Berlin – Last night was tough again. As always, actually in the emergency room of the Humboldt Clinic. Stella Merendino shared the shift with two other caregivers. One was smuggled into the isolated area for Covid cases, Merendino himself put on a large cast, her colleague was alone with around 20 patients. The nurse says: “It should be clear to everyone that this cannot work.”
Emergency services: “What happens is beyond imagination”
Stella Merendino is one of 163 nurses at Vivantes clinics who wrote a fire letter to the Berlin state politicians, above all to Franziska Giffey (SPD), the designated governing mayor. In it they denounce the conditions in the rescue centers. “The care in the emergency rooms has been ailing for years, but what is currently happening in the clinics is beyond imagination,” says the letter. Patients are parked in corridors for hours because there is no space for them on the wards. They would hardly be taken care of because the few nurses couldn’t keep up with the newly arriving emergencies. “Because of staff shortages, beds are being blocked in intensive care units and in other areas,” says Merendino. “There is no drainage. But we can neither turn away patients nor leave them in our acute rooms for a long time. “
The pandemic has made the precarious situation worse. “We now have a locked area for Covid patients, but no longer people,” says Merendino, describing the situation in the Humboldt Clinic. “We’re drowning,” write 163, “and we don’t know how long we can hold out.” On Tuesday, Vivantes announced a large-scale campaign to recruit nurses. But time passes before it bears fruit. Merendino says: “We need more staff as an immediate measure. Colleagues from other stations have to be put to the side and process concepts for relief have to be established in every rescue station. “
The state politicians have not yet reacted to the fire letter, although the authors have sent it three times since October. “Except for Bettina König,” a member of the SPD’s health committee, “we are glad that she is taking care of the matter,” says Merendino. Politicians are partly to blame for the misery. Evidence can be found in the city hospital plan, which sets quality criteria.
“For example, the staffing of a rescue center must be such that the doctor-contact times are adhered to,” a doctor from a Vivantes rescue center recently told the Berliner Zeitung. The emergency room determines how quickly a patient needs to be seen by a qualified doctor and then treated. The basis is the Manchester Triage System. The Vivantes doctor: “These times are nowhere observed.” When he asked why compliance was not checked, the health administration answered with the words: the operation would be too expensive.
Nursing staff no longer accept overload
The collective agreement for relief, currently negotiated by Vivantes with the Verdi union, defines a ratio of nurses to patients, also for emergency rooms, but depending on the treatments, financed by the health insurance companies. “Here it is crucial to note that there are significantly more patient contacts in emergency rooms than billable cases,” says the letter. This is the case with patients without a place of residence or insurance, says Merendino: “Even if someone comes to the emergency room several times in a quarter.”
The German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) recommends minimum staffing: A nurse should not see more than 1200 patients in the emergency room per year. The Vivantes doctor: “We are permanently over it.” The fire letter now states that “a binding minimum staffing is urgently required”. The demand on politicians is: “Refinancing of the personnel costs for care in the emergency rooms.”
It’s about human life. Studies show that understaffed emergency services lead to avoidable deaths. They will therefore follow their words with deeds, write the 163 nursing staff. And Stella Merendino says: “We can no longer. We will no longer accept the physical and mental overload. “