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CRIME

Nurse ‘killed patients because he was bored’

A nurse allegedly murdered three patients in a hospital's intensive care unit using lethal doses of drugs because he was bored, a court heard on Thursday.

Nurse 'killed patients because he was bored'
The accused hides his face from photographers behind court documents. Photo: DPA

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The 37-year-old man responded only by saying, “I'm remaining silent” when the accusations were read out on the first day of the trial in Oldenburg, Lower Saxony.

He is accused of injecting five patients with a drug that causes serious heart and circulation problems between 2003 and 2005.

Three patients, a woman aged 61 and two men aged 44 and 78, were definitely killed by the drug, while it could not be determined whether two further patients had died of their illnesses or the effects of the medication.

The nurse acted out of boredom and the desire to show off his resuscitation skills, prosecutor Daniela Schiereck-Bohlmann said, and counted the possible death of the patients an acceptable risk.

According to one senior doctor who gave evidence, the accused was a “passionate medic” who drove ambulances in his spare time and made a good impression on staff at the clinic.

The doctor did remember finding it strange that the nurse was always present when patients were being resuscitated. He was especially skilled at intubation – inserting tubes – often helping younger doctors with the procedure.

“There was no thought to ask about why he was always there,” the doctor said.

The accused has already been convicted once of a similar crime at a 2008 court case and is serving a seven-year prison sentence.

After that conviction, it was found that the rate of usage of the drug involved, Ajmaline, had increased by almost 10 times at the clinic between 2001 and 2005, and the death rate had also increased.

The drug could be ordered and administered by nurses without doctors writing a prescription.

A woman became suspicious when she learned of the case as her mother had died suddenly at the clinic in Delmenhorst, Lower Saxony, where the nurse worked. She brought charges and a new investigation was started.

The trial is expected to last into 2015.

SEE ALSO: Heart centre accused of fiddling transplant lists

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HEALTH

How to find available therapists in Germany

It’s no secret that mental health care can be particularly tricky to access in Germany. Here are some helpful tips for anyone who is struggling to book an appointment for therapy.

How to find available therapists in Germany

The process to find psychotherapy in Germany’s urban centres is arduous – licensed therapists often have impossibly long wait times, and private practices don’t accept public health insurance.

A major reason that public insurance funded mental health care is hard to find in Germany comes down to regulations. Specifically the ‘coverage plan’ (Bedarfsplanung) that basically limits the number of licences available for publicly insured therapists in a region.

Germany’s maddening bureaucracy probably won’t be fixed any time soon. So residents in need of therapy will need to find a way through the system as it is.

So here are a few helpful tips for finding therapists, as well as how publicly insured patients can have private practice therapy costs reimbursed.

Look for therapists enrolled at academies

You’ll probably have a better chance getting an appointment with therapists who are currently in training, because not everyone knows that this option exists.

You can search for “Akademie für Psychotherapie”, to find one in your location. The Berliner Akademie für Psychotherapie, is one in the capital city, for example.

If you arrange an appointment this way, you can expect to be connected with a grad student therapist in training who needs to complete their supervised practice hours. In this case, you would see your therapist as usual, and they will be going through your session with an experienced therapist afterward.

The main advantages to seeking a therapist in training is that it may be cheaper and you can probably more readily find an appointment. A potential disadvantage is that the therapist you’ll be seeing is less experienced. 

But according to a Stockholm University study, student therapists who receive regular feedback from supervisors may be just as effective as licensed therapists at treating patients.

How to get reimbursed for going to a private practice

As mentioned above, therapists covered by public health insurance are few and far between, especially in many urban centres, and therefore regularly come with long wait times. But for those willing to do battle with the bureaucracy, there is an option to have your costs reimbursed for seeing a private practice therapist.

Specifically, public insurance providers are obligated to provide full reimbursement of costs in the event of a “supply emergency”. 

Waiting times of more than three months are considered unreasonable. So generally, patients can claim a supply emergency if they have contacted several therapists, and none of them offered available appointments within that time frame.

But you’ll want to make sure that your process is properly documented so that you won’t be stuck with the out-of-pocket costs.

First, you’ll need to document your need for psychotherapy. To get this, make an appointment for a psychotherapeutic consultation with a practice in your area, and be sure to collect a written recommendation for treatment (a PTV 11 form). 

If you don’t know where to start with this, look to the Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung) for a database of therapists. You can also call 116 117 or use the 116 117 App.

After you’ve got your PTV 11 certificate, you’ll need to document your futile search for a licensed therapist. To do this, contact at least three to five therapists that have public health insurance approval. Keep a list of the names of therapists you contacted, as well as dates and times of contact and how long the waiting list for treatment is. 

Additionally, you should try to arrange treatment through the aforementioned Association of Statutory Health Insurance Physicians, and receive confirmation if it’s not possible. So you’ll need to call 116 117, or use the 116 117 App again. But this time go through the process to have them try to find you placement with a therapist. This should take a maximum of four weeks, but rarely happens.

Finally, if you have documented all of the above and have still not found a readily available therapist, then you can seek out a private practice. You’ll need to enroll as a self-paying patient initially, but then you can submit an application for an outpatient reimbursement (Kostenerstattungsverfahren) along with the previously collected certificates and proof of your search. Private practice therapists are usually familiar with this process, and may be able to help you with the application as well.

READ ALSO: What are the main reasons internationals in Germany turn to therapy?

Free phone consultations for students

Students in Berlin can also take advantage of a free 50-minute conversation with a therapist through StudierendenWERK.

For students elsewhere, it’s worth checking what kind of mental health support services your school offers. Many German universities offer mental health support to some extent, and if school counsellors can’t provide the care that you need, they may be able to offer helpful information about where such services are available in your area.

READ ALSO: Here’s how you can get mental health help in English in Germany

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