Generalist nursing training is a professional success

23.01.2024 13:53

In 2020, nursing training was reformed with the enactment of the Nursing Professions Act. Since then, all areas of the nursing profession—health and nursing, pediatric nursing, and geriatric nursing—have been trained together in a generalist manner. This development can be considered the greatest professional success for the nursing profession in the past ten years. At the beginning of 2023, despite the difficult circumstances caused by the coronavirus pandemic, the first nurses successfully completed this training.

However, critical voices are already being heard calling for the abolition or breaking up of generalism:

Children's hospitals and physicians complain about an acute shortage of staff in the pediatric field and are convinced that maintaining pediatric nursing training could improve this situation (1). Surprisingly, the CDU/CSU parliamentary group in the Bundestag takes a similar position (2). Although the successful introduction of generalist nursing was implemented by a CDU/CSU-led government, the current position paper "Making Nursing Future-Proof" announces an intention to reverse this development. The Federal Government's Commissioner for Nursing also expresses concerns: nurses may be less likely to choose a career path in geriatric nursing after completing their three-year training (3). However, there is currently no concrete evidence that such a migration is actually taking place. An evaluation of the currently planned specializations as health and pediatric nurses and geriatric nurses is not planned until 2025, and even then it will only be meaningful.

The challenges of generalist nursing training and the choice of work setting lie less in the realm of the training content and more in relation to the reality of the profession. During their training, trainees become familiar with various nursing care areas and the working conditions there. The choice of future field of work is largely determined by the practical experience gained during the training. A decision, for example, for long-term care is encouraged by attractive employment conditions.

It is essential for healthcare to make generalist training attractive. To achieve this, the training conditions must be consistent and, at a minimum, comply with legal requirements. Changes in scheduling due to staff shortages, pediatric placements in kindergartens, and trainees' independent care of entire residential areas are unacceptable. Instead of inadequate knowledge transfer in non-nursing or insufficiently qualified locations, practical skills can be taught through modern learning opportunities such as those offered by skills labs. This third learning location offers trainees a protected environment, which is often lacking in practice facilities due to the existing working conditions and staff shortages.

It is undeniable that the specialized knowledge and skills that nurses acquire over the course of their careers are essential for certain areas of care. Generalist nursing training provides a broad, solid foundation for professional life at the beginning of their career. The performance of the nursing tasks that form the foundation of our profession (nursing assessment, nursing process management, and evaluation) is independent of the field of practice. A three-year generalist training program equips nurses with nursing skills such as patient observation or family care, regardless of the age or illness of the patient. As in other professions, a significant increase in knowledge in the practical environment occurs within the first year of practice, providing confidence in generalist professional practice. Depending on their inclinations and interests, nurses can specialize later on and become experts in their field – just like young doctors who may decide to pursue specialist training.

A generalist nursing education meets international standards. In Germany, generalist training is common in many professional groups, particularly in the healthcare sector. Neither the training of physicians, speech therapists, nor physiotherapists is limited to the care of one age group. Instead, the emphasis is on continuing education and training throughout one's professional career. The goal should be to adhere to international standards to ensure the highest possible quality of care and increase international professional mobility.

Generalist training represents the professionalization of the nursing profession. It enables individuals to acquire a broad spectrum of key nursing competencies and work flexibly in various areas of healthcare. This versatility greatly promotes individual professional development and enables adaptation to changing demands in the healthcare system – especially in times of crisis such as a pandemic. It also represents a decisive advantage for the deployment and development of staff in times of skilled labor shortages. Generalist nursing training must be maintained and further developed. It provides the foundation for broad, high-quality nursing practice that can meet the needs of care recipients.

Sources

(1) https://www.alexianer.de/aktuelles/aktuell/gemeinsame-erklaerung-muensters-kinderaerzte-warnen-vor-kapazitaetsueberlastung-und-aufnahmestopp-an-kinderkliniken (accessed on 13.10.2023 / 13:40)
(2) CDU-CSU parliamentary group. Position paper "Making care fit for the future." October 10, 2023
(3) https://www.schwaebische.de/regional/oberschwaben/ravensburg/was-bei-der-pflege-in-oberschwaben-schief-laeuft-1897867 (accessed on 13.10.2023 / 13:37)