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Iris Ludwig, who holds a degree in nursing and educational science, was a vocational school teacher and expert on nursing didactics for many years. She was instrumental in the introduction of innovative teaching methods such as skills-labs and Problem Based Learning in Switzerland. From 1996 to 2006, she founded and managed the first master’s program in nursing science in Switzerland at the Weiterbildungszentrum für Gesundheitsberufe WE’G in Aarau, which was established in cooperation with the University of Maastricht. Today Iris Ludwig works as a freelance consultant and trainer for health professionals.

Interview: Ursula Reis, Josef Kälin

At the beginning of your career, you published about didactics, the workplace as a place of learning, skills-labs, and so on. Recently you have dealt with topics of intra- and inter-professional cooperation and have published a book on skill and grade mix. How did they get from one to the other?

Iris Ludwig: That is a very fitting description of my development. I was always interested in the teaching of nursing. With the master’s program at the WE’G, we were at a high professional level. It was a great success that we could offer this class. Afterwards I felt like something new. A request to run at a skill- and grade mix project came in handy. I started my own business. Since then I have been dancing at both weddings – on the one hand I still consult on didactics and do trainings, on the other hand I offer advice on skill- and grade mix and intra-professional cooperation.

The book «Wir brauchen sie alle» («We need them all») documents my years of consulting work on skill- and grade mix. It is an overview of what has been done in the various health care institutions. It was important to me that such a book – for me also a substitute for the dissertation, which I never wrote – would be useful for many people in the field. Someone from a home care organization, for example, can find examples on how similar institutions have organized the staffing of employees with different training levels. The findings can help to plan recruitment or to formulate job profiles. There are now sixteen care professions at different levels in Switzerland. It is important for each sector to know what kind of professional mix is needed and how the individual skills can best be used.

As a freelance consultant, you have insight into numerous institutions in the health sector. What is your impression, how satisfied is the nursing staff today with the working conditions?

Iris Ludwig: Nurses working at the bedside are under a lot of pressure. They suffer because of understaffing. At some places, they are affected by cost-cutting measures, which can mean some of their training is not financed. The high fluctuation rate and the short time spent in the job indicate a lack of satisfaction.

However, recent studies on the subject have concluded that the majority of nurses view their situation more positively. I also have experience in Germany and Austria. In comparison, there is more support for continuous training both outside and in the healthcare institutions – also the position of nursing in general is better. I think it is great that in Switzerland there is a demand for highly qualified nurses who work at the bedside. This is more difficult in the other German-speaking countries. Nurses with a master’s degree almost only find jobs in the management or as nursing teachers.

I am talking to you today on the occasion of the “Year of the Nurse and the Midwife”, which the WHO has proclaimed worldwide for the year 2020. You have been dealing with professional policy issues for years. What do you think is needed to strengthen nursing care in Switzerland?

Iris Ludwig: I think we have already achieved a lot. It is now possible to study nursing science at master level. Corresponding roles as nursing specialists are established. There are two educational paths on tertiary level – Höhere Fachschule or bachelor at a university of advances studies. On upper-secondary level, there is the vocational training for health care assistants (Fachfrau/mann Gesundheit, FaGe), which deserves great recognition. The Swiss educational system offers training on many different levels and is not so easy to understand for outsiders. However, it is precisely this differentiated education system that allows making best use of our diversity – if we succeed in sharpening the profiles in the coming years.

We need to improve the position of the FaGe as a separate occupational group. We urgently need them to meet the demand of the health care sector. Yet, it would be a mistake to see the FaGe role only as an intermediate stage to the tertiary education as a nurse, where there is a shortage. FaGe staff needs its own training opportunities so that they can further develop their skills at the work place. I recently moderated a workshop on attractive roles FaGe. Some institutions have already developed very interesting career models.

Our biggest problem in Switzerland is certainly the shortage of skilled professionals on all levels. I believe we could attract more people if we made vocational training more flexible for adults with a different background who would like to start a new career in nursing. Today, the rules are relatively rigid, long internships and a lot of school attendance is required. We are still a long way from exploiting the potential of all “care sensitive” people in society.

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Ursula Reis and Josef Kälin are subject specialists in the Main Library – Medicine Careum

Selected Publications:

Ludwig, Iris. (2015). Wir brauchen sie alle – Pflege benötigt Differenzierung = Soins et accompagnement – une diversité nécessaire des métiers. Nidda: Hpsmedia.

Ludwig, Iris und Schäfer, Monika (2011). Die Differenzierung beruflicher Funktionen in der Pflege als Herausforderung und Chance. In: Käppeli, Silvia (Hrsg.). Pflegewissenschaft in der Praxis: Eine kritische Reflexion (Pflegewissenschaft). Bern: Huber, S. 24-41.

Ludwig, Iris (et al) (2007). Der richtige Mix bringt’s! Handbuch für Projekte zu Skill- und Grademix im Bereich Pflege und Betreuung. Basel: OdA Gesundheit beider Basel.

Ludwig, Iris. (2006). Studieren geht über Probieren: Pflegewissenschaft und Pflegeentwicklung in der Schweiz: Jubiläumssschrift des Master in Nursing Science WE’G Aarau, CH [und] Universität Maastricht, NL. Hungen: Hpsmedia.

Ludwig, Iris. (2004). Das Skillslab im Lichte aktueller Entwicklungen im Bereich Pflege und Betreuung der Schweiz. In: Ludwig Iris (et al. Hrsg.) Pflege lehren und lernen: Pädagogische und fachdidaktische Impulse zur Ausbildung im Gesundheitswesen (Pädagogik). Bern: Hep-Verl.

Jürg Brühlmann, Iris Ludwig, Renate Schwarz Govaers (2000). Der Arbeitsort als Lernort in der Ausbildung für Pflegeberufe (Vol. Bd. 8, Pädagogik bei Sauerländer. Dokumentation und Materialien). Aarau: Sauerländer.

Ludwig, Iris. (1994). Berufsbildungsmodell “Pflege” : Vom Arbeitsort zum Lernort. Aarau: Verlag der Kaderschule für die Krankenpflege.