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Elisabeth Potzmann, President of the Austrian Healthcare and Nursing Association, has many years of experience in intensive care and nursing education. In this interview, we talk to her about two central issues in crisis prevention: Why a nursing register is missing as a basis for targeted support – and why the job description of the ‘disaster nurse’ should urgently be anchored in the civilian care structure in Austria.
Crises are not always large-scale – they are often very personal. Where can families turn if they need short-term respite care or a temporary solution?
SBC: How do you classify the topic of disaster care – and why do you think Austria needs clearer structures in civil healthcare in the future?
Potzmann: For us, this is not a stand-alone issue, but is embedded in the wider context of climate and health – and this is also one of the ÖGKV’s key priorities for 2026. We already started working on this in fall, including with the Planetary Health Charter, which we presented at the conference of the same name in Austrian Pinkafeld. And for us as a healthcare profession, this raises the very specific question: What does this mean in practice – for nursing, care and operational capability when crises become more frequent?
Because we are not just talking about ‘the’ blackout. We are talking about a wide variety of major events that all point in the same direction: Disaster care and disaster management. These can be major weather events – floods, storms, but also heat. Heat in particular is an underestimated risk in Austria, not least for people who are cared for at home. Then there are individual events that put a strain on entire systems: mass casualty incidents, such as a school shooting like the one in Graz, or tragic fires like the recent one in Switzerland. And, of course, infrastructural disruptions such as a major power outage – whether regional or widespread.
What we see: We are comparatively well organized in terms of emergency services – the Red Cross, the army, classic blue light structures. But in the civilian health and care structure, we are in a much worse position, both in terms of organization and training. There is too little systematic knowledge, too few clear roles and too few established responsibilities.
>> We are relatively well organized when it comes to emergency services—the Red Cross, the armed forces, traditional emergency services. But we are significantly less well prepared in terms of civil health and care structures, both in terms of organization and training. <<
People often work on the principle of hope, and there will be ‘someone dedicated on duty’ to take care of them. Yes, occasionally there are people with special training. But we often don’t even know who they are. Where are these people? And above all, there is no consistent structure that ensures that there is someone in every care facility – hospital, long-term care, mobile services – who can coordinate in the event of a crisis and also understands the language of the emergency organizations.
There is an established job profile in nursing care for precisely this purpose: The disaster nurse. Our aim is to anchor this profile in the civilian care structure so that there is a clearly designated, trained person in every facility who coordinates in the event of an incident, manages interfaces and quickly establishes a management and implementation logic.
At the moment, we live from the fact that people simply stay and help as best they can in an emergency. But that can’t be our system concept: That people stay an extra day or two and we hope that others who are free will somehow show up. That works once, maybe even a second time. But if events become more frequent – and that is a realistic prospect in view of more floods and more heatwaves – then this principle will break down at some point. After all, people are affected themselves: They have families, children, relatives, they have to go home, they have to protect themselves.
And this is precisely why it is so important for us to turn ‘hope’ into structure – and spontaneous improvisation into plannable, trained ability to act. Unfortunately, care is not yet considered and mapped everywhere in these structural plans.
SBC: The principle of hope generally applies to older people and those who need medical support during crises – because there is no universal care register. Where do you see a need for action?
Potzmann: In my view, the basic problem is quite banal: There is hardly any awareness. As long as nothing happens, for many it feels like an issue for later. And this is precisely where a second, very practical blind spot becomes apparent – Berlin has made this clear: In the event of an incident, we often don’t even know where people are who are in acute need of help. Of course, those who are already in care systems – for example through the Red Cross, Hilfswerk or other providers – are ideally registered, and these organizations can always contact their clients. But many people fall through the cracks because they are still being cared for by relatives, because they can just about manage on their own – and then suddenly can no longer do so in a crisis.
>> In the event of an incident, we often don’t even know where people are who are in acute need of help. <<
A classic example: Someone lives on the third floor, the elevator breaks down, the telephone doesn’t work reliably, the paths are too tedious – and all of a sudden, a situation that can no longer be handled without support somehow arises.
This is precisely why I think the idea of a care register is so important. There are already models for this – in Germany, for example, where relatives can register people if they live far away and cannot be there quickly in an emergency. The idea behind this is simple: Emergency organizations should at least know that there is someone there who has special needs – for example, someone who needs insulin, would be at risk in winter without heating or is simply not mobile enough to get themselves to safety. Then, in the event of a crisis, it is possible to look after them in a targeted manner – or, in extreme cases, take people to a warm, safe place.
This first requires a political decision that a care register should be set up at all – including funding and clear responsibility. Without this mandate, it remains just an idea, because operation, maintenance and data protection compliance require resources.
At the same time, it must be determined who will keep this register. As sensitive data is involved, there needs to be an institution that people trust and with which they are willing to deposit such information. From a practical point of view, this will only work if the sponsorship is at a level that is perceived as legitimate and reliable – such as the state or a very established organization that enjoys broad acceptance among the population.
The most difficult step comes next: Knowledge must be turned into an actionable structure. As soon as you know where people in need of care and support are located, the question of who is specifically responsible, who goes when, how to prioritize and what support can realistically be provided becomes imperative in the event of an incident. It is precisely this responsibility for implementation – especially at state and municipal level – that requires the most organization, resources and clear processes. Without this operational logic, a register would exist, but would not be effective in an emergency.
>>The most difficult step comes next: Knowledge must be turned into an actionable structure. As soon as you know where people in need of care and support are located, the question of who is actually responsible, who goes when, how to prioritize and what support can realistically be provided becomes imperative in the event of an incident. <<
SBC: Crises are not always large-scale, but very personal. How can we actually prepare ourself if we need short-term relief, for example through short-term care? I have read that hospital admissions occur in crisis or overwhelming situations because families simply no longer know how to organize care at home.
Potzmann: Such admissions for social reasons, i.e. because care is not possible at home, used to be much more common, especially before the pandemic. Today, the opposite tends to happen: People are sometimes discharged earlier than would have been considered justifiable in the past – sometimes even with complex care needs such as catheters or ventilation. And this is precisely what is increasingly pushing families and 24-hour care to their limits. It is clear that there is a lot going on at the moment – and the right structures are still lacking.
At the same time, there is movement: Lower Austria is just starting to develop care-led intermediate structures, nurse-led units, i.e. nursing-led units, wards and clinics. The idea behind this: People who no longer belong in hospital but are not yet stable enough to stay at home because they still need training, transitional care or simply a safe setting are to be supported there in a targeted manner. Situations in which caregivers are suddenly unavailable could also be bridged in this way, without having to use a hospital bed for a different purpose.
I also found the larger idea behind this exciting: When the hospital landscape changes, it doesn’t automatically have to mean closure – it can also mean closing the gap between acute hospitals and home care with this conversion to new forms of care. This is quite common internationally.
Public communication is often very much about responsibilities, funding and who is on board. For those affected, however, something else counts: that there is functioning, understandable support when someone comes out of hospital and everyday life at home is not yet sustainable. It is precisely this perspective that I would like to make more visible in the next step.
Thank you for the interview!
Author: Anja Herberth
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