Review Article

German nursing shortage in hospitals – Homemade by Profititis?

¹ Theodor-Billroth-Academy®, Munich, Germany – Sacramento, CA, USA
² INCORE, International Consortium of Research Excellence of the Theodor-Billroth-Academy®, Munich, Germany – Sacramento, CA, USA
³ Department of Surgery, Carl-Thiem-Klinikum, Cottbus, Germany
⁴ Department of Nursing Science and Gerontology, UMIT – Private University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria

^* Corresponding author: b-bruecher@gmx.de

Received: 17 December 2018
Accepted: 19 March 2019

Abstract

The shortage of nursing staff in Germany compromises public healthcare in deference to profits explaining why this is on the daily political and media agenda. In Germany, over a 22 year period, significant savings were achieved by decreases in: (1) hospital beds by −29.3% saving 119 000 beds, (2) patient care and treatment days by −23% saving 43.1 million patient days, and (3) length of hospital stay in days by −39% saving 4.7 days. This occurred together with the parallel increase of treated patient cases by +26.5% with an additional burden of 4.1 million patients. Since 2010, as birth rates increase again treatment cases will also increase. In parallel, the percentage of total nurses has decreased (−2.1%) as well as that of registered nurses in hospitals between 1999 (325 539) and 2009 (324 337) have decreased (−0.4%), in conjunction with nurses employed in preventive and rehabilitation facilities (+15.1%) and/or in outpatient care facilities (+41.1%) and/or nursing homes (+24.8%) and/or nurses working in retirement homes (+77.9%). This “profititis” endangers both patient care and detracts from people joining the nursing profession. It might even be a short-sighted tightrope act which, in the end, might counteract the marketing strategy of “patient safety” by risking quality of patient care. Maybe healthcare politics would be well-advised to re-think the fact that as the population gets older and as birth rates and immigration increases, these factors could result in increased patient caseloads in hospitals which need to be addressed now so as to avert a future crisis.