A new online survey by the German Society for Internal Intensive Care and Emergency Medicine (DGIIN) shows that nursing and hospital staff are even more dissatisfied with working conditions since the third Corona wave - a third of intensive care nurses plan to quit in the coming year.

Yet nursing emergencies, poor working conditions and calls for better pay are nothing new. "We are in a permanent crisis," Uwe Janssens, secretary general of the DGIIN and former president of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (Divi), tells the Daily Mirror.

That scarce staff quickly reach their breaking point during the pandemic is hardly surprising. Seventy-two percent of nonphysician staff reported being overloaded with the challenges of the third wave of Corona. More than two-thirds of ICU, emergency department and ambulance staff said their decision to reduce or even quit their job share was influenced by the stresses of the Corona pandemic.

Christian Karagiannidis, head of the DIVI Intensive Care Registry and president of the DGIIN, spoke of a "bitter balance after one year of Corona." Via Twitter, he asked staffers to stay, saying, "It will hit hospitals hard after Corona: Please stay!"

The consequences for health care would be catastrophic. The situation is already tense today: There is already a shortage of more than 100,000 caregivers in long-term care alone. Forty percent of all nurses will reach retirement age within ten years, Franz Wagner, managing director of the German Professional Association for Nursing Professions and president of the German Nursing Council, told Ärzteblatt. If an additional third of the current staff were to quit, that would be fatal.

The demands made by the staff, however, sound anything but absurd. In a study by the Bremen Chamber of Employees and the SOCIUM at the University of Bremen, re-entry criteria were defined for "Pflexiteers", i.e. nurses who have left their profession. These include: Time for high-quality care, time for human attention, guarantee of not having to work on days off.

A higher basic salary, collective bargaining agreements and higher bonuses for special activities are also important. Furthermore, a joint paper by Divi and the German Society for Specialist Nursing and Functional Services (DGF) calls for a staffing ratio based on actual nursing requirements and modern working time models. Finally, better psychological support for intensive care nurses, who are often under extreme stress, is important.

Psychological stress on staff
Janssens reports that the psychological stresses are not only caused by the daily work routine. "While they have been in a continuous marathon run in the clinic for almost 14 months, they are accused of scaremongering from the outside." Instead, she says, society should stand behind the staff.

Far-reaching measures are needed to meet the required criteria. Almost all respondents believe that a sustainable hospital reform with strengthening of intensive care and emergency medicine as well as better working conditions are needed to make the profession more attractive again.

"It's just not done with a bonus patch here and a minimum wage increase there. We need clearly more convincing measures" says Martin Dichter, Chairman of the German Professional Association for Nursing Professions Northwest (DBfK). Thus for example a gross starting salary of 4000 euro is meaningful. The merging of hospitals may also be a way to counter the crisis.

At present, however, the confidence of those affected in politicians to deal with the situation appropriately is almost non-existent, according to Janssens. The survey results confirm this: 96 percent of respondents do not believe that politicians are in a position to bring about effective solutions to the staff shortage.

Image by Gerd Altmann