Intensive care physicians are calling for a switch to emergency operation

Dhe first hospitals in Germany are reaching capacity limits due to the increasing number of Covid-19 cases. The University Hospital Düsseldorf only accepts inpatients for emergency patients. “The reason is the significant increase in patients with Covid-19,” said the maximum care provider. “The clinics in metropolitan areas such as Berlin, Bremen or Düsseldorf are running to capacity,” warned the President of the Interdisciplinary Association for Intensive Care and Emergency Medicine (Divi), Uwe Janssens, to the FAZ . “

Britta Beeger

Christian Geinitz

It is “completely incomprehensible” why politics has not ordered this so far. As in the first wave, admissions and operations would have to be canceled by prescription, which from a medical point of view could be deferred. At the same time, the clinics would have to be relieved of these sales losses. The fact that the Düsseldorf University Hospital is ceasing regular operations without compensation shows how serious the situation is.

Spahn announces concept

Driven by the development, Health Minister Jens Spahn (CDU) announced that he would propose regulations in the next week to secure the clinics financially. But Janssens doesn’t do it fast enough: “We’re running out of time.” The number of Covid 19 intensive care patients doubles every ten days. Currently there are around 2800 cases, more than half of which are artificially ventilated. In two weeks at the latest, 5600 cases are expected for which 7000 beds are free. “But there are big regional differences.”

In addition, the beds are less scarce than the employees. Even in normal times, 4,300 intensive care nurses were missing, so around a fifth of the places could not be used. To prevent corona, the number of beds had been increased, but not that of the staff. “The gap is growing wider and wider.” This is not least due to the fact that there are staff shortages due to corona infections. This is also why it is so important to focus the staff on Covid 19 cases and other seriously ill patients. In the intensive care units, anesthesia nurses could work from the unused operating theaters.

At the same time Janssens made it clear: “We are far from being overwhelmed. We’ll get the situation under control – when politics finally has our backs. “
Not only the Düsseldorf University Hospital is switching to emergency operation. The Berlin hospitals will also keep a quarter of the beds free for corona patients from Saturday, as a spokeswoman for the hospital company there said. On Thursday, the hospitals in the capital made an urgent appeal for former nurses to report. The state of Lower Saxony, in turn, has increased the maximum working hours for employees in clinics and nursing homes to up to 60 hours a week, as at the beginning of the pandemic.

Who will get the bonus?

It is precisely in this situation that frustration grows among some nurses in Germany, as reported by nurses themselves, as well as staff councils from large clinics and representatives of the Verdi union. The reason is the payment of the corona premium of up to 1000 euros. Initially, this was only intended to benefit employees in the care of the elderly, but after lengthy discussions it was also decided for the hospital staff. 100 million euros are to be paid out from the health fund to employees who were particularly stressed in the Corona crisis. There are clear criteria for this: clinics with more than 500 beds are eligible, for example, if they have treated at least 50 corona cases by the end of May.

However, a number of large maximum care providers did not appear on a list published on Thursday by the Institute for the Hospital Remuneration System (Inek) of the clinics that can count on an allocation. For example, the Saarland University Hospital and the Gießen and Marburg University Hospital are missing. Some of the houses concerned do not yet seem to know why this is so. The required number of more than 50 patients was actually “significantly exceeded”, said the deputy chairman of the staff council of the Saarland University Hospital, Frank Murer, of the FAZ. Assumptions that, for example, foreign patients were not counted, the responsible institute rejected on request. However, cases that had not been discharged by the end of May were not taken into account. Inek announced that the legal requirements were followed. There was “no room for discretion”.

That should be little consolation for the nursing staff concerned. Many of them feel that the distribution of the premium is unfair, said the Verdi care officer for Rhineland-Palatinate and Saarland, Michael Quetting. “The great solidarity from the early days of the pandemic will be destroyed.” Marcel Iwanyk, the chairman of the works council at the Giessen University Hospital, said that there was great frustration and resignation. An intensive care nurse writes on Facebook that she sacrificed herself for seriously ill patients, was partly helpless and was often at the edge of her strength. Her disappointment is all the greater: “Thanks for nothing,” she writes.