Working as a Nurse in Germany – What International Nurses Need to Know
You trained as a nurse abroad, or you are planning to work in German care? This guide explains how nursing is organised in Germany, what registered nurses are responsible for, and which German terms you will hear from your first day. Recognition is decided by the authorities – we point you to the official portals.
Plus 17 English self-study courses on German care standards – all included in the flat rate: €199 for 12 months.
Where nurses work in Germany
Most international nurses start in one of three settings. The German words matter, because you will see them in job offers, contracts and documentation.
The registered nurse (Pflegefachperson)
In the Nursing Professions Act (Pflegeberufegesetz, PflBG) the protected titles are Pflegefachfrau and Pflegefachmann; using them requires a permit (section 1 PflBG). The gender-neutral term Pflegefachperson is used, for example, in the Long-Term Care Insurance Act (section 71 SGB XI) and on the official recognition portal.
German law reserves three task areas for people who hold this permit (section 4(2) PflBG):
- assessing and determining a person’s individual care needs and planning the care,
- organising, designing and steering the nursing process,
- analysing, evaluating, securing and developing the quality of care.
Employers may neither assign these tasks to people without the permit nor allow them to carry them out (section 4(3) PflBG). In everyday work, registered nurses lead the nursing process; nursing assistants (Pflegehilfskräfte) support them. Residents of long-term care facilities are entitled to additional support and activation (section 43b SGB XI), which is provided by additional support and activation workers (Betreuungskräfte).
Care grades (Pflegegrade)
Under the Long-Term Care Insurance Act, a person is in need of long-term care (pflegebedürftig) when health-related impairments of independence or abilities mean they need help from others – permanently, and expected for at least six months (section 14(1) SGB XI). The degree is expressed in five care grades (section 15 SGB XI). On behalf of the long-term care insurance fund (Pflegekasse), the Medizinischer Dienst or other independent experts evaluate the situation (section 18(1) SGB XI).
(Descriptions in our own words, based on section 15(3) SGB XI. The grade results from a points-based evaluation in six areas, such as mobility, self-care and coping with illness-related demands.)
Documentation
For medical treatment, the German Civil Code requires the treating party to keep a patient record in direct temporal connection with the treatment and to keep it for ten years after the treatment ends (section 630f BGB). Nursing documentation shows the nursing process – needs, planning, measures and evaluation – which is exactly the area reserved for registered nurses.
In long-term care, many facilities work with the Strukturmodell and its structured information collection (Strukturierte Informationssammlung, SIS) to keep records focused and lean. (general professional knowledge, not a legal rule)
Expert standards (Expertenstandards)
You will often hear about national expert standards on topics such as pressure ulcer prevention, fall prevention, pain management or nutrition. They are developed by the German Network for Quality Development in Nursing (DNQP) and describe what good professional nursing practice looks like. How a standard is put into practice is laid down in your employer’s internal procedures. (general professional knowledge, not a legal rule)
Your first months: what to expect
(general professional knowledge, not a legal rule)
Recognition – neutral facts and official links
- General nurse (German: Pflegefachperson) is a regulated profession in Germany (Recognition Finder, BIBB).
- The permit to use the title requires, among other things, an equivalent level of training, personal reliability, health fitness and the German language skills needed for the profession (section 2 PflBG).
- For qualifications from outside the EU, the EEA and Switzerland, the equivalence of the training is checked. If it is not established, an equivalent level of knowledge has to be shown – either through a Kenntnisprüfung or through an adaptation period of up to three years (Anpassungslehrgang); the applicant may choose between them (section 40(3) PflBG).
- The competent authority of the federal state (Land) decides. Fees, documents and language requirements are explained there.
Official information: Recognition Finder: General nurse · anerkennung-in-deutschland.de · make-it-in-germany.com
Important: GermanSocialLab’s self-study courses do not replace the official recognition of foreign qualifications, they do not prepare you for the Kenntnisprüfung or an adaptation period (Anpassungslehrgang), and we make no promises about recognition, employment or residence. Only the competent authority decides.
17 self-study courses in English: Care & Nursing
Each course explains German rules and everyday practice in English, at your own pace. See all English Care & Nursing courses →
The system and your role
Expert standards and patient safety
Person-centred care
More guides in English
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Questions
The courses are in English. German key terms are named along the way, and our English glossary explains the most important ones. For your work in Germany and for recognition you will need German – the competent authority tells you which level.
No. Recognition is a separate official procedure. Our self-study courses do not replace it and do not prepare you for the Kenntnisprüfung or the Anpassungslehrgang. They help you understand German care standards and terms.
When you have marked all modules of a course as done, you can download a confirmation of participation for that course.
Sources
Bundesministerium der Justiz. (n.d.). Gesetz über die Pflegeberufe (Pflegeberufegesetz – PflBG) (§§ 1, 2, 4, 40). Retrieved October 26, 2026, from https://www.gesetze-im-internet.de/pflbg/
Bundesministerium der Justiz. (n.d.). Sozialgesetzbuch (SGB) Elftes Buch (XI) – Soziale Pflegeversicherung (§§ 14, 15, 18, 43b, 71). Retrieved October 26, 2026, from https://www.gesetze-im-internet.de/sgb_11/
Bundesministerium der Justiz. (n.d.). Bürgerliches Gesetzbuch (BGB) (§ 630f). Retrieved October 26, 2026, from https://www.gesetze-im-internet.de/bgb/__630f.html
Bundesinstitut für Berufsbildung. (n.d.). Recognition in Germany: Information portal of the German government for the recognition of foreign professional qualifications. Retrieved October 26, 2026, from https://www.anerkennung-in-deutschland.de/html/en/index.php
Bundesinstitut für Berufsbildung. (n.d.). General nurse (m/f) (German: Pflegefachperson) [Recognition Finder]. Retrieved October 26, 2026, from https://www.anerkennung-in-deutschland.de/en/interest/finder/profession/1695
Make it in Germany. (n.d.). Make it in Germany [Website; linked for official information]. https://www.make-it-in-germany.com/en/
GermanSocialLab offers self-study courses with voluntary self-reflection (not graded) and a confirmation of participation after working through all modules. Legal status: 26 October 2026. This guide describes the situation in Germany in general terms; it provides professional information and does not constitute legal advice or recognition advice. Rules can differ between the 16 federal states (Länder) and between employers – always follow your employer’s procedures and ask the competent authority. Created with AI assistance and editorially reviewed.