Why French Nurses Are Quitting In Record Numbers
After a honeymoon in France during the pandemic in March 2020, when the French applauded nurses fighting Covid 19, summer 2021 was a rude awakening. The hospitals where nurses worked still had a major spike in Covid-19 patients, and the pandemic had made all existing problems worse. As a result, many nurses have said they plan to leave the profession in the next two years.
A report conducted among 1,155 public and private health establishments shows that hospitals lost more than 2000 health workers including 1,245 nurses, 511 nurse aides and 300 doctors. According to the study, departures have been mainly due to resignations (54%) but also result from layoff or long-term leave (38%).
According to a survey of 300 hospitals from the French Federation of public and private hospitals Fédération hospitalière de France (FHF), 12,200 departures of nurses or nurse aides started in September, a phenomenon which continues, even worsens, and could be significantly higher in 2022 and 2023.
25,000 caregivers would needed to be hired just to replace empty jobs in hospitals.
Why are nurses quitting in France?
1. Overwork, lack of staff and working time
The nursing crisis has been going on for decades and the pandemic has only highlighted that fact. The current difficulties are indeed the result of decisions taken over the past 20 years in order to rationalize health expenditure, reduce the number of doctors, reduce by 30% the number of beds, and introduce profitability criteria into hospital management.
Due to lack of family doctors and without any connection between hospitals and GPs, in many French regions described as “medical deserts,” emergency departments have become the only place to go when care is needed 24/7 or during weekends. In the ED , you have to manage very demanding, sometimes aggressive patients who also come because they can’t find family doctors, or others because it’s just easier.
2. Unsupportive workplaces, overwhelming stress, and the fear of bringing Covid-19 home to their families
Before Covid-19, nurses were increasingly being told to "do more with less." This meant covering more hospital beds, handling more patients, and working longer hours. The result is that many nurses feel they can't provide the best care anymore.
Many nurses have been working nonstop since the pandemic began almost two years ago. They are bone-tired and frustrated from being asked to work overtime or dealing with people who chose not to get vaccinated or wear a mask.
According to a recent survey on working conditions and quality program for health workers in 2019 (1) rushing is thus more frequent by the nurses and midwives (72%) than by all employees in the hospital (62%) who declare an excessive amount of work (65% vs 57% of other health workers).
This emotional charge is not limited in the workplace: 46% of health workers continue to think about their work outside of the hospital. Doctors are the most concerned (74%), followed by nurses and midwives (54%).
The existence of teamwork does not erase the tensions: 34% of health workers report tensions with their hierarchical staff. In the public more than in private hospitals, 33% of employees declare tensions with their colleagues.
“We no longer have any hope of immediate improvement, we don't want to die at work, it's not worth it. “said nurse who has worked in recent months in emergency department, then in geriatrics. "This summer, one day out of two, we were understaffed, it was a doctor who was missing, then a caregiver, a nurse... We cannot work properly, we only do limit breakage.”
Another French nurse who decided to quit the hospital and work as a liberal nurse said, “Since I left, I have come back to life. I knew from the start that I was not doing this job for the money, but out of passion. But I only work ten days a month for an equivalent salary. I only miss the team because in liberal, we are alone, as in a ED teams are very close. This ED has nevertheless been a very good school, but for nothing in the world I would go back. Today, I have time to take care of people, and it's really nice!”
In my ED in Paris, 30% of nurses decided to quit. As the Covid 19 pandemic started to disappear, nurses were expecting a real change in their working conditions, including salary or working time.
More than a burn out situation, it is a global feeling of health workers who don't want any more to live with “the day after”. This global situation is progressively spread on many hospitals despite many tries of conciliation with administrators. Negotiations, staffs, meetings failed to stop this losing loop.
Active recruitments on nurses schools or retired nurses will not be sufficient to stop this tsunami.
A few months following the covid19 pandemic , the decision of the French government to enhance the situation of its health system which have devoted 8.2 billion euros to the revaluation of working conditions and salaries. The French government has just granted, as a a monthly bonus of 100 euros to some 30,000 nurses working in critical care departments.
In summary, despite the tremendous efforts of healthcare workers during the Covid19 pandemics, after applause and congratulations, the most unpredictable effect of “the day after Covid” on the health system was a massive resignation of nurses from hospitals. The Covid 19 blow up a supposed “strong health system” as it enhanced the need for a global change in the management of the hospital.
