Lots of needy people, few staff: That’s everyday life in retirement homes in Germany. An expert explains what is needed to improve the situation.
The police and fire brigade had to arrive at a Berlin nursing home. A nurse wanted to end her shift. She discovered that the following night shift was not sufficiently staffed to care for the more than 100 residents of the house. Attempts to reach the home management were unsuccessful. In her distress, she called the emergency services. The incident sparked discussions about the issue of nursing shortages.
The Domicil group, which looks after the house, admitted mistakes and said it was working on the case. She took action and changed the management of the home. Here you can read more about it.
Heike Prestin is managing director of the German Professional Association for Nursing Professions in Berlin, Brandenburg and Mecklenburg-Western Pomerania. In the interview she talks about the incident in Lichtenberg, but also about what she believes urgently needs to change in care.
t-online: Ms. Prestin, the emergency call from the Lichtenberg home. How unusual is such an emergency?
Heike Prestin: It happens more often that emergency chains are activated because a person is unavailable. The supervisor is then called and an alternative is organized. But if the home management cannot be reached, that is the absolute worst case. I have great respect for the employee’s decision to call the police. She had to muster courage because such an emergency call would damage the company. It becomes clear that something is wrong in the facility.
Would the nurse have had an alternative in this situation?
I can not judge over this. However, nurses are often expected to take on shifts in emergencies. This works in cooperative companies if the early shift comes a little earlier or the late shift stays longer. But if something like this happens more often and the specialists receive no support at all from management, situations like the one in Lichtenberg arise. Then the problem is not just one of the legal requirements, but also one of the operators.
In recent days, the home has been confronted with anonymous complaints, which the house vehemently rejects. A general question: Does the difficult situation in care mean that those in need are neglected?
Yes, that can happen. There are repeated reports of neglect in care facilities. You shouldn’t overdramatize something like this and you have to look at these incidents in a differentiated way, but: We have a fundamental care problem, especially in long-term facilities. The reasons for this are different. In companies where financial interests are paramount and not the well-being of the residents, such situations can arise more quickly.
Too few staff for too many people in need. So this is the order of the day in nursing homes?
Yes, there is a major staff shortage. This has been the case for many years, especially in long-term care. Unfortunately, it’s almost no longer a cause for excitement for me.
For outsiders, it is still hard to read when, for example, a single registered nurse is responsible for all residents at night.
That is understandable. Even if support staff are still present, this can be a source of anxiety for nurses. You have sole responsibility for people who are often unable to adequately express their needs, fears or pain. You decide: Is this an emergency or not? We are therefore demanding, together with the unions, that no nursing professional has to work alone at night. This applies to a nursing home with 120 residents, but also to a cardiology ward in a hospital with 25 people.
There was apparently a death in the home in Lichtenberg on the night of the police operation. It is still unclear whether this is related to the personnel shortage. Nevertheless: How difficult is it to decide, when in doubt, which person to care for?
The idea and wish of many people is that those in need receive appropriate support during the dying process. There usually isn’t time for that. The nurses only get to do what is absolutely necessary. This way of working causes many colleagues to burn out and leave the job. We are at a point where many colleagues can no longer imagine what it is like to work according to a balanced staffing ratio.
