Abstract

In democratic Switzerland, each of its 26 cantons (states) has its own government and its own laws. Thus there are 26 ministries of health and as many different laws regulating medical and health care practice. The Swiss Nurses' Association likewise has 13 regional chapters and a central organization that works on the national level. Medicine is private and practically all of the Swiss population is privately insured. High technology has led to high specialization with, among other results, a reduced number of premature deaths, longer life span but also rising costs of health. Health professionals are also becoming much more aware of ethical issues such as cost versus quality, high technology versus compassionate care, etc. A multilingual (four national languages) and multicultural country, Switzerland's health care system relies heavily on foreign nurses, many of whom come from neighbouring France and Germany but also from England, Yugoslavia, Canada and other countries. Regulation of nursing practice is still poor. Nursing or nurses are hardly mentioned in the state laws and, when mentioned, are often put in a dependent relation to the physician. Basic nurse training is regulated nationally by cantonal delegations to the Swiss Red Cross. Although there is a good postbasic training scheme, nurses are still striving for access to the university. Meanwhile, they go abroad to acquire degrees. Research in nursing is being developed mainly by the efforts of individuals and the Swiss Nurses' Association