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French nursing care


cooperlola

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A Scots friend who lives near here has a serious illness which requires a regular infusion.  She has been going to the hospital in Le Mans for this.  She phoned me last night and said the doctor at the hospital has now said she can undergo this treatment at home now and "get a nurse to do it."  He gave her a prescription and that was it.  She was so taken aback that she realised when she'd left that she had failed to ask how she should organise this.  I found her a "cabinet infirmiere" in our local village from the Pages Jaunes and she is going to phone them on Monday.  However, I thought it was an interesting question and wondered if anybody has a similar experience which would help me to give here some pointers.  Are local nurses paid for in the way in which you pay for other medical treatment - ie will she get the usual percentage paid for by the state (she's on an E106)?  Should she ask the hospital for some sort of referral letter? Or see her GP first?

It would be good to arm her with some others' experiences.

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Cooperlola, I know its not the same thing but my wife has to go and see the Infimiere (I have never seen an Infimier in France has anyone or does the masculine and feminine applies for both forms) on a regular basis for blood tests.  The charge is I think 4.35 and CPAM pay 100%.  But this is for a longue duree maladie and for which the E121 provided total cover.   Normally our specialist gives us a prescription which we give to the Nurse and we then pick up the results from the Pharmacie.

Obviously ones medical history is highly confidential and it is not for me to know but does this ladies serious illness come under the so-called 30 long duree maladies.

rdgs

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Thank you Llwyncelyn.  As you say, for obvious reasons, I do not broadcast the precise circumstances.  However, your answer is what I wanted as she has no problem with the actual percentages involved - she has adequate experience of such things.  It was just the method of doing this which concerned her - whether she needs some kind of referral or not to claim back whatever percentage she is entitled to.

You are right - I looked in Pages Jaunes again and indeed the general term is Infirmier so I was incorrect!  Masculine unless otherwise stated!

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It is fairly straight forward:

Your friend should ring the centre médical/cabinet infirmier and explain she needs daily injections and she will be put in the diary for a daily visit.

The nurse will want to see the prescription and will expect some payment. Your friend will be given a brown form partly filled in by the nurse, which your friend will complete and sends away to her CPAM for reimbursement at whatever rate...

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I broke my ankle in October and among the sheaf of prescriptions I was given at the hospital was one covering daily home visits by a nurse for three weeks.  I also had a separate prescription for the 21 individual syringes with which the nurse would inject me to help prevent phlebitis; this had to be taken to the pharmacy straight away so that everything would be ready when she called.  We asked our GP for the address of the nearest cabinet infirmier and fixed up the visits by phone.  When the nurse arrived, she asked to see the prescription but that was all.  On her final visit she wrote out (in great detail) a feuille de soins covering the cost of her care and we paid the whole amount to her by cheque. We took the feuille de soins with the prescription to our local CPAM office and in due course they reimbursed us for their contribution (the calculation of percentages was quite complicated but we received 60% of most of it and 100% of her travelling expenses! The whole bill seemed very reasonable).  Our Mutuel requires us to send the CPAM statement on to them for reimbursement which we are in the process of sorting out now.

I hope this helps: it was so convenient to have a home visit as I was not very mobile, and she always gave us a window of about an hour in which to expect her so we could arrange our day accordingly.

Val

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We've just gone through the same process, the doc gave us a scrip and I telephoned the infirmiere and made the appointment. Then we read the scrip and realised we needed to visit the pharmacie to get it! When we went there the pharmacist asked if we wanted him to contact the infirmiere for us, it all seems pretty well co-ordinated one way or another. Just a note of warning though, our infirmiere had to be asked to take away the used syringe, she was prepared to leave it lying on the kitchen table!
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I had to have these anti-coagulant shots for 10 days after coming out of the hospital a while ago. After being woken up by the nurse at 7 for 2 days on the trot, I opted to do them myself!!

The nurse will expect your friend to have obtained the necessary medication to inject as  shown on her prescription, as well as des compresses de gaze (sterile gauze) and some alcool à 90° (medical disinfectant) from the pharmacy if she doesn't have any, to wipe the skin with before the injection.

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Clair - I had the same experience as you, only I got my husband to inject me as he has 1st Aid training. The nurses do tend to arrive at the crack of dawn - they work very hard. Has anyone found a simple way of disposing of the needles/syringes? It is unbelievably complicated here, involving special yellow buckets, letters from the pharmacy, registration with the rubbish disposal people, and only accepted at the dechetterie the first week of the month. Is this normal? Pat.

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The complicated system you describe sounds pretty sensible to me given the risk if drug users etc pass on the needles.  My own instinct would be to follow the french system.  Otherwise, why not ask your gp or whoever prescribes the drugs?  In the UK I did a number of injections on animals and always gave the used syringes back to my vet for safe disposal.

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Blimey, go the infirmiere to have blood tests, not here, they come to the house by appointment as they do for me regularly and they did with my pal when he came out of hospital last year - ask them if you can have them visit at a time to suit you, all this 7 am is nonsense here where they do verything by appointment.

I could, in theory, have them come to the house for my chemo shots but I did them for so long myself in the UK, I've continued doing them myself here as I have them last thing at night and I can then sleep off the effects having taken painkillers with them.

Even tho I'm 100% I pay for the blood tests and get reimbursed without the brown form.  Only have to pay and get a brown form when I pick up the blood results and then get that money back 100%. 

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Tony yes of course the good folk will come to your house.  However we have taken a view(or rather my wife has and whose initial career was in nursing) that going to the cabinet (and in fairness this is two minutes away) is the better option.  Of course if the journey is onerous and the lady who needs the injections is not too well it is undoubtedly better for the nurse to come to the house.

Briefly off topic the best holiday we had in France was in an atypical French town house in St Cyprien owned by a nice couple from Bristol.  I am not sure but does it have a river or stream running through it? not the house but the village?

In any event we loved the house only a slight problem it faced the back door of the boulangerie and in the morning (early) and with the French going about their business the 'ping pong' of the bell drove us slightly mad.

St Cyprien is a lovely place and the market is it Sunday?

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If you live in a rural part of the country you will find there is no "cabinet d'infirmières". Look in the yellow pages, ask your doctor or the pharmacy and you will find your local nurse. From experience I can tell you that they usually start the day early with blood tests (so that the patient can eat breakfast before lunchtime) and injections close to home. The rest of the morning is spent doing longer treatments....dressings, bedbaths, getting old people washed and dressed for the day. A lot of them have patients in old folks homes. Their morning ends at about 1pm and they start again at about 4pm....getting people ready for bed, more injections and often don't finish until 9pm. Often their patients live 20kms or more apart so quite a bit of time is spent in the car.

Just so you don't complain too much when the nurse arrives at 7am!

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[quote user="Tony F Dordogne"]Blimey, go the infirmiere to have blood tests, not here, they come to the house by appointment as they do for me regularly and they did with my pal when he came out of hospital last year - ask them if you can have them visit at a time to suit you, all this 7 am is nonsense here where they do verything by appointment.[/quote]

The injection I needed every day for 10 days had to be had on an empty stomach (à jeun) hence the 7 am  call, on her way to or from my diabetic neighbour's twice-daily insulin shot...

As said in the previous post, in rural areas, you fit in with them, not them with you...

If I need a blood test, (usually done before breakfast), I go to the centre médical at 9 am and wait for the nurse on duty to return from her early calls and catch her before she starts her 'dressings and IV' round.

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Thank you all for your comprehensive answers.  As it happens, she was a little alarmed at having the procedure done at home as she has the builders in big-time so will probably opt to go to the cabinet, which is a couple of miles away from her.  At least now she will have  an idea of the options available to her. Great practical assistance from the forum, as ever.
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