Recognition process for nurses in Germany

You are trained in nursing and are considering a move to Germany? And you would like to work here as a professional nurse? Maybe you have already been
approached by a placement agency or language school about your potential for the German labour market. The labour migration of international professionals is a promising prospect, particularly with the increasing demand for professional staff in the healthcare and nursing sectors in Germany. It is also, however, a major step that should be well planned and well organised.

1.Information on the Professional Field

As a profession, nursing care is not practised in the same way everywhere in the world. Certain characteristics set the German approach to nursing apart from other countries in international comparisons. In this brochure, you will learn exactly what that means for your recruitment and recognition procedure. You will also learn some fundamentals about your professional activity as a nurse in Germany. You should know beforehand that nursing staff in Germany can work in different types of institutions. This means that health and social care providers can be run by different organisations. These include:

• Privately organised institutions (in other words private companies)
• Institutions run by churches (for example Caritas and Diakonie)
• Institutions run by non-church charity associations (for example AWO (Workers‘ Welfare Association) and Rotes Kreuz (Red Cross)
• State-run institutions (for example university clinics)

1.1 Nursing Professions are regulated professions

• What you should know:

Regulated professions are professions for which the training is prescribed by the State. In the federally-organised country of Germany this means that regulated professions are organised by either the Federation or by one of the Federal States. The Federation consists of all 16 Federal States. Regulations at the federal level thus affect all Federal States. Regulations at the State level, however, apply only to the respective Federal State.

Should you wish to work in a regulated profession in Germany, you must submit an application for professional accreditation. In this way, you prove your training and thus also your qualification for the relevant profession. Only after you have been granted professional accreditation you will be able to work as a nurse in Germany.

Should you have concluded your vocational training in another country, you must first of all have your final certificate recognised in Germany. Once this is done, you may be granted professional accreditation in Germany. You may then officially work in a regulated profession.

1.2 Qualification, further training and advanced training opportunities for nursing in Germany

• What you should know:

Immigration to Germany related to employment in the nursing sector can open up various career possibilities. There is thus a wide range of options for obtaining qualifications as well as further and advanced training within the field of nursing care.

Qualification options:
Nursing professions require vocational training in Germany. Since 2020 there has been a uniform vocational qualification leading to the title of “nursing professional”. This vocational qualification imparts overarching nursing competences. The competences gained here should enable one to look after people of different age groups in various areas of care. The designation “nursing professional” thus replaces the following former job titles:
● Geriatric nurse
● Paediatric nurse

Further/Advanced Training Possibilities:
Are you already working as a nurse but would like to take on new duties or more responsibility? If so, you may select from a very wide range of further training opportunities and thus achieve your new aims.

1.3 Information on the current labour market situation for nursing professions in Germany

• What you should know:

When selecting your employer and your future place of work, various factors will play an important role. For example, the situation in the labour market or the foreseeable opportunities for your occupational group in the relevant region. You should also ask yourself where you see your greatest potential: as a nurse in a hospital, an institution for long-term care, a rehab facility etc.

In Germany, there has been a shortage of qualified professionals in the fields of healthcare and nursing for a number of years. In the future there is also expected to be approximately 50,000 jobs vacancies in this field. What does that mean for you as an international nursing professional? — The shortage of qualified professionals will induce an increasing number of employers from the broad spectrum of healthcare and nursing to recruit nursing professionals from other countries. In order for hospitals and nursing facilities to be able to ensure their care in the future, nursing professionals from abroad will become increasingly important.

1.4 Tasks and Fields of Work for Nursing Staf

• What you should know:

There are a number of fields in which nursing staff can work. These include, for example:
● Patient care
● Paediatric nursing
● Geriatric nursing
● Intensive care
● Nurse in the operating theatre

The aforementioned fields are themselves sub-divided into various fields of nursing care. These are:
● Acute inpatient care (e.g. clinic)
● Long-term inpatient care (e.g. a nursing home)
● Outpatient care (e.g. nursing private persons in their own homes)

As you can see: as a nursing professional you look after and assist people in every phase of their lives. Your responsibilities include a broad range of important activities. These include:
● The autonomous observation, advising, supervision and care of patients
● The documentation and evaluation of the nursing measures
● The implementation of doctor’s instructions
● Assistance in medical measures

Basic nursing activities are highly important in German nursing facilities. This is why the following activities are not exclusively carried out by auxiliary staff, but are also a part of your own field of responsibility:
● Personal care
● Diet
● Mobility
● Preventive measures (prophylactics)
● Promotion of independence
● Promotion and maintenance of communication

2. Information on Gainful Employment

2.1 Rights and Duties of Employees in Germany

• What you should know:

The employment contract forms the legal basis for a working relationship in Germany. It defines the rights and the obligations of both employee and employer. In terms of content, you should always ensure that you specify the following information prior to or upon concluding the employment contract:
● Names of the contractual partners (your name and that of the company)
● Beginning and duration of the contract
● If applicable, details pertaining to the probationary period
● Place of work
● Description of activity (your duties at the workplace)
● Details of your salary
● Details of working hours in terms of the number of hours per week
● Details of your holiday entitlement in terms of the number of days per year
● Details of the periods of notice applicable to both parties

It may be the case, however, that you will be employed on the basis of a collective agreement. If so, the above information is to be found not in your own individual contract of employment but in that collective agreement. Should you, in the future, work for Caritas for example, the aforementioned points are set down in the AVR-rule book. This is “The Guidelines applicable to Employment Contracts in the Facilities run by the Deutscher Caritasverband”. These guidelines plus the valid collective agreements in general must be available to employees for inspection.

Periods of Notice:
Periods of notice inform you as to how long in advance you must inform your employer of your intention to terminate your working relationship. The same applies vice versa for the company towards you. As a basic rule, there is, in Germany, a legally binding period of notice of at least four weeks. But beware: this statutory period of notice only applies if you have been in an employment relationship of indefinite duration for more than six months.

All information pertaining to your periods of notice, also during the probationary period, is to be found in either your own contract of employment or in your collective agreement. You will receive collective agreements in facilities run by the Deutscher Caritasverband, for example.

Should you not find any details regarding periods of notice in either your employment contract or collective agreement, it is imperative that you should regulate these details additionally in writing.

2.2 Social Insurance Law in Germany

• What you should know:

During your term of gainful employment as a nursing professional in Germany, you are obliged to pay social insurance contributions. This means that you are automatically a member of various insurance institutions. Accordingly, a fixed percentage of your salary is directly retained as statutory social insurance contributions. These contributions are paid into the social insurance companies. In return, thanks to these insurances, you will receive financial
support should you become ill or lose your job.
The contributions to social insurance encompass all compulsory insurances. These are:
Pension Insurance, Health Insurance, Nursing Care Insurance, Unemployment Insurance, Solidarity Insurance:
The health and nursing care insurances are organised according to the principle of solidarity. This means that the contributions paid by you are not paid out directly and in the same amounts in all cases to recipients. Instead, these supportive benefits are paid out according to need and thus also in varying amounts to the contribution-paying members of the insurances

Contribution-based Benefits:
The pension insurance scheme is a contributions-based benefit. The amount of the insurance payments is thus made up of the sum of the contributions paid by you. Put succinctly, this means: you receive what you previously paid into your pension insurance scheme. Unemployment benefit will also be paid to you directly, should you lose your job. In this case, however, the amount of the payments will be calculated on the basis of your salary during the previous 12 months.
Details on Pension Insurance:
You pay into the pension insurance scheme in order to receive a pension upon retirement. This period is known as retirement. The amount of your pension is calculated on the basis of your income during your working life. The years during which you paid contributions in Germany are counted towards this. Generally speaking, pensions from the statutory scheme can also be paid to other countries. This is the case if you should, after retirement, leave Germany again. In certain individual cases, restrictions may apply, however. It is therefore important that you should seek information on your own individual circumstances from the German Pension Insurance Scheme in good time.
Details on Health and Nursing Care Insurance:
As an employee you are insured against illness at all times. You are thereby a member of either the statutory health insurance scheme or have a private health insurance policy. Should you become ill at any time, the health insurance fund will pay the costs of your medical treatment. When you join a health insurance scheme, you also automatically have nursing care insurance. This insurance comes into play should you, due to serious illness or the infirmities
of old age, no longer be able to take care of yourself. You may, for example, be able to pay for the assistance of a nursing professional with the aid of your nursing care insurance.
Unemployment Insurance:
The unemployment insurance scheme pays those who are without employment a regular income for a certain period of time. Generally speaking, in order to receive this benefit you must have been insured for at least one year within the last two while employed, and you must also be actively looking for new employment.

Recognition is essential in Germany for some professions. Working in these professions without recognition is not possible. Also important: Do you want to enter Germany to work? Then you might need recognition. Recognition is a procedure. For every recognition procedure there is a competent authority. The competent authority checks the following: Is the professional qualification equivalent to the German profession?

Commitment and/or Repayment Clauses:
Pay particular attention to so-called commitment and/or repayment clauses. You will find these in your employment contract or in supplementary documents. — What are commitment or repayment clauses? They describe certain obligations that you, as an employee, have towards the company. Quite specifically, these regulations determine that you may not change your job for a certain period of time. Should you, in spite of the respective regulation, nonetheless change your job, you must expect to have to make monetary payments to your employer. It is therefore imperative that you should review the financial aspects of your
contract for appropriateness. In case of uncertainties, independent lawyers specialising in German labour law will assist you.
You may also take advantage of the offer “Fair Integration” of the IQ network.

This offers you advice on topics such as commitment and/or repayment clauses. In this brochure you will find additional information on this under Point 6 (“Neutral Advice and Other Support”).

Co-determination and Active Participation in the Company:
As an employee, you have a right to co-determination and active participation in the decision-making processes within the company employing you. In the case of public or private employers you may also turn to the works council or personnel representatives. These are elected, institutionalised representatives in business establishments, companies and groups. They represent the interests and perspectives of all members of the workforce.
In church or charitable institutions, the body for co-determination is known as “MAV” (employee representative committee). Their elected members also represent the interests of the members of the workforce towards the employer. Their duties are comparable with those of works councillors.

4. Recognition Procedure

In order to be able to work in Germany, your foreign qualifications must first be recognised. This is done in so-called recognition procedure. In order to gain recognition, certain specific competences must be proven in Germany. The nursing profession differs from State to State. It is therefore possible that you may, under certain circumstances, lack the particular competences required in Germany.
Should you fulfil all prerequisites, however, your professional qualification will be recognised. It may even be possible that your professional qualification will be recognised before entering Germany. You will thus be awarded a permit to practise as a nursing professional in Germany. It is frequently the case, however, that competences are lacking that you may catch up on at the beginning of your residence in Germany.
These will be set down in writing in a so-called Deficiency Notice and communicated to you.

There are two ways in which you may remedy any deficiencies:

● By way of an assessment test:
This assessment test examines the extent to which the professional qualification you have gained abroad corresponds to its German equivalent. For this you must undergo both an oral and a written examination. Based on your results, a decision will be made as to whether your qualifications obtained abroad are equivalent to what is taught in training in Germany. But don’t worry, there are specific courses for nursing professionals that ideally prepare you for successfully taking this assessment test.

● By way of an adjustment qualification:
An adjustment qualification is a course that remedies an existing need for extra qualifications. Such courses are usually designed in a modular fashion. Should adjustment qualification be one of the preconditions for your recognition certificate, the following measures will be taken:
B2 Language courses, Professional training courses, Work experience placements in hospitals.Figures on nurses in Germany