Das „Image“ der Pflege: das Ansehen des Pflegeberufs in der Öffentlichkeit und bei Pflegefachpersonen

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Author(s): Claudia Bettina Maier , Marek Ludwig , Julia Köppen , Joan Kleine , Reinhard Busse

Publication date (Online): April 18 2023

Publisher: Springer Berlin Heidelberg

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Zusammenfassung

Der Beruf der Gesundheits- und Krankenpflege, deren gesellschaftlicher Status und die Arbeitsbedingungen sind – nicht zuletzt während der Covid-19-Pandemie – vermehrt in den Fokus der Öffentlichkeit gerückt. Der Fachkräftemangel ist allgegenwärtig geworden. Die Wahrnehmung des Pflegeberufs ist von unterschiedlichen, teils gegenläufigen Entwicklungen geprägt: In der Allgemeinbevölkerung besteht generell zwar ein gutes Ansehen des Pflegeberufs, der oftmals mit Respekt und sozialem Einsatz gleichgesetzt wird, jedoch ändert sich das Bild, wenn es konkret um die eigene berufliche Zukunft geht. So ist der Pflegeberuf nicht unbedingt die erste Wahl bei jungen Menschen, v. a. bei Schülerinnen und Schülern mit höherem Schulabschluss. Die mediale Berichterstattung schwankt zwischen Missstandsbeschreibung und Heldentum, insbesondere während der Covid-19-Pandemie. Es gibt wenige Beispiele in den Medien, die die Pflege als Profession realitätsgetreu abbilden. Innerhalb der Pflege wird der Beruf zwar als wichtig und sinnstiftend wahrgenommen, jedoch überschattet durch hohe Arbeitsbelastung und Stress, Fachkräftemangel und fehlende Wertschätzung. Es braucht multifaktorielle Ansätze, um einerseits das öffentliche Bild der Berufsgruppe hin zur Profession Pflege zu verbessern und andererseits deren Arbeitsumfeld und Tätigkeiten vermehrt wertzuschätzen. Dies erfordert Maßnahmen auf Politik- und Managementebene. Zusätzlich wäre es wichtig, dass die Berufsgruppe organisiert, professionalisiert und selbstbewusst auftritt, um so das Bild nach außen selbst vermehrt zu beeinflussen.

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Most cited references 19

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Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States

Linda Aiken, Walter Sermeus, Koen Van den Heede … (2012)

Objective To determine whether hospitals with a good organisation of care (such as improved nurse staffing and work environments) can affect patient care and nurse workforce stability in European countries. Design Cross sectional surveys of patients and nurses. Setting Nurses were surveyed in general acute care hospitals (488 in 12 European countries; 617 in the United States); patients were surveyed in 210 European hospitals and 430 US hospitals. Participants 33 659 nurses and 11 318 patients in Europe; 27 509 nurses and more than 120 000 patients in the US. Main outcome measures Nurse outcomes (hospital staffing, work environments, burnout, dissatisfaction, intention to leave job in the next year, patient safety, quality of care), patient outcomes (satisfaction overall and with nursing care, willingness to recommend hospitals). Results The percentage of nurses reporting poor or fair quality of patient care varied substantially by country (from 11% (Ireland) to 47% (Greece)), as did rates for nurses who gave their hospital a poor or failing safety grade (4% (Switzerland) to 18% (Poland)). We found high rates of nurse burnout (10% (Netherlands) to 78% (Greece)), job dissatisfaction (11% (Netherlands) to 56% (Greece)), and intention to leave (14% (US) to 49% (Finland, Greece)). Patients’ high ratings of their hospitals also varied considerably (35% (Spain) to 61% (Finland, Ireland)), as did rates of patients willing to recommend their hospital (53% (Greece) to 78% (Switzerland)). Improved work environments and reduced ratios of patients to nurses were associated with increased care quality and patient satisfaction. In European hospitals, after adjusting for hospital and nurse characteristics, nurses with better work environments were half as likely to report poor or fair care quality (adjusted odds ratio 0.56, 95% confidence interval 0.51 to 0.61) and give their hospitals poor or failing grades on patient safety (0.50, 0.44 to 0.56). Each additional patient per nurse increased the odds of nurses reporting poor or fair quality care (1.11, 1.07 to 1.15) and poor or failing safety grades (1.10, 1.05 to 1.16). Patients in hospitals with better work environments were more likely to rate their hospital highly (1.16, 1.03 to 1.32) and recommend their hospitals (1.20, 1.05 to 1.37), whereas those with higher ratios of patients to nurses were less likely to rate them highly (0.94, 0.91 to 0.97) or recommend them (0.95, 0.91 to 0.98). Results were similar in the US. Nurses and patients agreed on which hospitals provided good care and could be recommended. Conclusions Deficits in hospital care quality were common in all countries. Improvement of hospital work environments might be a relatively low cost strategy to improve safety and quality in hospital care and to increase patient satisfaction.

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Nurses' reports of working conditions and hospital quality of care in 12 countries in Europe.

Walter Sermeus, Luk Bruyneel, Linda Aiken … (2013)

Cost containment pressures underscore the need to better understand how nursing resources can be optimally configured. To obtain a snapshot of European nurses' assessments of their hospital work environments and quality of care in order to identify promising strategies to retain nurses in hospital practice and to avoid quality of care erosions related to cost containment. Cross sectional surveys of 33,659 hospital medical-surgical nurses in 12 European countries. Surveyed nurses provided care in 488 hospitals in Belgium, England, Finland, Germany, Greece, Ireland, the Netherlands, Norway, Poland, Spain, Sweden, and Switzerland. All nurses were surveyed from medical-surgical units 30 or more hospitals from geographically representative samples of hospitals in each country, except for Ireland and Norway, where all hospitals were selected, and Sweden, where nearly all hospitals were included by sampling all medical-surgical nurses who were members of the Swedish Nursing Association. Percentages are provided for each of the nurse and hospital characteristics reported. There was wide variation across countries in the percentages of hospital nurses that were bachelor's prepared (range 0-100%), in patient to nurse average workloads (3.7-10.2) and skill mix (54-82% nurses). More than one in five nurses (11-56%) were dissatisfied with their jobs in most countries, and dissatisfaction was pronounced with respect to wages, educational opportunities and opportunities for advancement. Sizable percentages (19-49%) of nurses intended to leave their jobs, though the percentage that thought it would be easy to find another job varied greatly across countries (16-77%). Nurse concerns with workforce management and adequate resources were widespread. While most nurses did not give their hospitals poor grades on patient safety, many doubted that safety was a management priority. Nurses reported that important nursing tasks were often left undone because of lack of time, and indicated that adverse events were not uncommon. Nurse shortages can be expected when national economies improve unless hospital work environments improve. Wide variation in nurse staffing and skill mix suggests a lack of evidence-based decision making. Additional research is warranted on the impact of these variations in nurse resources on patient outcomes. Copyright © 2012 Elsevier Ltd. All rights reserved.