, but we understand them because this level of care has a serious problem that requires economic investment,” he points out.
However, the person in charge of SEMES gives the example of the emergency services: “We have never stopped, strikes in the emergency room have a symbolic value and our minimums are the same presences as on a normal day.”
Vázquez insists that Primary Care needs a complete restructuring, but it also has a problem of “human resources and vocations, of people who want to dedicate themselves to Family Medicine, a specialty that is not sufficiently prestigious.”
For this reason, he believes that Primary Care should be self-critical and see why this specialty is discarded by many doctors. In 2022, more than a hundred MIR Family positions remained unfilled.
The urgenciólogos trust that 2023 will be the one of the specialty
Faced with the decline of Primary Care, Vázquez is convinced that the emergency specialty would be the first option for 10% of MIRs and is confident that this will be the year of the “definitive step” in which the specialty is created given the good understanding with Health.
Vázquez recalls that the doctor who treats a stroke, heart failure or sepsis in the emergency room has to be an expert and for this he must receive “regulated, homogeneous and structured training that is the same in Madrid, Murcia or Cuenca”.
“We want to train our people and make them the generational replacement,” he says. And this is urgent because in 2028 the emergency and emergency services will be the oldest in Spain, with 44% of the workforce over 55 years of age.