German has two words for "you", and choosing the wrong one is the fastest way to make a good impression disappear. On a ward the rule is stricter than in almost any other workplace, because half the people you speak to are patients whose dignity depends on the form you use.
This guide sets out the rule, the exceptions, and the exact sentences for moving between the two.
The Core Rule on a German Ward
| Who you are speaking to | Address form |
|---|---|
| Patients, of any age | Sie, plus the surname |
| Patient's relatives | Sie, plus the surname |
| Students and trainees | Sie, until they are invited |
| Colleagues at your level | du, once offered |
| Doctors | Sie, plus the title and surname |
| Agency staff you have just met | Sie, until offered |
The important asymmetry: du is normal between colleagues, and never correct with a patient. Not with a nineteen-year-old, not with a patient who calls you du first, and not with a patient you have known for months.
If you want to get the register right from your first day, learn German with workplace roleplays that practise formal and informal forms side by side.
The Same Instruction, Two Ways
This is the table that makes the difference concrete. Every one of these is a sentence you will say on a shift.
| Sie form (patients) | du form (colleagues) | English |
|---|---|---|
| Nehmen Sie bitte Platz. | Nimm bitte Platz. | Please sit down. |
| Heben Sie den Arm an. | Heb den Arm an. | Raise your arm. |
| Atmen Sie tief ein. | Atme tief ein. | Breathe in deeply. |
| Bleiben Sie bei mir. | Bleib bei mir. | Stay with me. |
| Sagen Sie mir Bescheid. | Sag mir Bescheid. | Let me know. |
| Können Sie sich aufsetzen? | Kannst du dich aufsetzen? | Can you sit up? |
| Möchten Sie etwas trinken? | Möchtest du etwas trinken? | Would you like a drink? |
| Warten Sie bitte kurz. | Warte bitte kurz. | Please wait a moment. |
| Setzen Sie sich hin. | Setz dich hin. | Sit down. |
| Drehen Sie sich auf die Seite. | Dreh dich auf die Seite. | Turn onto your side. |
Offering and Accepting du
| Situation | German |
|---|---|
| You want to offer | "Sollen wir du sagen?" |
| Softer version | "Wollen wir uns duzen?" |
| Formal version, older colleague | "Würde es Ihnen etwas ausmachen, wenn wir du sagen?" |
| Accepting | "Gerne, danke." |
| You are offered and unsure | "Gerne, wenn es für Sie in Ordnung ist." |
| You are the trainee | wait to be offered on each team |
Once du is agreed, it applies from that moment on. Switching back to Sie afterwards reads as a withdrawal.
Three Regional Details
Austria and Switzerland are more formal. In Austrian and Swiss workplaces, Sie persists noticeably longer than in Germany, and the offer to du often never comes. Do not initiate it there.
Bavaria and the south are somewhat more formal than Berlin or the north. The same nursing team in Munich and in Hamburg may hold different defaults.
Titles stay in place. In all three countries, Dr. and Prof. are part of the name in address: "Herr Dr. Weber", not "Herr Weber". This is true regardless of how friendly the relationship becomes.
Indicative pattern rather than a survey. The two zeros are absolute - du is never appropriate with patients or relatives.
Two Structures to Watch
German formality lives in more than the pronoun. Two other things change with register.
First names versus surnames. Colleagues on du use first names. Patients are always "Frau Müller" or "Herr Schmidt". Using a patient's first name is a register error even when the pronoun is correct.
Greetings. "Guten Morgen, Frau Müller" is standard. "Hallo" alone with a patient is informal in a way some older patients find disrespectful. Colleagues, by contrast, say "Hallo" or "Moin" constantly.
Four Mistakes Worth Avoiding
Switching mid-sentence. "Nehmen Sie bitte Platz - und dann kannst du mir sagen..." is jarring in a way English speakers rarely anticipate. Pick a register and hold it for the whole conversation.
Copying a patient's du. Some older German patients address nurses informally. The convention is that the professional holds the formal form until invited, so mirroring them is wrong.
Using du with relatives. Relatives are addressed with Sie and their surname, even when they are the same age as you.
Assuming the ward's culture applies to the doctor. du with the doctor is possible in some teams but far from universal. Wait until you are explicitly included.
Age, Setting and the Safe Default
If you are unsure, the safe default in German healthcare is Sie plus the surname, and you should hold it until someone explicitly offers du: "Wir können uns gerne duzen." That sentence is the invitation, and it comes from the person with the higher status or the longer tenure.
Two variables change the answer. Setting matters: a small Geriatrie team is far more informal than a Universitätsklinikum, where rotating staff make du impractical. Age matters less than English speakers expect, because a 60-year-old Pflegekraft may address a 25-year-old doctor with Sie: the role, not the birth year, sets the form.
Learn the verbs that carry the register as well. Anbieten, bitten, ansprechen and auffordern all behave differently depending on who is standing in front of you. Mastering that set is a large part of what it means to learn German for a German workplace.
Why This Is Worth Effort
Register is the difference between being understood and being trusted. German patients judge competence partly by whether you handle the formal form correctly, because it signals that you understand the setting you are working in.
That judgement happens in the first ten seconds of the first conversation, before you have demonstrated a single clinical skill.
Want to sound right in German from the first sentence? Learn German with formal and informal registers practised side by side at languageskills.net.
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