The nursing care crisis in Germany is one of the biggest challenges facing society in the coming years. An ageing population and the associated increase in demand for care services considerably outstrips the supply of carers. While more and more people need care, facilities are finding it increasingly difficult to find qualified staff. Forecasts predict that there will be one unfilled position for every active carer by 2030. This article sheds light on the causes of the nursing shortage, the relevant legal framework and possible solutions.
What is meant by a care crisis?
The term "nursing shortage" describes a critical staffing gap in the care sector, particularly in geriatric and nursing care. The main characteristics of the nursing crisis are the acute shortage of qualified nursing staff and the associated difficulties in providing adequate care for people in need of care. The coronavirus pandemic has further exacerbated the situation and brought the problem into the public eye.
Causes of the care crisis
1. demographic change and the ageing population
Demographic change is a key cause of the care crisis. The population in Germany is getting older and older, which means that more people are in need of care. At the same time, many carers themselves are entering retirement age. According to statistics, only around 25 % of carers are under 35 years old, while around 40 % are over 50. The German Nursing Council expects around 40 % of current carers to retire in the next ten years.
2. stressful working conditions and low pay
Carers are often exposed to enormous mental and physical stress. Working conditions in the care sector are challenging in many cases: long shifts, high labour intensity and often a lack of appreciation from society. Staff shortages further increase the burden on the remaining nursing staff, which often leads to frustration and health problems. Nursing staff in Germany also earn significantly less than in other systemically relevant professions, which means that there is little incentive for young people to enter the profession.
3. dependence on leased labour
Many care facilities now rely on leasing staff to fill the gaps. Leasing staff can be valuable for short-term assignments, but they incur additional costs and exacerbate the feeling of unequal treatment among permanent nursing staff. As leasing staff generally receive higher wages and often have better working hours, this often leads to resentment among permanent staff.
Legal basis for combating the nursing care crisis
The care sector in Germany is heavily regulated. Numerous legal measures and initiatives have been introduced to alleviate staff shortages and improve working conditions.
1st Nursing Professions Act (PflBG)
The Nursing Professions Act (PflBG), which fundamentally reformed training in the nursing professions, has been in force since 2020. The law introduces generalist training that combines the professions of geriatric nursing, healthcare and nursing as well as paediatric nursing into one profession. The aim of the Nursing Professions Act is to make nursing training more attractive and to make it easier to switch between the various nursing fields. In addition, nursing staff with a generalist training programme can work better in different fields, which creates flexibility.
2nd Nursing Staff Strengthening Act (PpSG)
The Nursing Staff Strengthening Act (PpSG) from 2019 aims to improve working conditions in the care sector and increase the number of nursing staff. Among other things, the law promotes the expansion of short-term care and the relief of nursing staff by funding additional positions in hospitals and nursing homes. Hospitals and care homes receive funding to create new jobs and improve working conditions in order to alleviate the staff shortage.
3. concerted action for care (KAP)
The "Concerted Action for Nursing" (KAP) is an initiative launched by the German government in 2019 in collaboration with various stakeholders from the healthcare sector. It pursues five fields of action: better training and employment opportunities, higher labour market participation, longer working hours through the creation of full-time positions, targeted further training and the targeted immigration of nursing staff from abroad. The KAP aims to increase the number of nursing trainees by 10 % by 2023 and to sustainably improve working conditions in the nursing sector.
4th Nursing Staff Minimum Limits Ordinance (PpUGV)
The Nursing Staff Minimum Limits Ordinance (PpUGV) introduced minimum staffing requirements for hospitals in 2019. This ordinance regulates how many nursing staff must be available per patient in certain areas. The aim is to improve the quality of care and reduce the workload of nursing staff. The minimum staffing levels were initially introduced in particularly busy areas such as intensive care units and geriatrics and are gradually being extended to other departments.
Solutions to combat the care shortage
1. targeted immigration of nursing staff
Germany is increasingly focussing on recruiting nursing staff from abroad in order to counteract the staff shortage. The German government has launched special programmes to accelerate the recognition of foreign nursing qualifications and facilitate integration into the labour market. These programmes focus primarily on nursing staff from third countries such as the Philippines and Mexico, where the potential for trained nursing staff is greater.
2. digitalisation and the use of technology in care
Technology can play an important role in care to alleviate staff shortages. Digital tools and care robots can take over administrative tasks or simple activities, giving carers more time for direct patient care. Initial pilot projects show that the use of technology can reduce workload and increase efficiency. It is estimated that digitalisation could reduce the demand for nurses by 10-15 % by 2030.
3. promotion of flexible working time models
Flexible working hours and the use of remote care could help to make the nursing profession more attractive and improve working conditions. Some care facilities are already experimenting with flexible working time models that enable carers to achieve a better work-life balance. Digital solutions could also be used to provide counselling and simple care consultations remotely, which could reduce the pressure on care staff.
4. better training and career opportunities
The Nursing Professions Act and the academisation of the nursing professions open up new career opportunities for nursing staff. The introduction of generalist training and new degree programmes makes the profession more attractive and creates incentives for a long-term career in nursing. Better opportunities for further training could enable nursing assistants to become specialists and thus reduce the work pressure on nursing staff who are already qualified.
Conclusion
The nursing shortage is an urgent problem that can only be solved through comprehensive measures. The legal foundations in Germany - from the Nursing Professions Act to the Concerted Action on Care - are already setting important priorities for improving working conditions and increasing the number of skilled workers. However, a sustainable solution to the nursing shortage will only succeed if these measures are continuously developed and supplemented. The appreciation and social recognition of the care professions must also improve in order to strengthen the care sector in the long term.
