Arbeits- und Personalsituation in der Alten- und Krankenpflege. Wie beurteilen Beschäftigte und Führungskräfte Belastungsfaktoren, Ressourcen und Handlungsmöglichkeiten?

"The demand for personnel in inpatient and outpatient care is rising much faster than the growth in the number of people employed in care professions. At the same time, the working conditions are considered unattractive both by the public and within the care sector. Against this background, the IAB and the University of Bamberg are investigating approaches to cope with the challenging for employees, employers, those in need of care and the state in the research project “Employment and Working Conditions in the Health Sector. A multi-method study”. This report presents results based on qualitative interviews with employees and managers in hospitals and long-term care. The focus of the interviews was on institutional and organisational conditions of professional care giving. In addition, interviewees were asked which instruments and approaches they consider effective in terms of maintaining the current workforce as employees and attracting new employees. Furthermore, caseworkers at employment agencies were asked about their experience in providing employment services in the area of health and care professions. The fact that employees in hospitals and long-term care report high workloads has been intensively documented in the literature. Our results show that stress perceptions of care staff are closely related to their professional understanding of their role. Professional needs orientation, i.e. care oriented to the health and individual needs of the person being cared for, is at the core of their professional identity. In their day-to-day work, care staff can hardly fulfil their own quality standard due to the high workload. This is associated with psychological strain and stress. The desire to exercise a meaningful activity is a common motive for choosing a care profession. Under the current conditions, however, care staff often do not experience their work as meaningful. All respondents believe that labour shortages play an important role for care work perceived to be stressful. Increased stress due to more frequent night and shift work and more frequent short-term stand-ins in the event of work absences are also attributed to the labour shortage. The interviews suggest that care professionals reduce their working hours in order to reduce individual stress and to create space for necessary regeneration phases. Caregivers attach great importance to the recognition they receive for their work. This involves recognition by the people they care for and, where appropriate, their relatives, as well as the recognition they receive in and from the care institution in which they work. Recognition is also reflected in salary, which is also perceived as significant. The respondents see pay primarily as a starting point for attracting new workers to the care sector. In order to retain people in the care sector, they also consider the working atmosphere and the esteem in which they are held by the organization to be important. If the staff situation is to be adapted to the needs in the care sector, significantly more people will have to be successively integrated into specialist care. Some employers refer to the increased number of people working in hospitals and long-term care as a counterargument to a generally poor image of these professions. But all respondents agree that there is no way around increasing the training more future care staff. According to managers, recruitment problems currently affect skilled workers in particular, whereas it is easier to recruit less qualified staff. It is therefore also important to train more the less qualified staff in hospitals and elderly care facilities to a greater extent than has been the case to date. This applies in particular to inpatient and outpatient care for the elderly, where the proportion of employees at helper level, at 47 percent and 40 percent respectively, is significantly higher than in hospitals, where it is 12 percent (Statistik der Bundesagentur für Arbeit 2023b, Abb. 3). In order to compensate for any migration to hospitals by elderly care, which is more heavily staffed with helpers, incentives would have to be created to fill the positions needed in elderly care, for example by adjusting salaries and nursing rates. Secondly, in order to encourage further training, incomes must be provided at a substantial level during the qualification phase. Employers should be informed about existing opportunities for subsidized training of their employees (e.g., via § 82 SGB III). Existing subsidies from the Federal Employment Agency for specialized training should also be expanded where appropriate." (Author's abstract, IAB-Doku) ((en))