Giuseppe Sandro Mela.
Il problema è molto semplice.
In Germania sta allungandosi la durata della vita media e, simultaneamente, sono crollate le nascite da tedesche autoctone: ne consegue una diminuzione numerica dei giovani autoctoni ed un aumento numerico dei vecchi. Mancano le braccia per sopperire alle esigenze dell’industria e dei servizi.
Larga quota dei vecchi, poi, non ha figliato: deve quindi affrontare la senescenza e le malattie senza il supporto familiare. I tedeschi vecchi sono soli come cani.
Sono ‘disperati’, riporta il Deutsche Welle.
Ma i problemi non vengono mai da soli.
È difficile trovare gerontocomi che accolgano per meno di 2,500 euro al mese, ossia 30,000 euro l’anno.
Se è vero che in Germania esiste una forma assicurativa per ottenere al momento un posto in un gerontocomio, è anche vero che ben pochi si sono potuti permettere il lusso di versare i necessari contributi a tariffa piena. Al dunque: pochi tedeschi hanno i mezzi per essere ricoverati in strutture idonee. Per entravi, quelli che ne dispongono vendono casa ed i restanti beni, ma mica tutti ne dispongono. Stesso ragionamento è per una badante: con meno di 18,000 euro l’anno non se ne parla. Non sono molti quelli che possono permettersi cifre del genere.
Ma c’è anche dell’altro.
I gerontocomi esistenti hanno una carenza di personale stimata a circa 40,000 unità lavorative. Ma ogni anno i pensionamenti falcidiano gli organici del personale.
I tedeschi giovani non gradiscono questo tipo di lavoro. L’ideale proposto della donna è la manager che dal settantesimo piano dirige affari miliardari, mica quello di una infermiera che imbocchi i vecchietti e che li pulisca quando siano sporchi.
I tedeschi si stanno dando quindi un gran da fare ad importare infermieri/e specie dai paesi dell’est europeo, ma sono più i problemi che causano che i benefici che producono.
Il primo grande ostacolo è costituito dalla lingua. Per fare l’infermiere servirebbe avere il tedesco fluente, mentre gli immigrati parlano la lingua a livello di sopravvivenza.
Il secondo grande ostacolo è costituito dal fatto che i diplomi infermieristici conseguiti all’estero non sono quelli presi in Germania. La differenza è evidente.
Il terzo ostacolo è costituito dal fatto che gli infermieri esteri vogliono fare gli infermieri: non ne vogliono sapere di fare i badanti. Pulire i pazienti loro non competerebbe. Nei loro paesi questo compete ai familiari.
Infine, anche gli infermieri esteri vorrebbero poter fare carriera, ma sembrerebbe che trovino molti ostacoli. Già: i tedeschi sono aperti a tutto tranne quando si parla dei loro stipendi. Vogliono sempre comandare.
È davvero ingenuo aver pensato che dei mercenari accudiscano con la cura e l’amore dei figli. E le ingenuità si pagano ad usura.
Ma siamo solo agli inizi: questi sono gli antipasti.
Continuando con una tasso di fertilità delle femmine autoctone attorno all’1.3, la carenza di giovani forze sarà sempre più evidente e non rimpiazzabile.
Sarà curioso vedere come i tedeschi rimpiazzeranno gli insegnanti, i burocrati, i funzionari di banca, i giudici che andranno in pensione: sono tutti lavori per i quali il tedesco fluente sarebbe ben mandatorio.
→ Deutsche Welle. 2019-03-01. Conflicts grow in German care sector as more foreign workers come
Misunderstandings between German-trained care workers and foreign colleagues can be a source of tensions, a study says. The number of carers in Germany who trained abroad has recently risen dramatically.
German hospitals and aged-care centers are seeing growing tensions among staff members as more and more carers come from abroad with different training and a lack of German-language skills, a study published on Friday said.
Researchers from the Hans-Böckler Foundation found that there were often two mutually hostile camps in care institutions, one made up of established carers and the other of staff recently arrived from abroad.
The study said that differing attitudes to the profession were often at the root of misunderstandings between the two sides.
For example, the report said, carers from abroad were often trained at universities, something that German-trained staff tended to see as lacking in practical relevance.
Foreign-trained care workers, for their part, often felt that they were working under their proper level, particularly those from southern Europe, who are used to taking on responsibilities for management and patient treatment — decisions that in Germany are left up to doctors. In southern Europe, helping patients eat or looking after their personal hygiene is usually done by special assistants or family members.
Language skills problematic
German-trained carers also often complained that staff from abroad could not work optimally because of a deficient command of the German language. The foreign-trained carers, in their turn, frequently had the impression that the German language was being used to create hierarchies and push them into an outsider role.
The researchers behind the study said it was essential that hospitals and aged-care facilities set aside enough time to allow an exchange of views and the resolution of conflicts. They said independent coaches should be employed to help overcome communication barriers between locally trained staff and those coming from abroad.
Most of the new care workers in Germany come from the EU countries of Romania, Croatia, Poland and Hungary, as well as Bosnia-Herzegovina, Serbia and Albania. In addition, a growing number of staff members come from the Philippines under a special agreement, the study said.
The annual influx of foreign-trained care workers rose from some 1,500 per year in 2012 to around 8,800 in 2017, the study showed. Despite the growth in numbers, however, Germany still has a much lower proportion of carers trained abroad than countries such as Great Britain or Switzerland, which have two to three times as many, according to the researchers.
German care institutions have long complained about a local shortage of qualified workers in the sector.
→ Deutsche Welle. 2019-03-01. Germany’s aging population desperate for more nurses
The German government has announced 13,000 more jobs for hospitals and care homes, but there is still a shortage of qualified medical staff. DW spent a shift with two nurses to learn more about the care sector crisis.
“110/70 — you have normal blood pressure, that’s good,” says nurse Valentina. She makes a note, inquires how the patient is feeling and then rushes off to see the next person. “We have to check on 23 patients today before the doctor tends to them at eight,” Valentina explains. Often, she admits, that leaves little time to chat.
The 48-year-old Oleg Busch, who heads the surgical ward at Helios hospital in the western German city of Siegburg, also works as a nurse. He’s been doing so for over 20 years now. Oleg likes his job, even though it can be very stressful at times.
Germany faces a massive lack of medical care personnel, which means many hospitals are overburdened. Nurses complain that they are too short-staffed to properly tend to their patients. Currently, roughly 1 million people work in the country’s nursing industry. It is projected that 3 million nurses will be needed by 2060, given Germany’s aging population. In late 2015, there were 2.9 million individuals in need of care — by 2030, this figure is expected to rise to 4.1 million.
Busch believes Germany is in dire need of additional care personnel, and his hospital is no exception. “Ideally, we should have three certified care-givers working the morning shift, just like today,” he says. However, Busch concedes that such ideal staffing conditions are difficult to achieve, as there simply aren’t enough nurses.
Patients are always his absolute priority, which can sometimes mean having to put bathroom and meal breaks on hold. Sometimes, there is not even enough time to complete all the patient paperwork, and it has to be postponed.
German government vows to improve situation
German Health Minister Jens Spahn, Family Minister Franziska Giffey and Labor Minister Hubertus Heil want to remedy this problem. Together, the three unveiled a plan for “concerted action regarding the care sector.” It envisions better nursing wages and working conditions through collective bargaining agreements. Spahn also wants to hire additional care personnel from abroad.
Christina Körner of the Johanniter Education Center in Bonn says this plan would merely relieve the symptoms rather than address the underlying problem. Körner, who is a trained nurse, is critical of the fact that the workload continues to increase in Germany’s health care sector, but staff numbers aren’t keeping up. “Their job is getting more and more demanding,” she says. “I can say this because I have 20 years experience working in the sector.”
Körner does not believe that hiring foreign care personnel to compensate for staff shortages is a good idea in the long term. People from other cultures need time to integrate into German society she says, stressing that there is not enough staff capacity to help foreign workers settle in.
Nurses fed up with heavy workload
Despite the hard work, Busch says he likes being a nurse. “I enjoy working with people and helping them,” he explains, adding that the rewarding work sometimes helps him forget about the inconveniences and little annoyances that come with the job.
Busch believes that nursing is only for people who deeply care about working with others. “Anyone who says they want to be a nurse because the money is good is in the wrong job. Here, the patient is the focus. Anyone who enjoys doing that will always have a future,” he says while putting together medical records for the doctor — several patients are set to undergo surgery today.
Körner sees a future for the nursing industry in Germany. After completing vocational training, she studied health and care education. In 2016, she became a member of the executive board of the German Nurses Association. “I believe it’s almost inevitable that the caregiver sector will develop and progress,” Körner says. “There are so many different education programs on offer, some for people with prior work experience and regular university degrees, too.”
Establishing an appropriate framework to make this vocation more attractive is key, believes Körner. “We have grown used to the current situation and keep telling ourselves ‘we will manage somehow,'” Körner says. However, she admits that Germany’s caregivers are becoming increasingly discontent with the heavy workload. “Maybe now would be a good time for the new government to tackle the issue and initiate a public debate on the matter,” she says.
Conditions must improve
As Busch’s shift comes to an end, he is preparing the hand-over with his colleagues. It entails telling the late night staff how the patients are doing. What matters most to him, says Busch, is knowing he has fulfilled all his daily tasks. Alas, often he is forced to work extra hours to get everything done. “The conditions need to be right, things are totally different when we are not short-staffed,” he says. As Busch closes the file, he bids farewell to his colleagues. “This is about human lives,” he says. “And that requires having reliable and trustworthy caregivers.”