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Help from abroad

Tobias Oelmaier / cmkOctober 17, 2012

Germany is facing a nursing shortage: 40,000 specialists are urgently needed now, and that figure is expected to jump to 110,000 in the foreseeable future. To make up the shortfall, Germany is looking to China.

A Chinese nurse prepares a dose of vaccination STR/AFP/Getty Images)
Image: STR/AFP/Getty Images

"When I had my tonsils removed in the 1960s, I had a Filipino nurse," remembers Thomas Greiner, president of the Arbeitgeberverbandes Pflege, the Federation of German Employers' Associations for Care Providers, in an interview with DW. "Therefore, this is no great innovation."

In order to respond to Germany's nursing shortage, which is expected to reach dramatic proportions if nothing is done, Greiner's association and the Federal Employment Agency want to recruit nurses from China.

According to Germany's Federal Statistical Office, there are approximately 2.3 million people in need of care in Germany, 83 percent of them over the age of 65, a third of them 85 or older.

Nursing care provided by family members has dropped, and social change, lower birth rates and a higher proportion of elderly in the population has led to the increasing institutionalization of care for the elderly. Today, already 40,000 skilled workers are lacking in the nursing profession, and by 2020 the Federal Employment Agency expects that number to rise by another 70,000. Greiner wants to address the problem from three sides.

Three-point plan

"The most important thing for Germany right now is to train nursing assistants to the professional level," said Greiner, adding that this staff would bring several years of professional experience and expertise with them.

A Filipino nurse in Bad Homburg in 1993.
Nurses came to Germany from the Philippines and Korea in the '60s and '70sImage: picture-alliance/dpa

Since these retrained nursing assistants, however, would not be sufficient to make up the deficit, the next step would be to look beyond Germany's borders to other European regions. "In this respect, we've noticed that Germany has unfortunately been asleep in recent years," said Greiner. Many nurses have found work in other parts of Europe: citizens of the Baltic states have found jobs in the UK, Ireland and Scandinavia, Czechs and Serbs have moved to Austria and Bulgarians and Romanians to Italy.

In many EU countries, nurses undertake a four-year study program; in Germany, nurse training takes only three years. "This raises the question as to what extent we can put these people in a traditional nursing home, where they would have to engage in activities which may not match their skills," said Greiner. Language is another barrier - English or French is taught in schools much more often than German.

Untapped market

The third option is China. There, according to the care providers federation, 400,000 unemployed nurses are looking for work. And these nurses, according to Friedhelm Fiedler of Pro Seniore, one of the largest private providers of nursing homes in Germany, are "top trained professionals." He raves about the 202 colleges and 12 universities in China where nursing can be studied, with a degree possibility at the bachelor and master level.

But since not all these graduates are able to find jobs, they have been forced to look elsewhere, to the US, Kuwait, England, Scandinavia, Australia or New Zealand - a brain drain that has even been supported by the Chinese government.

Zhang Zhenkun is tended by his wife and nurses at the Yiliang People's Hospital MARK RALSTON/AFP/GettyImages)
The quality of nurse training in China is seen as excellentImage: Mark Ralston/AFP/GettyImages

Fiedler has been to China and has been convinced by the quality of education. "And, we have asked about how satisfied people are in the countries where Chinese nurses are already working, and we've only had very positive feedback."

Fiedler is not concerned that these Chinese nurses would have difficulties overcoming the cultural and language barriers. "After their nursing education, these young Chinese students undertake an eight-month intensive training program focused on the country in which they will be working," he said. Apart from this extensive cross-cultural training, Germany's Goethe Institute also provides comprehensive language training courses.

Fiedler also sees other benefits for skilled workers from China and Asia in general. "There, the elderly are treated differently by society," he said. He brings up the example of the nurses who came to Germany from Korea and the Philippines in the 1960s and 1970s, who were praised by many German patients for their gentleness, kindness and willingness to provide tireless care.

First five years

The pilot project, which will start next year with 150 nurses, is initially expected to run for five years. The new arrivals would be distributed to specific facilities based on need, said Fiedler - five to eight Chinese nurses per facility, in order to provide an "all-important" support network.

Fears that these new workers could lead to an influx of cheap labor in Germany are unfounded, says Greiner. The Chinese nurses would be paid according to scale, an increase from around 500 to 1,000 euros ($650 to $1,300) per month in their homeland to around 2,400 euros gross in Germany.

In any case, nationality has long been a non-issue in the world of nursing, says Fiedler. "The world, also the world of nursing, is becoming more colorful. What's crucial is that the care that's delivered is the very best quality."