“As a nurse you despair”: How hospital staff suffer from the stress of the pandemic

In an anonymous letter, a group of nurses radioed SOS.

FT executives faced these complaints - and called for help themselves.

Freising

- "The work situation in nursing at the clinic has meanwhile become unbearable and extremely stressful for us." With this call for help, a group of nurses turned to the Freisinger Tagblatt in an anonymous letter. In an interview with FT, which was conducted before the clinic had to switch back to crisis mode in the wake of the disaster, Managing Director Maren Kreuzer, Medical Director Dr. Markus Neumaier, the corona officer Dr. Christian Fiedler, Head of Nursing Stefan Hörömpö, Works Council Chairman Manfred Rinke-Ludwig and Press Spokesman Sascha Alexander comment on these allegations.

They also report how they - regardless of the current precarious situation - want to improve the work situation for the nursing service during and after the pandemic - and also call for help themselves: to politicians.

After more than a year and a half of the pandemic, many nurses in hospitals feel burned out.

What is the mood like among the staff at the Freising Clinic?

Stefan Hörömpö:

The corona waves are unquestionably a burden.

But they are not only a burden for the nursing staff, but also for the medical service and all professional groups involved in the care of the patient.

This is why there are already dismissals at other hospitals - at the Freising Clinic too?

Hörömpö: Entries

and exits are currently in balance with us, we even have a slight increase in admissions.

And the withdrawals are mostly not due to the corona, but because the retirement age has been reached.

I also don't have the feeling that a resignation has set in that would soon lead to redundancies.

But regardless of whether it is in the medical or nursing field: You have to take care of your employees.

We are also aware of what this situation does to different professional groups, especially nurses who are directly with the patient.

Managing Director Maren Kreuzer

However, the FT has also received voices from nurses in your home who feel “bled out and burned out”.

Among other things, the anonymous letter criticizes the fact that insufficiently qualified nurses have to look after too many patients.

Kreuzer:

We do our best to create good working conditions for our nursing staff.

We are also aware of what this situation does to different professional groups, especially nurses who are directly with the patient.

This also burdens us because we can only influence the situation to a limited extent.

I have the impression that we have a stable base of employees who enjoy doing their job and who stay on the ball despite the pandemic.

(By the way: Everything from the region is now also available in our regular Freising newsletter.)

Complaints from clinic employees should also end up with the chairman of the works council, Mr. Rinke-Ludwig.

Has no one come to you with the message “It can't go on like this”?

Manfred Rinke-Ludwig:

Of course the works council is confronted with it.

It must also be said that the employees have now been working at the upper limit for more than a year.

Kudos to most of the employees for doing great things.

On the other hand, we have the overtime situation under better control than it used to be.

There were times when we put 30,000 overtime hours in the hospital.

It often happens that someone is absent due to illness, and then the colleague's phone rings with the request: Can you help out?

Works council chairman Manfred Rinke-Ludwig

So is it guaranteed that employees have enough free time and vacation?

Rinke-Ludwig:

On the whole, yes.

However, it often happens that someone is absent due to illness, and then the colleague's phone rings with the request: Can you help out?

But ward and care services try to keep this to a bearable level.

Does the clinic comply with the lower limit of nursing care, i.e. the legal key to the relationship between nurses and patients?

Hörömpö:

You have to know that the mean value from one quarter applies to this nursing staff

.

On average, we meet this PpUGV - with few exceptions.

I'm very unhappy about that too, but what can we do about it?

Locking the door is not the option we are allowed to. 

Corona officer Dr.

Christian Fiedler

What does the key look like?

Hörömpö:

It varies - from one nurse and two intensive care patients on day duty to one nurse and 22 patients on normal ward at night. Those are the two extremes.

Although Corona makes the situation more difficult because the ventilated patients in the intensive care unit have to be turned around again and again. Imagine you have to pick up a limp two-hundredweight person who is hanging by a number of cables, turn it over, and then lay it down again. You need at least six people to do this. The 1: 2 ratio works when the caregiver is doing their normal job. When you turn around a corona patient, you need the whole team, and that's when it gets tight.

That also shows the whole dilemma of this PpUGV. It is a technical instrument that employs a horde of controllers who have to fill out a hundred thousand lists, but it does not represent reality. If, for example, according to the ordinance, one sister is responsible for ten patients, then it makes a big difference whether these ten patients are self-sufficient or people in need of care.

And the PpUGV is about a mean value. There are also days on which, according to the key, there are staff for 44 beds in a ward, but 48 patients still have to be admitted. Of course, the nurse immediately recognizes that we are overcrowded. And the bottom line is: we have too many patients. Then, due to the corona, there is now a statement from upper government agencies that everyone who hits the clinic must be admitted. And when you see how much the fourth wave is spreading, you naturally despair as a caregiver. I'm very unhappy about that too, but what can we do about it? Locking the door is not the option we are allowed to.

As a clinic, we are the basic and standard provider.

We have a supply contract for 180,000 district citizens.

We cannot say: So now our ward is full and the others who need it should go to the nearest hospital.

That does not work.

Especially since the situation in the other hospitals is no different.

The anonymous letter also mentions that the nursing director was dismissed - astonishing in this difficult corona situation.

What has happened there?

Kreuzer:

The strategic goals that we set ourselves did not necessarily fit together.

You have to find a good solution for both sides.

In this difficult corona situation, however, it is probably not the most pleasant time for the clinic to lose its nursing director.

Kreuzer:

We will never find a better time at the moment.

Sometimes you just have to make decisions.

Is there already a successor?

Kreuzer:

No, not yet.

Corona patients are rather poorly remunerated compared to other patients and intensive care patients.

And that's why: Dear government, if you want us to do that, we also need refinancing from you. 

Medical Director Dr.

Markus Neumaier

What help do you want from politics?

Kreuzer:

That the financing of hospitals will finally be improved.

As a clinic, for example, we would like to be able to work more on an outpatient basis.

But that helps us in the medium term.

What would help immediately?

Kreuzer:

There aren't any great opportunities in terms of personnel. Because we cannot deploy forces from the Bundeswehr or the THW where we need them now in the pandemic, namely in the intensive care sector.

In the short term, politicians should promise us financial aid. Because if the government asks us, due to the increasing number of corona patients, to reduce normal operations again or even to close departments, then we as a clinic will run into unbelievable deficits again. Because corona patients are rather poorly remunerated compared to other patients and intensive care patients. And that's why: Dear government, if you want us to do that, we also need refinancing from you.

Last year we had a normal occupancy of around 57 percent.

However, the house needs almost 80 percent to be economical and to be able to cope with personnel and energy costs.

In view of the renewed increase in the number of infections: Shouldn't politics have relaxed so quickly?

Kreuzer:

What I didn't like is the approach based on the motto: Let's relax and see what happens.

On the one hand, football games with a large number of spectators are allowed without a mask, on the other hand, it is expected that clinics, as the smallest bottleneck, will somehow show off the whole thing.

The vaccination quota was not so adequate that one could have afforded the easing that has started in the past few weeks.

We are not frozen.

Despite the pandemic, a lot is going on to modernize the hospital and thus strengthen it for the future.

Press spokesman Sascha Alexander

There is not much air left to make the hospital fit for the future.

Sascha Alexander:

We are not frozen.

Despite the pandemic, a lot is going on to modernize the hospital and thus strengthen it for the future (see box below).

We can't wait until Corona has become normal.

What exactly is happening?

Alexander:

The focus is on improving operational processes and modernizing and expanding important specialist areas. These measures and projects are also intended to help improve the work situation of our employees.

Kreuzer: Over the past year and a half, we have also noticed that the intensive care department alone is not the solution. That we need an intermediate care station, i.e. an intermediate station between intensive care and normal wards - for patients who have to be monitored but are not in such a bad condition that the intensive care unit is absolutely necessary. Such an intermediate care ward would significantly relieve the intensive care unit, and we have just developed a room concept for this with the nursing and medical services.

Do you have any other projects?

Neumaier:

We are expanding and modernizing our emergency room.

This leads to more quality and shorter waiting times - and better conditions for future disasters.

If we have more staff, the stress for everyone becomes less and working conditions become more attractive.

And that is the best prerequisite for eliminating the nursing emergency

Works council chairman Manfred Rinke-Ludwig

One project that has already been implemented is the clinic's own vocational school for nursing assistants.

Can you train more specialists in the medium term and keep them at the hospital?

Neumaier:

Our previous vocational school for nursing is always full. The same applies to our new nursing school, which has been officially recognized for a year. We need both facilities in order to be able to adequately supply the district in the future.

We hope that with the help of the schools we can attract enough young people for an apprenticeship with us.

If we have more staff, the stress for everyone becomes less and working conditions become more attractive.

And that is the best prerequisite for eliminating the nursing emergency - in addition to adequate payment.

The clinic is exemplary here too: For example, we pay the conurbation allowance in full - in contrast to Erding, where only half is paid.

We also recently started offering bonuses for sisters who start with us.

Affordable living close to work is also part of an attractive job.

Kreuzer:

That too was initiated.

The master plan for a new staff dormitory has been in place since 2018. The structural concept has now been completed.

However, construction is not expected to start before 2024.

But it will be very nice.