To be a nurse in Germany – Here during the night at the hospital we are alone

Rebecca is a German nurse.. I was very interested in how does nursing work in Germany and question after question an interview is born.

1) How can you become a nurse in Germany? What kind of school do you have to attend, how many years does it take?

At the moment there are 2 systems (I know it sounds strange….but some politicians try to change the “old” system. However, this old system still exists and is more often and I also did this one).

According to the “old” system you do a training which takes 3 years. During this training you earn money and work on different stations in the hospital and go to a nursing school (I´m not sure if I can call it like this – anyway, it´s a school just for nurses. The teachers had been nurses in the past and they had to study to teach us). This school is mostly located in the hospital. You go to this school for 4 (sometimes it´s more) weeks and afterwards you work on a station for 3, 4, 5, 6, 7, 8 or even 9 weeks. This change between work and school exists the whole 3 years.

When you work, you have 3 shifts (06:00h-14:30h, 13:30h-22:00h, 21:45h-06:15h). Of course, you work on weekends and Bank Holidays. According to these shifts, there is no special system: it might be possible that you work 5 days running from 13:30h-22:44h. Or just 1 day from 06:00h-14:30h, 1 day from 13:30h-22:00h and 3 days from 21:45h-06:15h. Anyway, you´re not allowed to work more than 5 days running. When you go to school, it´s from 8:30h-16:00h (Monday to Friday; weekend is free). But the time depends on the nursing school. And you just have 24 days for holiday….so no big semester break😉

After the 3 years, you have pass a lot of tests to get the examination (of course you have to write exams during the 3 years at school and have to do other tests at the station): you have to write 3-hours-exams on 3 days running (one day is for the biological etc. stuff, one day for nursery and one day for rules, laws etc.). Then you have to do a test on a station which takes 2 days. On the 1st day the teacher chooses the patients. After this you have 2 hours to write a plan (what you´re going to do at first, what you´ll exactly do with the patients, so it´s like a timetable). On the 2nd day you try to realize this plan. The last test is an oral test which is about a disease. You have tell sth. about ethics stuff, nursery and physiological things about this organ. This test is about 30 minutes and many teachers and even a doctor are listening and asking questions.

The new system is dual as well. But it´s more similar to the Italian system I guess.You go to the university and work in the hospital as well. But you don´t earn money. However, you get the exam after 5 years….I´m not sure!! But it takes definitely more time comparing to the first system. And you can do this just in big cities which have big universities like Hamburg.

The majority of the people don´t know that this 2nd system exists, so the 1st one is usually done and I think it´s better.

2) Do you do any internship during your training? If yes, how many hours? During your internship, do you have to follow a special “teacher nurse”? Do you have to work during the night? Are you paid to do your internship? Your teachers are doctors or nurses?

Yes, but I forgot how many hours we had to work during these 3 years. But generally you have a 38,5-hours-week (however, this depends on the hospital….a 40-hours-week is also possible) and work 8,5-hours a day (but even this depends on the hospital….a 7,5-hours-day is also possible).

When you work on a station, you have a mentor. You work mostly with this mentor and he or she shows you everything. If you are good, you are allowed to do nearly everything on your own J

And yes, we have to work during the night, but not alone. You work together with an examined nurse and even this is just allowed at the end of the 2nd year.

Yes, we´re paid. Can´t exactly remember the pay: in the 1st year it was about 600€ monthly, in the 2nd about 700€ monthly and in the 3rd 850€ monthly. This is all after tax.

The teachers are teachers who had to study. They all had been a nurse before. Sometimes a doctor comes to do a presentation about a disease or an organ.

3) When you take your diploma of nurse, can you choose in which floor do you want to work?

It depends. Generally, you can mention a wish and you can also desire the station. But if for example some surgical hours are missing, you have to do your examination on a surgical station.

4) How are floor organized? How many patients more or less per floor? How many nurses?

Good question…. Are they organized???

There is definitely a lack of nurses. I usually worked on a station with 12 rooms and 33 patients. In the morning, there are usually 2 examined nurses (when you´re lucky 3 examined nurses) and 2 other nurses (They are not “real” nurses. They do not have an exam -or you call it diploma-. They are allowed to do less than examined nurses. Their training just takes 1 year. Those nurses work more with the patients and the nurses with an exam work more with the doctors, medicine and other documents) and sometimes 1 trainee. In the afternoon are mostly 2 examined nurses and sometimes 1 trainee. And during the night you work alone. However, another nurse goes to every station in the hospital and helps in bedding a patient etc.

Furthermore, it is required by law that in every shift has to be 1 examined nurse.

Anyway, the allocation of staff differs from the hospitals (but I think the hospital where I worked is the average of the allocation of staff). And it is even worst in nursing homes….

5) If talking about this doesn’t hurt you, how much do you take per month?

. In my first year as an examined nurse, I earned 1300€ after taxes, minimum. If you work during the night or on Bank Holidays etc., you´ll get much more. The pay increases after the 2nd year. There are other increases after some years.

6) How the public opinion talk about nurses in Germany? Are they well considered or not? (In Italy they are not, by the way), there is a lot of people who want to become nurse or not?

In my opinion this has changed in Germany. The majority of the people still think that we just have to handle with shit etc. However, they have respect for nurses, but it´s still less respect comparing to doctors. To my mind, we should get as much of respect as doctors get. Doctors earn definitely more and nurses work as hard as they do. This doesn´t mean that we should earn the same (doctors have a better and longer education), but it should be more than this pay at the moment.

I think politicians don´t know what we are doing. The working conditions are terrible (that´s why I don´t want to be a nurse anymore). Comparing to this what we´re doing, we definitely don´t earn enough. It´s ok for one person, but if you have to feed children, it´s very complicated. Another think is that nursery health problem – you can´t work as a nurse until you´re 67- it´s totally stupid!!

In other words, the majority of the German population respects us. But on the other hand they just do it because they have grandparents who have been in a hospital or nursery home and they see and recognize what we are doing. Someone who hasn´t seen this, doesn´t respect. But this is just my part of view.

Politicians are totally stupid. They destroy the health system and that´s why there is a lack of money for the nursery. The consequence is that the pay and the number of nurses decrease. Anyway, this I like a vicious circle, because less nurses have to take care for more patients (the number of the patients increased in the last years in Germany because the people are getting older and older. And at the moment we have more old people than newborns […]

7) How is the relationship with doctors?

I never had any problems with doctors. They respected me and I respected them. I was allowed to say “Du” and not “Sie” (in Germany you normally say “Du” to friends, relatives or just young people and “Sie” is used when you do not know or respect someone. In the past it was usually to say “Sie” to a doctor). In general, all jobholders used the “Du” in my hospital except the managers. Some of the doctors had been just 6 years older than me, so they were like friends and we even spend our free time together. The younger doctors know that they need the nurses. But I know that there were some “fights” between nurses and doctors on other stations but I have never experienced it. I think when you´re friendly, polite and self-confident, they recognize it and are nice😉

But in the very past doctors haven´t respected the nurses.

8) Is there something that you don’t like in your formative process or in how the work is organized in Germany?

I think 3 years aren´t enough. The training should end after 4 years. Apart from that, I liked and enjoyed my training. And I think it´s better than the other system, because you work more with in hospital and you learn how to talk with patients, their relatives, how to handle with moribund patients etc. In my opinion, you are too often in the university (when you´ve chosen the other system) – you´re more a theorist than a practitioner.

What definitely has to be changed is that the hospitals, nursery homes etc. need more nurses! This is the reason more and more of the young nurses quit and start to study. Look at me. And I know 3 other nurse from my course who started to study. By the way, we had been 19 trainees and 4 aren´t nurses anymore. You know what I mean????

9) Now you are attending university, does a bachelor improve in any way your being nurse or you are doing it for personal growth?

Health and Social Care Management is the name J

After this study I´m not a nurse anymore. Of course, I´m still allowed to work as a nurse, but I´ll be a manager. I´ll be the chef of the nurses in an hospital, old people´s home etc. But I´m also allowed to work in health insurances…. So I´m doing a personal growth, will earn more money (Yeeeeaaaaaah  )

Thank very much Rebecca!

Laura

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