For the HEROES project, it is particularly important to understand and know the country-specific framework conditions and challenges in recruiting nursing and care staff. Katharina Molterer, research associate at the Institute for Ageing Research at the Eastern Switzerland University of Applied Sciences, conducted an interview with Edith Wohlfender, Director of the Swiss Nursing Association in St.Gallen, on 16.06.2022. The most important statements and answers to the questions asked are listed and summarized below:
Challenges and recommendations in the recruitment of nurses and caregivers
The current challenge in recruiting nurses in Switzerland is that there are too few staff. The influx from Germany and Austria is also not as great as it used to be. Very many nurses in Switzerland are leaving their profession, the reasons can only be assumed. Ms Wohlfender assumes that some quit their jobs because traveling is again possible after two years of the pandemic. Due to the shortage of nurses, institutions can no longer cover unpaid leave and as a consequence many nurses quit. But others also leave the profession and change to a completely different sector. Ms Wohlfender sees this as a great loss: “We have to keep at it and try to keep people on the job. On the other hand, many nurses who re-enter the profession work for temporary companies, which Ms Wohlfender considers critical because many nurses are confronted with gaps later in their pensions.
In this regard, the demands of the nursing initiative, which advocates for better working conditions for nurses, are important. This starts with regular duty rosters, better paid Sunday work, shift work and night work. Employers must take care of improvements in this regard, also in their interest. In this context, issues such as pay, social security benefits and development opportunities play an important role. The shortage of nurses makes it easier than ever to re-enter the nursing profession. Any person who wants a job tomorrow will have one within a week. In addition to professional qualifications, it will therefore be increasingly important for employers to see the person behind the application documents.
Caregiver protection
Professional caregivers are protected by certain regulations in Switzerland. This includes that every employee receives a contract where the minimum standard, such as working hours and salary, are recorded. There is also compulsory insurance, such as accident insurance, which must be taken out. Daily sickness benefits, on the other hand, are not compulsory. As an employee, it is worthwhile to study the insurance benefits well. Employers have a duty of care. They are responsible for not overtaxing their employees and for giving them tasks that are appropriate to their skills. Competence-based placement was a demand of the care initiative.
Protection of beneficiaries
The most important thing is that the caregivers have good qualification that enables them to deal specifically with the beneficiaries. This is also a protection against violence. Good care requires clear contracts. If a private person employs a carer, he or she is responsible and has a duty of care towards the person employed. This means that the protection of personal integrity must be guaranteed.
Ensuring the quality of care services
A clear division of roles in the process of care is important. The job or task description must make clear who is responsible for what in a care situation. In this context, competences count, that a caregiver acts only within his/her competences. There are clear guidelines here about what someone is allowed to do and what not. Ms Wohlfender always recommends consulting Spitex when a caregiver is involved in the process, because the employees are trained and work according to their competences. In addition, they notice if something abusive is happening. This would protect both sides. In terms of financing, it is advisable to have the care services provided by Spitex and the care and support provided by a so-called CareGiver.
Differences in the recruitment of nurses between urban and rural areas
There are rural regions where it is challenging to attract people. In Ms Wohlfender’s observation, it is not only the region that keeps nurses away but also the outdated structures or institutions where smooth processes are not possible due to the lack of infrastructure, e.g. lack of PCs. Ms Wohlfender pleads for making rural regions more attractive through flexible work-time models. This would be possible, for example, by allowing sportswomen to do sports in the morning or to climb mountains in the afternoon and only start their service afterwards. Ms Wohlfender is critical of rigid duty time models: “Some residents can also have a shower at one o’clock in the afternoon; it doesn’t always have to be at seven in the morning. These are still old processes that could be broken up.” This would benefit both the residents and the caregivers. Ms Wohlfender also emphasizes that working mothers could be better integrated in this way.
What kind of support can be provided by local authorities? And what legal requirements are needed to support cooperation between authorities and NGOs?
According to Ms Wohlfender, clearer regulations are needed for care, support and social assistance in the home setting through the introduction of standard employment contracts. There is a standard employment contract for domestic workers that still needs to be optimised, as she sees that it currently allows precarious working conditions, such as exceeding maximum working hours in the context of 24-hour care. If domestic workers stand up for fair working conditions and wages, politicians fear that institutionalisation will still be considered as an alternative. For the state, this would result in additional costs for long-term inpatient care.
In addition, she also sees a need for better framework conditions for working parents, such as affordable day-care centres, childcare places and day schools. She also suggests that employers of large institutions introduce in-house day-care centres on site: “You could also offer attractive prices and maybe many women would also work at higher percentages, because the journey to the day-care centre is no longer necessary and if they don’t have the pressure from all around. Many things could be better controlled. The federal government has such support measures for the establishment of day-care centres. I don’t know of any old people’s home in eastern Switzerland with a day care centre.”
How can more people be motivated to participate in aid activities?
Ms Wohlfender emphasises on the one hand that it is important for people to build a social environment even at a fit age, and here she sees politics as having a duty to promote social issues and social space. She also mentions various associations and organisations that offer voluntary work, such as Benevol, the churches’ visiting services, Pro Senecture, etc. She only sees tensions in the voluntary sector when it comes to professional care activities, but not in the social assistance setting.
Do you already have experience with the use of technology for recruitment?
Ms Wohlfender is convinced that there is no way around digital marketing in HR, but she herself has no experience with it yet. With e-log, the professional association SBK has created a tool for this.
Where do you see advantages in digital recruitment from your point of view? What do you see as possibly critical in digital recruitment?
With online applications, Ms Wohlfender sees the advantage in the fact that you can define the profile in advance and eliminate all those who don’t fulfill it. The disadvantage, in her opinion, is that you lose all the people who can only do one part of the job but have good soft skills. In other words, if people with soft skills or specific skills don’t have all the competences of a job, they fall through the cracks. She finds the idea of the app to find someone regionally in the neighbourhood practical because people live much more anonymously today. Ms Wohlfender is critical of the issue of care migration through digital recruitment: “We don’t want people to take staff away from other countries just because we can pay better”. Accordingly, this must be avoided. A country-specific demarcation is therefore important and good. According to Ms Wohlfender, women’s rights and labour law must also be respected in digital recruitment.
What does the HEROES app need to look out for in terms of quality assurance of services and finding suitable care and support staff?
In order to ensure the quality assurance of the app, in her opinion, clearly formulated assignments or job offers are needed that describe exactly what service is expected. You have to look for the right people with the right skills based on the assignment and the needs. There must also be room for personal information, as nursing and care are always relational and hence focus on relationship building. “The definition of the assignment and the corresponding needs must be clear to everyone. This requires a written contract that clearly and bindingly regulates wages, working hours, social benefits, notice period, board and lodging, etc.”
She also suggests asking for a character reference, work references and further references. It is also important to know that in Switzerland only those with tertiary education are allowed to become self-employed. It is important for both clients and employees to know which competences are required for which activities and tasks (see also below under further links). Curaviva has produced a good overview of this.
For this reason, Ms Wohlfender thinks it is very important for foreigners to have their qualifications recognised in Switzerland by the Swiss Red Cross (SRC). When recruiting someone from abroad, Ms Wohlfender recommends that employers obtain the SRC recognition. When recruiting someone from abroad, Ms Wohlfender recommends that employers obtain SRC recognition. This procedure ensures the quality of care and protects against negative surprises.
Could such a platform as HEROES motivate professional nurses to return to their profession (e.g. after maternity/paternity leave or retirement) due to its flexible working time model?
“We must somehow succeed in getting mothers/parents back into work. Not so many drop out completely anymore, most of them continue to work part-time. And we have to remain attractive enough for them to come back. Better pay for shift work, and regulated and flexible shifts. I think that’s the only way to succeed. There must be space in the educational institutions for courses for those re-entering the labour market and also for career changers. The Confederation and the cantons currently provide financial support for re-entry courses.”
Conclusion:
“From that point of view, I can support the project because we have to develop new ideas on how to deal with future demographic conditions and the concurring higher need for care. How do we manage to ensure that the elderly can be cared for? The question also arises as to whether there is a need for alternatives to the current model of long-term care in old people’s and nursing homes. Personally, I would like to be able to live my old age in a self-determined way. A good social environment, a benevolent and supportive community and self-care certainly support staying healthy in old age and caring at home until the end of one’s life”.
Further links:
Überblick über die Kompetenzprofile der unterschiedlichen Ausbildungen in der Pflege
Übersicht heutige und altrechtliche Ausbildungen im Bereich des Gesundheitswesens
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