(WHAT ARE NURSES ALLOWED TO DO? COMPETENCES AND LEGAL RESPONSIBILITIES OF NURSES IN GERMAN HOSPITALS)

Abstract

As nursing becomes more and more important in an eldering society and the shortage of professional nurses becomes bigger nurses in Germany are emancipating themselves. This occasion shall be used to look into the competences of nurses in German hopitals. After presenting some data on nursing in Germany, especially the nurse-patient-ratio, the author drafts an outline of the competences of nurses. In a first step the competences in general are divided into three scopes: one of original competences, one of derived competences and the interdisciplinary one. This division is deduced from the professional codes of conduct for nurses of the four Bundesländer that enacted such codes in combination with the German law on the profession of nursing, soft law and the comparison with other countries. It is important to understand that the German law on the profession of nursing only has an indirect effect on the competences of nurses as they federal government does not have the legislative power to define such competences. As a next step the author then defines the field of activities of every scope. The original competences contain all the activities that can only be conducted by professional nurses, because only these persons do have the necessary knowledge, education and training for such actions. Thus, all those activities that need to be overseen by a physician in order to minimize the risk of harm for the patient are to be defined as derived competences. Moreover - in a third step - the limits of competences are presented. Such limits may be special legislation, e.g. activities that can only be conducted by a physician by law. After a short description of the legal responsibility that can be derived from the division of competences into different scopes the new bill concerning the profession of nursing (Gesetz über den Pflegeberuf) is analyzed. If enacted as proposed there will be a definition of activities that may only conducted by a professional nurse for the first time in German history.