Skilled Workers | Feature About a Care Worker   The Quiet Hours at Virchow-Klinikum

Malika came to Berlin from the Ivory Coast to help people. Today, she works as a care giver at Virchow-Klinikum. Her story shows how rewarding, but also how demanding this profession is. It also highlights why the work of care workers and nurses is vital for the future of our healthcare system.

At night, the grounds of Virchow-Klinikum are quiet. Only a few rooms are illuminated by a dim light. Outside, Berlin’s loud and lively district of Wedding is abuzz with life, but inside, none of that energy can be felt – even though not everyone is asleep.

Malika* has been working on the clinic’s general ward for three years now. It’s a tough job. But at night, she has a bit more time and can even step outside for some fresh air. “It’s a wonderful profession,” she says. “Patients come to me when they’re unwell. I watch them recover and see how I can help them. That is incredibly rewarding.”

From Studying German to Care Work

It was sheer coincidence – or rather, a series of coincidences – that Malika ended up in care work. She learned German at her school in Abidjan, and later completed a degree in German studies in the Ivory Coast’s capital city, eventually discovering a passion for literature – first Dürrenmatt, then Brecht and Kästner.

An internship in integration assistance, working with children with disabilities, eventually brought her to Germany. “The people were really kind, but the village was very backward,” she recalls. When she started there, they didn’t even have internet. “I come from a big city, so that was quite an adjustment for me.”

Virchow-Klinikum – a City Within a City

Today, she lives in Berlin, which has become her second home. But she also feels at home in the sprawling complex of Virchow-Klinikum, which is like a city within a city.

Designed in the 1890s, Virchow-Klinikum opened in 1906 – at a time when medical science was only beginning to understand infectious diseases. Each department has its own building: Internal Medicine, Orthopaedics, the Maternity Clinic. The German Heart Centre is located in the eastern part of the campus. Altogether, the clinic has around 1,300 beds, and thousands of people from all over the world work and study there – just like Malika.

One in Five Care Workers Comes from Abroad

She is one of many care workers who have immigrated to Germany. They work not only in hospitals, but also in nursing homes, assisted living facilities for people with disabilities and home-care services. Of the roughly 1.7 million care workers in Germany, almost 18 percent come from abroad – that’s around one in five.

And the trend shows no sign of slowing: as Germany’s population ages, the demand for care continues to grow. Today, every second person in Germany is 45 or older. In the next 20 years, millions will retire, and an ever increasing number of people will require medical care. Germany already faces a shortage of at least 200,000 care workers. According to the Federal Statistical Office, this number could climb to 690,000 by 2029.

Measures to Address Nursing Shortages – and Their Limitations

To address this growing challenge, Germany has introduced various measures, including the new Skilled Immigration Act. The main goal of this Act is to make it easier for qualified workers from non-EU countries to come to Germany. Progress has also been made within the nursing sector itself, including the introduction of a minimum wage for care workers. Since 2025, it has been set at €16.10 per hour for nursing assistants and €20.50 per hour for qualified nurses.

For Malika, these are not symbolic changes – they affect her entire life. “We work in shifts. We work hard and we work long hours. Being able to eat out occasionally, grab a coffee to-go, not having to worry about next month’s rent – these measures go a long way.”

Norway Sets an Example: Full Pay for Part-Time Work

For the critics, however, these measures are not enough. Many care workers only work part-time and are paid correspondingly. According to the Federal Employment Agency, around 50 percent of nurses and 65 percent of carers of the elderly fall into this category. In Norway, a 30-hour week is considered full-time in care work – an approach currently under discussion in Germany, though it is still far from being widely adopted. Yet it is clear that the demands of shift work, weekend duties and the physically and mentally challenging nature of the job require longer periods of rest.

Since the 1990s, nursing has been systematically underfunded, resulting in staffing levels deteriorating to the point where it is sometimes impossible to guarantee basic care. Major hospital strikes in Berlin and North Rhine-Westphalia in 2021 and 2022 were therefore not primarily about higher pay, but about relief: more rest periods and more staff.

The strikes ended, at least on paper, with a major victory: the new collective agreement brought significant improvements to working conditions. Employees are hopeful that this example will serve as a model for the rest of the country.

The Pandemic and its Consequences

The COVID-19 pandemic showed just how exposed care professionals are to infectious diseases. According to an RKI study, the risk of infection in the care sector during the first two waves of the pandemic was about twice as high as in other professions. This was one reason why then Health Minister Jens Spahn urged care workers at the Berlin Nursing Day in 2021 to mobilise more effectively – to advocate their own interests and, in doing so, promote the well-being of their patients.

For Malika, the rewarding moments outweigh the challenges, even though working with patients can be exhausting and the job as a whole is very demanding. What she finds even more challenging, however, is interacting and working with a team. “You can be lucky and end up in a great team, but there’s no guarantee.”

Racism in the Workplace Remains an Issue

Malika has had very different experiences across the various fields. After working with children, she shifted her focus to adults with disabilities. But training in that area was fee-based, so she then moved into elderly care, eventually finding a job in a hospital. “I changed workplaces several times before I found this team. The work is stressful, both physically and emotionally, and without a good team, nothing works.”

The main reason Malika has changed jobs several times is racism. “I don’t take it personally when it comes from patients, or even relatives. The problem is the colleagues – or even worse, the instructors. My assigned teacher was racist, and at the beginning there were several people of colour in my class. Quite a few gave up because of her; I was close to giving up, too. You have to be mentally strong to put up with hostility like that.”

More Openness Within the Team

Some institutions, especially in major cities, have learned from experience. At the Charité hospital, for example, there is a research unit dedicated specifically to the topic of racism in nursing. But even if progress has been made, a lot still depends on the team, says Malika. “One thing I no longer tolerate is gossip. If colleagues have a problem with something, they should speak up, and we can talk about it.” The positive thing, she adds, is that there is now an awareness of these issues.

As the ward gradually comes to life at around 5.30 a.m., Malika’s shift draws to a close. The first medications are handed out, and patients ring their bells for help getting out of bed. Outside the gates of Virchow-Klinikum, the morning is at its quietest. Around Amrumer Straße U-Bahn station, the first bakeries open while bars finally close their doors. A brief moment of transition. There is something comforting about the calm – a reminder of how important breaks are – for bakers, bartenders, just as much as for care workers like Malika.


* The name has been changed by the editors for reasons of privacy protection.

January 2026