Xavier Caloin, 52, is a liberal nurse west of Cahors. Every day, he walks the small roads of the department to go and treat his patients. La Dépêche du Midi followed him for a morning. Reporting.
It’s 6 o’clock in the morning. This Friday, some are still sleeping, but Xavier Caloin is already on the bridge. The latter is a liberal nurse, and is about to begin his morning round. 6 a.m. – 1 p.m. Then, it will resume at 4 p.m. to end around 8 p.m. Her patient list? Especially old people. The latter are kept at home, and manage thanks to the carers and private nurses. “Our first job is the prevention of falls. We try to preserve the little autonomy they have left,” says the man who is also elected to the Order of Lot nurses.
His first patient is Odile*, she lives in a residential home. “When I arrive, it’s true that it’s early, and she never wants to get up,” murmurs Xavier before gently knocking on the door. Miracle: today, the 98-year-old lady is already up. “Usually, I have to come back, free of charge, around 8 a.m. for her to agree to go to the shower”, slips Xavier Caloin, 52 years old. Because his morning round is 50% technical care, but above all, 50% nursing: washing, dressing, shaving the beard…
Maintain hygiene care
And in the Convergence Infirmière union, in which Xavier Caloin is active, a fight is being waged: to defend this hygiene care and keep it. “Some say it’s not a nurse’s job. But when I bathe people, I discover things. Heart problems, diabetes, malnutrition, all of this can be seen when you put patients naked” , he explains. After spending several minutes with Odile, it’s time to get back on the road. “See you tonight!”, launches the ordinal nurse.
Xavier Caloin mainly takes care of the elderly.
7am, heading to the home of another patient. The exchanges are accomplices, without being familiar. “What weather is it ?”. Fog, says the caregiver, asking the elderly woman to get up. “Minute! There is no fire in the Lot”, replies the latter tit for tat. A small smile on the corners of the lips. A few meters further on, Bernard* is waiting. He needs help, three times a week, to wash himself. The nurse sometimes takes the time to have a little coffee with the couple. The clock already shows 8 o’clock. Time flies, and patients file past. But Xavier Caloin takes the time with each of them.
Busy days
Being a liberal nurse also means making pillboxes, organizing medical appointments but also the ambulances to get there, going to the pharmacy to take the drugs… So, a little after 9 a.m., you have to make a stop at one of the local pharmacies. Here, Xavier Caloin is well known. “And here is the prescription for the patient we were talking about yesterday, it’s not urgent, I know you have to order it,” he told the preparer. There, he was able to do it between two patients. But usually these are things he does at the end of his tour. On his rest time.
The nurse takes care of the pillboxes of his patients.
In his day, it is also necessary to count 1h30 of administration. A red tablet follows him everywhere. He must meticulously complete the care given to each patient. Tedious, but necessary. All of this adds time to already busy days.
“There is institutional abuse”
“Liberal nurses, we are at the center of care. If we disappear, it’s a disaster. There are medical deserts. Nursing deserts are very rare”, breathes Xavier Caloin. In his office west of Cahors, they are 4. And they accept all patients. No matter the age, no matter where. “Behind, there is someone in pain, we are not going to close the door to him”, assures the nurse. So the kilometers, he counts them without counting them. This morning, he traveled more than thirty minutes, round trip, to reach the home of a patient. On average, in a day, he travels more than 150 kilometers.
Every day, he has to fill in the care given to each patient on this little tablet.
Currently, the travel allowance amounts to 2.50 euros. An amount that has not increased since 2009, despite periods of inflation. At the moment, negotiations are open with the health insurance, and this could increase by 10%. Or 2.75 euros. “Convergence will not sign. We are given crumbs”, annoys Xavier. At night, he can sometimes go to the bedside of his patients, when there is an emergency. A move that is not taken into account. The elected ordinal also wants recognition of the arduous nature of his profession. According to him, all the boxes are checked: exposure to heavy loads, staggered hours, exposure to infectious, chemical or bacteriological risks… The life expectancy of liberal nurses is 7 years lower than the national average. “Pushing a syringe hurts me,” he sighs.
The liberal nurses are also fighting to increase their skills in acts: carrying out an emergency assessment when a patient is not well, obtaining medical equipment linked to autonomy… This is how the Lotois sums up the situation: “There is institutional mistreatment. But, it is not because we are mistreated that we must mistreat our patients”. It’s 10 a.m., and Xavier Caloin has already seen more than a dozen patients. But the nurse’s day has only just begun.
* loan names