On June 1, a beautiful Sunday evening, a frightening incident occurred at Nuremberg, Germany’s North Hospital (Nordklinikum): a 19-year-old patient was injured by police gunfire in the clinic’s psychiatric ward.
A Nuremberg police patrol had just brought in a man when the uninvolved young patient threw a fit due to the presence of the uniformed officers. A police officer then shot the 19-year-old, seriously injuring him. He allegedly threatened the police with a broken glass bottle, according to the police report, which was uncritically reported by all the media.
The incident caused great unrest among us nursing staff: What does it mean for both patients and nursing staff when police officers simply shoot in psychiatric wards?
The Nursing Action Committee states: The responsibility for the escalating violence does not lie with the patients and certainly not with the nursing staff. The blame for an escalation like the one in Nuremberg lies solely with the politicians at federal and state level who are responsible for the ongoing crisis in nursing.
The dramatic incident is an expression of a healthcare system that has already collapsed and is being further destroyed by deliberate policy. The Merz government’s new war budget is being debated in the Bundestag (the German Congress): It provides for billions for war and armament of the state. This will inevitably result in cuts to social spending, including health.
It is clear that a radical cutback in healthcare will lead to ever more people with mental health problems suffering breakdowns. The state is responding with repressive force: on July 6, Gerald Gass, head of the DKV hospital association, called for zero tolerance and “harsh penalties” for assaults on nursing staff. Gaß told Deutschlandfunk radio that the state must ensure that violence is not tolerated “despite excessive waiting times in the emergency room and complicated processes in hospitals.”
However, this only exacerbates the explosive issue of safety in psychiatric wards. It has long been known that patients in crisis can react aggressively towards nursing staff, fellow patients or themselves. According to the Nürnberger Nachrichten, there are around 30 documented attacks on staff every month in the hospital in question alone. This is an alarming signal that underscores the acute crisis in nursing and the shortage of trained nursing staff. The basic rule is: the fewer staff in psychiatry, the more violence.
In fact, the state has clear guidelines regarding patient safety and the protection of nursing staff. Specialists receive training in multiple disciplines in order to de-escalate dicey situations and ensure that patients do not endanger themselves or others. In a psychiatric ward, such therapeutically trained specialist staff must be present around the clock.
However, our reality reveals a very different picture: more than half of all psychiatric facilities in Germany do not meet the minimum requirements. This was documented two years ago by the responsible Institute for Quality Assurance and Transparency in Healthcare (IQTIG). According to this report, around 51 percent of adult psychiatric clinics and as many as 56 percent of child and adolescent psychiatric clinics had too few therapeutically trained specialists in 2023. And the situation has only worsened since then, with more and more psychiatric clinics complaining of a lack of continuously present, trained security staff.
At the Nuremberg Clinic, the security concept was fundamentally changed just a few months ago. A private security service now only visits sporadically, for a few minutes once per shift, and is on call if not otherwise engaged. In a branch where mentally ill people are in acute crisis, this is an untenable situation.
Both the nursing staff and the patients themselves suffer from the staff shortages, uncertainty and time pressure. Many patients are suffering exceptional psychological situations; they are traumatized, frightened or even suicidal. They need protection, peace and quiet, and human attention—but not a ward that is so understaffed that escalations are almost inevitable. Those who rely on de-escalation must first have conditions under which de-escalation is even possible.
The hospital management claims that they would like to provide more security but cannot afford it. That is cynical: while employees are under pressure and at risk, budgets are distributed according to business “efficiency” and not actual need. This shows once again how sick the system itself is. Health is becoming a commodity, care a cost factor and safety a luxury.
But safety is not an optional item. The Nursing Action Committee demands:
· Immediate introduction of continuously present, therapeutically trained security staff on psychiatric wards
· Massive investment in increased staff, better working conditions and fair pay, financed by financial redistribution from top to bottom and not paid for by workers. €500 billion for care instead of for armaments and war
· Abolition of the flat rate system and profit orientation in the healthcare sector. Hospitals do not belong under the logic of the market, rather under the democratic purview of the workers.
· Full control over working and safety conditions by democratically elected workers’ committees. Build action committees in all workplaces as part of the International Workers’ Alliance of Rank-and-File Committees (IWA-RFC)
The situation in psychiatry is not an isolated case. It is the direct result of a system that does not aspire to heal, but rather to profit. The shooting in Nuremberg was a tragic occurrence, but is only a symptom: The cause is a healthcare system in the stranglehold of capitalist interests.
The representative service union Verdi offers no solution. Rather, it is part of the system. Its leadership explicitly supports the war policy of the ruling coalition between the Christian Democrats (CDU/CSU) and Social Democrats (SPD). With Verdi, we run up against a wall: instead of real improvements, we get empty promises. The collective agreement that they recently imposed upon us has locked in for years to come the ongoing state of emergency. But what use are such negotiations and pseudo-“labor disputes” if they only lead to rotten compromises with the war policy that dominates everything? Our reality is characterized by flat rates per case, privatization, and pressure to cut costs as a result of the so-called “debt brake” and real wage cuts.
It is high time to organize, not just for better wages, but for the abolition of capitalism and the establishment of a socialist system that puts people and humanity front and center, not profits. We workers must have democratic power over the working conditions and decisions we face every day.
Health is a human right, not a commodity. And safety is not a bargaining chip, but a basic condition for dignified work and care. To deny our safety today is to endanger our lives tomorrow.
Join the fight to build Rank-and-File Committees. Send a WhatsApp message to the mobile number +49 163-3378 340 or register right here using the form below.