The Association of Nurses in Luxembourg, ANIL, has delivered a scathing verdict on the government’s planned bill to reform the nursing profession, describing it as a missed opportunity that falls far short of genuine modernisation for nurses and patients alike.
ANIL president Anne-Marie Hanff explained that the legal text may have doubled in length, but it still fails to properly define what non-specialised nurses actually do on a daily basis. Worse still, much of what nurses currently carry out in practice has no clear legal foundation under either the existing law or the proposed reform. “If we really adhered strictly to what the law says, it would no longer be possible to maintain current routines,” she warned.
One of ANIL’s main frustrations concerns the administrative burden placed on nurses. More than a third of a nurse’s working time, according to Hanff, is consumed by paperwork. For even the most routine treatments, a nurse must first obtain a doctor’s prescription.
She illustrated the absurdity with a telling example. Any member of the public can walk into a pharmacy and buy a basic antiviral cream such as Zofirax against Herpes or a painkiller like Dafalgan without a prescription, yet a nurse, a university-trained health professional, is still not permitted to administer such treatments without one. “If she does so without a prescription, she is technically guilty of practising medicine illegally,” Hanff said. The reform, she added, does nothing to change this.
The question Hanff asked herself is who is opposed to extending nurses’ autonomy, pumping the breaks on progress. When ANIL raises these concerns with the ministry, the response is invariably that its against doctors’ wishes. But Hanff pushed back on this. “If you actually speak to doctors, they themselves find these situations absurd,” she said.
The communication with the Ministry of Health and the responsible Minister Martine Deprez was, to say the least, unfortunate, according to Hanff. This applies to the Ministry’s communication on plans to introduce a new professional category between the nursing assistant and the qualified nurse, referred to as the technician too. Hanff is skeptical and explains that the concept seems redundant. Given that the reform adds almost nothing to the existing scope of the nursing role, Hanff said she could not see where this new technician would fit into day-to-day practice. The role would be paid less than a qualified nurse but carry almost comparable responsibilities, prompting Hanff to question whether cost-cutting rather than clinical logic is driving the proposal.
ANIL is now placing its hopes in the Chamber of Deputies, calling on MPs to ask hard questions and push for substantive amendments to the bill. Hanff was clear about what the association expects: a reformed professional practice with more room for manoeuvre: “We expect that facts will now be created, that our opinions and the many proposals we have put forward will finally be heard,” she said.
For ANIL, nothing less than a thorough and forward-looking reform will do, one that gives the nursing profession the autonomy, recognition and long-term prospects it deserves.
