Germany is suffering from an acute shortage of medical staff, which further intensified over the course of 2021. Twelve percent of positions in intensive care units remain unfilled.
Persistent nursing shortage in Germany
German hospitals have been suffering from a shortage of nursing staff for years, which worsened further last year. In 2021, nationwide around 14,000 positions for registered nurses in clinics remained unfilled, and another 8,000 positions were vacant in intensive care units.
The number of vacant positions for registered nurses corresponds to about 6 percent of all positions on general wards and about 12 percent in intensive care units.
Staff shortages have worsened exponentially in recent years: five years ago there were only around 3,900 vacant positions on general wards.
No staffing reserve in German hospitals
The lack of staff reserves is the reason why some intensive care units had to close 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 qualified professional, while it took 21 weeks to fill a position in intensive care or the emergency medicine could be filled.
The reasons for the labor shortage are varied. One is that the large birth cohorts have either retired or are 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 because of the increased workload.
Concerns about staffing 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 searching for ways to keep nursing homes open if a vaccination mandate for healthcare workers comes into force.
His region near the Czech border has one of the lowest vaccination rates in Germany. Since only 57% of healthcare staff there have received two vaccinations against the coronavirus, implementing the rule would lead to staffing shortages that would force the 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?,” says Vogel.
The obligation for healthcare personnel to get 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 outbreak of the pandemic.
The debate in Germany makes it clear 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 around 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 resulted.
Christine Vogler, chair of the German Nursing Council (DPR), said the mandate would affect a sector that has already been suffering from staff shortages two years after the pandemic, as more than 200,000 nursing positions are currently vacant.
„I have the choice between unvaccinated care workers and no care 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 health personnel are unvaccinated, have pleaded with federal and state health authorities to strike the mandate passed by parliament in December.
After a meeting of the state health ministers last week, however, it looks as though the law will take effect. All 16 federal states said they were willing to implement the law, provided they find ways to avoid staffing shortages.
For example, facilities could deploy former nursing staff or people without nursing qualifications to assist in non-medical areas, a spokesman for the health ministry said.
Nevertheless, Eike Hennig, head of the health office of the eastern city of Magdeburg, expressed skepticism about implementing the regulation in a city where around 900 health workers, i.e., 10% of the total staff, are still unvaccinated.
He suggested using the coming weeks to persuade staff to get vaccinated with the newly approved vaccine from Novavax (NVAX.O), whose more traditional technology might convince some skeptics.
Feel betrayed
The looming mandate, the stressful working conditions—especially during the pandemic—and the low pay, however, already seem to be prompting some to leave the profession.
Nearly 23,000 healthcare workers have registered as job-seeking in the past two months, 60% more than a year earlier, according to data from the Federal Employment Agency.
A 36-year-old nurse who works in emergency medicine said nearly half of her colleagues, like her, are unvaccinated. 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're supposed to get vaccinated and give up this right of self-determination over our bodies? No!The nurse said.
Some healthcare workers have tried to challenge the mandate, but Germany's highest court rejected urgent appeals earlier this month.
„In my opinion, the solution at the moment is to drop the mandate and wait to see how the COVID pandemic develops", Vogel said.
