“Almost 40% of nursing staff leave the profession.”

That being said, nursing staff leaving the profession early is nothing new…

Correct. Even 20 years ago, international studies showed that many nurses were abandoning the career prematurely. Today, almost 40% of trained nurses leave the profession sooner or later. These are people that we urgently need, and action is required if we’re to keep them in the job they’ve been trained to do.

Why are nurses leaving the profession?

There are many reasons: For example, nursing loses many people when they leave to raise a family — and many healthcare organizations, hospitals and home care services are still too inflexible. It’s often a case of “you can only work for us if you cover a minimum number of hours”. That rules out shorter, personalized working hours, which are particularly important when it comes to raising a family. When professionals lose their connection with clinical practice, it’s difficult for them to return at a later stage.

What’s more, irregular shifts and last-minute scheduling are incompatible with the fixed times of childcare provision.

Exactly. Many healthcare facilities have now understood the need for adaptation and for working time models that can better address the needs of staff. Many hospitals have become more flexible and try hard to develop suitable offers.

Working time models are one thing, but is it not also a question of making the occupational profile more attractive?

Over the last 15 years, Switzerland has already taken steps in this direction, and there are now many more opportunities for specialization. There’s the three-year training program as a healthcare assistant and the nursing diploma offered at vocational colleges, as well as bachelor’s, master’s and doctoral programs — for example, here at the university. On the one hand, we’ve reduced the threshold for entering the nursing professions; on the other, there are now opportunities for advanced training.

How could this problem be solved?

There’s no easy solution. You’d have to reduce fluctuations in workload through improved capacity management and personnel planning. This would include responding better to fluctuations in patient numbers by increasing flexibility in shift planning, for example, or by using reserve staff. At the same time, however, we’re also seeing a huge increase in short-notice absences of personnel, particularly since the COVID-19 pandemic.

Why?

The system was more stable before the pandemic. We had more staff and also more reserve staff who could step in to help. We recently did a study of nurses in oncology, a field that suffers from short-notice staff absences of up to 30% — and, in 80% of cases, no one takes the place of these absentees. That was a very surprising finding.

What does this have to do with the pandemic?

The pandemic resulted in the mobilization of all the healthcare system’s reserves, and the system has never recovered. Now, many baby boomers are also entering retirement and will need care themselves in the future.

How can we fill these huge gaps?

We need new solutions in terms of how we organize nursing care, and we’ll probably increasingly be forced to work with lower-skilled staff in the future. What’s more, nursing professionals will need more skills so that they can manage these staff. In Switzerland, health policy has always counted on skilled personnel arriving from abroad — and this has indeed proven to be an attractive option for many foreign workers. Whether that’ll continue to work in the future is doubtful. There is a lack of skilled workers everywhere, including in our neighboring countries.

Is it not also unethical for a rich and attractive country such as Switzerland to take skilled workers away from other countries?

Yes, that’s also a factor. There’s the WHO Code of Practice, which frowns upon recruitment from countries with staff shortages. In reality, however, all the political sermons are quickly forgotten, and everybody recruits from wherever they can. I recently spoke to colleagues from Germany, where staff are recruited from around the world, and the nurses trained in Germany are already in the minority in some hospital wards. It’s a stark development.

In 2022, we adopted the Nursing Initiative in Switzerland. Are the effects already apparent?

The Nursing Initiative has led to some positive developments, such as the nursing monitoring program launched in July 2024. Other consequences of the initiative include the cantonal training initiatives and the appointment of nursing officers in some cantons to act as a central point of contact for nursing-related issues. Although these are key steps forward, there is a need for further, far-reaching measures in order to resolve the underlying problems.

How important is the recognition of nursing work in society?

Very important. Nurses make an enormous contribution, but there’s often a lack of appropriate recognition — both financially and in terms of their expertise. Nursing must be recognized as a high-skilled profession in its own right that is an indispensable part of healthcare.

Do you think robots could play a role in the future of nursing?

Robots could help with certain tasks, such as heavy lifting or the monitoring of vital signs. There’s also room for improvement when it comes to documentation. What the technology cannot do, however, is replace human interactions or nursing expertise, both of which are vital parts of the job. Nursing requires not only specialist knowledge and experience but also empathy and understanding — and remains a profoundly human occupation.

How do you think nursing will develop in the next five to 10 years?

Nursing will become increasingly specialized and individualized. New care models will emerge that better respond to patients’ needs and make better use of nursing professionals’ skills. There will be more specialist nurses, such as clinical nurse specialists or nurse practitioners, who will work even more independently. With this in mind, it’s also crucial that our institute forms part of the Faculty of Medicine. Developments such as these will only be possible in partnership with doctors and nurses.