Nursing professionals in Luxembourg: "We constantly operate outside the law"

Janine (name changed by the editors) works as a nurse in outpatient care. In an interview with the Journal, she talks about an elderly gentleman. He has a urinary catheter because he can no longer go to the toilet independently. When she checked on him one evening a few days ago, she noticed that the catheter was no longer draining urine and that the patient was complaining of abdominal pain. Apparently, the catheter was blocked and needed flushing, as if it remains blocked, urine builds up, causing pain and potentially damaging the kidneys. Janine knows that flushing the catheter would solve the problem, and she learnt how to do this during her training. However, she is not allowed to do it without a doctor's prescription. The GP surgery is closed. She therefore had to arrange for the patient to be taken to hospital. He was subjected to the additional strain of the distress and the long back-and-forth, alongside extra costs for the ambulance and waiting time at the hospital. Janine could have resolved the whole situation on the spot in less than fifteen minutes with a few skilful moves – but had she done so, she would have committed an offence.

This is not an isolated case. In their day-to-day work, nursing professionals in Luxembourg constantly walk a tightrope between common sense and the legal situation. This is because they are not permitted to carry out any acts that are not classified in their law as independent nursing interventions without a doctor's prescription – and there are quite a lot of those. Although nurses are permitted to act independently in life-threatening emergencies, the situations that make their day-to-day work difficult rarely fall into this category.