Nursing in Germany

To become registered as a nurse, an individual needs to take and pass an official state exam in nursing. Different departments (in [Baden-Württemberg] f.i. the Regierungspräsidium) are responsible for registration in different locations of the country.

A German nurse

In most cases, nurses learn the profession in a special nursing school that is often connected to a hospital. Before matriculating, individuals are required to complete several weeks of practical training in a hospital setting. The nursing course is completed according to EU regulations, and is three years long, including around 2100 hours for theoretical knowledge and 2500 hours of practical training in different hospital settings.

In the first year of education, nurses are paid about 750-800 Euro per month. In the second year of education, nurses are paid about 800-900 Euro per month. In the third and last year of education, nurses are paid about 930-1030 Euro per month.

There are some changes to be expected in the future as it is now possible to study nursing on a B.Sc. basis (mostly in universities of applied sciences). But individuals still need to pass the official state exam to become a registered nurse. Some universities offer a special program with local nursing schools wherein students earn the B.Sc. and accordant state registration. Some universities offer post-graduate studies leading to a master's degree and the possibility to continue studies for a Ph.D. degree.

There are also nursing helpers who attend a one-year program in nursing school. This may change again with the introduction of university nursing curricula.

There are different ways to specialize after the nursing schools, called Fachweiterbildung. Salaries are typically higher with a Fachweiterbildung. Specialization includes some 720–800 hours of theoretical education and practical training. In the end, there is a state exam or writing of a thesis. There are official two year specializations in:

• ICU and anesthesia
• OR
• oncology
• home care
• psychiatric
• palliative care
• quality management
• hygienic
• ward manager

It is possible for nurses to undergo a variety of shorter programs to continue learning and enhance their knowledge (e.g. wound management, oncology, palliative care, etc.).

In hospitals, there are mostly working registered nurses and nursing students. Registered nurses in Germany take care of the patients and there are different systems who and how the patients are treated: (a) taking care of a set of patients including all work that needs to be done or (b) taking care of the patients on a ward doing just one special function. Work includes planning based on the patients' needs and condition, documenting, writing about the progress and current condition. Preparation of medication is in the hands of nurses and its application: tablets, infusion etc. but not the i.v. application by syringe (except in the ICU). Blood samples and setup of venflos are not done by nurses (except in the ICU), but mostly done by students of medicine or doctors, even if it is in the curriculum. All basic care is done by registered nurses or coordinated and done by the nursing students. Special care like setting up urine catheters, nasogastric tubes, treatment of wounds and wound dressings are done by registered nurses or nurse students (under supervision).

Job satisfaction is not the best in Germany because of the heavy work-load, low salaries and a low appreciation of the nurse profession in the public. Even some politicians in the past claimed that everybody is able to nurse. The nurse associations are working hard to achieve the acceptance for the installation of nursing chairs in universities but they are often undermined by politicians who are looking for the cheapest work force but not skilled and professional workers.

In Germany, all nurses who want to work in their nursing profession have to have their qualification recognized by applying for an "Anerkennung". This is through the official administrative body responsible for licensing health care professionals which varies from state to state. Requirements include: language proficiency of level B2 in German, registration with the Nursing Midwifery Council (NMC), evidence of nursing education (including an academic transcript and degree certificate which may need to be translated into German), evidence of current residence, evidence of allowance to work in the EU, and evidence that your Nursing education meets the "EU Berufsanerkennungsrichtlinie/2005/36/EG" standards.

German Nurses Association