Much has been said about care, not just now, but especially since the outbreak of the corona pandemic.

The biggest problems are well known: too many patients, too little staff and too little time.

What this means in concrete terms in everyday life in German clinics - for nursing staff as well as for sick people - very few people should have any idea about it.

Because voices from nursing staff themselves are seldom heard.

The book “Systemrelevant” by Maximiliane Schaffrath closes this gap.

Britta Beeger

Editor in business.

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    It is a relentless and personal insight: the author trained in nursing and describes what she experienced in the wards of a large hospital during this time.

    The book begins suddenly with her first practical use after three months of nursing school, in hematology, or, as Schaffrath writes, the “cancer ward”.

    On day two, she is supposed to help out in the palliative care unit because a colleague is absent.

    What if someone freaks out?

    Already in these first weeks everything reveals itself that will run like a red thread through your training. By far the biggest problem is the lack of staff. It means that hardly anyone has time to explain something to her, that she is often overwhelmed and that she is constantly accused of being too slow, for example when distributing food or washing bedridden people. Your female colleagues - most of them are female - are often themselves at the end of their tether. Fifteen deaths in eight weeks, that is the result of her first stop. She would like to speak to someone in her work environment about it. "But there is no time for it."

    But not only they themselves and their training are neglected, according to their description, but also the patients.

    The author calls it "the eternal gap between how it should be and how it is, because there is simply no other way."

    An example: A colleague in trauma surgery reports sick, so that Schaffrath and another nurse are responsible for thirty-five patients.

    When one of them freaks out, the question is: will they manage to calm him down, or will the other thirty-four fall by the wayside?

    Especially since different values ​​would have to be measured regularly for all freshly operated patients.

    "We can be happy if we can do that once per shift."

    Blood, pain, suffering and death

    Schaffrath only draws far-reaching conclusions and recommendations for action from what she has experienced in a few places. In some cases, these are specific suggestions, for example stations that do not treat the youngsters badly, to be closed for training. Elsewhere it is basically: "For my decision to learn a profession that confronts me with vomit, shit, blood, infectious diseases, pain, suffering and death every day, I want to be better treated."

    She writes so emotionally in large parts of the book.

    Even when it comes to how she keeps reaching her limits, sometimes crying every day because she cannot switch off, and can no longer create a distance from her job.

    From a certain point on, it's all about perseverance, the question of when the “torture” will finally end.

    "Systemically relevant": This attribution of care that arose during the Corona crisis should seem like a mockery in their eyes.

    Completely disaffected

    The afterword is responsible for the analytical superstructure, a more sober look at the problems in nursing, in which the nursing lawyer Thomas Klie speaks with Andreas Krahl, a nurse and member of the Bavarian state parliament.

    But as subjective as Maximiliane Schaffrath's descriptions may be, they alone make it clear how difficult the nursing situation is and what needs to be changed.

    In any case, it is not the profession itself, the illnesses or the patients that weigh on it, writes Schaffrath.

    And in fact, the author also shows how diverse training in nursing can be and that collegiality is possible.

    Started full of idealism, looking for a job that makes sense, after three years she was “completely disillusioned”.

    Maximiliane Schaffrath: "Systemically relevant". Behind the scenes of care.

    S. Hirzel Verlag, Stuttgart 2021. 240 pp., Br., € 18.