MDear staff: That’s what many nurses in Germany want most – so that they have enough time for their patients, don’t have to constantly stand in on their days off and can also reduce their overtime hours. But despite all the promises made by politicians and although nursing received a lot of attention during the corona pandemic, little has happened so far.
That should change now. Federal Minister of Health Karl Lauterbach (SPD) announced new personnel requirements for the clinics in Berlin on Thursday. These are to introduce an instrument for personnel assessment that is more oriented towards actual needs and was developed by the German Hospital Society, the German Nursing Council and the Verdi service trade union. According to their will, the new regulation should have come into effect as early as 2021, now it should come in three stages from 2023 to 2025. The SPD, Greens and FDP had agreed in their coalition agreement to implement the regulation “at short notice”.
The hope of the federal government is to relieve the nursing staff through the mandatory personnel key and thus make the profession more attractive. How many nursing staff are needed should be determined by them themselves using uniform criteria. To do this, they divide the patients into different care levels, to which specific minute values are assigned. In addition, there are so-called basic and case values, which result in a total time specification for each patient.
The situation on the labor market is taken into account
Taken together, the results indicate the nursing staff needs of a home. According to initial estimates, the innovation will lead to an additional time requirement of more than 8 percent per patient. The regulation is intended to replace the minimum staffing levels that were set by law for certain wards in the clinics, but only define the minimum and are repeatedly undermined in practice.
According to the key points presented by Lauterbach, a pilot phase lasting at least three months will come into effect in January next year in a representative selection of hospitals. At the beginning of 2024, the regulation will then become mandatory for all wards with beds, unless there are already contractual agreements to relieve the staff there, for example via a collective agreement. If the hospitals cannot meet the staffing ratios determined, this initially has no consequences for them. First of all, the personnel situation in the clinics will be “made visible”, according to Lauterbach’s proposals, for which a legal basis should be created “soon”.
Only from 2025 onwards will the hospitals have to implement the personnel requirements to a certain extent. This is gradually being increased, but should be based on “achievable values” and take into account the situation on the labor market for nursing staff. Unspecified sanctions are envisaged if a hospital consistently fails to achieve its goals despite a staffing plan. It is striking that the key points do not contain anything about compensation, for example in the form of days off for the nursing staff, if the staff ratios are not adhered to. On “Care Day”, Lauterbach said at an event in his house that a sticking point with the new personnel requirements was the question of what the consequences would be if the nursing staff were overworked. Then there must be relief.
Employees at the six university hospitals in North Rhine-Westphalia have been fighting for such a solution for around ten weeks. On Thursday, Verdi again called for rallies and protests, this time in Essen. The goal is a “collective agreement for relief”, which stipulates exactly how many employees are needed for patient care. If shifts are understaffed, there should be an entitlement to days off. The Berlin Charité and the clinic group Vivantes, where Verdi has already negotiated similar collective agreements, serve as models.
The university hospitals have offered up to seven additional days off a year for bedside nurses and employees in patient-related areas, but Verdi thinks that is too general. The medical director of the Essen University Hospital, Jochen Werner, warned on Thursday that the shortage of staff, which was exacerbated by corona-related absences, and the ongoing strike sometimes led to “acutely threatening situations”.
