What are you allowed to do where? Understanding and using your skills in care

What am I actually allowed to do in my nursing profession - and what not?

This question is asked by thousands of nurses every day - regardless of whether Nursing Assistant (PA), Nursing Assistant (PFA) or Diploma in Healthcare and Nursing (DGKP). In a professional field that carries so much responsibility and works so closely with people, it is crucial to know: What am I allowed to do on my own responsibility? When do I need a doctor's orders? What limits apply - and why?

Nurse holding the hand of an elderly patient in a hospital bed and smiling

 

However, the reality is often different: The legal basis - such as the Gesundheits- und Krankenpflegegesetz (GuKG) or the Pflegeberufegesetz (PflBG) - are formulated in a complex way. The differences between professional groups become blurred in stressful everyday life. And there is often a lack of time or space to really get to grips with these important issues. This is exactly where this article comes in! 

We give you a structured, practical and legally sound overview of the central areas of competence in nursing - tailored to professional practice in Austria and Germany. You will learn:

  • Which activities are permitted in 24-hour care, mobile care, in hospital or in long-term care.
  • Where your competence limits lie - and how you can adhere to them safely and responsibly in everyday life.
  • How the five legally defined areas of competence are structured and how you live them in your role every day.

     

This article is aimed at anyone who works in nursing - or wants to get into nursing: Nursing staff, nursing students, practice instructors or decision-makers in the healthcare sector. And it shows: Good care starts with clarity.

Put an end to uncertainty and half-knowledge - here you get what you really need: Orientation, security and professional self-confidence.

 

Register here

 

 

24-hour care: closeness, trust and clear boundaries

A woman in a wheelchair has a conversation with an older woman, both smile and share a moment together.

 

The 24-hour care is a special form of care that is strongly characterized by closeness and continuity. Caregivers usually live in the household of the person being cared for - this creates a close relationship of trust. At the same time, this closeness is associated with a high level of responsibility: What am I allowed to do? What not?

Legal framework according to GuKG

Many 24-hour caregivers are trained as Care assistant (PA). According to Gesundheits- und Krankenpflegegesetz (GuKG § 15) perform the following activities:

  • Assistance with personal hygiene and dressing
  • Assistance with eating
  • Assistance with mobilization
  • Skin care, storage, prophylaxis
  • Simple documentation

Daily activities - what is allowed

 

What activities are allowed for PA?

Activity Allowed for PA? conditions
Personal hygiene & hygiene ✅ Yes Possible on own responsibility
Assistance with eating ✅ Yes Without a doctor's order
Administering medication (orally) ❌ No Only by DGKP or on doctor's orders
Supply PEG tube ❌ Only partially After instruction, under medical supervision
Blood glucose measurement & insulin injections ❌ No Not in the area of competence of PA
Stoma care ❌ Only partially After clear instructions and training by specialist staff

 

Emotional challenge: Closeness with responsibility

This close care not only brings trust - but also emotional strain. The caregiver and the person in need of care often spend weeks or months together under one roof. Conflicts, excessive demands or insecurities are a reality.

Example from everyday life: 

Elena, a 24-hour caregiver from Romania, reports: "I was unsure whether I was doing it right with the PEG tube. Only after being instructed by the mobile care I was reassured."

If caregivers feel overwhelmed, it is essential that they are not left alone. Mobile services or qualified nursing staff can be consulted - this is not only permitted, but even required in terms of quality of care.

 

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Nora's tip: Anyone working in 24-hour care should undergo regular training and make clear agreements with families and specialist staff - for more safety and trust on all sides.

 

Mobile care: flexibility and professional responsibility

Mobile care brings care workers directly to people's homes - often several times a week. Various professional groups are deployed: Home nursing care (HKP), Nursing Assistant (PFA), Nursing Assistant (PA) and Home Help (HH). Each has clearly defined tasks - regulated in GuKG (Austria) resp. im PflBG (Germany).

 

Overview of tasks by professional group

Occupational group Areas of responsibility Special features
DGKP (HKP) Admission & care planning, medication nesting, complex dressings, drainages Carries nursing process responsibility
PFA Medication administration, subcutaneous injections, simple wound care Activities are carried out on doctor's orders or care plan
PA Basic care (personal hygiene, mobilization, elimination assistance) Work under instruction/delegation
HH Household support, companionship, light care assistance No medical activities permitted

 

Time printing every quarter of an hour

The mobile maintenance will be in 15-minute units - this means that every action must be efficient and targeted. There is often little time for in-depth discussions or spontaneous support.

A study by Gesundheit Österreich GmbH (2023) shows: 73% of mobile care workers perceive the time pressure in everyday life as high. Nevertheless, they value the interpersonal relationships that develop over weeks and months.

Example of experience: Sandra, mobile care worker from Upper Austria "At the beginning I was frustrated - 15 minutes to do everything seemed impossible. But over time, I learned to prioritize. And I realized that if you come regularly, confidence develops in small stages. Today, I'm more than just 'the carer' for many people - I'm a conversation partner, a listener, sometimes also a source of support in difficult moments."

Note: Good mobile care needs organization, empathy - and a strong team in the background. The more clearly tasks and responsibilities are distributed, the more successful the care will be.

 

Long-term care facility: everyday life with heart and structure

Teamwork is crucial in retirement and nursing homes. Residents often live here for months or years - care staff become trusted companions. But here too, each professional group has clearly defined competencies.

 

Distribution of tasks in the nursing home

Occupational group Typical tasks Special instructions
DGKP Medication management, care planning, instruction of PA/PFA, injections, PEG care, documentation Indwelling intravenous cannulas usually not permitted, as no acute care
PFA Assistance with personal hygiene, mobilization, simple medical measures Work according to care plan or doctor's orders
PA Basic care, meal assistance, mobilization Work under supervision and with close patient contact

 

Medical interventions such as the insertion of intravenous catheters or intravenous infusions are usually not provided. Instead, drugs are administered subcutaneously - i.e. under the skin..

  • Nursing in numbers: According to Statista (Pflegebericht Österreich 2024), over 92.000 people live permanently in inpatient care facilities - and the trend is rising. The average length of stay is 2.8 years.
  • Example from everyday care: Renate, a DGKP with 18 years of professional experience, explains: "The home is not just about medication. It's about knowing biographies. Knowing that Mr. Maier drinks his morning coffee with two spoons of sugar is just as important as the insulin dose. Proximity is our strongest competence."

Note: Long-term care creates intense bonds - but also emotional challenges. Supervision and a good team atmosphere are crucial to staying healthy in the profession in the long term.

 

Hospital: complexity and professionalism

A female surgeon in blue scrubs and with a stethoscope around her neck holds the hand of an elderly patient. Both are smiling and standing in a hospital room. The elderly patient is also wearing blue clothing.

 

Hospital nursing is one of the most versatile, but also most demanding areas of work. Here, nursing staff work with patients with a wide range of medical conditions - from emergencies and chronic illnesses to post-operative care.

Who does what?

  • DGKP (Certified Healthcare Professionals and Nurses) wear the overall responsibility for the nursing process. They are responsible for administering medication, care planning, interdisciplinary communication and nursing documentation.
  • PFA (nursing assistants) provide support with medical activities such as infusions, wound care, dressings - usually according to doctor's orders.
  • PA (Nursing Assistant) focus on basic care, mobilization and everyday support for patients.

According to the report on the Nursing Personnel Needs Forecast 2024 of the Federal Ministry of Social Affairs is the Skilled labor demand in the acute care sector particularly high - with up to 35% more DGKP positions required by 2030.

Challenges in acute care

Hospital care is characterized by time pressure, a high level of responsibility and a wide range of tasks. Especially in emergency rooms or surgical wards, nursing staff have to act quickly and precisely - even in emergency situations.

Example from everyday life: Thomas, DGKP in an intensive care unit: "Sometimes I look after five seriously ill people at the same time - that means prioritizing, keeping calm and still being there for everyone."

The workload is high - but so is the professional development: In the hospital, nursing staff apply the full range of their skills and expand their knowledge every day.

Note: If you love variety, want to develop your professional skills and work in an interdisciplinary environment, the hospital is the ideal place for you - provided you know and respect your own limits.

 

The five areas of nursing competence according to PflBG & GuKG

Group of five smiling medical professionals in blue scrubs with IDs, standing in a modern medical facility.

 

Professional nursing in Germany and Austria is based on five legally defined areas of competence. These are considered the foundation for professional nursing care not only in training, but also in daily practice.

1. nursing-process & nursing-diagnostics

This is about the ability to systematically identify and document care needs and implement appropriate measures. Nursing staff observe, assess, plan, implement and evaluate care - on the basis of scientifically sound standards. According to § 14 GuKG, the main responsibility for this lies with the DGKP. In Germany, § 4 PflBG regulates the assumption of tasks in the care process.

The care process comprises six phases:

  • Collection of information
  • Identify maintenance problem
  • Determine goal
  • Planning measures
  • Implementation
  • Evaluation

A structured care process ensures quality and enables patient-centred action. Studies show that the quality of care increases measurably when care planning is systematic (see Care Report 2024, GÖG).

2. communication & consulting

Nursing is relationship work. Whether with patients, relatives or in an interdisciplinary team - successful communication creates trust. This also includes providing advice in difficult life situations, e.g. when dealing with illness or care transitions.

Studies like the Nursing Staff Needs Forecast 2024 (GÖG, Austria) show that empathic communication makes a decisive contribution to the quality of care. In Germany, this is also emphasized in the National Competence-Based Learning Objectives Catalogue for Nursing (NKL-P).

Typical tasks:

  • Conversation with patient:inside
  • Guidance for relatives
  • Crisis talks in a multi-professional setting
  • Culturally sensitive communication

3. Interprofessional action

Nurses work closely with doctors, therapists, social services and other professional groups. The aim is to provide coordinated, patient-centered care. It is important to know your own role in the team and to take responsibility without overstepping areas of responsibility.

Communication across professional boundaries is essential, especially in inpatient care or during handovers in hospitals. A lack of cooperation increases the risk of treatment errors - for example, the GÖG 2023 quality assurance report shows that interprofessional action makes a significant contribution to patient safety.

4. law, ethics & quality assurance

Care always takes place in the field of tension between legal requirements, ethical dilemmas and institutional framework conditions. Nursing staff must be familiar with legal principles (e.g. confidentiality, liability, professional duties) and act in an ethically reflective manner - for example when providing end-of-life care or coercive measures.

Quality assurance also includes:

  • Obligation to undergo further training (obligation to undergo further training on a regular basis)
  • Complete nursing documentation
  • Participation in supervision, case discussions and nursing rounds

Compliance with these aspects is also relevant under labour law - see § 13 GuKG (responsibility and liability) and current statements of the ÖGKV.

5. scientific work & professional ethics

Nursing is a learning profession. New studies, guidelines and technologies are constantly changing practice. Scientific work means critically questioning nursing measures, developing them further and undergoing evidence-based further training.

At the same time, the professional ethos - i.e. the inner attitude - is a central element: empathy, a sense of responsibility, integrity.

According to Pflegebildung 2030 (BMASGK, Austria), ethically sound action is a key competence for nursing staff in the 21st century. In Germany, § 5 PflBG explicitly requires "professional ethics and the ability to reflect" as a central training objective.

Sources: Pflegeberufegesetz (PflBG, Germany), Gesundheits- und Krankenpflegegesetz (GuKG, Austria), GÖG Pflegepersonal-Bedarfsprognose 2024, Pflegebericht Österreich 2024, ÖGKV-Kompetenzrahmen Pflege, NKL-P Deutschland and Pflegebildung 2030 (BMASGK).

 
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Nora's tip: Are you unsure whether you are allowed to do everything your colleagues do? Then talk to your team leader or take a look at the Nursing Professions Act (PflBG) or GuKG. Both laws will help you to legally classify your tasks.

And if you want to work in a new area: Do an internship or accompany colleagues for a day - that way you can find out whether the care setting suits you.

If you want to present your skills in a clear, professional and legally compliant way, register at noracares.at. There you can make your care profile transparent - and be found by families who appreciate your experience and qualifications.

 

Register here

 

 

Graphic of nurse Nora with a stethoscope around her neck and the text 'Nora's conclusion' on a green banner. Closing remark or summary in the health sector.

Care is more than a profession - it is a vocation with clear tasks, rights and duties. Whether in mobile care, in a home or hospital: what you are allowed to do depends not only on your training, but also on the area in which you work and the legal framework. Those who know their competencies protect themselves - and ensure better care. That's why you should inform yourself, ask questions and take every opportunity for further training. And if you are prepared to make your skills visible, noracares will help you find the right nursing assignment - fairly, transparently and on an equal footing.

 

A turquoise banner with white text that reads 'Nora's Frequently Asked Questions'. On the right is an illustrated avatar figure of a nurse with blonde hair wearing a turquoise nurse's cap with a white cross, a white collar and a stethoscope around her neck
The most important competencies include professional (nursing knowledge, technique), social (empathy, communication), methodological (organization, problem solving) and ethical skills. They form the basis for professional nursing care.
As a PA, you are allowed to carry out basic care activities - such as personal hygiene, mobilization, help with eating and simple documentation. Medical interventions are only permitted if ordered and under supervision.
Nursing assistants have extended skills and may, for example, give subcutaneous injections, administer medication or provide simple wound care - usually on doctor's orders or according to the care plan.
Certified nurses bear the main responsibility for the nursing process, take on medication management, care planning, interdisciplinary communication and the guidance of other nursing staff.
Because it's about safety - for you, for colleagues and for patients. Anyone who takes on tasks outside their area of expertise risks not only professional errors, but also legal consequences.
In the Healthcare and Nursing Act (GuKG), the Nursing Professions Act (PflBG), as well as in the guidelines of your institution or at the responsible trade union (e.g. ÖGKV, GPA).

 

Graphic logo of Nora's treasure trove of knowledge, a collection of information for nursing staff. Ideal for presenting nursing knowledge and advice.
  • Nursing Assistant (PA): One-year training for basic nursing activities such as personal hygiene, mobilization, meal assistance. Work is carried out on doctor's orders or under supervision.
  • Nursing Assistant (PFA): Two-year training with extended competencies (e.g. injections, medication administration). e.g. injections, administration of medication, simple wound care).
  • DGKP (Diplomierte Gesundheits- und Krankenpflegeperson): Highest nursing qualification with responsibility for the nursing process, documentation, advice and guidance.
  • Care process: Structured process for professional Care planning - includes anamnesis, diagnosis, planning, implementation and evaluation.
  • GuKG:Healthcare and Nursing Act - regulates the nursing professions in Austria, incl. training content and legal framework. training content and legal framework.
  • PflBG: Pflegeberufegesetz - German law on the training and practice of the nursing profession.
  • Subcutaneous injection: Administration of a drug under the skin, e.g. insulin. e.g. insulin. Only permitted under certain conditions.
  • Interprofessional action: collaboration between different professional groups in the healthcare sector with the aim of ensuring the best possible care.
  • Care diagnostics: Assessment of care needs and basis for individual care planning.
  • Professional ethics: The inner attitude and value orientation that guides a professional nurse in everyday working life.

 

 

 

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