Berlin.
Emergency admissions in need: The situation has worsened massively since the corona pandemic. What experts experience in everyday life, what they demand.
The whole country was shocked when on New Year’s Eve rescuers were attacked. The horror at the unprecedented brutalization was great. But not only in the exceptional situation on New Year’s Eve do helpers experience violence: in the emergency rooms of German hospitals the level of aggression is increasing, experts warn of a “spiral of stress”. New figures show how tense the mood is now.
Emergency room: why violence is on the rise
“In whole Germany we observe an increasing aggressiveness towards rescue workers. This not only affects helpers in rescue operations, but also the staff in the emergency rooms,” says Felix Walcher, emergency physician in Magdeburg. “Emergency room workers are reporting an increase in verbal abuse and bullying, but fisticuffs are now more common. The tension in all areas of the healthcare system has recently increased significantly. Walcher is President of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI). What the doctors are observing is consistent with a new nationwide survey by the German Hospital Society (DKG).
“Nine out of ten hospitals have already had experience of violence against their employees in the emergency rooms,” summarizes DKG boss Gerald Gass the results. 48 percent of the clinics already have one security service involved. The situation has worsened in recent years, also due to the pandemic. “This can be felt every day in the emergency rooms, when time pressure, staff shortages and the fears and worries of patients and their families collide.” The fact that people who help other people and even want to save their lives are attacked and threatened is untenable Condition.
Survey: Why the waiting times are getting longer
DIVI boss Walcher speaks of a “spiral of stress”. The stress in the emergency rooms is exacerbated by the growing shortage of staff, not only in the emergency rooms himself. There are also major problems in transferring patients to the regular wards – because there are too few usable beds due to the lack of staff. The DKG survey, in which more than 100 general hospitals took part in January, showed that last year 77 percent of hospitals had to completely deregister their emergency departments at least once due to a lack of staff.
Even where there is no threat of closure, emergency patients feel the lack of staff immediately: The waiting times in the emergency room are getting longer. “On a nationwide average, we see a significant increase in the length of stay in the emergency rooms,” says Walcher. This puts the emergency rooms under pressure because more patients in the emergency room have to be cared for at the same time, and they have to be monitored and cared for while they wait. “If patients spend an average of ten to fifteen minutes longer in the emergency room today than they did before the pandemic, this has massive consequences for everyday life. Aggressiveness increases, patients lose patience and take their anger out on the staff.” The DIVI also regularly collects data from clinics nationwide.
Background:Clinic reform: What should change in the hospitals
Numerous incorrect controls make the work difficult
The emergency rooms would be helped if really only emergencies came to the ambulances: “In order to relieve the emergency care, we need a sensible control for in the future acute cases‘ Walcher demands. Anyone who dials the emergency number 112 does not necessarily need the rescue service to be transported to the emergency room. As surveys show, the medical emergency service under the number 116117 can often make much more sense, but is often not asked at all.
There are many examples of misdirection: For example, if a family caregiver calls in because the elderly husband has bladder pain, calling a community paramedic experienced with urinary catheters may be a better option than rushing an ambulance to the emergency room. Or, if someone is dying at home and in pain, it may be wiser to call palliative care than to rush the patient to the busy emergency room. Experts also warn that people from retirement and nursing homes are often only admitted to hospitals because they cannot be cared for in the facilities due to a lack of qualified staff.
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Emergency Care Reform: What Politicians Must Do Now
“We have to get to the point where a digitally networked control center of rescue service, clinic emergency room and medical emergency service clarifies what kind of care the caller needs and where he can get it afterwards,” warns Walcher. “We are currently assuming that in five to ten percent of cases there will be a wrong assignment.”
The government commission for hospital care headed by Federal Health Minister Karl Lauterbach (SPD) is already working on proposals for one reform of emergency care. “We need concrete steps as soon as possible,” demands Walcher.
To the growing force to counteract this, DGK boss Gass also demands legal action: With the tightening of penalties for assaults on paramedics, the politicians have already taken the right path. “But we would like violence against nurses, doctors and other hospital staff to be punished more severely and attacks on prison staff to be treated on an equal footing.”
Also read:New Year’s Eve riots: planned tightening of criminal law?
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