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Nurse on the cruise ship Germany

The terms nurse or nurse are  used synonymously in German-speaking countries - sometimes shortened to nurse and sister - as a general job title for people who practice a health profession or a part-academic medical profession in the health care system . In Germany they are protected job titles of regulated professions .

The basis for the profession is training in health and nursing . The various training laws for nursing professions in Germany, Austria and Switzerland each provide for new protected job titles, whereby in Germany the old job titles nurse and nurse are still protected, but can be exchanged for the new ones. A further change is planned by law from 2023.

On the concept of the nurse

Nurses with and without state recognition of their vocational training are often addressed as "sister", but this address is not an official job title, but an outdated, traditionally from the address of members of religious communities, nuns / religious sisters or deaconesses , as sister ( English sister , Latin soror ) originated. The form of address and the self-designation as a nurse is a legally protected professional title in Germany since 1953. They are not allowed to be used by caregivers or employed caregivers without the corresponding completed training .

Some dates on the formation of a "worldly" nursing

The following data represent the historical development of the nursing activities of sisters and carers, who initially worked almost exclusively in church services (nursing orders), via an employment model of wage keepers or celibate nurses tied to a parent company, to non-organized workers in one Service society .

Church mother houses, whose “sisters” were not or are not all active in nursing, have in the course of the years partly become hospital operators , to which in some cases even senior doctors subordinated themselves as employees. These mother houses exercised care as a form of charity and as an opportunity to convert people without religion. In addition to these church-based care communities, the so-called wage waiting system resulted in paid care activities for the first time. In the 19th century, patriotic women's associations emerged as secular organizations, particularly for care during war. The best-known groups are among them the Red Cross sororities (in Germany since 1882) and since the beginning of the 20th century the Agnes-Karll-Verband (since 1903).

The turning point in English society, given here as 1860, is striking. The Nightingale training model provides for nursing schools that are only attached to hospitals for training purposes. It spread in the Anglo-American region and Scandinavian countries, but was not recognized in Germany, as the idea of ​​care as an expression of charity prevailed, which hindered the development of a professional self-image.

  • 1782: Franz Anton Mai founds the first German nursing school in Mannheim, which was soon incorporated into the University of Heidelberg as the "High School" and existed until 1806.
  • 1859: The Ecole La Source is founded as the first secular nursing school in Lausanne. It is now a center for the history of nursing . In addition, she is involved in the research and development of the profession. The sponsor is the Swiss Red Cross ; the founder, Valérie de Gasparin , explicitly opposes the parent company system.
  • 1860: The Nightingale School of Nursing opens in London with 15 female students between the ages of 25 and 35 at St. Thomas' Hospital (London).
  • 1885: The Viktoriahaus nursing school is founded in Berlin (Crown Princess Viktoria). It was at the Friedrichshain Hospital. The nurses from here were called Victoria Sisters and trained according to the English model for hospital service, especially for poor and large families.
  • 1899: British nurse and matron Ethel Bedford Fenwick founds the International Council of Nurses (ICN).
  • 1903: Agnes Karll founds the first German professional organization for nursing. A three-year training according to legal requirements and state examination was required.
  • From 1906: The "Regulations on the State Examination of Nurses" are introduced, and in future the nurses will take state examinations after one year of training. Based on the regulations of Prussia, the individual states follow at different times: Württemberg, Hessen and Lippe 1908, Saxony and Bremen 1909, Mecklenburg-Schwerin 1915, Baden 1919, Hamburg 1921, Thuringia 1922, Bavaria 1924. The regulations for general nursing do not apply to so-called insane care. Here the status was retained that the individual directors held more or less lessons depending on their discretion.
  • 1925: The first training guidelines for nurses are issued in Switzerland (Bern)
  • 1938: Law on the Order of Nursing in the German Reich; the duration of the training is one and a half years with a subsequent year of recognition. Theoretical lessons are 200 hours.
  • 1953: First Nursing Law in the FRG; special designation of men in this training occupation is protected by law.
  • 1957: The duration of training in Germany is increased to two years; the theoretical lesson comprises 400 hours.
  • 1965: The duration of training in Germany is increased to three years; theoretical lessons are increased to 1200 hours.
  • 1985: The guidelines required by the European Union are implemented in Germany with the law on professions in nursing. Theoretical lessons are now 1600 hours.
  • 2004: With the 4th Nursing Act, the new protected job titles health and nurses or health and child nurses are introduced in Germany for trained nurses . The legal protection of the previous job titles is not removed, the nurses, nurses, pediatric nurses and nurses trained according to the third KrpflG of 1985 can either continue to use the previous job title or use the new one.

Current training in nursing

The training, like the exact job titles, is regulated differently by national law:

  • Germany: Nursing and nurse since 2004 . Nursing staff who completed their training before 2004 may optionally continue to use the original and still protected professional title of nurse or nurse . From January 1, 2020, the job title is nursing specialist. In any case, the prerequisite is completed vocational training and a corresponding professional permit.
  • Austria: Qualified health and nurse (at school or as a university of applied sciences degree) (general name: qualified nurse )
  • Switzerland, Liechtenstein: Nursing specialist (since 2004) or FA SRK nurse
  • United States (USA): Training to become a Registered Nurse (RN) usually takes place as a nursing course at universities and colleges. In order to be able to work in a certain US state, you have to apply for a license there and usually take a further exam ( National Council Licensure EXamination-Registered Nurse ; NCLEX-RN).

Since 2016, transnational recognition has been taking place in the EU using the European Professional Card .


According to the figures available, professional care is a typical female occupation . In 2007, 638,787 people in Germany were employed as health and nursing staff subject to social security contributions. The quota of women was 86.3 percent (13.7% men). While the number of employees under 25 years of age fell from 8.0% to 6.0% between 1999 and 2007 and that of those between 25 and 35 years of age fell by 9 percentage points to 23.4% in the same period meanwhile more than half of the nurses 35 to 50 years old. The group of carers over 50 years of age increased from 12.2% to 20.6% between 1999 and 2007.

Personnel assessment in an international comparison

According to a study from 2017, the ratio of the number of nurses to the number of patients is an important indicator of both the quality of care and working conditions. Therefore, in some states there are legal requirements or collective bargaining agreements for staffing in nursing, especially in the USA and Australia. The quotas depend, among other things, on the respective level of care. The personnel keys applicable in Japan, South Korea, Taiwan and Belgium are based on so-called nurse-to-bed ratios , which are based on the ratio of staff positions to the average number of beds. However, the average values ​​said little about the actually available staff and the bed occupancy at a certain point in time.

According to the international comparative nursing study RN4CAST from 2012, there are an average of 5.3 patients per nurse in the USA, seven in the Netherlands, 7.7 in Sweden, 7.9 in Switzerland and 13 in Germany.


  • Ruth Elster: The Agnes Karll Association and its influence on the development of nursing in Germany. A contribution to the history of the nursing professions and a professional association. Frankfurt / Main 2000.
  • Marion Kaster: Development of care to a profession. In: Basics of occupational care. Published by Annette Lauber, Thieme, Stuttgart 2012. ISBN 978-3-13-127243-0
  • Ilse Schulz: Sisters, Beguines, Masters. Hygieia's Christian Daughters in a City Healthcare. A contribution to the history of nursing and medicine. Ulm 1992.
  • Elisabeth Seidl: Nursing in Transition. The social environment of care and its historical roots presented on the basis of an empirical study. Vienna, Munich, Bern 1993.
  • Ludger Tewes : Red Cross Nurses Your assignment in the mobile medical service of the Wehrmacht 1939-1945. Paderborn 2016. ISBN 978-3-506-78257-1 . [Nurses / paramedics / doctors p. 271–287]

Web links

Wiktionary: Nurse  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. Jonathan Gawlitta, René A Bostelaar: From for "Sister Anja". University of Cologne Clinic is investigating how to use name tags. In: Die Sister / Der Pfleger , 44, 11/2005 pp. 890–893, Bibliomed.
  2. Sigrid Schmidt-Meinecke: The call of the hour. Sisters under the Red Cross. Association of superiors in the German Red Cross. Kohlhammer, Stuttgart 1963, pp. 16-17.
  3. Marion Kaster: Development of care to the profession. In: Basics of occupational care. Edited by Annette Lauber. Thieme, Stuttgart 2012, pp. 42–49
  4. Marion Kaster: Development of care to the profession. In: Basics of occupational care. Edited by Annette Lauber. Thieme, Stuttgart 2012, pp. 52 and 26
  5. 1859 - Naissance de l'École La Source. ; accessed on February 19, 2019
  6. Bill a. Reason. (PDF) The term child nurse was expressly not intended at the time. For the first time, there were protected job titles - but no protected activities for this group of people.
  7. § 1 of the Nursing Professions Act of July 17, 2017 ( Federal Law Gazette I p. 2581, 2582 ), see also the Nursing Professions Training and Examinations Ordinance of October 2, 2018 ( BGBl. I p. 1572 )
  8. ↑ Job information system - qualified health and nurse. In: Retrieved October 26, 2017 .
  9. , accessed on July 30, 2015
  10. The information is published by the Federal Employment Agency : Berufe im Spiegel der Statistik 1999–2007 . ( Memento of the original from February 5, 2006 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot /
  11. Michael Simon, Sandra Mehmecke: Nurse-to-Patient Ratios: An international overview of state requirements for a minimum staffing in the nursing service in hospitals. Working paper of the research funding of the Hans Böckler Foundation No. 27, February 2017.
  12. Personnel key in nursing: Other countries are showing the way. Ärzteblatt, February 9, 2017; accessed on March 23, 2020.
  13. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ 2012; 344: e1717; March 2012; accessed on March 23, 2020.