At the HART

The time is now! Nursing affects us all – when will we finally act?

Who will take care of us when we are old? Questions like this are on people's minds in Germany. “The public is aware of the nursing crisis – now something has to be done about it”, says Andreas Joehle, CEO of the HARTMANN GROUP.

While topics such as the asylum controversy dominate the media, people in Germany are most worried about their living conditions. This is shown by the current Eurobarometer survey of the most important problems facing the nation. Social Affairs rank number one for half of respondents. Around three-quarters of Germans believe that the government should spend more on the health sector.

And for good reason: The demographic change poses a huge challenge for our society, as we are growing ever older. Today, there are already 962 million people over 60 years old around the world – including 25% of the population in Europe. The United Nations estimates this number will reach more than two billion globally by 2050. Add to this that since the nursing reform of the last legislative period, there are now significantly more recipients of benefits from nursing care funds.

Who will care for these people?

Health minister Jens Spahn speaking at the Deutscher Pflegetag
Health minister Jens Spahn at the German Nursing Day (Deutscher Pflegetag)

The growing group of people in need of care is already facing a declining number of care givers. This also means less time per person. According to the German Nurses Association (DBFK), by 2050 there will be 4.21 million people in need of nursing care in Germany, an increase of 72% over 2012. A precarious situation, as there could be a shortfall of around 500,000 full-time nursing staff by 2030 according to the nursing report by the Bertelsmann Foundation. The nursing crisis deepens.

Pressure on the German government is rising, leading Health Minister Jens Spahn, Family Minister Franziska Giffey and Labour Minister Hubertus Heil to give the go-ahead for the "Concerted Action Nursing", which will include the German states, employers and unions, churches and charitable societies, health insurance companies and stakeholder representatives. Specific plans for more attractive working conditions should be released in a year.

Short time in the profession

Our Pflexit Monitor, conducted for the first time this year, also identified an urgent need for action. 54% of German nurses are considering leaving the profession. Only one-third would recommend the profession to others, and a mere 35% would choose it again.

The reasons for this are many: A generally high workload due in part to a lack of staff and a simultaneous increase in patient numbers faces growing documentation requirements. While these are necessary, they distract from the actual care itself. Nurses already fall sick more often than workers in other fields. According to the DBFK, the average time spent in the profession is correspondingly brief too: 8.4 years in geriatric care, and 7.5 years in nursing.

The situation cannot continue like this.

Andreas Joehle and Dr. Eckart von Hirschhausen talking on stage during the HARTMANN Future Forum.
Andreas Joehle and Dr. Eckart von Hirschhausen at the HARTMANN Future Forum

The way a country handles its caregivers, both professional and private, also defines how we want to coexist as a society. Do we take care of each other, or do we pull back? We also held intensive discussions with top experts from the healthcare sector at the HARTMANN Future Forum – and the future of nursing was clearly the main topic.

The recognition is already there: Nursing needs greater recognition, and the entire profession should be elevated. But nursing also needs to become more professional, since higher qualifications also justify nurses' taking on other activities, such as prescribing wound and incontinence products and thus increase the individual responsibility of nurses.

This is a position that our company has long supported and actively promoted, for example by granting the PAUL HARTMANN Care Award and our commitment to trainees as a Premium sponsor of the "Best Student in Geriatric and Nursing Care" initiative.

The first actions have been taken:

  • The Nursing Profession Act (Pflegeberufegesetz) that took effect in July 2017 will modernise nursing education and adapt it to the changed requirements, for example by merging nursing care, paediatric nursing and geriatric nursing into a standardised professional qualification recognised throughout the EU. Specialisation in the last third of the educational program is still possible, and tuition fees are finally eliminated.
  • To open up new career possibilities, appeal to new target groups and better integrate scientific findings in nursing into practice, it also promotes academic development in addition to the vocational nursing training. Some university programs already exist, including the online Bachelor's program "Interprofessional Healthcare" at Alice Salomon University (ASH) or the Bachelor of Science in Nursing that will start at Charité in 2020.
  • However, nurses still have to organise and speak with a single voice. On the topic of self-organisation: The state of Rhineland-Palatinate has already taken this step, and North-Rhine Westphalia will soon follow suit. Only around 20% of German nurses are currently organised.

A recent whitepaper by the German Federal Ministry of Health gives hope for change here. The increased nursing workload in hospitals should be rewarded by higher remuneration for more nurses. Further, 13,000 nurses are to be added to support nursing facilities and be paid for by the health insurance companies. While this is a good step, it does not even mean an additional nurse per facility.

Franz Wagner at the HARTMANN Future Forum

Franz Wagner, President of the German Nursing Council (DPR), therefore calls on politicians to create 100,000 additional jobs for all health care disciplines in hospitals, outpatient and long-term inpatient care, in the foreseeable future. To him, professional nursing is "the most underappreciated resource in the German health care system".

Develop proud – for a meaningful profession

Andreas Westerfellhaus, the new Nursing Commissioner for the German government, also made proposals. Nurses should receive a one-time tax exemption of up to 5,000 euros. And employees who get a permanent job immediately after completing their education should receive a bonus of 3,000 Euros. The politicians are now aware of the issue. Nursing and geriatric care should become more attractive, not least by improving the work-life balance.

But that's not all, as there is another equally important issue: Nurses have to develop a new understanding of their role as well as greater self-confidence. They can and should be proud and look with pride on their meaningful profession, a characteristic that many other industries don't share. Dr. Eckart von Hirschhausen, physician and moderator of the HARTMANN Future Forum, rightly said:

Dr. Eckart von Hirschhausen
"Nurses need to view themselves as an effective part of the whole; after all, they are the ones who comfort patients"
Nurse and patient

Nurses are much more than just the doctor's right hand. They are close to the patient, and their expertise is therefore indispensable. Their autonomy must grow – in treatments that urgently require special nursing expertise. Nursing should be recognised as a separate profession in health care and act as equals with other health professions.

Especially in rural areas, nurses can take on medical duties in primary care. Other countries are further along the path of transferring medical duties. In Finland, for example, a nurse acts as gatekeeper – she receives the patients on her own, is responsible for handling chronic patients in particular and prescribes incontinence products, wound dressings and medications.

This elevation in her position can ultimately provide much-needed relief for general physicians, especially in rural areas that are already experiencing a shortage of physicians.

All of these facts are reason enough to inform more about the nursing profession and to enter into dialog – and that as early as possible. Why, for example, not go straight to the final classes that are in the final phase of making their career choice?

Andreas Joehle on stage
Andreas Joehle

Maintaining and promoting health

We recognise our responsibility as PAUL HARTMANN AG, as we aspire constantly to improve health care and to increase people's quality of life. This is why we are committed to developing long-term solutions, especially on the subject of nursing. After all, it is ultimately nurses in hospitals or nursing homes who come into daily contact with our products and services. These should facilitate their daily work and create measurable added value, because they are easy to use and time-saving.

We also want to motivate nurses who have left the profession to come back and thereby make possible the nursing that our society urgently needs and wants. By the end of 2018, we will therefore launch a "Care Offensive" together with prominent partners in the German health sector, including the German Nursing Council and Franz Wagner. This will define how we can be a sustainable supporter of nursing in Germany and around the globe.

We cannot wait any longer. Let's get going!

2018 marks HARTMANN’s 200-year anniversary.

To commemorate this milestone, we have put together this series of articles. In it we show how our employees and partners contribute to advancing healthcare, as well as discussing trends and issues that affect the healthcare systems we serve.