The story of German Health Minister Jens Spahn and Judith Heepe, the nursing director at Berlin’s Charite Hospital, is a bit like the story of the hare and the hedgehog. Heepe, like the sharp hedgehog, is somehow always faster.
In September 2019, Spahn was in Mexico signing a contract to speed up the process for Mexican nursing staff to receive work permits in Germany. Heepe had already been there. A month earlier, Spahn had sent his secretary of state to the Philippines on a recruitment mission. Heepe had been there too.
In the Brothers Grimm fairy tale, the hare thinks to himself: this is not possible. Judith Heepe sees the funny side when she recounts her imaginary competition with Spahn. In the race to hire nursing staff from abroad, you have to be very creative. And sometimes it takes things into your own hands.
“International nursing staff has brought warmth and openness,” says Judith Heepe
For more than five years, Heepe has headed Charite’s nursing division, Berlin’s oldest hospital and Germany’s most famous. She is responsible for 4,600 staff members, and during the second wave of the pandemic they have been working every day under pressure, especially the COVID-19 intensive care nurses.
Struggle to recruit nurses in Germany
If the pandemic had erupted four years ago, Charite probably would have had to admit defeat. “At that time we were short of 400 nurses. Every year we have closed this gap for 100 workers and expanded our training capabilities at the same time,” says Heepe.
As a result, he has not only flown to Mexico and the Philippines, but has also been to Albania and made approaches to South America. Soon, Charite also wants to bring Brazilian nurses to Germany. “The market in Germany has dried up completely,” he says. According to the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), the country lacks between 3,500 and 4,000 skilled workers in intensive care.
Politicians are constantly asking Heepe how the situation has come about. “I can only tell you: this situation is our fault. In recent years there have simply not been enough trained and qualified people. We now have what was a totally avoidable gap in the next four or five years,” he says. It is an emergency that could cost a lot in Germany in the coming weeks, with intensive care stations crowded due to the pandemic. “It also means we have to pay people better,” Heepe says.
Struggles with officials and bureaucracy
Heepe is someone who gets things done. His motto: Don’t take no for an answer.
“At one point, I knew more about the State Office of Health and Social Affairs than I ever wanted to be,” he says with a laugh. I always had to discuss the requirements of the office for foreign nurses to provide original documents. His relationship with the health authorities in Berlin has a history: it happened almost three years ago, halfway around the world in Mexico. And Heepe can still remember every detail.
“I was in a video conference with 15 Mexicans who were totally desperate because their recruiting company had crashed,” he recalls. “And then I said to them,‘ Who cares? We can do it! We will take you here! “”
For Heepe, this marked the beginning of a parallel work. He took on everything the agencies would normally handle, from visas and flights to dealing with officials, bank accounts and health insurance to organizing language courses. And sometimes, when the whole project was seen at risk because of the German bureaucracy, he took unconventional measures.
“I say to my German colleagues,‘ You have it all here. You don’t have to emigrate, “says Mexican nurse Herbert Perez
A suitcase full of documents
In April 2018, Herbert Pérez boarded a plane from Mexico City to Berlin with a suitcase and a backpack. Charite had paid for the flight. In his backpack were two pants, three T-shirts and two shirts. In the suitcase: all the original paper documents of the 15 Mexican nurses who wanted to work in Germany. The young indigenous nurse of the southern state of Oaxaca with the first German name became the vanguard; he had in his luggage everything that the Berlin officials demanded.
“The balance at the airport showed exactly 22.5 kilograms,” Pérez recalls. “At the last second, people were still coming to the airport to drop off the documents.” The nurse may laugh now when she thinks of her first trip to Germany, but at the time it was a nervous wreck.
“What would have happened if I had forgotten something in the middle of the hustle and bustle, or if documents were lost in transit or if the airlines made a mistake and my suitcase was missing?” All these thoughts went through his head. But it all worked out. Today, after a six-month program to certify his credentials, Perez is a valuable colleague. She works in the coronavirus intensive care unit and helps day by day to bring Germany into crisis.
Dramatic situations in intensive care units
“The current situation is extremely critical, there are only a few intensive care beds,” Pérez says. “At the moment we are reaching the limits of our capabilities.” He himself has already tested his limits: how many nurses contracted the coronavirus and lay in bed with a fever for a week.
Perez wanted to be a nurse from an early age. It is the type of person who should be told when to brake. Even today, he is surprised when his classmates tell him he needs to relax, that he is entitled to a vacation or rest days. “I didn’t know things about Mexico. There you have less rights as a worker.”
Heepe is organizing everything so that Pérez’s partner, a preschool teacher, can join him in Berlin and start working at Charite Kindergarten.
An international success story, then, with only winners? Not exactly. There is growing criticism that Germany is capturing well-trained personnel from developing countries when they are also urgently needed in their own countries. A recent report in the German newspaper Frankfurter Rundschau he spoke of “nurse imperialism.”
“Germany must solve its own nursing problem”
The German Interdisciplinary Association for Intensive Care and Emergencies (DIVI) is aware of these allegations. Experts agree: Germany’s nursing shortage is a country-specific problem and, in an emergency like the current coronavirus pandemic, other countries should not be weakened.
“The incorporation of qualified staff from abroad always sounds like the big answer to the problem. But the more research is done, the less response it seems,” says Michael Isfort, vice chairman of the board of the German Institute for Applied Nursing Research. . Currently, the proportion of foreign nursing staff in the hospital sector is about 1%. “This is extremely small.”
Nurses like Herbert Pérez go mainly to big cities like Berlin; according to Isfort, 90 to 95% of international staff work in large urban centers. “We have not yet managed to get welfare workers from abroad in rural areas,” he says.
According to experts, it is clear that hiring staff from abroad will not be the long-term solution for the German nursing emergency.
This article was translated from German.