Four years after Swiss voters overwhelmingly approved an initiative to improve working conditions in the nursing sector, thousands of healthcare professionals are set to gather in Bern this Saturday. Citing frustration over delayed implementation and worsening staff shortages, nurses and their unions are calling for immediate government action.
The demonstration highlights a growing crisis in the nation's healthcare system, where burnout and high turnover rates threaten the quality of patient care. Organizers warn that without significant progress on the reforms promised in 2021, more disruptive industrial action, including strikes, could become unavoidable.
Key Takeaways
- Nursing staff are holding a national demonstration in Bern to protest delays in implementing the 2021 Nursing Care Initiative.
- Only the training-focused first part of the initiative is active; crucial improvements to working conditions have stalled in parliament.
- The proposed changes could cost up to 2 billion Swiss francs annually, a figure that has become a major point of contention.
- Switzerland faces a severe nursing shortage, with over 8,600 open positions and a staff turnover rate that has increased by nearly 30% in a decade.
A Promise Unfulfilled
In November 2021, at the height of the COVID-19 pandemic, 61% of Swiss voters cast their ballots in favor of the Nursing Care Initiative. The result was seen as a powerful public mandate to address the systemic issues plaguing the profession. However, the initial optimism has since faded into deep frustration.
The initiative was designed in two parts. The first, an educational offensive, is already underway. It allocates one billion Swiss francs to support student nurses and allows experienced professionals to bill certain services directly to health insurance providers. But the second, more critical part—aimed at improving daily working conditions—remains stuck in political debate.
A proposal from the Federal Council has been sitting with the National Council's Health Committee for over six months, with debates largely centered on the financial implications.
What the Federal Council Proposed
The government's plan includes several measures to ease the burden on nursing staff. Key proposals include:
- Reducing the maximum weekly working hours from 50 to 45.
- Requiring employers to provide work schedules at least four weeks in advance.
- Mandating financial compensation for last-minute changes to shift plans.
- Obligating social partners to negotiate for better collective labor agreements.
However, the proposal does not include a core demand of the initiative: legally binding staff-to-patient ratios, which advocates say are essential for ensuring patient safety.
The High Cost of Inaction
The proposed improvements come with a significant price tag, estimated at up to 2 billion Swiss francs per year. Employers, including hospitals, care homes, and home-care organizations, argue that their financial situations are already extremely strained and that they cannot absorb these additional costs under current tariff structures.
The National Council's committee is now exploring various financing models, from federal and cantonal subsidies to increased tariffs, which could lead to higher health insurance premiums for the public.
"The most expensive option is to do nothing," stated Yvonne Ribi, managing director of the Swiss Professional Association of Nurses (SBK). "We can't afford to invest in a training offensive only to watch those highly skilled professionals leave the job because of unbearable conditions."
Ribi argues that the Federal Council's failure to propose a clear financing plan is negligent. If institutions are forced to fund these changes without additional support, she warns it will only intensify the pressure on an already exhausted workforce.
Switzerland's Nursing Crisis by the Numbers
- 8,600+ open nursing positions nationwide.
- 40% of nurses leave the profession before reaching retirement age.
- The average career span for a nurse is just 14 years.
- Staff turnover has risen by nearly 30% between 2013 and 2023.
- One in four nursing professionals change jobs within a single year.
Voices from the Front Lines
For those working in the field, the delays are not just a matter of policy but a daily reality. Sandra Schmied, a nurse at a care home in the canton of Bern, plans to attend the protest. "The number and complexity of care-dependent residents are increasing, but many nurses are burnt out and quitting," she explained. "The slow implementation of this initiative is only making the nursing shortage worse."
Friederike Flückiger, who works at the university hospital in Lausanne, shares this sentiment. She feels conditions have deteriorated since the initiative was passed.
"The staff is at its breaking point," Flückiger said. "I am disappointed and angry with the Federal Council for not presenting any effective improvements." She added that she would not rule out supporting strike preparations "if it comes to that."
A Growing Reliance on Foreign Professionals
The staffing crisis has made Switzerland heavily dependent on healthcare workers from abroad. Data from the Swiss Health Observatory reveals the extent of this reliance. Across the country, 30% of nursing staff in hospitals and care homes hold a foreign diploma.
The figure is even more pronounced in certain regions. In French-speaking Switzerland and Ticino, nearly half of all nursing professionals were trained outside the country.
While this influx of skilled labor has helped fill critical gaps, experts warn that it is not a sustainable solution to a domestic workforce crisis. Advocates for the initiative argue that the only long-term answer is to create a working environment that retains the talent Switzerland trains.
As thousands prepare to march in Bern, their message is clear: the time for debate is over. They are demanding that politicians honor the will of the people and take decisive action to save a profession that is vital to the health of the nation.