In psychiatric hospitals, there is evidently more and more violence - assault on the employees, forced fixation of patients and belong according to an online survey of the union ver.di everyday life in the clinic. Therapists and caregivers are always bruised and cut, and people are repeatedly attacked by fellow patients at the overcrowded wards. "Our work is becoming ever more dangerous," says Hamburg occupational therapist MajaSchauberick. She has been working in psychiatry at the University Hospital Eppendorf for 32 years and now, like employees throughout the country, she is protesting for better working conditions together with her colleagues. One reason for the increasing violence is the lack of staff at the stations. ZEIT ONLINE told Schauberick how dramatic the situation on their station is.
ZEIT ONLINE: Today, you and your colleagues have gathered in front of the Department of Psychiatry at the Hamburg University Hospital. Usually you work behind these doors - invisible, so to speak. Why now this step out?
Maja Schauberick: It just can not go on, we have to do something. Many colleagues are at the end of their power. Going to work every day with a bad feeling. Some are really scared - about themselves and their patients. Not only at UKE, in all psychiatric clinics is it the same story: more and more patients, more and more violence, less and less time to do the work the way we should.
ZEIT ONLINE: How do you know that this is a nationwide problem?
Schauberick: From a survey conducted by ver.di (see info box, editor's note) , the so-called supply barometer . The results are dramatic, but they sound familiar to us as well. One out of every two respondents reported that they had experienced a dangerous situation in the last four weeks before questioning at the ward. And what really depresses me is that 80 percent can not imagine continuing on to retirement. But who should do this work then?
ZEIT ONLINE: What does this work look like?
Schauberick: We take care of people who are in psychiatric emergencies. With all sorts of measures, from medicines to therapeutic talks and physiotherapy. That is laborious. For example, on an acute care unit, many have lost touch with reality. Perhaps a deep despair has seized on them, so that the only way they still see is suicide. Or it is people who are stuck in the feeling that the whole world is turning against them, that they are being persecuted. It takes a lot of patience to get through to it. But exactly for such discussions the staff is missing now.
ZEIT ONLINE: And that means?
Schauberick: If somebody on the station becomes visibly uneasy, for example, scoldling around, then one would actually have to address him and bring him down again before an outbreak occurs. But the personal blanket is often too thin for that. This is also a result of the study, which we know well from our Hamburg everyday life: For the timely de-escalation time is missing. Increasingly, there are injured employees - and injured fellow patients.
ZEIT ONLINE: Actually, psychiatrists are set up for violent outbreaks. In the UKE, there is the option of including patients in an isolation room or strapping them in place with special straps until they have calmed down.
Schauberick: These measures are a last resort, an exception. Patients do not understand what is happening, they traumatize them. And it is a burden on the employees. At the moment, coercive measures are with us and apparently everywhere in Germany but rather the rule. Anyone who works on a house that is responsible for urban hotspots like us can do it regularly. The public must be aware that many of these coercive measures are likely to be avoidable if the clinics have enough staff.
ZEIT ONLINE: How that?
Schauberick: Personal relationships are the key. If you meet someone in a longer conversation, then you also get an idea how to bring it down again. There is, for example, the proven concept of nursing care: Everyone in the team is responsible for certain patients, so that he and he can get to know them better. Actually, this is also standard with us. But in practice it is hardly possible. Due to the high daily load, the sick leave is also high. The teams are constantly being torn up because they have to step in as fire brigade on other stations.