Alongside the broadcast of a documentary commissioned by Vivalia on emergencies in the province of Luxembourg, we take stock of this vital service for Luxembourgers, at the dawn of the overhaul of the hospital landscape in our province.
Meghann, 32 years old, from Liége by adoption but a Bastogner at heart, and Julien, 34 years old, from Ochamps, agreed to talk to us about their daily life as an emergency doctor.
A job, as you can imagine, is not always easy. More and more complicated, in fact.
By definition, nothing is predictable in the emergency department. There are quiet days, others more tense.
Increasingly, teams must manage people under the influence of alcohol and/or drugs, complicating treatment. “This drug addiction brings exponential violence that we must know how to deal with. We didn’t see any or very little when I started, in 2015, now it’s almost daily“, explains Meghann.
The last aid
The aging population and the lack of general practitioners are also leading to more and more people in emergency departments, and more and more bedridden patients. These require a heavy and long assessment to diagnose where the change in general condition comes from, important support to nourish them and change them. If one or another demented patient also arrives that day, the teams can quickly become overloaded. Not to mention that if the SMUR and the PIT (read below) have left, the service is disrupted.
“There are days when drinking a glass of water and peeing is a luxury“, summarizes Julien.
Working in the emergency room also means dealing with precariousness and social poverty. “Many come to the emergency room, because they do not have to pay the third-party payer directly, the emergency room is their last resort.“, says Julien.
“Create a shell, but not too big…”
There is also the hidden poverty which is no longer hidden, when emergency workers intervene at home: homes without heating, houses in which it rains, children who live in homes which have not seen the shadow of ‘a broom or a vacuum cleaner for several years…
“In the emergency room, we also see the dark side of societysummarizes the head emergency nurse at Libramont. In relation to all this, many create shells for themselves, but we try not to create too big ones either, because otherwise, we no longer have empathy.“
Meghann doesn’t hide it. “I’m not at all embarrassed to say it, we act a bit like robots without being robots. We follow protocols to be as efficient as possible. “Back at home, it’s sometimes more complicated to manage. Especially since she’s a mother.”I have always been attentive to my patients, but since I had children, this has increased. “In the family home, sometimes she dwells on things.
Dealing with death and distress
Working in the emergency room also means coming into contact with death.
Almost every week, emergency doctors go on a cardiac resuscitation mission, with low probability of success. We must face the distress of loved ones, support them when they have just lost a loved one before their eyes.
Faced with all these difficulties, did our two nurses ever regret their choice, think about leaving the emergency room? “Never“, they answer us straight away, passionate about the diversity of their profession. “It’s not always easy to cope, but we always have relay people on whom we can rely, explains Meghann. I have my partner of course, but also a caring team, thanks to which we manage to overcome challenges..”
Julien also talks about the importance of the team, and technical and psychological debriefings. “There are a lot of people who don’t find meaning in their job, there are some of us“, he continues.
So yes there is violence, easy criticism…”but every day we receive thanks“, they tell us. Thanks that are priceless. Well, yes, for having brought comfort, for having cared for, for having saved a life.
Quickly said
Racism
What terribly shocks Meghann are the patients who are openly racist towards caregivers of foreign origin. “It’s gratuitous and violent! “
12 hour breaks
In Libramont, emergency doctors work 12-hour breaks. “We are in the hospital longer, but we are also at home longer, because we work 3-day weeks“, explains Julien Gourmet.
Significant interventions
We asked them for an intervention that left their mark. Julien Gourmet recounts a home birth in Bouillon. “When SMUR arrived, the baby took his first breastfeed from his mother..” Meghann tells us about the gas explosion in Bastogne in August 2017. “I had lived on this street, I was afraid that my roommates would be affected.” In the end, it didn’t happen. And the man she took care of came back later to thank her.
Urgent medical aid “for dummies”
Ambulance: no nurse or doctor
The ambulance service is provided by at least two paramedics, who are often also firefighters. It is the most widely used means of relief.
PIT, our province as a precursor
The PIT (Paramedical intervention team) is made up of, at a minimum, an emergency nurse and a paramedic. Currently, there are two PIT departures in the province of Luxembourg: Virton and Bouillon. They carried out 1978 missions in 2023. The PIT is particularly capable of managing quite a few missions previously intended for the SMUR, such as breathing difficulties, chest pain, hypoglycemia, convulsions and many other problematic situations.
SMUR, with an emergency doctor
The SMUR (mobile emergency and resuscitation service) is a mobile medical team, composed, at least, of an emergency doctor (who must therefore leave the hospital emergency room) and an emergency nurse. The SMUR is the mobile extension of the hospital emergency service to which it is necessarily attached. Currently, there are 4 (Arlon, Bastogne, Libramont and Marche). Soon, there will only be two (Houdemont and Marche). In 2023, they carried out 3454 missions. The SMUR does not know how to transport patients. He is usually accompanied by an ambulance.
The CMH, the medical helicopter
The CMH (helicopter medical center) of Bra-sur-Lienne (Lierneux) is a kind of flying SMUR, although it is not attached to a hospital. Unlike a rolling SMUR, the CMH helicopter is capable of transporting a patient.
Less than 15 minutes response time
In 2023, the average intervention time for PIT and SMUR in our province was 14’19”.
Urgent medical aid, at a crossroads
To find out more about urgent medical aid in the province of Luxembourg, you can read Governor Olivier Schmitz’s announcement, delivered last January. She is entirely dedicated to it.
More than 90,000 admissions in 2023
In 2023, a total of 90,139 admissions were recorded in Vivalia’s emergency services:
– 34,683 in Arlon
– 24,535 in Marche
– 20,797 in Libramont
– 10,124 in Bastogne
