Switzerland doesn’t make it into the international news very often, and when it does, it sometimes is for the wrong reasons, making itself the target of ridicule and disbelief. Perhaps you heard of the referendum a couple of years ago that dealt with the question “Should Cows have Horns?”. The initiative designed to stop farmers from dehorning their cows and goats was rejected.

But Sunday 28^th of November was different. Uniquely, the Swiss had a say in their nurses’ working conditions, in a vote called “the nursing initiative”. And this time, Swiss voters took the cow by the horns, voting Yes, for better working conditions and protection of healthcare staff by law.

Just like in many countries around the globe nurses had heard a lot of clapping during the pandemic. But unlike everywhere else, feelings were strong that applause was not enough. The Swiss wanted real action, and change. It was time for mere gratitude to be converted into improvements of nurses’ and doctors’ compensation and the funding of the health system.

Over 65% of voters cast their vote on 28^th November on the Swiss government’s call to maintain Covid restrictions and the referendum on changing nurses’ pay, which won a majority of 61%. There had been growing concern – just like in most countries – about a shortage of health workers and deteriorating conditions in the levels of training and retention. The complaints most often heard were: understaffed, stressed and poorly paid. And there was a high drop-out rate – 46% of nurses leave the profession – or emigrate to other countries where wages are better when compared to cost of living. Calculations say that unlike action is taken, by 2030 an extra 70,000 nurses will be needed.

As one third of nurses are recruited from abroad, mainly neighbouring countries, when the pandemic hit and borders were closed, special negotiations were required to allow health workers to continue commuting across the border. This put Switzerland in a vulnerable position – and acted as a genuine wake-up call, boosting the support for the initiative, which had actually been started in 2017.

The “nursing initiative” called on the federal government and the cantons to train enough registered nurses and to improve their professional prospects. It asked for the profession to be valued adequately by guaranteeing appropriate working conditions and wages and making this an affair of the State. That in turn would be reflected in a better standard of care. Pay of nurses when seen against average salaries in Switzerland is one of the lowest, found an OECD health survey in 2019 – a long way down from countries like Chile, Mexico, Greece … with only Lithuania and Latvia being further down the scale! So, a truly historic vote, and interesting because it is the first time for a specific group of professionals to win a nationwide ballot and obtain protection by the constitution. So, perhaps this is one positive outcome of Covid-19.