["All that time we were working hand in hand ..." a comparative study on the effects of professionalization on German and American intensive care nurses].

The discussion about improving and reevaluating nursing education and nursing practice in Germany is often oriented at the US-american nurses' training. Here one finds a higher degree of professionalisation and university nursing programs. A German-US-American comparative study of 13 ICU nurses each analyzes what effects a higher degree of professionalism has on every day nursing practice. Using the data of structured interviews, dimensions of job perception and aspects of coping capabilities with stress in regard to patient care and relation with physicians of both nursing groups are compared. Results show that US-American nurses often refer to cognitive aspects of being in control of a situation and emphasize their professional part. When assessing their experiences they mainly describe actions they took emphasizing cooperation and help they gave each other. German nurses accentuate the emotional side, describing fear, anger, rage and helplessness. In their relations with physicians the US-American nurses are more likely to insist on their nursing competence, while German nurses tend to be annoyed, resignated, and try to withdraw from the situation. These differences are discussed in relation to the different nursing programs. The US-American education, stressing supervision and the ability to reflect upon one's action seems to have a positive influence on coping capabilities and enhance job satisfaction.