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Information on the migration of nursing professionals to Germany

You have a nursing education and are considering coming to Germany to work as a nurse? You have been approached by a placement agency, via a language school or through other channels about working for an employer in Germany? This may be a good idea, especially in light of the increasing demand in the health and nursing professions in Germany.

But an international job migration is also a big event and so it is advisable to inform yourself about specific circumstances and possibilities in advance.

Here are some tips on topics that may be relevant for internationally employed nursing professionals.

Do not rely on simplistic or generalized descriptions or promises and gather as much concrete information as possible. Feel encouraged to gather information on your own and assess and evaluate the situation for yourself. This will protect you from unpleasant surprises and allow you to choose the path that best suits you.

 

1 Occupational field

Nursing as a profession is not practiced in the same way everywhere in the world. In Germany, there are – in international comparison – some special features. This is important for you both during the recruitment and recognition process and for the subsequent professional activity in Germany – perhaps even until you leave the workforce. In Germany, nursing professionals work either in private-sector institutions, in church-run institutions (Caritas, Diakonie, etc.) or in public-sector institutions (e.g., university hospitals)

 

1.1 Nursing professions are regulated professions as well as training, further training and continuing education opportunities.

Regulated professions are professions for which training is regulated by the state. In the federal state of Germany, professions are regulated either by the federal government or by the respective state.

 

Important:

If you want to work in one of these professions in Germany, you have to apply for a professional license and prove your qualification, i.e. education. Only with the obtained professional license one is allowed to work as a nurse in Germany.  Persons with a degree acquired abroad must therefore have it recognized in Germany. Only then can a professional license be applied for or granted.

If you decide to immigrate to Germany for work in the nursing sector, you will probably also be interested in career opportunities, i.e. training, advanced training and continuing education opportunities for your professional field.

 

Training opportunities

Nursing professions are vocational training programs in Germany. Since 2020, there has been a standardized professional qualification “Pflegefachmann” or “Pflegefachfrau”, which teaches overarching nursing competencies. These competencies are intended to enable the care of people of different age groups in various areas of care and, in the long term, to replace the previous occupational titles of geriatric nurse or health and pediatric nurse in the long term.

 

Further education and training opportunities

If you are already working in nursing and would like to take on new tasks or more responsibility, you can choose from a very wide range of further training courses to achieve these goals.

 

How and where can you obtain further information on the subject of regulated professions independently?

  • https://www.pflegeausbildung.net/
  • The website Perspektive Gesundheitswirtschaft of the Berlin IQ Network is designed to give you an overview of the health care industry and inform you about qualification requirements and fields of work.
    Perspective on the Health Care Industry:
    https://www.netzwerk-iq.de

 

How and where can you find out more about training, further training and continuing education opportunities in nursing professions in Germany?

 

1.2 Labour market situation

The labour market situation for your occupational group as well as labour market opportunities by region or employer (hospital, long-term care facility, rehab…) may play a role in your choice of employer or region of interest in Germany.

In general, there has been a shortage of health professionals in Germany for several years. About 50,000 positions will remain unfilled in the future. As a result of this shortage, more and more employers, such as hospitals and long-term care facilities, are recruiting skilled nursing staff from abroad in order to be able to guarantee the provision of care in the medium to long term.

 

How and where can you find out more about this on your own?

You can obtain reliable information on the labour market situation in the field of nursing in Germany from the online website of the Federal Employment Agency:

Statistik der Bundesagentur für Arbeit: Startseite

 

1.3 Tasks and fields of work of nursing professionals

There are different fields of work for nursing professionals. Some are:

➔ Nursing

➔ Paediatric nursing

➔ Elderly care

➔ Intensive care

➔ Operating theatre

The above-mentioned areas are in turn carried out in different nursing care areas, namely acute inpatient care (e.g. hospital), inpatient long-term care (e.g. nursing home) and outpatient care (e.g. care at home).

 

As a nurse, you will care for and look after people at every stage of their lives. The various tasks in the care sector include:

➔ independent observation

➔ counselling,care and nursing of patients

➔ documentation and evaluation of nursing measures

➔ carrying out medical orders

➔ Assisting with medical measures

Basic nursing activities, i.e. personal hygiene, nutrition, mobility, prevention (prophylaxis), the promotion of independence and communication, are of great importance in Germany and are carried out not only by nursing assistants but also by nursing professionals.

 

How and where can you find out more about this independently?

You can find more information on this topic here, for example: Brief description of nursing specialist from the Federal Employment Agency.
https://berufenet.arbeitsagentur.de/

Short description of health and paediatric nurse from the Federal Employment Agency
https://berufenet.arbeitsagentur.de/

Overview of the health industry sector of the Berlin IQ Network
https://www.netzwerk-iq.de

 

1.4 Professional and trade associations

A professional association is a free and independent interest group whose members are members of the same profession or closely related professions. The aim is to better represent the interests of many workers in the field of care to employers or the general public.

Professional associations have the task of representing the interests of their members with regard to the content of the exercise of the profession, i.e. with regard to the meaning and manner of exercising the nursing profession and in the economic, social and societal sense. For example, are you looking for advice on legal issues? Then a professional association could help.

 

How and where can you get further information on your own?

In Germany, there are a large number of professional and specialist associations for the nursing profession. You can find some selected professional and specialist associations for nursing professions here:

 

 

2 Gainful employment

Germany has a well-developed labour law. Working hours, holiday and break entitlements, termination rights and many other points are regulated in employment contracts.

 

2.1 Rights and duties of employees in Germany

The employment contract is the legal foundation for an employment relationship within Germany. It sets out the rights of employees and their obligations towards employers. In terms of content, it is essential to obtain the following information before concluding the contract, if it is not mentioned in the employment contract:

  • Names of the contractual partners (of you and of the company).
  • the start date of the contract and its duration
  • details of the probationary period (if one is specified)
  • the place of work
  • if applicable, a job description, i.e. above all what tasks you will be expected to perform
  • Details of the salary
  • Details of working hours, i.e. how many hours you will work per week
  • holiday entitlement, i.e. how many days you can take per year
  • Details of notice periods on both sides, i.e. how long you or the company must give notice in advance that the employment relationship is to be terminated. In principle, a legally binding notice period of at least four weeks applies in Germany.
  • However, it may be that you are employed through a collective agreement. In this case, this information is not in the individual employment contract, but in the collective agreement (e.g. AVR at Caritas).

 

Pay particular attention to so-called commitment and/or repayment clauses in your employment contract or other documents. These are special formulations that oblige you as an employee not to change your job for a certain period of time or to pay money back to your employer if you decide to do so. These should be appropriate and of course comply with German law. The IQ Network’s “Fair Integration” service (see also point 6 of this information brochure) offers advice on these topics.

As an employee, you are also entitled to co-determination and participation in the decision-making processes of the company that employs you. In the case of public or private employers, you can contact the works or staff council. As elected, institutionalised employee representatives in companies, enterprises and corporations, they represent the interests and perspectives of all employees. In church or charitable institutions, the body for co-determination is called employee representation (MAV). Here, too, their elected members represent the interests of the employees vis-à-vis the employers. Their tasks are comparable to those of works councils.

 

How and where can you find out more about this on your own?

 

2.2 Social security law in Germany

During your employment as a care worker in Germany, you are subject to social insurance, which means that you are automatically a member of various insurance schemes that provide you with financial protection in case of illness or unemployment. Accordingly, a fixed percentage of your salary is deducted directly from your salary as social security contributions and paid into these insurances. Social security contributions include all types of compulsory insurance, i.e. pension, health, long-term care and unemployment insurance. Insurances such as health or long-term care insurance are solidarity-based, which means that the contributions you pay are not paid directly to recipients, but are paid out to the contributing members as needed.

Pension insurance is a contributory cash benefit, which means that if you become insured, the amount of your benefits will be based on the amount of contributions you have paid and will be paid directly to you. Unemployment insurance is also paid directly to you if you become unemployed. However, the amount of the cash benefit here is calculated on the basis of your salary for the past 12 months.

 

Pension insurance:

You pay into the pension insurance scheme in order to receive a pension, i.e. a state living allowance, after you have retired. The amount of the pension is determined by the amount of income during employment and the number of years of contributions in Germany. In principle, pensions from the statutory pension insurance scheme are also paid abroad. In certain individual cases, however, there may be restrictions, which is why you should inform yourself in your case in good time beforehand at the German Pension Insurance.

 

Health insurance / nursing care insurance:

As an employee, you are always covered by health insurance – either as a member of the statutory health insurance or a private health insurance. If you ever become ill, the health insurance company will cover the costs of medical treatment. By taking out health insurance, you are automatically also insured for long-term care. Long-term care insurance comes into effect if, for example, you can no longer look after yourself due to a serious illness – i.e. you need help from a carer.

 

Unemployment insurance:

Unemployment insurance pays unemployed people a regular income for a certain period of time. In principle, you usually have to have been insured for one year within the last two years while you were working and you have to be looking for work again.

How and where can you find out more about this on your own?

You can find more information on social insurance at “Make it in Germany”, among others.
https://www.makehttps://www.make-it-in-germany.com/de/leben-in-deutschland/zurueckkehren/sozialversicherung-it-in-gemany.com/de/jobs/sozialversicherung/deutsche

 

 

3 Immigration process and promotion of integration

If you wish to enter Germany from a third country, you will need a residence title, which is determined by the purpose of your stay. There is a wide range of immigration and integration advice available in Germany.

 

3.1 Immigration options

If you want to enter Germany from a third country, you need a residence title that depends on the purpose of your stay. Germany offers a wide range of migration and integration counselling services.

The Skilled Workers Immigration Act (FEG) opens up the possibility of accelerating the entry procedure for skilled workers (Section 81a of the Residence Act (AufenthG)). This means that if you have a concrete job offer, the employer can apply for an “accelerated skilled worker procedure” for you against payment of a fee. In the accelerated procedure for skilled workers, the foreigners authority plays a key role and is responsible for advising employers about the entry requirements for you, for checking all applicable requirements, for initiating the recognition procedure, etc…. The authorities involved are bound by relatively tight deadlines throughout the procedure. As a rule, however, the accelerated procedure for skilled workers does not take longer than four months (approx. six weeks for issuing a visa, approx. two months for the recognition procedure and approx. one week for the approval procedure). Alternatively, the regular entry procedure and, if applicable, the procedure for obtaining a preliminary approval from the Federal Employment Agency pursuant to Section 36 (3) BeschV are still open to you. Which procedure you choose if an accelerated skilled worker procedure is not an option should be decided together with the employer. The procedure can also be applied to the family reunification of spouses and children, provided that the applications for this are submitted in a temporal context (i.e. entry of the family members within 6 months of the entry of the skilled worker).

Since March 2020, in addition to measures such as Triple-Win, there has been the possibility of entry to Germany within the framework of placement agreements between the Federal Employment Agency and the employment services of selected countries of origin (Section 16d (4) Residence Act). Unlike the previously mentioned procedures, a visa for entry does not require a completed individual recognition procedure. However, entry within this procedure is only possible if, in the opinion of the Federal Employment Agency, full recognition of the foreign professional qualifications is achievable. The Federal Employment Agency therefore only concludes agreements for selected professional qualifications from the country of origin which it deems suitable in consultation with a body responsible for professional recognition or the professional associations or where, in its estimation, “appropriate training structures” exist.

 

How and where can you obtain further independent information on this?

  • Detailed information from the IQ Network on entry in the context of placement agreements can be found here in English and German
    https://www.netzwerk-iq.de/en/

 

3.2 Migration and integration counselling infrastructure

There is a wide range of migration and integration counselling services in Germany. Some of the most important contact points can be found in the following list:

  • Since 2005, the federal government has offered migration counselling for adult immigrants. It is a service specifically for newly arrived migrants: https://www.bmi.bund.de/
  • mbeon migration counselling is a digital service that offers those seeking advice the opportunity to take advantage of free, anonymous and data-secure chat counselling on issues related to arriving in Germany (topics such as work and career, learning German, health and housing) via the mbeon app. At the same time, extensive information on migration is provided in the app and on this website as an initial orientation aid. In addition, it is possible to get personal counselling at an MBE counselling centre:
    App: https://www.mbeon.de/Counselling centre: https://bamf-navi.bamf.de/de/Themen/Migrationsberatung/

Fair Integration is a nationwide counselling service on social and labour law issues for refugees and other non-EU migrants. In the counselling centres, people who are already in work, training or internships can receive advice on specific issues as well as those who want preventive information about their working conditions. The counselling centres also offer workshops for the target group, e.g. as part of integration or language courses. The counselling services cover labour and social law issues directly related to the employment relationship, e.g.: Wages, working hours, leave, dismissal, health insurance, etc. For other thematic issues – e.g. job search or residence status – referrals are made to specialised counselling centres and advisory institutions:
https://www.faire-integration.de/

Associations play an important role in the integration of immigrants. An association is an association of several people who share a common interest or a common goal. According to the Federal Association of Associations, there are a total of over 620,000 associations in Germany. These include, for example, various sports clubs, religious associations, cultural associations, self-help associations and a multitude more.

 

How and where can you get general information on migration counselling?

  • You can get information on associations in your place of residence from the municipal administration and from the Bundesverband der Vereine und des Ehrenamts e.V. (Federal Association of Associations and Volunteers)
    https://bundesverband.bvve.de/

 

 

3.3 Political, social, religious and cultural participation opportunities

In Germany you can become politically, socially, religiously and/or culturally active in many ways. A first start for finding opportunities for participation and support can be made on the website of the Federal Government Commissioner for Migration, Refugees and Integration: https://www.integrationsbeauftragte.de

Social and cultural participation is also possible through migrant (self-)organisations, such as the Association of Internationally Recruited Nurses in Germany. Another option is to contact your municipality/church community or associations in your place of residence.

Furthermore, you can participate in political, religious or sporting activities within associations. An association is a group of people who share a common interest or goal.

 

How and where can you get more information on your own?

 

 

4 Recognition process

In order to be able to work in Germany, your foreign qualification must be recognised. This requires a so-called recognition procedure. In order to obtain recognition, very specific competences must be demonstrated in Germany. The nursing profession differs from country to country, so you may still lack certain competences that are particularly important in Germany.

If you meet all the requirements, your professional qualification may already be recognised before you enter Germany. You will receive a licence to practise as a care worker in Germany. Often, however, you still lack skills that you can catch up on at the beginning of your stay in Germany. These are shown by a so-called deficiency certificate.

 

4.1 Ways of professional recognition as a nursing specialist (recognition procedure)

There are two ways to make up deficits:

  1. knowledge examination: In a comprehensive oral and written examination, contents which you have acquired through your training abroad are tested for equivalence with the German training. Special courses for nursing professionals prepare you optimally for successfully passing the knowledge examination.
  2. adaptation qualification: Unlike the knowledge test, the adaptation qualification is a course that is adequately oriented to the need for post-qualification. Most of these courses are modular. If it is part of the requirement in the recognition notice, B2 language courses are taught, specialist training is provided and internships are completed in hospitals.

 

4.2 Information and counselling services offered by the Federal Government

How and where can you obtain further information on your own?

  • Federal Institute for Vocational Education and Training (BIBB): Information on the recognition of foreign vocational qualifications in Germany
    https://www.bibb.de/de/719.php
  • The Integration through Qualification (IQ) funding programme supports you with the help of its regional IQ networks in finding a suitable measure in your area.
    https://www.netzwerk-iq.de/

 

5 Language acquisition

In order to obtain a professional licence in Germany as a nurse who has completed his/her training abroad, a certain level of language proficiency must be demonstrated.

 

5.1 CEFR (Common European Framework of Reference)

Currently, the language certificate of level B2 according to the Common European Framework of Reference for Languages (CEFR) is required for professional admission. The aim of the CEFR is to make the various European language certificates comparable with each other so that a reliable statement can be made about your personal language skills. The CEFR distinguishes between 3 main categories: A (language beginner), B (practised speaker with an intermediate language level) and C (language professional). A B1 language certificate (CEFR) is currently required for entry into Germany; qualification for B2 can be obtained in Germany.

 

How and where can you find out more about this independently?

 

5.2 Technical language for care professionals

Since nursing professionals often need special vocabulary and phrases in their everyday work, it is helpful to prepare specifically for this. Special language courses for nursing professionals are available for this purpose. Such courses are often offered from level B onwards or nursing vocabulary is integrated into regular lessons.

In the future, the language certificate will be based on a B2 specialist language test, i.e. for the specialist language of nursing. Some Länder are already preparing the changeover. Initially, this B2 specialist language test is to be introduced in Schleswig-Holstein, Hamburg, Bremen, Lower Saxony and Mecklenburg-Western Pomerania. General language courses will be offered, as well as those that specifically prepare people for working in nursing professions.

 

How and where can you find out more about this independently?

  • The IQ Fachstelle Berufsbezogenes Deutsch offers another service for German in care with the interactive learning game “Ein Tag Deutsch – in der Pflege”: exercises on communication, vocabulary, structures and pronunciation for learners of German from B1.
    Available as an app and web version as well as with detailed additional materials for teaching.
    https://www.ein-tag-deutsch.de/
  • On the website of the IQ-Fachstelle Berufsbezogenes Deutsch you will find a collection of materials for the field of nursing that can help you with language acquisition. There is a detailed collection of materials for the field of care, in which the target group addressed could certainly also find useful materials.
    https://www.deutsch-am-arbeitsplatz.de/

 

5.3 funding opportunities

The “Verordnung über die berufsbezogene Deutschsprachförderung” – DeuFöV for short – is the legal basis on which vocational German language courses are conducted. The Federal Office for Migration and Refugees (BAMF) is responsible for conducting the DeuFöV courses. For this purpose, the BAMF allows public and private providers. For persons in the recognition phase of their foreign vocational qualification, authorisations can be granted by the BAMF.

 

How and where can you obtain further information on your own?

 

 

6 Neutral counselling and other support

There is a large and wide-ranging counselling and support landscape in Germany, most of which also provide free assistance and offer neutral counselling services.

 

6.1 Counselling and contact points

Regardless of the information you receive through your employer or agency, you should know about neutral counselling centres. There are numerous offers, some of which are listed here. Do not be afraid to take advantage of these offers – they can be very helpful in various situations.

 

How and where can you get more information on your own?

There is a wide range of advice on employment contracts, commitment clauses, breaks, dismissal and compulsory insurance. You can find a selection here:

  • The Fair Integration offer is a counselling focus of the IQ funding program. The counselling offer includes labour and social law issues directly related to the employment relationship, e.g.: Wages, working hours, holidays, dismissal, health insurance, etc:
    https://www.faire-integration.de/
  • The Work and Life Network for counselling foreign workers was founded for professional exchange, qualification and joint public relations work. Counselling is available in several languages (mostly German, English, French, Spanish, Polish, Ukrainian, Croatian, Russian, Turkish, Arabic).
    https://www.arbeitundleben.de/

 

How does the German care system work?

The following YouTube offer of the DGB on labour law topics is recommendable, but there is no direct reference to care professions here:
https://www.youtube.com/channel/UCvkGt1DZgxJFjK2X-JyV4YA

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