While many countries are struggling to find trainees for their hospitals, German high school graduates are flocking into nursing schools, ready to help people who are suffering. But many quit the training early.
In “ER" and other hospital soap operas, the job of a nurse is to look good, flirt with doctors and to say sentences laden with drama.
But reality looks different.
At the gynaecological ward of Hamburg’s university hospital, nursing student Dominique Hammermeister recently attended to a patient who underwent an emergency operation the night before. As she poked the syringe in the woman’s arm, Dominique softly talked to her - to calm her down. The woman who recently underwent an operation was worried about having lost too much blood.
Later Dominique will hand out meal trays and collect them, she will change bandages, make beds, attend to new admissions, wash patients, pass out pills and attach drips, she will listen to all kinds of worries, and finally scribble down the documentation about each patient.
Dominique started at 6 o'clock in the morning, at 3 p.m. her shift will be finished. She is well into her third year at nursing school and earns little over €600 ($739) per month. As a full nurse she might earn twice that – but still: the wages are peanuts in relation to the work load she copes with. Yet, like most other young people studying nursing, she does so out of real enthusiasm.
„I simply enjoy that you can help others and you do see the results," she said. "If you see people who have terminal cancer and only three weeks left to live, you really start appreciating your own life.”
What really gets at her, though, is that with all the commitment she shows in her job, she is banned from doing certain jobs, such as drawing blood. Nursing is a job full of limitations and it doesn’t really offer great perspectives.
A lack of perspectives
Today, German nurses stay on the job for an average of only five years. A comparative European study called NEXT showed that Germany produces the highest number of quitters.
“It is not the exhaustion that is the main motivation for quitting in other countries," said Stephanie Jöres, a spokeswoman for the Association of Protestant Hospitals, adding that one in five students thinks about quitting the job. "It is the lack of perspectives, the lack of possibilities to be creative and independent on this job.”
Part of the problem is the old-fashioned education system in German nursing, said Edith Kellnhauser who used to work as a nurse all over the world: in Egypt, in Great Britain, in Germany and the United States. Germany has been very slow to invite progress into the profession, she said.
“One barrier I would think was the language," Kellnhauser said. "Many advanced books and articles in nursing come from English speaking countries and it was very difficult for German nursing students to read these publications in the original language. The second barrier was that many of our nursing organizations in Germany for many years were of the opinion that nursing is a profession that you do with your hands: 'You don’t need theories, you don’t need to be educated.' Well, that has changed dramatically."
A profession in need of change
In 1992 Kellnhauser acted as founding dean of the Department of Nursing Science at the University for Applied Sciences in Mainz – one of the first schools to offer classes in Nursing Management and Nursing Pedagogy. This country still has a long way to go, she said. American nursing students, in comparison, have it a lot easier.
“When you have a basic university education, okay, you can do nursing for two, three years," she said. "And then you say: 'Well, I didn’t think this would turn out like this,' so you can go and study a few more years and go into another profession. I have seen that nurses become lawyers or social specialists, professions like that. So you have a lot more opportunity, which in Germany we don’t yet have.”
It better not take too long before German Nursing changes its face. Germany cannot afford scaring too many young enthusiasts out of the job. This country is getting old, really old. Demographs estimate that by the year 2050 more than half of the population will be over 50 years old. And old people need a lot of health care. So while many high school graduates know that their apprenticeship or studies cannot guarantee them secure jobs, nursing holds the promise of life long employment.
Dominique Hammermeister said she wants to go back to school after two or three years of working as a nurse. Once she is finished with her studies in Nursing Management, she says, she might want to have children herself. It's a great advantage this job holds for many women: its compatibility with family commitments. And it is one of the reasons why they are willing to put up with meagre wages.