Last week she came out of the hospital crying again. When she tells it, Míriam Marcos, a nurse at the Virgen de la Torre hospital, in the Madrid district of Villa de Vallecas, remember the months of March and April and cannot understand how it could be happening again. A total of 402 physicians from all the specialties of that center and the hospital to which it is attached, the Infanta Leonor, signed a letter on September 16 that they sent to the Madrid Minister of Health, Enrique Ruiz Escudero. They speak of “pre-collapse.”
Like this nurse, the text it also refers to the spring and how, then, “the hospital reached an occupation of 202% only of patients affected by coronavirus, without taking into account other pathologies “. The center became the Madrid hospital with the highest pressure from patients admitted for covid regarding the number of beds ―they have 361 of which 92 belong to Virgen de la Torre, dedicated to palliative and non-subsidiary patients needing ICU―, being the that less number of ICU places can offer in relation to the patients they had admitted. That caused “the suspension of all types of surgical activity including the urgent one (only the emergent one remained) and resulting in the dedication of doctors from all specialties to the management of covid-19 patients.”
At the time they sent the letter, their occupancy was 54% by acute covid patients and 100% in their critical units. In it, they warned of a rapid increase. This Sunday they were 55% in acute and 135% in the ICU. The reason? The high incidence of the virus in the area they cover, 305,262 people in Puente de Vallecas, the Madrid district with the most infections. In the last 14 days, 2,914 cases have been reported there and they have a cumulative incidence of 1,240.76, the highest in Madrid. It is one of the basic health areas that since Monday are subject to the new restrictions that President Isabel Díaz Ayuso announced on Friday and that has put neighbors and health workers on their feet.
The area with the highest incidence in Spain
Friday night at Puerta del Sol and this Sunday in front of the Madrid Assembly thousands of residents of the eight affected municipalities protested measures that they consider “ineffective and discriminatory”, some adjectives that are also used by health workers and epidemiologists, which point to more restrictive and applicable measures throughout the region and once again insist that, without a reinforcement of primary care and public health, it will not be possible to stop the pandemic.
While the population of that district left this Sunday morning to demand investment in their areas “and no segregation”, Marcos finished a night shift in which there were two nurses and two assistants for 28 covid patients. The normal thing is that there would be “three nurses and three assistants in the morning, the same in the afternoon” and two of each of these specialists at night: “But what there should be six and six in each shift. What is coming is unaffordable ”.
While reinforcements arrived at the hospital in March, April and May, “now no one has come.” In the text sent to the counseling they say that they have already had to move specialists to treat covid patients, “leaving aside their specialty and patients who may have as or more serious and limiting pathologies”. They have already postponed scheduled surgeries and assure that this activity “will suffer even more. Also the care for patients with chronic diseases, which are mostly carried out in the outpatient care area, will be reduced or canceled ”.
Solutions: human resources and patient redistribution
“How can you take care of patients like this? How are you going to provide quality assistance under these conditions? You want to do your best, but it’s impossible ”, asks Marcos. The hospital pressure of this center is not that of the rest of Madrid, which affects hospitals in an asymmetric way, a fact that is also underlined in the document: “The principle of justice insists on the need for all patients to have equality of opportunities to access assistance ”.
The specialists who sign the letter, 87.3% of the workforce, request “redistribution of patients” among Madrid hospitals – “it is a priority and required to maximize the common good” -, and a “proper functioning of the ICU corridor ”, a measure that was launched in March through a WhatsApp group in which the heads of the Intensive Medicine service were of all Madrid hospitals and the Ministry of Health. During the toughest moments of the pandemic, to try not to leave any patient who needed it out of an ICU, these patients were referred to the center that at that time had the best capacity to care for them.
Sergio Fernández, CC OO delegate at the Infanta Leonor, recalls that they have been denouncing the situation for months. On the one hand, the ineffectiveness not only of the ICU corridor, but also of the transfer of patients in the plants: “According to the management, this transfer has been requested but it is not granted and no one understands what is happening.” And on the other, the lack of professionals who suffer: “Add the infected, those who are in isolation because they are contacts, the holidays that are being respected to the maximum so that professionals can rest, that it is not possible to hire more people because they have left due to the indecent working conditions that they were offered, that we have 20 years of cuts and underfunded templates and now a primary school that, if possible, is dying even more ”. The result, he says, “is obvious.”
We are there, in the pre-collapse, a place we should never have returned to
Míriam Marcos, nurse at Virgen de la Torre Hospital
That second wave, say three other professionals from the Infanta Leonor, It “arrives much earlier” than they expected. The exhaustion, they regret, continues, and the human resources they have are limited. “And there is a very long time with a very high load.” The same is observed by Joaquín, who joined from his vacation last Friday: “I am a midwife and although in our service we operate by self-management, covering casualties and problems that may arise, as if we were an island, the increase in patients is clearly observed . In March and April we suffered, above all, for our patients and because we could not help our colleagues, and now we fear that the same thing will happen again ”.
None of these professionals care about the workload or the hardness of it, they “hurt” the lack of resources to handle it. Míriam Marcos, the nurse, says that she does not know how far the situation will go again: “But we are already there, in the pre-collapse, a place we should never have returned to.”
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