Nearly everything a nurse says to a patient is an instruction. Open your mouth. Breathe in. Turn on your side. Hold still. In German, an instruction can be delivered at six different levels of directness, and choosing the wrong one is what makes non-native nurses sound either brusque or unsure.
This guide sets out the six forms, the irregular patterns behind them, and the conventions German clinical staff actually follow.
The Six Levels, Ranked
| Level | Form | Example |
|---|---|---|
| 1 - Most indirect | Konjunktiv II question | "Würden Sie bitte den Arm heben?" |
| 2 - Indirect | Modal verb question | "Könnten Sie den Arm kurz heben?" |
| 3 - Softened | Passive | "Der Arm wird jetzt gehoben." |
| 4 - Neutral, standard | Sie imperative | "Heben Sie bitte den Arm." |
| 5 - Efficient, clinical | Bare infinitive | "Bitte den Arm heben." |
| 6 - Direct, informal | du imperative | "Heb den Arm." |
Levels 4 and 5 are the workhorses of German clinical speech, and level 5 is far more common than most learners expect.
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Why the Bare Infinitive Works
"Bitte tief einatmen." has no subject and no verb ending. It sounds abrupt in English, and it sounds entirely normal in a German treatment room. German uses the infinitive as a concise instruction in three situations.
When the patient is mid-procedure and speed matters. "Bitte Mund öffnen."
When addressing a group. "Bitte rechts stehen."
In written instructions and signage. "Vor Gebrauch schütteln."
The politeness comes from "bitte". Drop the bitte and the same sentence becomes commanding.
The Sie Imperative, Formed Correctly
The Sie form is the easiest in German, because there is only one pattern: verb first, then Sie.
| Infinitive | Sie imperative |
|---|---|
| nehmen | Nehmen Sie |
| atmen | Atmen Sie |
| warten | Warten Sie |
| sich setzen | Setzen Sie sich |
| sich anziehen | Ziehen Sie sich an |
| aufstehen | Stehen Sie auf |
Notice the last two. With separable verbs, the prefix goes to the end. With reflexive verbs, the pronoun comes after Sie.
The du Imperative and Its Irregulars
You will use the du form with trainees and colleagues, not with patients. It is worth knowing because colleagues will use it at you, and the irregular forms are unpredictable.
| Infinitive | du imperative | Pattern |
|---|---|---|
| nehmen | nimm | vowel changes to i |
| geben | gib | vowel changes to i |
| helfen | hilf | vowel changes to i |
| sprechen | sprich | vowel changes to i |
| essen | iss | vowel changes to i |
| lesen | lies | vowel changes to ie |
| sehen | sieh | vowel changes to ie |
| schlafen | schlaf | no ending needed |
| aufstehen | steh auf | prefix to the end |
| sich setzen | setz dich | pronoun after the verb |
Twenty Instructions You Give Every Day
"Bitte atmen Sie tief ein." - Please breathe in deeply.
"Atmen Sie langsam aus." - Breathe out slowly.
"Öffnen Sie bitte den Mund." - Please open your mouth.
"Strecken Sie die Zunge heraus." - Stick out your tongue.
"Bitte halten Sie still." - Please hold still.
"Heben Sie den Arm an." - Raise your arm.
"Ballen Sie die Faust." - Make a fist.
"Öffnen Sie die Hand wieder." - Open your hand again.
"Drehen Sie sich auf die linke Seite." - Turn onto your left side.
"Setzen Sie sich bitte auf." - Please sit up.
"Bitte stehen Sie nicht allein auf." - Please do not stand up alone.
"Drücken Sie bitte kurz auf die Stelle." - Please press on the site briefly.
"Sagen Sie mir, wenn es wehtut." - Tell me if it hurts.
"Bitte schlucken Sie." - Please swallow.
"Nehmen Sie einen Schluck Wasser." - Take a sip of water.
"Bitte ziehen Sie den Ärmel hoch." - Please roll up your sleeve.
"Legen Sie sich bitte flach hin." - Please lie flat.
"Bitte entspannen Sie die Schultern." - Please relax your shoulders.
"Versuchen Sie es noch einmal." - Try again.
"Sehr gut, danke." - Very good, thank you.
The Grammar Worth Noticing
Three structural facts do most of the work.
With separable verbs, the prefix moves to the end. "Stehen Sie bitte auf", not "Aufstehen Sie bitte".
With reflexive verbs, the reflexive pronoun follows Sie or du. "Setzen Sie sich", "Setz dich".
Bitte is the politeness marker, and its position is flexible. "Bitte atmen Sie ein" and "Atmen Sie bitte ein" are both standard. It is rarely omitted with patients.
The setting selects the level. Moving too far up or down the ladder is what makes a nurse sound uncertain or abrupt. If choosing the level is your weak point, learn German with instruction and consent roleplays.
Four Mistakes Worth Avoiding
Using the du imperative with a patient. "Atme tief ein" to a patient is a register error that German listeners notice immediately.
Over-using the Konjunktiv II. "Würden Sie vielleicht freundlicherweise den Arm heben?" is so indirect that it sounds like a request the patient is free to refuse. For necessary care, level 4 or 5 is correct.
Omitting bitte. Without it, the infinitive form becomes an order rather than an instruction.
Forgetting the reflexive pronoun. "Setzen Sie" instead of "Setzen Sie sich" changes the meaning to placing an object rather than sitting down.
Why This Is the Highest-Frequency Skill on the Ward
You will give more instructions in a shift than you will do anything else with language. Getting the level right, automatically, is what makes your German feel professional rather than translated.
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