How nurses get rich
Nursing under National Socialism
Why is this topic so important?
The participation of sisters and carers in all phases of the “euthanasia” actions constitutes murder and a crime against humanity. It represents a punishable disregard for human dignity as well as abuse of power and dependency. The lack of reflection and processing of this time in the nursing professional field certainly contributed to further segmenting the inferior role of psychiatric nursing in post-war Germany. This past has resulted in behavior of blind obedience and adaptation as well as a few of refusal and resistance to the present day and in the present day-to-day work. This historical background shapes our professional self-image and the resulting questions that we have to confront again and again. From a historical point of view, it is imperative to implement professional values in nursing, to advance nursing science and nursing research - especially historical and ethical ones - and to integrate them into everyday life, to develop concepts based on nursing science principles and to establish expert controls.
Comments on the significance of the period of German National Socialism for the history of care:
In the history of nursing under National Socialism there is both blind obedience and adaptation as well as courage and refusal. Specifically, National Socialism and its consequences for German nursing led to a lag in the international development of nursing as a profession, which was also shown by the fact that many advances that had already been made in other countries were only able to gain a foothold here after a long delay. In addition to these aspects, it is primarily questions of professional self-image that arise from dealing with this time. Certainly, the German care has to bear its own share of responsibility for the millions of victims and to put the preservation of memory against oblivion. On the one hand, this concerns the function of care in the health care system.
How far does care go here with its adaptation to a system, how long is it obedient and when does it begin to refuse?
For the most part, the German nursing staff under National Socialism did not refuse and was nevertheless convinced that they had only done good and that they were not to blame. Is this really the role of the care service - always doing what others say and think is good? Secondly, it has to do with the responsibility that people assume for their own actions in the specific exercise of their profession. Up to what point is this responsibility passed on to others and how is it that nursing obviously does a lot in practice that is not always called good personally, but justified with the "actual" responsibility of others. Quite a few German nurses justified their involvement in crimes against humanity with precisely this lack of responsibility - and were acquitted. So how long are caregivers only handlers and therefore always “not guilty”? Thirdly, it concerns the overall understanding of the profession, which should urgently be reflected on in the sense of how far the beautiful ideas of personal responsibility and autonomy are really a reality and how far the care sector is really willing to take its humanitarian claims seriously itself. The care under National Socialism showed how far a profession is ready to go - in the sense of obedience and adaptation and also on the path of resistance and refusal.
So how does it look today with the implementation of professional values, how sensitive is the care for even small signs of inhumanity and how open are your eyes, ears and hearts to deal with your own limits and errors.
Dealing with the darker side of a job like nursing leads to fundamental questions about the professional self-image, namely when the result of humanity turns into the opposite and where job-specific responsibility begins.
HEALTH CARE FROM 1933
The classic problems of nursing already existed in the Weimar Republic: professional political fragmentation and polarization, mixing of professional requirements with character traits, content-related diffusion and ambiguity, strict subordination to the doctors.
The time of the Weimar Republic is on the one hand the point in time when all professional rights and opportunities commence, and on the other hand it is also a time of the unbroken professional tradition. German nursing was thus divided, unclear and politically fragmented on the threshold of National Socialism.
Nursing from 1933
If you look at the overall situation of nursing in the period from 1933-1945, you can see several parallel strands that, given the decades of devaluation and disregard for the nursing profession, see the relatively seamless integration into the nursing profession Makes the system at least comprehensible. Nursing as a female profession was enormously upgraded, the German sister was on an equal footing with the German woman in the service of the people. The politicization of nursing increased this appreciation enormously and made every single sister an important member of a political system, the standardization and organizational punishment made both transparency and control possible. The tactic of occupying the highest positions in nursing with sisters themselves increased the appreciation.
However, the nursing staff did not actually admit these organizational changes. The health policy was still determined by doctors and nursing remained strictly subordinate in all professional matters. The unionized had always been a thorn in the side of many and that is why the reorganization of nursing under National Socialism was so positive for them - it corresponded to the "new times" and promised further development, so many thought. What this further development ultimately looked like and why nursing care was to be misused in the National Socialist system only became clear much later.
Nursing training in the Third Reich
The regulations in nursing education indicate the following intentions:
The need to secure a sufficient number of trained nurses should be ensured. For this purpose, training centers were set up at hospitals, the number of training positions was fixed and it was compulsory to fill these positions. In this way, suitable offspring were ensured at the same time. Political reliability and German ancestry were assumed (with the exception of Jewish schools).
At all nursing schools there were ideological lessons by a representative of the NSDAP (Gau trainer).
On the part of the authorities, influence was exerted as to which sisterhood became the school owner and the headmaster could only become a "politically and morally stable" doctor.
According to the regulation, the nursing training had to be based on an official textbook. Thus it became possible to transport National Socialist ideologies into every nursing education and to present the desired image of the nurse to the student nurses as worth experiencing. National Socialist views take up a large part of the textbook from 1943:
»The hereditary and racial care, which is presented as an urgent requirement to protect the German people from extinction. The detailed presentation is based primarily on the performance of the “clan” and the preservation of German culture.
Within the framework of these views, the sisters have new areas of responsibility:
»Public health care: keeping the German people healthy was the focus. The people should be advised, supervised, educated and influenced by the sisters. They should have an educational effect and carry on the National Socialist thinking. That is why the church parish sisters were gradually replaced by NS sisters.
»Hospital care: The care of sick people in hospital remained one of the central tasks of nursing, as it had developed since the decline in private care. Sisters of all associations and, to a lesser extent, nurses were employed here, although nursing was generally referred to as a woman's occupation due to the use of men in other places, such as during the war.
»Nursing care for the party apparatus:
These areas of responsibility were carried out exclusively by Nazi sisters. Men in the medical service or in other party departments, such as the police or the SS, could relatively easily obtain recognition as nurses. Sisters were deployed in the BDM, in the Hitler Youth, in the residential homes, in the children's area deportation, in the hospitals of the Waffen-SS, in mother-and-child homes, in hospitals, concentration camps and labor camps.
»War Nursing: A lot of nursing staff was needed in case of war. The existing autonomy of the DRK was therefore tolerated. The expansion of the war in 1942 meant that more nurses were needed and so “Germanic voluntary” nurses and “second-degree mixed race” were again admitted to nursing.
»Nursing in the conquered areas: After the conquest and occupation of Eastern Europe, nurses were deployed there in education and care. They should bring German and National Socialist ideas into these areas and ensure health care and advice in the interests of the conquerors.
»Participation in“ euthanasia ”: Participation in“ euthanasia ”and in human experiments is probably the darkest chapter in German nursing. Sisters and nurses were employed as nursing staff in the sanatoriums both during the gassing campaigns and in the phase of the “wild” euthanasia in 1941. Especially in the last-mentioned phase, the nursing staff often worked alone on the orders of the doctors. Death was caused by withdrawal of food, injections (air or appropriate medication) or oral administration of medication (see “With tears in my eyes ...).
Since she observes a lot in the public health service and as a community nurse, she also has to fulfill so-called reporting obligations.
Traditional sister characteristics such as care, self-conquest, loyalty to duty are expected of her. As in the 19th century, she takes her hierarchical position behind the doctor and superiors.
In inheritance and race care, the student nurse is required to over-fulfill the legal regulations. They are appealed to as future mothers and future community nurses.
The NS nurse schools can thus be portrayed as pioneers of nursing training in the NS spirit. In them, concepts were developed in order to later transfer them to other nursing schools.
The nurses emerging from the Nazi schools should have National Socialist ideologies in the service of the “great political army of the Führer”.
These goals were attempted by:
»The strict selection of applicants. They had to fully commit to National Socialism, have a preschool and get out of the BDM.
»The great importance of ideological training. This should stimulate the activity to think politically. The training should contribute to the internalization of National Socialist terms such as “race” or “space” and convey a National Socialist view of history based on the “clan in the Germanic-Völkisch state”.
»Permanent linkage of ideological and political training with technical training, above all inheritance and racial care and the position of the NSV sister within the NSV's women's work.
»The establishment of the NS nurses' schools as a young nurses home, in which everything was carried out together with a guide for young nurses, from daily morning exercise to lessons and leisure.
This was intended to promote community spirit and camaraderie.
Care in WW2
Care during World War II was in the hands of the German Red Cross, which had made itself the willing henchman of the Wehrmacht and thus of the Nazi state.
In order to do justice to the diverse tasks, it was essential to achieve an ideological agreement with the state. That is why the most important official positions have been refilled with the help of DRK functionaries. These now acted willingly in the interests of the Nazi state.
As a result of the general upgrading of women’s ability to work and as a matter of urgency, because men were sent to war and their jobs had to be replaced, it was possible to win over a large number of women to the nursing profession. Thanks to ideological preparations, they could hardly wait for the day they were called up and were then confronted with the cruel reality of inhuman working and living conditions in almost all theaters of war.
Like “real men”, they were often given unusual honors such as the Iron Cross for their work. In addition to their enormous achievements in the humanitarian field, with the DRK they have contributed to keeping the war machine alive, often at the expense of life and health.
The two phases of murder
• Murder phase: patients were reported to Berlin using a registration form. From there, it went to three different medical experts who ticked who was classified as questionable or responsible for the killing. The patients were picked up by buses with all their belongings. They were first undressed, photographed, shown to a doctor and then taken to the gas chambers. This usually took place immediately after arrival. The relatives were informed by "consolation letters" in which false causes of death were given.
“From January 21, 1941 on, I accompanied ten ambulances from various institutions to Hadamar. We drove to Weilmünster, Scheuert bei Katzenelnbogen, Eichberg, in the area of Weinsberg and to Kalkhausen near Cologne. We usually drove with three buses that were initially provided by the Reichspost; later we drove buses that were painted gray and must have come from Berlin. All of these buses only had seats and no berths. They also did not contain a toilet. Today I don't remember exactly how many seats the individual buses had. One transport, consisting of three buses, contained around 60 to 70 patients; it could have been 80. We did not take any breaks on our journeys so that the sick could emerge. The journeys never lasted too long. My longest journey was the Weinsberger transport. It too was carried out without a break. The sick had been given something to eat at the hospital, at least that's what I assume. They did not have travel provisions with them. One of our carers and a sister sat in every bus. The transport manager drove in front of us in a car. (...)
When we got to the dispensaries, the sick were ready to go. The hospital staff escorted the sick to the bus. There we took over the patients. Those who could not walk were lifted in by us. The other patients got on themselves. When they arrived in Hadamar, the sick came into a large hall with benches with blankets. Then the patients came in groups into the changing room. We were there. In the undressing room, the staff who stayed at home were added. We helped undress those sick who were unable to do so. The office manager, who was initially Netscher and later Bünger, also sat in the dressing room. The office manager checked the sick people's personal details. A sister standing by his side then stamped each patient on the back. The stamp consisted of a number that was also pressed into the medical files that he, the office manager, had brought with him. A hanging section that was intended for the bundle of clothes was also stamped. A lady from the office was still sitting in the dressing room, taking valuables from patients. Then the patients were led into the adjacent doctor's room, one at a time. You were received at the door of the doctor's room by other carers or nurses (depending on whether it was a male or female patient). I don't know what was going on in the doctor's room, I didn't see it, I didn't go into the doctor's room. (...)
The others came out of the photo room and gathered in another large room. The sick had been given a coat and wore slippers. The sick were then taken to the cellar together. There they came into the so-called anteroom. I escorted the sick to the anteroom. I then went upstairs again and took care of the sick people's clothes, which had to be tidied up. In the meantime, the sick were being taken downstairs to the gas chamber by other personnel. I don't know who that was. The sick were then gassed.I don't know who operated the gas tap either. "(Statement by the nurse Benedikt H., 1966)
In April 1946, an Ursberg sister said the following about the situation shortly before the evacuation: “Some people hung on to their sister who tore off their veils. It was horrible. Even if you have controlled yourself that way. They immediately suspected and noticed what was going on. We have given them the sacraments. It was terrible, indescribable ... it was really bad with the girls. They instinctively felt that nothing good was going to happen to them. They screamed and cried outright. The nurses and doctors had cried themselves at the farewell scene. (...) That was something heartbreaking. Most of them had not known, but suspected what was to come. Already the violent farewell to the institution where they were at home.
Albert B. has sunk on his knees. We had to pick it up right away ... most of them cried. Albert screamed. Little fifteen-year-old St. didn't eat a bite from that moment, he was pale as a sheet. He didn't speak another word, didn't look at you. "
“About the horror ... I only need to say that the individual patients clung to me in their desperation, so that they literally had to be torn from my body, and my clothes were also torn. An elderly patient clung to the rafters in the attic, screaming in fear of death, and had to be picked up by five people and brought into the car. In response to my unsuccessful request to release the patient ..., the transport driver told me that the prescribed number had to be reached and that if Miss ... had to stay there, then I had to go with her. The strange thing about all of this was that our foster children knew a lot more about the so-called euthanasia than we did ourselves. "
• Murder phase: In the second murder phase, the patients were declared to be killed during the rounds. The head nurse noted the names. The patients were then transferred to specially constructed isolation rooms. The patients died as a result of medication (sleeping pills in overdose, injections with morphine-scopalmin, air syringes that led to embolism). In parallel, the murder ran through malnutrition and food deprivation, and involved even larger numbers of killings. The corpses were initially removed by nursing staff, later a group of mentally ill, able-bodied men was put together.
Sister Luise E., the main defendant in the later Obrawalde trial, described the start of the killings as follows: “I can still remember the first case very well. Soon after I became a department nurse, Dr. Wernicke a visit. There were about 12 beds with patients in the hospital ward. A middle-aged woman, around 30 to 40 years old, was lying in a bed, and she was very restless. It was a schizophrenic. Dr. Wernicke stood by the patient's bed and looked at her. Then she said to me: "Give this patient 4 to 5 grams of veronal." Then she looked at the other patients and left. I was convinced that I should only give the patient the veronal to calm her down. The appropriate amount of veronal was available in the department's poison cabinet. I took the veronal from the cupboard and gave the patient two doses of "0.5 grams. Since the patient remained calm after this amount, I did not give her the entire prescribed dose. On the following day, during my visit to Dr. Wernicke that I did not give the entire dose because the patient was immobilized with the partial doses. Then Dr. Wernicke: I had to give what the doctor ordered. She did not respond to my objection that the patient had been sedated by the smaller amount. I didn't ask any further questions. When asked what my thoughts were about this, I have to say that at that moment I realized what the doctor Dr. Wernicke wanted to aim with the high dose of veronal. "
The involvement of nurses in the crimes against humanity
“When I am asked to describe the process of administering the medication in detail, I have to say that this description is not easy because it happened differently every time. The patients all behaved differently. Our approach varied depending on the patient's mental state. One patient, for example, could still understand that he should take a drug. There were even some who were waiting greedily for a drug, so to speak, were addicted and thus hoped that their addiction would be satisfied…. Other patients were unable or unwilling to drink. They had to be given the remedy with spoons. In general, the department nurse or I would pull the patient up and hug him. They were persuaded as long as it was possible. "(Sister Luise E.)
What is certain is that the nursing staff was a not unimportant part of the Nazi machinery of extermination. It is also certain that the people involved nevertheless gave themselves up to the illusion that they had remained true to their professional humanitarian ethos. The feelings of guilt that many of the nurses expressed in their interrogations and which evidently even led to suicide in one of the nurses accused in Obrawalde probably do nothing to change this conviction.
From today's point of view, what makes things more difficult is the absolutely internalized duty of obedience and the trust in the doctors and "those-there-above", which they already do right or at least that there is no possibility of disobedience. Since its redesign in the 19th century, one pillar of the professional ethical framework of nursing has been strict subordination to the omnipotence of doctors. How sustainable this pillar should be has been shown in the time of National Socialism.
Surrendering the individual responsibility for one's own actions to a superordinate authority on the one hand made it possible to actually carry out acts that were actually morally condemnable and on the other hand allowed the feeling of innocence or non-participation to be maintained. The perfection of the bureaucratic and division of labor handling of the entire extermination program of the National Socialists also offered every individual who was only active in one part of the profession the opportunity not to perceive the overall context.
So it was obviously possible that nursing staff accompanied transports of sick people who they did not know where they came from or where they were going, let alone with what purpose they were carried out.At least the division of labor offered this possibility of perspective for those involved and was accepted as such by many. For the nursing staff in the institutions of the “wild euthanasia” this division of labor was most severely broken, they mostly knew the sick longer, cared for them even before the murder and they knew what the medical orders meant. They could only argue with the duty of obedience and trust in the state and doctors and emphasize their subordinate role of care.
The specific situation of psychiatric care, which was even more exposed to social discrimination, should certainly not be underestimated. The working and living conditions of the carers, the inadequate training situation and the devaluation of the work of a madman as something one was still good enough for when nothing else was possible - these factors also led to a negative selection of the staff. Many worked in psychiatry because it made them feel that they were sacrificing themselves to the poorest of the poor through devoted care. This basic attitude was not given up when the activities changed fundamentally. The perpetrators now felt themselves to be victims, because they had only wanted to do good all their lives and should now also be punished for it. The superiors told them what was “good” in each case.
Care was certainly not a decision-maker under National Socialism, but the subordinate position should not serve as a legitimation for not having acted otherwise. Today's NS research also often takes the role of care as a given and does not take independence or personal responsibility in this profession for granted.
Law enforcement, trials and judgments
There are only excerpts from trials that took place after 1945. In the first Hadamar trial, an American military court sentenced employees to death or long imprisonment for the murder of Polish and Russian nationals.
In 1946 the senior physician Hilde Wernicke and the nurse Helene Wieczorek were sentenced to death in the Obrawalde trial and executed. At the same time, three ward attendants and one sister were sentenced to death in Schwerin.
In 1948 six more nurses were added and these were sentenced to prison terms of between three and four years.
The court found these mild penalties because "the entire nursing staff cannot be expected to have their own will."
In 1965 the second Obrawalde trial took place for the staff involved in the Meseritz-Obrawalde institution. The procedure extended to 14 sisters. All were acquitted.
Excerpts from the court proceedings justify the acquittal, among other things, by the fact that the defendants no longer thought about the reason for the killing, since the question of whether the mentally ill may be killed at all has receded completely into the background. A lack of information and constant orders from the doctors led the nursing staff to consider that killing them would be a relief for the severely disabled.
This process caused a sensation among the population. Newspapers wrote: "The acquittals inevitably had to be so, as long as those primarily responsible for the crimes were not brought to justice."
The “mild” judgments that were pronounced for the nursing staff should also be seen in relation to the Nazi crimes of the time. The prosecution and judgments against lawyers, doctors and others complete the whole complex.
If - as happened in the Nazi trials - this subordination, the results of a long disciplinary process and actually directed against the interests of the nursing staff, is even possible as an explanation and excuse for the active participation in the murder of helpless patients, then it is really the highest Time to fundamentally change structures and adapt them to realities.
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