Can U.S. Certified Nurse Practitioners Work in Germany?

From the Virgin Islands to Italy, France, and the United Kingdom, we’ve been talking international practice here at ThriveAP over the past few weeks. If you’re a nurse practitioner certified in the United States, taking your career abroad may be an exciting option. Countries around the world are increasingly recognizing the nurse practitioner profession and implementing NPs into their healthcare systems. Today, let’s take a look at how nurse practitioners certified in the U.S. can work in Germany. 

Scope of Practice

Similarly to France, the nurse practitioner profession is still very underdeveloped and unrecognized in Germany. However, with two current Masters programs in Advanced Practice Nursing, the founding of The German Networking Group for APNs and ANPs (known as the Deutsches Netzwerk APN & ANP e. V.) in 2008, and with the support of the German Nurse Association, the implementation of advanced practice nursing is officially underway.

NPs certified in the United States looking to relocate to Germany have the option to work as Registered General Nurses, Children’s Nurses, or Geriatric Nurses while the role of the nurse practitioner unfolds. However, with no regulation through a national nursing board or council, there are many gray areas and the role of nurses in Germany has been compared to that of a CNA.

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Certification and Licensure

In order to work as a nurse in Germany, you must first determine whether you are able to legally work in the country. Provided you are able to do so, you will then need to apply to have your professional qualifications recognized by the federal state in which you plan to reside and obtain a license within that state. Each federal state in Germany has its own Competent Authority, the entity in charge of the recognition process. You must determine the appropriate authority with whom to send your application and documented qualifications. These documents must be mailed directly.

Several other documents are required as part of the licensing process for nurses in Germany. You will also need to provide a copy of your CV in tabular form, a copy of your qualifications, certificates of competence, certificates regarding relevant professional experience, a medical certificate confirming fitness to practice in the profession, and a statement of whether you have criminal proceedings pending. The documents must either be in German or be accompanied by certified translations.

Upon receiving your application, the Competent Authority will review your qualifications for equivalence against the German qualifications for the type of nursing to which you are applying. Provided that there are no substantial differences between yours and the corresponding German stipulations, you will be granted a license to practice. If the Competent Authority finds that your qualifications are not up to par, you will be given the opportunity to take either an exam to test your knowledge of the field or participate in an adaptation period, which can last up to three years.

In addition to possessing certain qualifications and obtaining a state license, you must also have a record of proficiency of at least a B2 language level under the Common European Framework of Reference for Languages in German.

The cost of the recognition and licensing process varies on an individual basis. You may be able to receive financial assistance from Employment Agencies or Job Centres for the licensing process if certain conditions are met. 

Once your nursing qualifications have been recognized and your have been given a state license to practice, you will be able to work in hospitals, at specialty medical practices or health centers, and other institutions such as infirmaries or in special wards for children or geriatrics, depending on the type of nursing license obtained.

Other Considerations

Bear in mind that as part of the European Union, it is often difficult for U.S. trained nurses to find employment in Germany as preference is given to EU Citizens. You may also be required to apply for a visa and/or work permit to relocate to Germany for an extended period of time.

Given the developing role of nurse practitioners in Germany, the country may not be the best option for NPs looking to work internationally as one’s scope of practice will be significantly limited. 

Would you consider working internationally as a nurse practitioner?


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