Experiences of a nurse in Germany - daily work and tasks
"So, for now, I can say that I'm happy at work, because in Germany, too, I have the opportunity to grow."
Jessica: Where and when did you graduate, Carmen?
Carmen: I graduated in 2015 from the Second University of Naples. I attended a detached site located in Benevento.
Jessica: When did you come to Germany?
Carmen: I arrived in Germany on 23 April 2016. We arrived with an agency. We did the interview in Italy. They were looking for intensive care nurses. A few days later they told me that I had been taken and I left. First step, first destination: Pirmasens. In this city, my "adventure" companions and I took a four-month intensive German language course. Then we started work on September 12, 2016. (After taking the B1 language certificate)
Jessica: How was the German course held?
Carmen: The German course is very very, very intensive, but it gives you a lot. It creates a good foundation, you can talk and communicate with people.
Jessica: Where do you work and in which ward?
Carmen: I work in intensive care at the Westpfalz-Klinikum in Kaiserslautern. As an intensive care unit, I find it truly multidisciplinary. We have different types of patients and every day we learn a lot, about diseases, about care... The nurses are very well prepared and helpful, the head nurse also helps and listens to you. Every day, I grow a little bit more.
Jessica: Tell me about a typical day, maybe a morning shift.
Carmen: The morning starts at six in an area where we do the hand over, the generic one, for all patients, for example: what happened during the night, the patients, if they were intubated or not, if they are stable or not. The allocation of beds, rooms, etc. takes place. Who takes which patient. It lasts about ten minutes. Normally we are a nurse for two patients in the morning. We then go to the bed of each patient and there we make a more specific handover. If the patient has had transfusions, what kind of drugs are in the diffusers, ecc.
Once the patient has been taken care of, we show up and our shift begins! We write down the vital parameters, we perform hemogasanalysis (to check the patient's respiratory, metabolic, electrolytic and blood state); then we move on to therapy (7 o'clock). From 7.30 a.m. we have a break (we have half an hour break in each shift). Once back from the break, we organize ourselves to wash the patients. We do everything related to the care of the patient, general care and treatment procedures.
Around 9 a.m. there is a tour of visits. The person in charge on duty goes around with the doctors to record any transfers, changes to the therapy or communicates what's new. In the morning, not only, is the patient's hygiene taken care of, and also in collaboration with the physiotherapists, the awake patients and also those, who are "Fit!" as the Germans call them are mobilized
It is important to preserve the condition of the skin not only for those patients who are awake but for all patients. In intensive care, this is not always simple; or rather, patients are not in a state of autonomy, because often in a pharmacological coma (typical example). It is up to us nurses to prevent bedsores precisely by mobilization. Also there is a nursing documentation that must be completed in the event that a decubitus develops. If very serious, photos are taken and attached.
At the end of each shift the balance of income and expenditure (in nursing jargon) is made and the doctor is kept informed if a patient has had too much or too little liquid. At 13:15 afternoon shift starts and repeats as follows: general handover and then those at the bedside. The shift ends at 2 p.m.
Jessica: How are the night shifts?
Carmen: The night shifts: wow! We work! The shift lasts from 21:00 until 6:30. In addition to the routine (parameters, withdrawals, therapy...) there can be post-operative patients who must receive hygienic care. The night is not always a walk! Same things as in a day shift can happen! Unstable patients, new hospitalizations (typical with respiratory failure), emergency intubations!
At 3:00 a.m. we carry out complete samples which include, for example, the patient's state of coagulation, blood count, troponin tests. Patients are mobilized during the day and night (in bed of course).
At the end of each shift are again the handovers, around 6 o'clock.
Jessica: What is the difference, in your opinion, between work in Italy and Germany
Carmen: Objectively speaking, the training path. In Italy it is a university degree, in Germany it's not. But that doesn't mean that nurses in Germany are less qualified. Nurses are very well prepared, for what is a nursing diploma! They have the possibility of specializing, i.e. in intensive care and deepening what is not only the nursing part but also the medical one (pharmacology, anesthesia, psychology ...).
One of the most common rumours is that the nurses in Germany are not allowed to take samples that are arterial or venous. In Germany, this is no longer done, not because the nurses are not trained. They are authorised and trained to do so. But since many people in Germany are fighting over what their duties and rights are, they have asked to increase their salaries for all the skills and responsibilities they have. Salaries were not increased as much as desired and so nursing practices were reduced. But there is a but:
For example, those who specialize in intensive care learn how to place an arterial line and a venous line. So here, too, you can aim for 360-degree training.
Nursing work in Italy as well as in Germany (to the amazement of many) involves the management of a central venous catheter, a tracheotomy, a Peg, a nasogastric tube, a thoracic drainage, a bladder catheter or a colostomy. Therefore, there is no difference on this one. They equal each other.
Jessica: So the rumors are wrong?
Carmen: Yes, they are. We left with the awareness of those voices: "Don't go to Germany! Go to England! In England you will be treated in the same way as in Italy" We thought that in Germany nurses worked only as healthcare worker/operators. We came here and saw something else. In Germany the nurse is a nurse. They never let us only work as healthcare workers. From the very first moment they placed us in the nursing world. That was a good reason to encourage us to study for B2 to then work independently. Today those voices have been surpassed by great expectations. I would do it again and again, without regret!
Jessica: How would you describe the relations with doctors and those with colleagues?
Carmen: My team is made up mostly of young people, from 21 to 30 years old. Those colleagues have a lot of positive energy, they can motivate you, they can involve you. Some colleagues have taught us "the art of the trade", they wanted to share their knowledge with us. Even if at first there were communication difficulties (you didn't know all the terms in the medical field), it didn't limit their way of supporting us. They were very open professionally but also from a human point of view.
They always invited us to go out with them, to go to departmental parties and when it happens that we have to work on holidays, Christmas, New Year there is and there was always an invitation to do something together or at least, since you were at work, everyone prepared something and we ate it together. There is a phrase, that at the beginning they have always repeated: "You are very brave! Maybe I would never have done it (leaving Italy). I couldn't imagine leaving my country, my family and going to work where I don't even know the language. They were very sensitive from this point of view.
Jessica: What do you miss in Germany?
Carmen: Politicians! Just kiddin! The only thing I can say point-blank is that I miss my mother tongue. Professionally, I don't have any shortcomings. In Italy I found a good education and training, but not a job. So, for now I can say that I'm happy at work because in Germany I also have the opportunity to grow.
Jessica: Do you miss Italy?
Carmen: I miss Italy but for the sea, for the good food, the mild winters, the friends. The family visits regularly and I manage to get off every three or four months. Maybe at the beginning I missed Italy more. In Italy it would have been easier to talk, to learn, well, simpler, not more better. Today, unfortunately, I see Italy as a country poor in possibilities, for young people, for recent graduates...
We're fine here today. Many people ask us: "Would you like to return to Italy?" and the answer is really: "No!", very spontaneously! Without having to think about it. Because a country that gives you a job, can make you feel good. Work helps to make you feel satisfied with what you did when you were at university. The university in Italy is tough, especially the bachelor degrees, because you have to learn everything in three years. So, you don't want to be in a country that doesn't recognize the sacrifices you made when you studied. Here we feel rewarded. It's bad to say because it's made by a country that's not yours. But staying at home and not working...no!
If you're interested in an experience similar to Carmen's, please apply! We offer you the same language course and we are looking for nurses for the intensive care unit.
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"...a country that gives you the opportunity to work, makes you feel good."