Nurses Helping Doctors Sign Death Certificates: ‘Our Patients Never Stop Living… And Die’

It’s rare that a simple manual stroke of a pencil can make a difference to an entire profession. “You forget to cross out the word doctor on the death certificate title and add your title instead: state certified nurse. »

Submitted Dr Claire Morgand, General Practitioner, who at the request of the Regional Health Agency of Ile-de-France (ARS), this Tuesday, March 12, took on the role of trainer at the Nursing Care Training Institute in Bichat. Hospital Claude-Bernard (Assistance publique-Hôpitaux de Paris, AP-HP), the instructions caused a few smiles among the 76 participants installed in Amphitheater A. Then 76 picked up a pen and 76 crossed out the same number of A4 copies. Death certificate, still blank.

An experiment included in the Social Security Funding Act of 2023 would allow nurses to sign these certificates in place of doctors when they are not available.

The ability to share: these three words, which the authorities have used as leverage in the fight against medical deserts, are taking shape. Little by little: we have to overcome it “Certain Obstacles” Among educators, we defer to the Ministry of Health and wait almost a year for the publication of the texts implementing the experiment in December 2023.

Slowly but surely: six regions volunteered – Île-de-France, therefore, the center of the Loire, Auvergne-Rhône-Alpes, Haut-de-France, Reunion and Occitanie. Before generalization, it was promised to the whole area, without presenting the procedures“availability” of the doctor. In any case, that’s the commitment made by Health Minister Frederic Valetu, who inserted the measure introduced over the winter into the Affordable Care Act.

We still have to wait for the publication of the new resolution – they promise the Ministry of Health in April. “In a health care system under pressure, the goal is to give greater confidence to a greater number of health professionals.Protected by the minister. To better support the French while ensuring that everyone stays in their role, everyone in their place. »

“Overcome the fear of making mistakes”

It is a question of space, and through it, the skills required, that concern those interested in the ranks of the amphitheater. These volunteer nurses spent three and a half days – during training – leaving their daily practice area, hospitalized at home or in a residential facility for dependent elderly people (Ehpad) in the Île-de-France region, to return to their classrooms. .