Nursing in Germany

German registered nurses are now known as Gesundheits- und Krankenpfleger (health- and sickness carer), which is a registered name.^{[clarification needed]} Before this the official name was Krankenschwester (female) and Krankenpfleger (male).

Registration

To get registered as a nurse you need to take the official state exam in nursing. There are different departments (in [Baden-Württemberg] f.i. the Regierungspräsidium) that take care of the registration in the different states.

Education

A German nurse

In most cases nurses start to learn the profession in a special nursing school that is mostly connected to a hospital. Before starting the school you need half a year practical training in a hospital setting. The nursing course is done according EU regulations and is three years long including around 3300 hours for theoretical knowledge and 2500 hours for practical training in different hospital settings.

There are some changes to be expected in the future as it is now possible to study nursing on a B.Sc. base (mostly in universities of applied sciences). But you still need the official state exam to get the registration. Some universities offer a special program with local nursing schools where students learn in school and university to get the B.Sc. and state registration. Some universities offer post-graduate studies leading to a Master degree and the possibility to continue studies for a Ph.D. degree.

There are rarely assistant nurses in Germany because the schools for them were mostly closed years ago. This may change again with the introduction of university nursing curricula.

Specializing

There are different ways to specialize after the nursing schools, called Fachweiterbildung. Salaries are a bit higher with a Fachweiterbildung. Specialization includes some 720–800 hours of theoretical education and practical training. In the end there is an state exam or writing of a thesis.

There are official two year specializations in:

• ICU and anesthesia
• OR
• oncology
• home care
• psychiatric
• palliative care
• quality management
• hygienic
• ward manager

It is possible to undergo a variety of shorter programs to continue learning and deepen knowledge f.e. wound management, short courses in oncology and palliative care etc.

Working as a nurse

In hospital are mostly working registered nurses and nursing students, as well as Zivildienstleistende.

Registered nurses in Germany take care of the patients and there are different systems who and how the patients are treated: (a) taking care of a set of patients including all work that needs to be done or (b) taking care of the patients on a ward doing just one special function. Work includes planning based on the patients' needs and condition, documenting, writing about the progress and current condition. Preparation of medication is in the hands of nurses and its application: tablets, infusion etc. but not the i.v. application by syringe (except in the ICU). Blood samples and setup of venflos are not done by nurses (except in the ICU), but mostly done by students of medicine, even if it is in the curriculum. All basic care is done by registered nurses or coordinated and done by the nursing students. Special care like setting up urine catheters, nasogastric tubes, treatment of wounds and wound dressings are done by registered nurses or nurse students (under supervision).

Job satisfaction

Job satisfaction is very low in Germany because of the heavy work-load, low salaries and a low appreciation of the nurse profession in the public. Even some politicians in the past claimed that everybody is able to nurse. The nurse associations are working hard to achieve the acceptance for the installation of nursing chairs in universities but they are often undermined by politicians who are looking for the cheapest work force but not skilled and professional workers.