nursing staff

Information for employers and recruitment agencies on the recognition and employment of foreign nursing professionals.

Here you learn ...

everything about the recognition of foreign nursing professionals
Deficit notice and recognition partnership for nursing staff
Requirements for recognition of nursing staff
Legal hurdles for recruiting foreign nursing staff

1. Why Germany needs nursing professionals

2. The path to recognition: The deficit notice

3. Requirements and documents

4. Recognition partnership as an alternative to the deficit notice

5. FAQ for nursing staff

6. Conclusion Nursing professionals

1. Why Germany needs nursing professionals

Germany is facing a severe shortage of qualified nurses . Currently, around 15% of nurses working in Germany come from abroad, and the trend is rising. Migrants from Turkey, Russia, and Southeast Asia are particularly well represented. Demographic change and an aging population mean that qualified nurses are urgently needed.

To meet this demand, the federal government has created new immigration opportunities. Nursing assistants, for example, can apply for a visa under Section 22a of the Employment Ordinance , while simplified recognition options, such as the Recognition Partnership , apply to skilled nurses. These regulations make it easier for foreign nursing professionals to work legally and with qualifications in Germany – a step that not only stabilizes the nursing system but also opens up new perspectives for migrants.

Nursing activities are among the so-called regulated professions . This means that foreign nursing staff require recognized training and a residence permit. Recognition can be granted through a deficit notice or a recognition partnership – central procedures through which foreign qualifications are compared with German standards.

2. The path to recognition: The deficit notice

Nursing professionals whose training abroad is not fully recognized must undergo a so-called deficit procedure (see also our guide to deficit assessments ). The deficit assessment is an administrative act that determines the differences between the foreign and German training. This assessment forms the basis for qualification-related further training in Germany.

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The recognition process for nursing professionals involves several steps: First, an application is submitted to the responsible recognition authority, including proof of training and a CV. A deficiency notice is then issued. Based on this notice, nurses can apply for a visa to enter Germany and complete the necessary adaptation measures (theoretical and practical).

After completing this phase, an examination follows, which, if passed, leads to the issuance of a professional practice permit under the Nursing Professions Act (PflBG) . From this moment on, the foreign national is officially considered a nursing professional and can apply for a corresponding residence permit for professionals with vocational training (Section 18a of the Residence Act) . In addition to the professional permit, long-term prospects such as a settlement permit or even future naturalization now open up.

3. Requirements and documents

Applying for a deficit notice for nursing professionals requires various documents , including a passport, proof of training, a CV, and—if available—employment references and language certificates. All documents must be in German. The subsequent visa process also requires extensive documentation. This includes, among other things, a signed employment contract, proof of the intended place of work, health insurance, and the deficit notice itself. Careful preparation is crucial to avoid delays in the process.

VISAGUARD supports nursing professionals and employers in compiling the necessary documentation. We help streamline communication with authorities and avoid legal hurdles in the recognition process – whether at the embassy or with the immigration authorities.

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4. Recognition partnership as an alternative to the deficit notice

The recognition partnership is an attractive alternative for nurses with foreign qualifications. It allows them to work in Germany while the recognition process is underway – provided the activity is aligned with the desired target profession and the nurse has at least two years of vocational training.

Further requirements include German language skills at least at level A2, approval from the Federal Employment Agency, and a rapid start to the adjustment measures after entry. The recognition assessment can be applied for online in advance through the ZAB (Federal Employment Agency). This accelerates the entire process and makes it more practical.

For many employers, the recognition partnership is a flexible and legally secure way to integrate qualified nursing staff into operational processes at an early stage.

For further information on the recognition partnership, please see our corresponding VISAGUARD Guide .

5. FAQ

Which activities may only be carried out by nursing staff

According to the Nursing Professions Act, the activities of nursing professionals are regulated (see Section 4, Paragraph 2 of the Nursing Professions Act). Therefore, only nursing professionals may perform the following activities:

Survey and determination of individual care needs
Organization, design and control of the care process
Analysis, evaluation, assurance and development of quality

What language skills are necessary to complete the recognition procedure?

With regard to the required language skills, a distinction must be made between the individual administrative procedures. A2 language skills are generally required for the visa application process with the deficit notice. B2 language skills are necessary for the issuance of a professional practice permit. However, no language skills are required for the application for the deficit notice itself. The assessment of language skills falls outside the competence of the recognition authorities. Where the information sheets of the recognition authorities provide otherwise, these instructions mostly refer to the requirements of employers and educational providers.

Is the recognition of nursing training (deficit notice) possible in the accelerated skilled worker procedure?

Yes, the recognition process can also be carried out as part of the accelerated skilled worker procedure. The immigration authorities will then take over the recognition process for nursing qualifications from third countries.

When can nursing professionals apply for a residence permit?

After completing the adaptation measure, the foreigner is a skilled worker within the meaning of the Skilled Immigration Act and can therefore apply for a settlement permit after four years instead of five.

6. Conclusion

The recognition and employment of foreign nursing staff in Germany is a key component in securing nursing care. Due to the shortage of skilled workers, the legislature has created numerous ways to facilitate access to the German labor market for qualified nursing staff from third countries. The focus here is on the recognition procedure with a deficit notice and the recognition partnership pursuant to Section 16d Paragraph 3 of the Residence Act. In the deficit notice procedure, the deficit notice must first be applied for from the recognition authority, followed by the visa procedure. With the visa, entry to Germany is possible. In Germany, the adaptation measures are then carried out, and at the end of the process, the nursing staff receives a license to practice their profession in accordance with the Nursing Professions Act.