New figure in healthcare, the nursing assistant

A new healthcare worker should be arriving in the healthcare sector in 2025, the nursing assistant: a professional who is ‘halfway’ between the Oss (social health worker) and the nurse. A ‘hybrid’ figure who, in the most difficult period for public healthcare workers – between lack of units, grueling shifts and constant violence – is causing no small amount of discontent among the trade unions. “The health assistant is a step backwards – explains to Adnkronos Salute Michele Vannini, National Secretary Fp Cgil – and it is not an answer to address the shortage of nurses beyond the declarations. The reason why the profession is not attractive, and if they do not take urgent measures the available positions will remain deserted, is divided between the low quality of the pay, the enormous workloads and the crisis of social recognition that is found in the continuous attacks. The original project of the nursing assistant dates back to two years ago, in August 2024 two decrees were made and the passage in the State-Regions Conference is missing”. Presumably at the end of 2025 this figure will arrive in public hospitals and in private contracted facilities.

What are the weak points of this operation? “The scenario will be to have these ‘assistants’ who are not nurses but are above the Oss but the point is also the salaries – warns Vannini – In recent years there has been no work to raise the salaries of nurses in the public and private sectors, today there is a difference and in the private sector they are on average lower. If the assistant arrives, this figure could also lead to the fact that an assistant who arrives in the public sector could have a higher salary than a nurse who works in the private sector”.

“Are there no nursing professionals in Italy? Don’t worry, the Nurse Assistant is coming, who will solve everything in one fell swoop. A big mess, which exacerbates the already precarious stability of the nursing profession, and the quality of care, of which nurses undeniably represent the foundation, with their skills and high responsibilities”. Thus Antonio De Palma, national president of the nurses’ union Nursing Up. “In April 2023 – continues De Palma – we were called to report with the technicians and experts of the Regions on this proposal, the issue was defined as ‘birth of a new operator of health interest who collaborates with the nurse’, and we were clear and direct, fully expressing our legitimate doubts. We reiterate, therefore, after more than a year, our position of that time, naturally enriched with further points of analysis and insights, not hiding those doubts that in the state of the art, today more than ever, they have transformed into a peremptory negative judgment“.

According to the national secretary of Fp Cgil, “the real reason why this operation was done – without ever having really listened to the unions – is the pressure from employers in private healthcare but also from the social-assistance sector, in this way nurses who perhaps cannot be there full time will be replaced in the facilities by assistants, reducing labor costs, but with consequences on assistance to citizens because nursing assistants do not have the training and skills of graduate nurses”.

“In addition, there is the issue – adds the national secretary of Fp Cgil – of compliance with the Gelli law on healthcare liability. Assistants are not configured in healthcare professions, they do not have insurance coverage and what if something happens while they administer insulin to a diabetic? Or while they assist a tracheotomy patient? Are we going back to 25 years ago when nurses had a generic role? It is an operation that takes nurses back to the end of the 90s when the Oss were created and before the university training of nurses was decided”.

But how will nursing assistants be trained? “In two ways – explains Vannini – you must already be an Oss and for the moment there is no state school – as we had suggested – to train them but courses. The Oss who already has a high school diploma must take a 500-hour course, the Oss who does not have a diploma must demonstrate that he has worked for 5 of the last 8 years and to the 500-hour course he must take another 100-hour course. How can we think – concludes Vannini – that these courses are enough, which each region will then decline differently based on the structures and money it will have available?”.