Swiss Review 4/2021

Swiss Review / August 2021 / No.4 28 Covid-19 SUSANNE WENGER Switzerland in late spring 2021: the number of infections was going down, garden restaurants and gyms opened again, the vaccination campaign was progressing. People did not want to hear any more talk about Covid-19. How- ever, in the hospitals, it was a different story. Healthcare personnel were still fighting to save lives. The third wave saw younger people in particular ending up in intensive care. “It put extraordinary pressure on the nursing staff again,” says Yvonne Ribi, managing director of the Swiss Professional Association of Nurses (SBK). For almost one and a half years, the nursing staff “have given their all, in hospitals and retirement homes”, says Ribi. Now they are exhausted, “physically, psychologically and emotionally”. The peoplewere grateful for themassive effort by healthcare staff. On a given day in March 2020, they applauded all across the country from their balconies. This broad public recognition also raised awareness of nurses’ situation. The largest professional group in the Swiss healthcare system has been pointing out their prob- lematic employment conditions for a number of years. Criticism of the extreme pressure The fact that average monthly salaries have hardly in- creased in years is just one bone of contention. Pressure at work is themain issue for nursing staff. There is not enough time to care properly for the patients and retirement home residents, they say. Of course it is true that professional groups represent their own interests. Healthcare costs in Switzerland are rising, the financial pressure on institu- tions is increasing. And nursing by its very nature is a sen- sitive area when it comes to cutting costs. By European standards, nursing in Switzerland is admittedly not badly off in terms of the number of nursing staff per thousand in- habitants. Nevertheless, the complaints are not unfounded. There are not enough qualified nurses in the country. Thousands of jobs remain unfilled; teams have to work round that. Moreover, given the growing number of old people and the increase in chronic illnesses, the situation maywell worsen. According to an expert report, therewill be a shortfall of 65,000 nurses across all training levels by 2030 if no action is taken. This is partly due to the fact that only about half of the number of nurses in Switzerland that will be required in the future are currently undergoing training. As a result, there is a lot of recruitment from out- side the country. A high turnover rate Qualified nurses find theirwork fulfilling. At the same time, the demands of the job plus the shifts are draining. More than 40 per cent of nursing staff in Switzerland, many of whom are relatively young, are leaving the profession, ac- cording to a report by Swiss HealthObservatoryObsan. The turnover rate is higher in nursing than in other healthcare sector jobs. The “for strong nursing” initiative submitted in 2017 aims to counter this situation. The petition was initi- ated by the SBK and is the largest mobilisation in the pro- fessional association’s history. The nursing initiative calls for improved training, quality assurance through more staff, fair employment conditions and improved recogni- tion of the profession. For the Federal Council and parliament the initiative goes too far. They argue that regulations regarding specific professional groups do not belong in the Federal Constitu- tion. The cantons and social partners should decide on nurses’ employment conditions themselves. However, the pandemic has prompted parliament to address some of these concerns via an indirect counterproposal. The Fed- eration and cantons intend to contribute almost a billion Swiss francs towards training more nursing staff in Swit- zerland. Moreover, nurseswill be able to charge certain ser- vices directly to the health insurer. Nursing to be assigned more competencies This will mean the end of a legal anachronism: nurses in Switzerland can complete aMaster’s degree and carry a lot of responsibility on a daily basis. At the same time, their services must, to date, be prescribed by a doctor in order for the health insurance to pay. Nurses will nowhavemore Covid-19 to bring nursing staff more than applause Nursing staff in Switzerland: feted as heroes during the pandemic, they have had to go above and beyond the call of duty for quite some time now. Parliament has plans to improve their situation, although the nurses say this is not enough. The people will now decide on the nursing care initiative.