gms | German Medical Science

Background: In Germany, a shortage of nursing staff has been discussed for years. During the COVID-19 pandemic, the importance of having a sufficient number of nurses available became even more apparent. In a country where nurses are usually not registered, those who are no longer working in the profession were called upon by various organisations to volunteer to fill in in nursing if necessary.

Aim: Our aim was to identify factors that contribute to the decision for or against such voluntary registration in a crisis.

Methods: We developed an online-survey, addressing various dimensions. The questionnaire asks whether or not the former nurses were registered. It contains questions related to the professional qualification, the experiences made while working as a nurse, reasons for leaving the job, the current professional and personal situation and attitudes towards the registration of the non-active nurses. Between 27. April and 15. May 2020, we distributed the questionnaire via social networks, organisations and institutions. In a snowball sampling approach, recipients were requested to pass the link to wherever further non-active nurses might be reached. Overall, there was a high willingness to support the researchers and the link was widely spread.

Results: A total of 344 participants, 72% of whom were female, were included in different analyses. 77% (n=264) are general nurses, 6% (n=21) paediatric nurses and 16% (n=54) geriatric nurses. Main reasons for leaving the profession were occupational reorientation (12%, n=156), working hours (10.1%, n=131), time pressure/not enough time for patients (9.1%, n=118), and poor career options (8.3%, n=108). More than three quarters (76.6%) of the non-active nurses are still in jobs related to health, care or nursing. 67% (n=231) had not or not yet registered. 112 (49%) out of 229 participants, who provided reasons (multiple answers were possible) why they had not registered, reported that they saw, at this stage, no reason for registration. Those who are registered, stated, for example (multiple answers were possible), that they want to do their bit to manage the corona crisis (22.8%, n=72), that they feel a duty (19.3%, n=61) and that they have a sense of belonging to the nursing profession (17.4%, n=55). One person felt pressured by colleagues. For many participants, it would be important to clarify financial, legal, and other issues with their current employer prior to registration.

Discussion: The survey suggests that the experiences, which made the nurses leave the job, seem to be lasting and are now limiting the willingness to fill in. A major proportion of participants did not register but nevertheless found out about the survey and took part. One explanation would be that experiences during their active time in care were so intense and persisting that they made them take the opportunity of this survey to report on them. A certain attachment to the profession seems to remain.

Practical implications: With two thirds of the participants not being registered, the reserve pool of nurses, with whom to plan in case of an emergency, may be smaller than previously assumed.

Appeal: To motivate former nurses to return to care for a limited period of time, precise agreements and clear regulations are required.