Germany is experiencing a serious shortage of nursing staff - there is hardly any other area where the lack of qualified personnel is as pronounced as in nursing. According to estimates, over 100,000 nursing positions are already unfilled today, and by 2034 the demand could increase to up to 500,000 nursing professionals. At the same time, there are many motivated nurses in countries such as Albania and Serbia who often cannot find adequate employment opportunities in their home countries.
Is it possible to build a bridge between the Western Balkans and Germany that benefits both sides? How can cooperation between a German employment agency and Albanian or Serbian recruiting agencies help to close this gap? Our expert article addresses these questions.
A joint commitment to nursing care: German and Western Balkan partners recruit nursing staff for Germany - with heart and mind.
Win-win situation through international cooperation
In fact, the shortage of nursing staff in Germany and the potential workforce in Albania and Serbia can be combined to create a real win-win situation. While German hospitals and care facilities are desperately looking for staff, some countries in the Western Balkans - such as Albania - have something that Germany can currently only dream of: a surplus of qualified nurses. Even the renowned Charité clinics in Berlin have already recruited dozens of nurses from Albania, deliberately choosing a country that is not suffering from an acute nursing shortage itself.
This concept follows the so-called „triple-win“ principle: everyone involved benefits. German healthcare facilities can fill urgently needed vacancies with motivated specialist staff, the nursing staff receive fair employment opportunities and new career prospects, and the countries of origin benefit from falling unemployment and remittances from workers working abroad.
A joint program of the German Federal Employment Agency (ZAV) and the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) - the Triple Win project - has been successfully placing nurses from selected countries in Germany since 2013. It is of central importance to work exclusively with countries of origin that have a surplus of well-trained nurses in order to avoid a brain drain and ensure ethically responsible recruitment.
Concrete advantages of cooperation
Why should Albanian or Serbian recruiting agencies cooperate with a German recruitment agency? The advantages are obvious:
- Targeted local talent acquisition: Local partners know the regional job market, speak the candidates' language and enjoy local trust. This means that suitable nursing staff can be approached in a much more targeted manner and assessed both professionally and personally in advance.
- Highly qualified specialists: Nursing training in countries such as Albania, Serbia and North Macedonia is of a high quality - nurses often complete a three-year bachelor's degree in nursing. German employers value this solid training and the high professional level of the applicants.
- Joint language support: As part of the cooperation, organized language courses up to level B2 (according to the Common European Framework of Reference for Languages) are offered before departure. In this way, both partners ensure that language barriers do not hinder integration. Established intermediaries organize German courses from A1 to B2 in the country of origin, including official certificate examinations (e.g. Goethe certificate).
- Cultural preparation: Nursing is a deeply human profession - empathy and understanding are crucial. The Western orientation and European background of many Western Balkan countries make cultural adaptation in Germany easier. In addition, intercultural training and preparatory seminars help candidates to adjust to living and working in Germany.
- Efficiency in the recognition process: The German partners guide the skilled workers through the bureaucratic process. From translating the documents to applying for professional recognition and obtaining a visa - together, this process is faster and smoother. Thanks to the German government's Western Balkans regulation, skilled workers from Albania, Serbia and other Western Balkan countries now have much easier access to the German labor market: up to 50,000 visas can be issued each year specifically for these countries.
- Sustainable integration and support: The collaboration does not end when the contract is signed. Instead, the nursing staff placed are closely supported - through mentoring programs in the German hospital, support with administrative processes and regular feedback meetings. This structured onboarding ensures that new employees feel that they are in good hands and remain with the team in the long term. A recent study of Albanian nursing staff in Germany shows that a supportive working environment with mentors and training opportunities significantly promotes integration. The respondents felt recognized and respected and saw good career development prospects.
The joint process: step by step to success
How does such a transnational recruitment process work in practice? The cooperation between the German GmbH and the partner agencies in Albania and Serbia covers the entire value chain - from the first contact to the successful start of work:
- Identification of suitable candidates: Local recruiting experts specifically approach potential applicants - such as young nurses from Tirana or experienced intensive care nurses from Belgrade. In personal meetings or video interviews, they gain an initial impression of qualifications, professional experience and motivation. This is where the local network of the partner agencies comes into its own.
- Language course programs up to level B2: German language skills are essential - at least level B2 is required for professional recognition in the nursing professions. The partners therefore coordinate intensive language courses at an early stage. Candidates often spend 6 to 12 months learning German, whether in evening classes, full-time courses or with additional one-to-one tuition. Success rates and stamina increase significantly when future employers and recruiters accompany the learning progress and continuously motivate the participants.
- Cultural preparation: In addition to the language, understanding the new culture is crucial. In workshops, prospective nursing staff learn everything about German work culture, patient rights, manners and everyday life - from the principle of punctuality to team communication in care facilities. At the same time, expectations are realistically assessed: How does the shift system work? What differences are there in care documentation? The open discussion of such topics creates clarity and allays fears.
- Support in the recognition process: As these are regulated professions, qualifications acquired abroad must be officially recognized. This formal procedure can be complex - this is where the expertise of the German partner comes into play. They provide support in compiling the necessary documents, coordinate adaptation courses or knowledge tests if necessary and are in close contact with the responsible recognition authorities. This ensures that the qualified specialists can work as equivalent nursing professionals as quickly as possible.
- Coordination with employers in Germany: At the same time, matching takes place with German hospitals, nursing homes or outpatient services. German recruiters present the profiles of selected candidates to employers - often supported by digital interviews or even by organizing trial working days on site. This allows both sides - employers and applicants - to check whether there is a professional and personal fit before signing a contract. This transparency creates trust and strengthens loyalty.
Overcoming challenges together
Of course, such a project is not a sure-fire success. Typical challenges in the recruitment of nursing staff from abroad should be openly stated:
- Language barriers and professional communication: Despite passing the language test, some new arrivals feel insecure at first - for example when talking on the phone or filling out care documentation. Medical terminology and abbreviations are challenging, even for native speakers, which is why it is essential that they are given some on-the-job training. Many Albanian nursing staff report that the specialist terminology and written documentation in particular were a challenge at the beginning of their careers. Career entry in Germany represent a hurdle.
- Bureaucracy and waiting times: Many months often pass between the visa application and recognition. This waiting time can be stressful - both for the candidates and for the employers waiting in Germany. Patience and professional project management are required to keep track of deadlines and applications. Although there are political efforts to improve the situation (keyword: accelerated skilled worker procedure), until then, close support from the placement offices helps to avoid unnecessary delays.
- Emotional stress and homesickness: Moving abroad is a major challenge for nursing staff. A new country, a foreign language and being separated from family and friends for the first time can be very stressful. Without a stable social environment, there is a risk of homesickness and frustration. This makes targeted emotional preparation all the more important: what to do if you feel homesick? How do you quickly make contacts in Germany? Some programs establish contact with compatriots in the target region before departure or organize sponsorships so that no one feels left alone.
- Different care cultures: Despite increasing European convergence, there are still differences in the care systems. Work processes, hierarchies and the role of the nurse are defined differently in some cases. Misunderstandings can arise if, for example, a nurse from Serbia is used to implementing doctors' orders without questioning, whereas in Germany independent action is expected - or vice versa. Such cultural differences must be bridged through training and open dialog.
- Tendencies to return or move on: Not every placement is permanent. Some skilled workers return to their home country after a few years or move on to a third country, for example because relatives live there or there are better earning opportunities. This risk exists in principle, but experience shows that it decreases significantly if integration is successful, the new employees feel valued and, if necessary, have the opportunity to bring their families with them.
Solutions: How to make the partnership work
How can these stumbling blocks be overcome and collaboration be successfully organized? Some proven best practices have emerged from practice:
- Comprehensive information & expectation management: From the outset, everyone involved - from the candidates and local agencies to the German employers - should communicate clearly and openly what they can expect. Realistic timetables, transparent conditions and open discussions about possible challenges create trust. Experience shows: The better nurses know what to expect in Germany before they leave, the smoother the adjustment process will be.
- Quality before quantity: The aim is not to place as many people as possible in the shortest possible time, but to find the right ones. Motivation and personal suitability are just as important as formal qualifications and references. Soft factors should also be taken into account in selection interviews - ideally in person and by a well-coordinated team of German and local specialists: Does the person fit into the German team? Do they have the necessary resilience and empathy for everyday care work? It makes more sense to select fewer candidates but provide them with intensive support than to place large numbers without sufficient quality.
- Intensive preparation & qualification: The importance of language courses and professional qualifications can hardly be overestimated. Some placement projects also offer nursing professionals additional job-specific training in their country of origin - for example, training courses lasting several days on German nursing standards. This strengthens the participants' professional self-confidence. At the same time, employers in Germany should also be prepared: Integration workshops help existing teams to better understand cultural differences and warmly welcome new colleagues.
- Mentoring and long-term support: After their arrival, nursing staff should not be left to their own devices. Mentoring programs, regular interim meetings and an open ear for the concerns of new employees pay off. Nursing managers play a key role here: they create an inclusive working environment and actively promote integration. An appreciative climate in which questions are allowed and mistakes are seen as learning opportunities strengthens the long-term loyalty of specialist staff.
- Networking: It is motivating for the Albanian and Serbian partners to see that they are part of a larger network. The exchange with other recruiting agencies in the region that have similar collaborations with Germany can help to share experiences. Why not organize best practice meetings to celebrate success stories and learn from challenges? Together, the wheel turns faster than if each organization works on its own.
Outlook: Shaping the future together
This German-Western Balkan cooperation in the care sector is far more than just a business model. It is an investment in people and in the future. Every nursing professional from Tirana and every care worker from Novi Sad who their way to Germany stands for a story of courage and change - and shows how important the placement of international nursing staff is for both sides in building bridges between our countries.
For Albanian and Serbian recruiting agencies, partnerships with Germany not only offer economic benefits, but also a considerable boost to their image: they demonstrate their ability to act internationally and at the same time make an active contribution to solving a highly relevant social problem. German institutions, in turn, gain insights into new cultures through this cooperation, develop an appreciation for international specialists and gain loyal, grateful employees who are often highly motivated and committed to their work.
Ultimately, the leitmotif is: Hand in hand for care. When everyone pulls together - the talent scouts on site, the language trainers, the administrators in the authorities and the colleagues on the wards - bureaucracy and geographical distance become a joint project. A project that changes lives: for the patients in Germany who receive dedicated care. For the nursing staff, who can realize their professional and personal dreams. And for the recruiting experts in Albania and Serbia, who can be proud to be part of these success stories.
The task may be challenging, but the message to potential partners in the Western Balkans is clear: be courageous and break new ground together! The first chapters of this cooperation have already been written - with commitment, passion and a clear vision, there are many more success stories to come.
