[Influence of working conditions and salary on temporary agency work for intermediate care and intensive care units : Partial results of a nationwide survey]. / Einfluss der Arbeitsbedingungen und des Gehalts auf die Leiharbeit für Intermediate-Care- und Intensivstationen : Teilergebnisse einer bundesweiten Umfrage.

BACKGROUND: Agency nursing is used as a form of labour to counter vacant staff positions in hospitals. Stakeholders and nurses might view this critically for different reasons. AIM: The aim of this study was to evaluate what individual net income nurses in German intensive care units and intermediate care units consider "fair and acceptable" for their work. Furthermore, what influence does salary have on the willingness to change to agency nursing or back to a permanent position. METHODS: From September-October 2020, an anonymous online survey was performed among nurses of intermediate care units, intensive care units and special care units in German-speaking countries. The results were evaluated using descriptive statistics. RESULT: Of 1203 participants, 1036 (86%) of those working in Germany could be evaluated. The question about the individual net income was answered by 1032 (99%) participants. The majority of respondents (n = 522) stated that they had an individual net income of 2000-2999 €/month. The higher the level of the net income, the lower the willingness to switch to agency work. The participants in permanent employment only perceive a net income of 3200 €/month (median 3200 €; interquartile range [IQR] 2800-3800 €) as acceptable and fair for their work. In all, 142 agency nurses stated that an individual net income of 3200 €/month (median 3200 €; IQR 3000-3950 €) would be sufficient to move from agency nursing back into permanent employment. CONCLUSION: The intensive care nurses in this survey consider a salary of 3200 €/month as acceptable and fair for their work. The salary level can be a parameter for the decision to go into agency work, but also to move back to permanent employment. Regardless of the salary, better working conditions were indicated as an essential element in terms of job satisfaction for all respondent groups.

Influence of working conditions and salary on agency work for intermediate and intensive care units : Part 2: Partial results of a nationwide survey.

BACKGROUND: Agency work in nursing is used as a form of labor to counter vacant staff positions in hospitals. Both hospital owners and nurses view this critically for different reasons. AIM: The aim of this study was to assess what personal net income nurses in German intensive care units and intermediate care units consider "fair and sufficient" for their work (addressed in Part 1 of the survey) and what influence-aside from the salary-the working conditions have on the willingness to change to temporary work or back to a permanent position. METHODS: From September to October 2020, an anonymous online survey was conducted among nurses of intermediate care units, intensive care units, and special care units in German-speaking countries. Descriptive statistics were used for the analysis. RESULT: Of 1203 participants, 86% (n = 1036) could be evaluated. None of the job satisfaction factors queried received four or five stars (maximum five stars) from those participating in the survey. The most unsatisfied group proved to be regularly employed nurses with an additional part-time job. Key job satisfaction factors differed markedly between the groups, with regular employees favoring consistency and stability. Agency workers prefer gaining experience in a broader range of tasks. Unreliable duty rosters and poor nurse to patient ratios were common points of criticism. CONCLUSION: For job satisfaction, making nurses feel appreciated and respected is essential. This includes a guaranteed nurse to patient ratio and reliable duty rosters that also include tasks outside direct patient care. In order for nurses to leave agency work, it is necessary to take into account the differences in interests in terms of the focus of activity.

["I am in conflict with myself every day"-Moral distress among geriatric nurses during the COVID-19 pandemic]. / "Ich stehe jeden Dienst mit mir selbst im Konflikt"­"Moral distress" bei Altenpflegenden während der COVID-19-Pandemie.

Background: Due to the COVID-19 pandemic-related changes and guidelines, nurses in the setting of inpatient geriatric care are exposed to specific burdens and may experience dilemmas with respect to their moral responsibility. Aim: The aim of this study was to explicate the effects and perceptions regarding the development of moral distress of nurses in the setting of geriatric care during the SARS-CoV­2 pandemic in Germany and to draw conclusions for the design of care in residential care settings. Methods: Based on a subgroup analysis (n = 510) of the qualitative survey of the COVID-19 Nursing Study, perceptions of nurses working in residential care settings during the pandemic are presented and evaluated with respect to the development of moral distress. Results: The results show five categories ("That we have no time to care properly", "Loneliness", "Conflicts with relatives and residents", "Constant fear for patient safety but also for one's own safety" and "Grief, stress and anger"), which represent differentiated criteria for the development of moral distress among nurses as well as its effects. Conclusion: It can be concluded that structural and professional solutions must be developed that enable nurses to shape their own working environment and to undertake professional nursing decision-making competence.

[Scientific development of critical care : Position paper]. / Wissenschaftliche Weiterentwicklung in der Intensivpflege : Positionspapier.

Demographic changes in Germany means that nursing and medical care is becoming increasingly complex. This is especially true for intensive care. Despite the closure of hospitals in Germany, the number of beds in intensive care units rose between 2002 from 23,113 to 26,162 in 2010. At the same time the number of patients treated in intensive care units increased by 148,989 to 2,049,888. The increasing complexity requires specific education for nurses in intensive care based on a model of advanced nursing practice (ANP). Nursing experts who fulfill an advanced practise nursing are competent to make decisions autonomously and accountably within complex care situations. This includes decisions such as artificial ventilation, weaning, nutrition management and the management of delirium, wounds and pain. Nursing experts are responsible for specific clearly defined areas of care and initiate nurse-led services and practice. Scientific and research based evidence are transferred directly into health care practice and can be implemented directly. The DGF demands a scientific and with it academic development of critical care as advanced nursing practice based on a master level qualification. This also includes the request for expansion of competencies and roles and the assignment of decision making authority within complex health care situations and an orientation on the Competencies for European Critical Care Nurses of the European Federation of Critical Care Nursing Associations (EfCCNa).

Self-esteem among German nurses: does academic education make a difference?

Self-esteem is not typically associated with the nursing profession. However, the concept is indispensible for job satisfaction and good-quality patient care. Many healthcare systems are confronted with declining numbers of qualified nurses, and desperately seek suitable strategies to recruit and retain sufficient trainees and junior staff. This investigation examined self-esteem in 212 German nurses using the Rosenberg Self-Esteem Scale. Nurses with an academic degree displayed a statistically significant higher level of self-esteem than nurses without academic education (P < 0.01). The type of professional training may therefore have a direct effect on the self-esteem, thus offering a myriad of potential benefits to both nurses and patients. Self-esteem is a quality relevant to this profession and, as such, the findings of research in this area should be reflected in the design of nurse training curricula.