After several intense weeks in the heart of the Covid-19 epidemic, the Bellissen nursing home in Foix, a time the largest cluster in Ariège, is once again welcoming visitors in droplets. Of this ordeal, with 77 residents and 42 agents who tested positive, it is solidarity that will be remembered … But also the memory of 9 people at the end of their life whose deaths were undoubtedly accelerated by the coronavirus. Back to an unprecedented crisis.
At the Bellissen nursing home this Thursday, faces are still marked by fatigue. Little by little, residents are starting to leave their rooms. The staff are looking for their bearings. “For several weeks, the nursing home was transformed into a hospital,” says Catherine Colettedirector of the general coordination of care. With 77 residents and 42 agents testing positive for Covid over several weeks, and nine deaths, the structure has been one of the largest clusters in Ariège, and has paid the price.
“Stopping all the staff was impossible, notes Catherine Colette. As normal we would already like to have more staff. But the Covid increases the workload considerably.” This explains why, according to ARS guidelines, staff who tested positive but asymptomatic had to continue working. “We forced no one, insists Catherine Colette. The caregivers could very well go to the doctor to request a work stoppage. That was not the case. And the carers who were arrested in view of their medical history would have liked to work. . “
The director admits that the decisions have sometimes seemed long. “We groped around, we thought about it on a case-by-case basis. But we avoided disaster thanks to the mobilization and cohesion of our teams.”
A surge of solidarity
“Psychologically we are exhausted, confides Sandrine Rodriguez, nursing assistant. But this crisis has allowed us to find between us a solidarity that we had lost.” Staff of Chiva, Chac, nursing aides and retired doctor, liberal nurses… many have come to help their colleagues at Bellisen. “I still have chills,” says Catherine Colette. The staff received packages of sweets from Chiva, little touches from the families. “It was not always easy, because there was care that we were no longer used to providing, says Perrine Eychenne, nurse. So those who helped us know that if we are mobilized to our turn, we’ll be there. “
“The residents are part of our lives. It was hard to lose nine, says Sandrine Rodriguez. We could not accompany them to the end, provide mortuary care. It was hard.” Despite everything, the staff did their best to maintain the link with the family. Stéphanie Sereda, the host, for example sent photos to relatives, or organized skypes. “We are now working to treat the consequences of the Covid, says Doctor Bernard, who has returned from his retirement as reinforcement. We have observed problems of undernutrition, dehydration, as well as a loss of autonomy and mobility. But the most urgent thing was to reopen the visits little by little, because this lack created a lot of behavioral problems. ” The nursing home is catching its breath, but caution and vigilance remain in order.
Back to the key dates of the crisis
SEPTEMBER 2, 2020> The level 2 alert is triggered in all nursing homes in Ariège. Visits are by appointment and under medical supervision. Some units, such as the day reception, are closed.
OCTOBER 5> First case. An employee of the Bellissen nursing home tested positive. A few patients show symptoms. Visits are stopped, residents are isolated in their rooms.
OCTOBER 12> First massive screening. 49 residents and 25 staff members tested positive for Covid during this first massive screening. Three more will be organized on October 19 and 29, as well as on November 5.
NOVEMBER 9> Improvement. The situation is improving. The management of the nursing home decides to gradually lift the isolation of residents.
NOVEMBER 16> Visits. The situation is stabilized. Some residents remain isolated in their rooms. Supervised visits are gradually resuming.
BALANCE SHEET. In all, 77 residents and 42 agents tested positive for Covid during the crisis. 9 residents died.
The CGT points the finger at the lack of personnel
Sandrine Prax is deputy secretary of the CGT Chiva union and secretary of the health, safety and working conditions committee in nursing homes. Some of his colleagues at the Bellissen nursing home shared with him, throughout the crisis, their difficulties, in particular due to the lack of personnel.
Sandrine Prax, how are the Bellissen agents doing?
They are physically and psychologically exhausted. They have had a huge workload lately, the Covid protocol is heavy. And they worked in a climate of anxiety. When they had no symptoms, they had to come to work, they were not arrested, precisely because we are short of personnel. And we know that zero risk does not exist, even if they acted very quickly with the greatest professionalism. It’s hard to know how the virus spread, you can only make assumptions.
However, reinforcements came from several places to support the teams
There was not enough back-up, only a caregiver in the morning and a nurse. While COvid patients represent a huge burden. Chiva agents were contacted by SMS to come to nursing homes during their off-hours. But since it was not paid in overtime, they did not come back, we can understand that. There have also been people “in office” who are not trained on the hygiene protocols specific to the Covid. It took them three weeks to learn all the details. They also mobilized a night nurse at Bariols… which meant that the nursing home found itself without IDE at night, and therefore there was more work for the day shift. Bellissen took 11 days to apply the blue plan, because they were trying to have civic jobs as reinforcements. We have been warning about the lack of personnel for years. There we see the catastrophic consequences.
A nursing aid: “These reinforcements, we already need them in normal times”
Disinfect, put on a blouse, charlotte, gloves, glasses and apron. Enter, take care of, go out, undress. Restart. For several weeks, Martine * engaged in this ritual. “We hardly did more than that. We had the same time as usual, but we had to do more, says the nursing assistant. And those who suffered the most are the patients.” Monopolized by barrier measures and hygiene protocols, Martine believes that she has neglected the human relationship. “We had even less time than usual. We were no longer in the accompaniment. Yet these are people at the end of their life, so holding their hand is even more important.” A situation that could have been avoided according to her with more human resources. “The doctors insisted on dehydration. But we only had time to pass for the toilet. It would have taken more people who pass in the rooms regularly.” Initially, like other colleagues, she came as a backup on her days off. “I ended up quitting, we would have killed each other. The reinforcements we had we need already in normal times.”
A lack of listening
Martine nevertheless indicates that the material was not lacking. “The problem is that decision-making is done vertically. For example, it has been said several times to sector the wings of nursing homes to prevent patients from wandering in the corridors and carrying the virus. Another example, a doctor told us to be careful with our nails. Except that with all these protocols, we had neither the time… nor nail clippers. ” The caregiver also wonders if it would not have been necessary that the positive patients but with few or no symptoms were deconfined. “What is the benefit? Why not live the 6-8 months they have left, sometimes by being better surrounded, better supported, while continuing to protect those who are not infected?” For her, nursing homes must allow people to die with dignity. “The elderly are living libraries. They must be taken care of.”