What is involved in becoming a nurse

"Bachelor of Nursing" : As a nurse at the university

Because Ida Lenze was very thirsty for knowledge, and because she had the goal of being involved in a responsible position to heal people from serious illnesses, there was only one thing left for her: she had to start studying medicine. In Switzerland. The heroine of the ARD series “Charité”, who is harassed as an assistant guard by the deaconess superior Martha, could at best have completed a six-month training course in nursing and become a “nurse”. No chance of an academic career in nursing in 1888.

It was not until 1904 that Agnes Karll, President of the International Council of Nurses, recommended training nurses for three years. In most German countries, it still took a while before the current form of training came about. More than a century later, the Science Council made a clear recommendation in 2012: Ten to twenty percent of young people who decide to train in nursing should complete it in the form of a university degree. As early as 2007, the Advisory Council on the assessment of developments in the health care system demanded that the professional groups in the health care system redistribute their tasks and responsibilities. Examples are countries such as the Netherlands, Switzerland, Denmark and Sweden, where not only doctors but also nurses study their subject.

Postgraduate courses in nursing management or nursing pedagogy for nursing staff who have already completed the usual three-year training and possibly have practical experience in their job, but then want to switch to hospital management or get involved in the training of the next generation, have been around for a long time. The German pioneer in the field of undergraduate courses, however, was the Evangelical University of Berlin, where you can now begin studying for a “Bachelor of Nursing” right after graduating from high school.

The students are also trainees

The model course, which is carried out by the SFIVET and currently ten cooperation partners, integrates the teaching that takes place at the university with the practical nursing training in hospitals and other facilities. In the first three years, the students are also trainees in health care and nursing, during this time they are entitled to a training allowance and the prospect of receiving two qualifications after four years.

A bachelor's degree in nursing is now also planned at the Charité, which is due to start in the 2019/20 winter semester. With the graduation, the graduates will at the same time acquire the professional license as "nursing specialist", the overall responsibility should lie with the medical faculty of the Charité. "This pattern is linked to the internationally customary qualification for nurses," says Yvonne Lehmann, who is significantly involved in the development of the new course at the Institute for Health and Nursing Sciences.

The Alice Salomon University of Applied Sciences Berlin (ASH) is also working on an undergraduate bachelor's degree. It should also start in the 2019/20 winter semester and take in 40 new students every semester. The ASH also wants to take sole responsibility for the course, says Gudrun Piechotta-Henze, professor in the already existing course in health and care management. In practice, this means that students do not receive any training allowance, but can apply for student loans.

Together with her colleague Lutz Schumacher, the trained nurse and doctor of sociology developed the concept for the new bachelor's degree in nursing. In the curriculum, theory and practice should be closely interlinked. Anyone studying nursing with the goal of a Bachelor of Science is confronted with the methods of scientific work. "Our goal is evidence-based care, that is, based on research results," says Piechotta-Henze. "Our graduates should be able to understand research results and carry out their own scientific investigations; they should be able to question and evaluate their own actions."

"This is slowly gaining momentum"

If Piechotta-Henze has its way, all nursing staff should be trained at universities in the long term. "This is gradually gaining momentum, but there is still a lot of wild growth in nursing training in Germany." It is part of the tradition of the profession that the profession was shaped by nuns and deaconesses, and nursing was understood as an act of Christian charity. For a long time, subordinate functions, unexplained competencies and poor pay were not the topic of this classic “women's job”. With the generalized training, in which everyone learns together in the first two years and only in the third year aspiring nurses for adults, child nursing and geriatric care go separate training paths, a new fixed structure for the training is now to be created. The corresponding Nursing Profession Act will come into force in 2020.

Nevertheless, Piechotta-Henze advocates promoting the academization of the profession. She does not share the concern that this could deter those interested in the profession. “More and more young people finish school with the Abitur, and under certain circumstances there is also the possibility of studying without a university entrance qualification.” In their opinion, the bachelor's degree makes the professional field even more attractive. "There must be clearly defined, self-responsible fields of work - and the associated higher pay."

Uwe Bettig, Rector of the ASH, thinks this is also important because there are major changes in the health system due to demographic change and economic pressure. The special expertise of the nursing staff is urgently needed for this. In addition, scientific progress leads to completely new treatment and therapy options. "This makes it necessary for experts to work together on an evidence-based, interdisciplinary and cross-sector basis."

Universities of applied sciences do not have the right to award doctorates for a real academization of the profession

Bettig sees parallels here with other professions for which you can already prepare yourself today by studying at your university. For example the upbringing and education of children of kindergarten age. “In the area of ​​early childhood education, too, the requirements and expectations that go beyond looking after the children have changed massively.” The results of school studies have led to the educational work in day-care centers being based on binding educational programs. Even for children under three years of age, they are no longer seen as pure care institutions. Kindergarten teachers are supposed to promote the language of the children, arouse their enthusiasm for the natural sciences and prepare them socially, fine motor skills and cognitively optimally for school. The introduction of courses of study with the (linguistically somewhat weird) name "Childhood Education" was only logical.

There are points of contact between care and early childhood education, says Bettig. “In both cases, we are dealing with classic female occupations, which are recognized as being paid too low. On the other hand, the requirements are steadily increasing. ”In nursing, for example, the number of multimorbid patients is increasing.

Both classic women's professions have in common the immense shortage of skilled workers - and the desperate search for people who, as lateral entrants, can be enthusiastic about work in old people's homes, hospitals or daycare centers. "We need more professionalism and quality in order to be able to meet the challenges," says Bettig. Because courses in the fields of nursing and upbringing are predominantly located at universities of applied sciences, and real academization is not conceivable without independent research, the Rector of the ASH also demands the right to award doctorates for universities of applied sciences.

Whether a determined person like Ida Lenze would switch from a planned medical to a nursing degree under these circumstances remains questionable. According to the new plans, she could also learn a lot there in a bachelor's and subsequent master's degree. And then become a “doctor”.

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