German hospitals are now confronted with major challenges from both shortages and fluctuations in the numbers of physicians and nurses. This makes it even more important that physicians and nurses do not prematurely leave patient care. The objective of the present study was to improve our understanding of the factors that trigger intentions to leave the profession. For this purpose, data from 1060 young physicians and nurses in hospital care were analysed. Intentions to leave the profession was assessed with the Copenhagen Psychosocial Questionnaire (COPSOQ). In the first step, the association was determined between intention to leave the profession and the factors of perceived quality of care and job satisfaction. In a second step, a mediation analysis was performed to determine the effect of perceived quality of care after correction for the possible mediator of job satisfaction. There were statistically significant negative associations between perceived quality of care and intention to leave the profession (beta: −2.9, 95% CI: −4.48-−1.39) and job satisfaction and intention to leave the profession (beta: −0.5, 95% CI: −0.64-−0.44). The effect of perceived quality of care on intention to leave the profession was partially mediated by job satisfaction. Thus, high perceived quality of care and high job satisfaction are both important factors that tend to prevent young physicians and nurses from leaving their professions.for this include overtime, psychosocial stress, burnout, career aspects and particularly, a low level of job satisfaction [2][3][4][5][6]. In order to improve their balance between work and family, some physicians switch to nontherapeutic work or emigrate, in the hope of finding better working conditions in other countries [7].Although the absolute number of all physicians in Germany has been constantly increasing over the years [8], it is still justified to discuss a "relative lack of physicians" or a "lack of medical working hours". The reasons for this include the relatively high number of hospital beds (in comparison with other European countries), the imbalanced distribution between conurbations and rural areas, the fact that many physicians are very highly specialized, and finally the entry of more women into medicine [9]. At the end of 2018, it was found that women made up 47% of physicians registered at the German Medical Association [10]. This proportion is increasing, as is the proportion of female physicians who work part-time.The position was similar for nursing staff. Even during training, 20-30% of trainees were considering not remaining in the profession for more than 5 years [11]. Systematic reviews have proposed a wide variety of reasons that trained nursing staff may consider leaving the profession. These include inadequate earnings, lack of personnel, lack of autonomy and high stress at work [12][13][14]. At the individual level, these factors lead to low job satisfaction, which is also empirically associated with thoughts of leaving the profession [15][16][17][18][19][20][21]....

Der medizinisch-wissenschaftliche Fortschritt sowie der demografische Wandel haben die Bezahlbarkeit von solidarisch finanzierten und hoch entwickelten Gesundheitswesen zu einer großen gesellschaftlichen Herausforderung gemacht. In Deutschland hat diese Entwicklung zu einer Ökonomisierung geführt, welche als entscheidende und viel diskutierte Größe neben die primäre Patientenorientierung in das System getreten ist [1, 2]. Die Autoren M. Raspe und P. Koch teilen sich die Erstautorenschaft. Hinweis zu geschlechterneutraler Sprache Aus Gründen der leichteren Lesbarkeit wird in der vorliegenden Arbeit überwiegend die gewohnte männliche Sprachform verwendet. Dies impliziert jedoch keine Benachteiligung des weiblichen Geschlechts, sondern soll im Sinne der sprachlichen Vereinfachung als geschlechtsneutral zu verstehen sein.

Background: Second victim phenomena (SVP) are critical to workplace and patient safety, and epidemiological data are limited to investigate the causes and impact on German health care. We investigated SVP in German nurses regarding prevalence, causes, and predisposition compared to a preceding study on German physicians (Second Victims in Deutschland/SeViD-I). Methods: We conducted a nationwide anonymous cross-sectional online study in 2020 using a modified SeViD questionnaire including the BFI-10 (personality traits). Statistical analysis was conducted using chi² tests and binary logistic regression models. Results: Of 332 nurses, 60% reported to experience SVP at least once a working lifetime, with a 12-month prevalence among SVP of 49%. Of the nurses, 24% reported recovery times of more than 1 year. In contrast to physicians from SeViD-I, a main cause for becoming a second victim was aggressive behavior by patients. High neuroticism values, higher age, and medium work life experience, but neither gender nor workplace position, were predisposing for SVP. Like SeViD-I, nurses reported demand for an institutional response in cases of SVP. Conclusions: SVP is common among German nurses and comprises other causes and a different course than in physicians. Further research should concentrate on specific prevention strategies, e.g., profession- and workplace-based educational programs.

Background Post-stroke delirium (POD) in patients on stroke units (SU) is associated with an increased risk for complications and poorer clinical outcome. The objective was to reduce the severity of POD by implementing an interprofessional delirium-management. Methods Multicentric quality-improvement project on five SU implementing a delirium-management with pre/post-comparison. Primary outcome was severity of POD, assessed with the Nursing Delirium Screening Scale (Nu-DESC). Secondary outcome parameters were POD incidence, duration, modified Rankin Scale (mRS), length of stay in SU and hospital, mortality, and others. Results Out of a total of 799 patients, 59.4% (n = 475) could be included with 9.5% (n = 45) being delirious. Implementation of a delirium-management led to reduced POD severity; Nu-DESC median: pre: 3.5 (interquartile range 2.6–4.7) vs. post 3.0 (2.2–4.0), albeit not significant (p = 0.154). Other outcome parameters were not meaningful different. In the post-period, delirium-management could be delivered to 75% (n = 18) of delirious patients, and only 24 (53.3%) of delirious patients required pharmacological treatments. Patients with a more severe stroke and POD remained on their disability levels, compared to similar affected, non-delirious patients who improved. Conclusions Implementation of delirium-management on SU is feasible and can be delivered to most patients, but with limited effects. Nursing interventions as first choice could be delivered to the majority of patients, and only the half required pharmacological treatments. Delirium-management may lead to reduced severity of POD but had only partial effects on duration of POD or length of stay. POD hampers rehabilitation, especially in patients with more severe stroke. Registry DRKS, DRKS00021436. Registered 04/17/2020, www.drks.de/DRKS00021436.