[Developoment of qualifications in German nursing care--results of current data analysis]

Nursing provides a service catering to the needs of the individual and, as such, makes its own contribution towards community health care. Apart from organizational and instrumental determinants, manpower resources are of central significance in this context. The number of staff employed in nursing, their qualifications and competences are all factors which fundamentally influence the quality and efficiency of nursing care. Based on current data, the following article will first describe which manpower resources are available in the individual nursing sectors. It will then articulate as a central theme some of the main problems in professional training at the various levels (general, advanced and further education), including Germany's comparatively new university and college degrees in nursing. The results of our analysis indicate, on the one hand, that there is movement towards an improved professional profile in nursing, which could be classified as optimizing manpower resources. For example, far more than two thirds of all nursing staff and other care workers have completed three-year professional training courses. In addition, nursing trainees overproportionately graduate from junior levels of secondary schools. It may, furthermore, be noted that nursing continues to be in high demand as a vocational profession and that there has been a professional upgrade in particular at the teaching and leadership levels. On the other hand, however, we can make out anti-professional developments which contribute to an impairment of manpower resources in nursing. A comparison of 1996 and 1999 figures shows that the number of qualified staff in the care of the elderly has decreased whereas the number of untrained staff has increased by six times. In spite of heavier work loads there has been no increase in the number of staff and trainees in hospital nursing over the past few years. And, with the introduction of statutory insurance covering ongoing nursing care, various semi-professional trainee programs have emerged, leading to a partial displacement of qualified staff. In conclusion, the authors will reflect on how to overcome such developments and further optimize manpower resources in nursing.