Picture Series
Patricia Kühfuss Nicht müde werden
Peter H. prepares a room for a patient returning from surgery. The staffing crisis in German hospitals has been steadily worsening for years. According to a recent survey, four out of five hospitals have problems filling vacant nursing positions. Audio: Jennifer G., Nurse
A nurse prepares a ventilator for a patient. Because medical devices are subject to constant further development, nurses are required to keep learning. It is possible for one station to have four different models of the same machine. Correctly setting and adapting the devices to each patient’s condition takes extensive experience and specialised knowledge. Germany is the only country in Europe that does not require post-secondary study for prospective nurses. Audio: Anna W., Nurse
The administration of drugs is documented late in the night; here, it is still analog. The data entries must be accurate; this is vital for the patients. As there is often no time to complete this task until two o’clock in the morning, the nurses check each other’s entries. (Note: To protect patient privacy, the data at lower right have been pixellated.) Audio: Thorid G., Nurse
Two nurses turn a patient onto her side to assess the condition of a bedsore bandage. Bedsores are wounds that appear when patients lie too long in one position. As part of their training, nurses experience just how great the discomfort is even after ten minutes of lying absolutely still. However, they are often so overworked that they can shift patients only once during a ten-hour shift. Audio: Jennifer G., Nurse
During his night shift, Michael B. tends a patient. He has worked in the intensive care unit for more than ten years. His experience makes him an important member of the team, for many of the other members are still young. He has also worked as a nurse in the USA and misses the strict division of labour that means nurses can fully concentrate on their tasks. Audio: Anna W., Nurse
In the morning, a nurse sets out breakfast for a patient who is no longer able to do it himself. In care, help with routine matters is just as indispensable as quick response times in emergencies. However, as these things count as classic care tasks historically understood both as a matter of course and as women’s work, unlike the work performed by doctors, they go without adequate recognition. Audio: Thorid G., Nurse
An elderly patient helps bandage his own hand. In elder care, as in nursing, it is important to involve elderly people in routine activities in order to keep them mobile and active. Because this can make some things take longer, many nurses relieve the patients of these tasks, which often leads to a deterioration in their condition. Audio: Anna W., Nurse
Hanna M., who is undergoing a year of voluntary social service (FSJ), selects drugs from the medicine cabinet. Because pharmaceutical companies often switch or discontinue drugs, care workers must constantly learn about new compounds and be able to allocate them quickly. This works only with great concentration. Although interns, volunteers and trainees are actually at the station to learn and support the real team, they must often do the work of regular employees. Many become overwhelmed by the amount of work and responsibility and decide to take up a different profession. There is a drastic shortage of new nurses, which makes things even worse for the healthcare situation. According to studies, by 2025 the healthcare system will no longer be able to meet its need for specialised workers. Audio: Thorid G., Nurse
Jennifer G., Susanne M. and Jana S. (l. to r.) have a discussion during the night shift. Although many nurses are dissatisfied with their working situation, there is no other professional group with so few unionised members. Being unable to unite them to strike for better working conditions is difficult. Many nurses fear that if they were to stand up for their own interests, the patients would pay the price. Audio: Jennifer G., Nurse
On the night of the first of May, a patient feels very unwell. A nurse speaks reassuringly to him and wipes the sweat from his back. In the face of the insecurity experienced by many patients who suddenly become ill, mental support is just as important to recovery as medical care. But there is seldom enough time for this. Audio: Thorid G., Nurse
A nurse calms a demented patient who is convinced that he must leave the hospital and has already got out of bed several times. It takes time and patience to treat patients, who are often confused, with empathy. Some nurses reach their limits, then the patients must suffer from their irritability. Audio: Anna W., Nurse
Thorid G., 27, records nursing activity and a patient’s values during the night shift. She has again jumped in for a sick colleague, although she has already worked several nights in a row. She has two small children. Over the past few years, the amount of paperwork has increased significantly: hospitals can charge health-insurance companies only for services that have been documented. Audio: Thorid G., Nurse
A nurse has found a patient having a heart attack in his sickbed and tries to resuscitate him until the CPR team arrives. As nurses spend the most time with patients, the lives of these patients often depend on their skills and attention. When one nurse must tend to 40 patients on her own, fatalities are not discovered until the following morning. Audio: Jennifer G., Nurse
Jennifer G., 27, assesses the condition of a patient who is not doing well. Jennifer has worked in the intensive care unit for three years and describes the beginning of her career as a intimidating experience. “There is a great responsibility towards the patients, and every decision has consequences, some of which can be observed live on the surveillance monitor. Sometimes, you can’t counteract them right away.” However, it is always better to make a poor decision than none at all. Because of the shortage of staff, new nurses must sometimes work in intensive care without supervision after one to three months. Ten years ago, hospitals planned for a one-year induction phase. Audio: Jennifer G., Nurse
A nurse holds the infusion-pump cable while a patient is washed. The doctor prescribes the drugs, but when needed, the dose is adapted by the nurses. They know about effects and interactions. Audio: Anna W., Nurse
During the night shift, a nurse washes a patient. The public debate about the nursing crisis started in Germany after nurse Alexander Jorde appeared on a talk show and asked Chancellor Angela Merkel how it was possible that “in a country like Germany, people have to lie for hours in their excrement”. Many nurses report that with their workload, they can neither fulfil the increasing number of tasks nor meet their own standards. Audio: Anna W. and Jennifer G., Nurses
Irina G. at the station after a patient there did not survive resuscitation attempts. Audio: Anna W., Nurse
A nurse enters data documenting care procedures into the computer. She is wearing a glove, which represents a risk, as this can transmit germs. But in the constant back-and-forth between patient and documentation, time pressure can make it difficult to maintain hygiene standards. Audio: Jennifer G., Nurse
In order to avoid transmitting resistant germs, a nurse may enter the sickroom of an infected patient only if wearing a waterproof protective smock. This adds to the time needed for care. One-to-one care should not be a luxury, particularly in intensive care. Audio: Thorid G., Nurse
Jana S. during a night-shift break. The shortage of staff in hospitals is sometimes so great that employees are called back from their holidays. Jumping in at short notice is a daily occurrence. For a job that is not only physically challenging, but mentally as well, it is vital for staff to have enough time to restore their strength. Audio: Thorid G., Nurse
The work carried out by healthcare practitioners is of great value to society; however, their working conditions do not reflect this. Financial requirements determine the daily routine; carers must look after more and more patients in less and less time. In a system that measures every action with money, no one considers that good care takes specialist knowledge and, above all, time. Healthcare work is a highly complex profession that requires technical, medical and interpersonal competence. It is difficult to depict this work on the visual level, for care touches people’s private space and questions the limits to what can be shown. Therefore, the media often serve up a symbolic image of a care worker pushing a bed, and the true achievements behind care work remain invisible. Patricia Kühfuss’ photographs direct our view to the people who reach the limits of their capacity in looking after others. They show the real, day-to-day working lives of healthcare workers in German hospitals.
For the presentation of the digital Lumix Festival 2020, curators Jonas Dengler and Kai Nolda, together with photographer Patricia Kühfuss, interviewed health and nursing professionals Thorid G., Jennifer G. and Anna W. about the images of the photographic work. You can hear excerpts from this conversation via the audio tracks below the pictures.
- Everyday Life
- Germany
- The Future
- Work
*1988 in Oberndorf am Neckar, Germany
Patricia Kühfuss studied Photojournalism and Documentary Photography at Hanover University of Applied Sciences and Arts and the Danish School of Media and Journalism in Aarhus until 2018. Since then, she has been working as a freelance photographer and is represented by the laif agency. She received the VG Bild-Kunst scholarship in 2019 and took second place at the Sony World Photo Award in 2018. Her work has been published in Frankfurter Allgemeine Zeitung, GEO, National Geographic US and ZEIT Magazin.
