Death certificates, vaccinations, prescriptions... What you can now ask a nurse

Eight hours, ten hours, sometimes up to eighteen hours of waiting before finding a doctor available to come and record the death of a loved one and sign the death certificate... However, this process is mandatory to initiate the procedures funeral services and remove the body. A traumatic experience for families, which pushed the government to change the rules. You will now be able to call on a nurse to note the death of a loved one, and write the death certificate, which until now could only be signed by a doctor. A decree published this Thursday in the Official Journal authorizes them to do so, extending to the entire territory an experiment underway in six regions of France since December 2023.

The measure, which concerns voluntary state-certified nurses and concerns deaths occurring at home or in nursing homes, removes the condition that they can only draw up the death certificate in the event of unavailability of a doctor in a nursing home. "reasonable time", as was the case in the experiment. Volunteer and trained nurses will be able to issue these certificates “at any time”, specifies the decree. “This is a very important step for the revaluation of our profession”, welcomes Sylvaine Mazière-Tauran, president of the National Order of Nurses, for whom “the difficulties of families in having death certificates drawn up and organizing funerals of bodies are an intolerable illustration of the problems of organization of the health system.

However, to exercise this new skill, nurses must have a minimum of three years of experience and undergo specific training. “To date, 1,217 nurses have already been trained in anticipation of this development,” indicates the Ministry of Health, which estimates that this measure “will make it possible to better support each family in these painful moments”, specifying that 150,000 deaths have occurred. every year at home.

This decree adds an additional skill to nurses, while the 640,000 nurses - including more than 120,000 liberals - have been waiting for almost a year for the "refoundation" of their profession. The reform had been promised in spring 2023. Faced with shortages of doctors and the aging of the population, nurses “must be able to monitor chronic diseases” or “extend prescriptions”, declared the Minister for Health Frédéric Valletoux . The idea of ​​nursing “consultation”, however, has caused certain doctors’ unions to jump, such as the UFML-S, which denounced “the planned destruction of medicine”, with practitioners who “will be replaced by less trained, less competent” .

“We are not going to play doctors”, only “give dedicated, valued time” to the invisible work that nurses carry out for free today, particularly on prevention, such as “the time spent convincing a patient to be vaccinated” , assures Daniel Guillerm, president of the majority union among the liberals (FNI). This consultation would offer “a space for therapeutic education”, adds John Pinte, president of the second representative union, Sniil. The nurse could, for example, teach diabetic patients to manage their treatment, their symptoms or their diet, etc.

Already in the Social Security financing bill, passed this fall, nurses had been authorized to make vaccination prescriptions and the list of vaccines that they can administer had been expanded, in particular the vaccine against the papillomavirus in schools. . In addition, they were authorized to carry out prevention consultations at key ages of life, desired by the government at 18, 45 and 65 years old.