“With this derogation decree, non-specialized nurses from operating room having received only a short awareness training of a few hours, will be able to carry out the same operating procedures as state-certified specialized operating room nurses (IBODE) who follow 2,800 hours of training.”
Compiégnois Evan Van den Brock, 25, vice-president of the French Association of Operating Room Nursing Students, is sounding the alarm regarding the decree of October 23. A decree published on October 25 “allowing nurses without specific training to have authorization from the prefect to carry out highly technical procedures, with the presence of the surgeon or under protocol”.
The state-certified operating room nurse (IBODE), dressed in sterile fashion, works in close collaboration with the surgeon, the IADE (state-certified nurse anesthetist). “As there is a lack of IBODEs, we put in place transitional measures in 2019, to allow the practice of 10 exclusive IBODE acts,” continues Evan van den Brock. He himself is employed at the Compiègne hospital, “which finances my professional training” at the CHU Amiens school.
Among these ten exclusive procedures, there is, for example, surgical installation, placement of supra-aponeurotic drains and cutaneous and subcutaneous closure (suture).
“Only 21 hours of training”
A nurse can therefore carry out these acts after having carried out these transitional measures. “It represents 21 hours of training, but it is mainly information and legislation,” explains Evan Van den Brock. So it’s theory, because there is no internship. Whereas it takes a year in the operating room to start to feel a little comfortable. It’s a technical platform.” He cites the example of a craftsman: “To be a plumber, you need at least two years of training. Not 9 p.m..”
Currently, 2800 hours of training are required to obtain the Ibode diploma. “Once we graduate, we have exclusive acts listed in a decree dating from 2015,” continues the Compiégnois. Nurses have been practicing them for a long time: surgical installation of the patient (hemodynamics), checking the skin condition (bed sores), closing the skin (cutaneous and subcutaneous), placing drains, helping with exposure (spreading to make the area accessible to the surgeon), hemostasis (cauterize)…
“Since 2015, it has been in the decree of our actions,” insists Evan van den Brock. Before, surgeons paid their secretary to help them in the operating room. It’s a historical fact.”
“A brake on the quality of care and training”
Since 2022, the Ibode diploma is a Master’s degree with training in 4 university semesters, with an extension of procedures such as excision, anastomosis…a master’s degree. “There is an extension of possible actions,” continues the nurse in training. He cites three roles: 1. Circulating: conductor (in the room) who ensures the connection between the operating room and the outside. 2. Instrumentist, who gives the tools to the surgeon. 3. Surgical assistant who performs procedures such as hemostasis, aspiration, but also highly technical procedures (e.g. removal of the fallopian tubes).
“We’re not just nurses without skills,” considers Evan van den Brock. This decree endangers Ibode training, financed by public or private establishments. That is between €16,000 and €20,000, not including salary and expenses. “With this decree, public or private health establishments will no longer want to finance training when they will be able to employ a nurse doing the same procedures as IBODE without having to spend such a sum,” he explains. This puts a brake on the IBODE profession, which is nevertheless essential, on specialized training and on nurses with the desire to train.”
And above all, he concludes: “It is a brake on the quality of care of the French health system that we are. It’s always better to have a specialist than a generalist who does things by mimicry, without the knowledge of training.”
