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The nursing and health scientist Iren Bischofberger was significantly involved in the establishment and expansion of the Careum Hochschule Gesundheit. On the one hand, she set up the research and development program «work & care – reconciling work and care for family members» with her interdisciplinary team. On the other hand, she managed from 2009 to 2019 the Master of Science in Nursing, which is offered part-time with concentration on either «applied research» or «clinical excellence».

Interview: Josef Kälin, Ursula Reis

For more than ten years you have been in charge of the research and development program «work & care», which in recent years has met with a great response not only in health care but also from the media and politics. What are your most important findings and how can they be put into practice?

Iren Bischofberger: We started 2006 on the white paper. In September 2019, the National Council passed the federal law «Verbesserung der Vereinbarkeit von Erwerbstätigkeit und Angehörigenbetreuung». When I wrote the first research proposal in 2006, I would not have expected such a response. We received funding from the Swiss National Science Foundation and were soon supported by a number of human resource departments, equality offices, employers, unions, health organizations – and of course by affected caregivers. In all those organizations, there are people who have to balance work and caregiving.

We know today from repeated studies (1) that between ten and fifteen percent of the employees in Switzerland have caregiving responsibilities. The health care sector is challenged several times: firstly, as employer of health care professionals who are also caregivers in their families (so-called «double-duty caregivers») and secondly, as service provider dealing with relatives who have to keep up with working hours and have limited time for their relatives. In addition, employees and patients increasingly live far apart, especially in the health care professions, where about one third of the staff consists of immigrants. Video calls and electronic patient files can make it easier for all relatives, independent of their employment status, to take part in the care of their loved ones (so-called «distance caregiving»). There is still a lot to do.

As a University of Applied Sciences, we want to deliver practical outcomes for citizens. We cooperated with other institutions and chose a variety of communication channels. Bank Cler and the Swiss Alzheimer’s Association were our first partners. Over the years, we have created websites, brochures, blogs, lectures, publications, posters and explanatory videos. I would particularly like to highlight the website www.info-workcare.ch. Travail Suisse developed it together with a group of experts.

You know both sides: You have worked as a nurse in hospitals for many years and are now doing research and teach at university level. What ist the value of nursing science for a nurse’s everyday work?

Iren Bischofberger: Studying broaden your horizons. Knowledge of research and literature from all over the world complements local experience. At the same time, a university degree will sharpen a nurses’ awareness of current health problems, train her or him to recognize connections quickly, think systemically and work with data support. All these skills are becoming increasingly important in healthcare, both in clinical work and in management positions, in nursing education and in committee work. On the website of the Swiss Association for Nursing Sciences, there are constantly vacancies published.

Patients with a wide range of diagnoses and therapies benefit most from qualified nurses with an MSc in nursing. For example, one of our part-time master’s students has acquired knowledge of polypharmacy. She noticed an overmedication of a substance with a patient who was transferred from intensive care. She discussed this observation with the senior doctor and they adapted the therapy. A few days later, the patient was better. Nursing experts with a master’s degree are now increasingly working in patient-oriented roles according to the motto “patients first”. This is an important development. In the last 20 years, nurses with academic background were mainly working in roles removed from the patients, for example in training, quality assurance, expert panels, projects or research.

I am talking to you today on the occasion of the «Year of the Nurse and Midwife» the WHO is proclaiming for the year 2020. What do you think is needed to strengthen nurses and nursing science in Switzerland?

Iren Bischofberger: There are three important points. First, speaking about quality, we need to take the perspective of the users of health services more into account. What is important to them? From their point of view, what works well and what less? Such questions could be, for example: How has your mobility improved at home after a hip operation? How well were you advised about the new drugs? Has the coordination between the different service providers been successful so that everything works out at home? People will realize that their tax and insurance money is not just used for «hardware» (hospitals, nursing homes, medication), but also for «software», as for example for advice, guidance and coordination by nursing staff.

Secondly, people must learn more about treatment and care options outside the hospital, especially at home. That is where people with health problems and their relatives spend most of their time. To make this possible, we need more advice and instruction that suits people’s needs, either on site straight in their living rooms or remote via video calls and e-learning. Such services, however, require a modern reimbursement system. Not just measuring the blood pressure should be paid for, but also advice on dealing with high blood pressure – one of today’s biggest health problems, by the way.

Finally, working conditions in health care are still not family-friendly enough to keep nurses in the workforce and to keep them working high percentages. It is not good enough if we only create additional training places in the health care sector, but do not feel the effect. For a typical female profession – this also applies to midwives – balancing work and family life is important, also for the spouses. According to our research results, it is not sufficient to offer part-time work. We need comprehensive programs to improve work life balance to solve the puzzle.

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

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1. Radvanszky, A., Craviolini, J., & Bischofberger, I. Erwerbstätige mit privaten Pflegeaufgaben am Beispiel zwei schweizerischer Unternehmen. Schweizerische Zeitschrift für Soziologie, 42(3), 543–571.
2. Büro für Arbeits- und Sozialpolitische Studien BASS AG, im Auftrag des Direktionsbereichs Gesundheitspolitik, Abteilung Gesundheitsstrategien, BAG. Massnahmen für eine bessere Vereinbarkeit von Erwerbstätigkeit und Angehörigenbetreuung in Unternehmen der Schweiz. Bern: September 2019.

Further publications by Iren Bischofberger on the website of the Careum Hochschule Gesundheit.