We document a speech by an apprentice care worker held at a recent ‘Walk of Care’ in Berlin. The ‘Walk of Care’ emerged out of a series of meetings of health and care workers in Berlin. For several years now, they have been organising regular protests against shortcomings in the care sector. This year the protests were joined by midwives, physios, critical medical students and patients. Amongst other things, they demanded a general and free health service that meets the needs of the patients, a 30-hour week for health workers, and a living wage for relatives and friends who care for their next of kin. Berlin has a vibrant scene of health workers and patients who have supported each other in recent struggles.

“As healthcare professionals, we work for and with people to promote and restore health and, in the case of chronic or fatal illnesses, to relieve pain and suffering. But when the system is geared toward profit maximisation, this unfortunately gets in the way of our aims. In this case we are just supposed to restore people’s labour power (meaning,  the physical and mental minimum to go to work) or, if their ability to work has been exhausted, to accompany them to death.

An economic system that is geared towards the maximisation of profits has no interest in caring for people: it seeks efficiency. An economic system focused on making more and more money creates jobs in which the interests of the workers are always worth less than the profit that can be made from them. Profit has always come before human lives, and we experience that very directly.

We experience the importance of our work for patients and the community. But we currently cannot influence the wider conditions of our labour. Nursing work increasingly takes place in an environment characterised by financial cuts, overtime, discrimination between “profitable” and “unprofitable” patients, and the exploitation of immigrant workers and women in particular. At the same time, cutbacks jeopardise psychological and social services and health care for vulnerable and highly marginalised groups in society. 

These conditions mean that care workers, patients and people in need of care face precariousness. Staff shortages and constant work overload lead to psychological suffering, exhaustion, and fear of causing harm or making mistakes. As care workers, we experience daily that we are unable to meet our expectations and do justice to our patients. When there is hardly any time for humane care, the dehumanisation of patients is the protective reaction of many care workers. Getting through the shift is the order of the day. Often, professional nursing workers only stay in their profession for a few years after their training.

We must fight so that our work is not reduced to a series of interventions and measures around the sick body. Other futures are possible: community-oriented and/or self-managed care that develops ideas of health and care through its practice, based on the needs and interests of the communities with which it interacts directly. We must be prepared to challenge and resist the limitations of our roles and of the institutional structures that govern our practice. Our autonomy is important if we are to provide dignified care that is not hindered by the over-regulation and economisation of the health and care sector.

Let us build more just and collaborative relationships. By reducing power imbalances we can improve care practice. Solidarity among colleagues is paramount: let us engage with colleagues and healthcare professionals from other specialties or settings. Dialogue between different social groups is also important: we must nurture relationships between patients, staff, friends and family in order to create a permanent state of solidarity and support in the healthcare institutions.

The numerous recent protest actions have shown that the system is sustained through us. Without nursing, it would not work. However, it is not enough to improve staffing. Nor is it enough to denounce the injustices of our work environment. We need to defend our interests as workers and patients. And we know that we have a better chance of asserting our interests if we join forces, form majorities and develop power through collective processes, commitments and solidarity. The time has come to enforce fundamental changes ourselves. Let us begin to fight within the care sector for a self-determined society and turn illness into a weapon.”