Germany is suffering from an acute shortage of medical personnel, which has worsened over the course of 2021. 12 percent of positions in intensive care units remain unfilled.
Ongoing nursing shortage in Germany
German hospitals have been experiencing a shortage of nursing staff for years, which has intensified over the past year. In 2021, around 14,000 positions for qualified nursing staff remained unfilled in clinics nationwide, and another 8,000 positions were unfilled in intensive care units.
The number of unfilled positions for qualified nurses corresponds to about 6 percent of all positions on general wards and about 12 percent in intensive care units.
The staff shortage has worsened exponentially in recent years: five years ago, there were only about 3,900 vacancies on general wards.
No staff reserves in German hospitals
The lack of staff reserves is the reason why some intensive care units had to be closed either temporarily or permanently during the coronavirus pandemic.
Last year, it took an average of 17 weeks to fill a regular nursing position with a specialist, while it took 21 weeks to fill a position in intensive care or emergency medicine.
The reasons for the labor shortage are manifold. One is that the baby boomer generation has either retired or is taking early retirement. In addition, more and more employees are taking parental leave, and nurses in cities have to compensate for the shortage of nurses in rural areas, which often pushes the workforce to its limits. This leads to a downward spiral, as many of the remaining nurses are quitting their jobs due to the increased workload.
Concerns about staff shortages call Germany's vaccine mandate into question
Frank Vogel, a 64-year-old local politician from the Ore Mountains in eastern Germany, is desperately looking for ways to keep nursing homes open when a mandatory vaccination for healthcare workers comes into effect.
His region near the Czech border has one of the lowest vaccination rates in Germany. Since only 57% of healthcare personnel there have received two coronavirus vaccinations, implementing the regulation would lead to staff shortages that would force facilities to close.
„In the end, the question arises: How do you then deal with the people who are being cared for in these facilities?” said Vogel.
The requirement for healthcare personnel to be vaccinated is the first step in the new government's plan to make vaccinations mandatory for all adults.
However, this has raised fears that thousands of people will become unemployed, hospitals and nursing homes will be understaffed, and the healthcare system will be overwhelmed two years after the start of the pandemic.
The debate in Germany highlights how difficult it is to make vaccinations mandatory in the country's federal system and is likely to undermine efforts to extend the regulation to all adults.
Acute staff shortage
In Germany, the vaccination rate is about 75%, which is lower than in many other Western European countries. Around 92% of hospital staff have received two vaccinations against the virus, according to a survey by the Robert Koch Institute.
Christine Vogler, chairwoman of the German Nursing Council (DPR), said the mandate would hit a sector that is already suffering from staff shortages two years into the pandemic, as more than 200,000 nursing positions are currently unfilled.
„I have the choice between unvaccinated nursing staff and no nursing staff at all. That is a bad solution,” she said.
Vogel and other district administrators in eastern Saxony, which has the lowest vaccination rate in Germany and where almost 30% of healthcare personnel are unvaccinated, have pleaded with federal and state health authorities to scrap the mandate passed by parliament in December.
However, after a meeting of state health ministers last week, it looks like the law will come into effect. All 16 federal states agreed to implement the law, provided they find ways to avoid staff shortages.
For example, facilities could use former nursing staff or people without nursing training to provide support in non-medical areas, said a spokesperson for the Ministry of Health.
Nevertheless, Eike Hennig, head of the health department in the eastern city of Magdeburg, expressed skepticism about implementing the regulation in a city where around 900 healthcare workers, i.e., 10% of the total staff, are still unvaccinated.
He suggested using the coming weeks to convince employees to get vaccinated with the newly approved Novavax (NVAX.O) vaccine, whose more traditional technology might convince some skeptics.
Feeling betrayed
However, the looming mandate, stressful working conditions, especially during the pandemic, and low pay seem to be already prompting some to leave the profession.
Almost 23,000 healthcare workers have registered as job seekers in the last two months, 60% more than in the previous year, according to data from the Federal Employment Agency.
A 36-year-old nurse who works in emergency medicine said that almost half of her colleagues are unvaccinated like her. She said that neither the mandate nor the Novavax vaccine would convince her to get vaccinated.
„We feel… betrayed. So we were good enough to expose ourselves to this risk for two years, and now we are supposed to get vaccinated and give up this right to self-determination over our bodies? No!” said the nurse.
Some healthcare workers have tried to challenge the mandate, but Germany's highest court rejected emergency appeals earlier this month.
„In my opinion, the solution at the moment is to drop the mandate and wait and see how the COVID pandemic develops,” said Vogel.
