In launching the Segur of health on the 25th of may, the ministry of Health set the goal of " benefit collectively from the lessons of the ordeal crossing [...] to build the foundations for a health system that is more modern, more resilient, more innovative, more flexible and more attuned to the needs of its professionals, users and territories, with solutions of strong and concrete ". Today what is it ? To date, only agreements relating to salaries have been concluded. Obviously, and in particular, to the stall of France vis-à-vis its european neighbours, a reassessment of pay is required. But this measure does not guarantee the sustainability of our health system. To build a health system that is more efficient, more sustainable, and more human, a deep transformation is necessary, and it will inevitably result in an upgrade in overall first health profession by the number. The 700 000 nurses in France have (also) ideas.

first, It is important to allow the medics to have prospects, they are able to evolve throughout their career. According to the latest consultation we have conducted (61 000 respondents), 91 % of nurses say they are " proud of their profession ", but less of a nurse on two said he " was satisfied with his job ", and only 42 % " would choose again this business ". These teachings invite us to reflect : our model can he count forever on the commitment and dedication of a profession that is chosen most often by vocation, while remaining deaf to her calls ?

Read also Vallancien – Ségur health : money, money for the hospital, and after ?

We can treat, immunize, counsel, support, educate, prevent...

The nurses also want to broaden their skills, benefit from more autonomy to better support the patients." This can include, for example, by the formalization of the existence of the consultation nurse (desired by 92% of nurses), or the possibility of adapting prescriptions (79 %), while 73 % felt that " the medical prescription sometimes makes it difficult to access care." We know conduct diagnostics, make referrals to other health professionals, coordinate a course of care, fit of requirements, ensure adherence to treatment... We can treat, immunize, counsel, support, educate, prevent... To the hospital, but also in medico-social establishments, in long-term care facilities, or home patients, our real contribution to the health system is not sufficiently valued.

note that the texts that govern the exercise of the profession have not changed since 2004 (decree 2004-802 of July 29, 2004), in spite of the changing needs, and despite many reforms of the health system. However, the extension of the role of nurses has been developed for several years, sometimes several decades, in industrialized countries such as the United States, Canada, the United Kingdom, Switzerland... The many scientific studies on the subject show significant benefits for the health systems concerned. To strengthen the link between the hospital and the care of the city, it will have to rely on the nurses. For the development of e-health and ensure that digital tools benefit the greatest number, he will have to rely on the nurses. For that our health system can meet the challenges of an ageing population, increased health needs, chronic disease... again, it will have to rely on an appreciation of the role of nurses.

Greater autonomy

These proposals regarding the place of the nurse in the organization of our care package, we have listed, detailed, and presented to the competent authorities in the framework of the Segur of health. We have also submitted to an independent firm, the firm Asterès, which has done an analysis on each of them, before concluding that greater autonomy of 700 000 nurses in France would "maintain the quality of care in a context of increased demand for health care" ; "improve the productivity of the system and revitalises the role of the doctors" ; "reduce the time taken in the care of patients" ; "to compensate for the decrease of the density of general practitioners in a context of ageing of the population" ; " generate significant savings ". Many beneficial consequences to our health-care system, and thus for the patients.

Let us learn how to draw collectively on the lessons of the health crisis without precedent that we have just been through : care for our health-care system, revalorisons the place of nursing.

*Patrick Chamboredon, president of the national Order of nurses