Germany is experiencing a severe nursing shortage – in hardly any other sector is the shortage of skilled workers as severe as in nursing. According to estimates, over 100,000 nursing positions are already unfilled, and by 2034, there could be a shortage of as many as 500,000 nurses. At the same time, countries like Albania and Serbia have many motivated nurses who often cannot find suitable positions in their own countries. Could a bridge be built between the Western Balkans and Germany to help both sides? How can cooperation between a German employment agency and Albanian or Serbian recruiting agencies fill this gap? These questions are the focus of our expert article.
A joint commitment to care: German and Western Balkan partners are recruiting nurses for Germany with heart and mind.
In fact, the nursing shortage in Germany and the labor potential in Albania and Serbia can be combined to create a true win-win situation. While German hospitals and nursing homes are desperately looking for staff, some Western Balkan countries – such as Albania – have something Germany can only dream of: a surplus of qualified nursing staff. Even the renowned Charité hospitals in Berlin have already recruited dozens of nurses from Albania, having deliberately chosen a country that is not itself suffering from an acute nursing shortage.
This concept follows the „triple win“ principle: everyone involved wins. German healthcare facilities can fill urgently needed positions with motivated staff, the specialists are given fair job opportunities and new perspectives, and the countries of origin benefit from lower unemployment and remittances from migrants. A joint program of the Federal Employment Agency (ZAV) and the Society for International Cooperation (GIZ) – the Triple Win Project – has been successfully placing nursing staff from selected countries in Germany since 2013. It is important to only cooperate with countries of origin that have an oversupply of well-trained nurses in order to avoid a brain drain in these countries and to recruit ethically.
Why should Albanian or Serbian recruiting agencies cooperate with a German recruitment agency? The advantages are obvious:
Targeted local talent acquisition: Local partners are familiar with the local labor market, speak the candidates‘ language, and enjoy the trust of the region. This allows them to target suitable nursing staff much more specifically and assess in advance who is a good fit, both professionally and personally.
Highly qualified professionals: The training of nurses in countries like Albania, Serbia, and North Macedonia is of high quality – these professionals often complete a three-year bachelor’s degree in nursing. German employers value this solid foundation and the high level of professionalism of the applicants.
Joint language support: Through this cooperation, organized language courses up to level B2 (according to the Common European Framework of Reference for Languages) are offered even before the applicant departs. This ensures that both partners ensure that no language barriers hinder integration. Established intermediaries organize German courses from A1 to B2 in the home country, including official certification exams (eg, the Goethe Certificate).
Cultural preparation: Nursing is a very human profession – empathy and understanding are crucial. The Western orientation and European background of many Western Balkan countries facilitates cultural adjustment in Germany. In addition, intercultural training and preparatory seminars help candidates adjust to living and working in Germany.
Efficiency in the recognition process: The German partners guide the skilled workers through the jungle of bureaucracy. From translating documents to applying for professional recognition to obtaining visas – 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 states now have significantly easier access to the labor market: Up to 50,000 visas can be issued specifically for these countries each year.
Sustainable integration and support: The cooperation doesn’t end with the signing of the contract. Rather, the placed nurses receive close support – through mentoring programs at the German hospital, assistance with administrative procedures, and regular feedback sessions. This onboarding ensures that new employees feel well looked after and remain with the team long-term. A recent study among Albanian nurses in Germany shows that a supportive work environment with mentors and continuing education significantly promotes integration. Respondents felt recognized, respected, and saw good career opportunities.
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 chain, from the initial meeting to the successful start of employment:
Identifying suitable candidates: Local recruiting professionals target potential applicants—for example, young nurses from Tirana or experienced intensive care nurses from Belgrade. In face-to-face interviews or via video call, they gain an initial understanding of qualifications, experience, and motivation. This is where the partner agency’s local network comes in.
Language course programs up to B2 level: German language skills are essential – at least a B2 level is required for professional recognition in nursing professions. Therefore, the partners coordinate intensive language courses early on. Candidates often spend 6–12 months learning German, whether at evening schools, full-time courses, or with tutorials. Success rates and perseverance increase when future employers and recruiters monitor and continually motivate students‘ progress.
Cultural preparation: In addition to the language, understanding the new culture is important. In workshops, prospective nurses learn everything about German work culture, patient rights, etiquette, and everyday life – from the principle of punctuality to team communication in a nursing home. At the same time, any expectations are adjusted: What is the shift system like? What differences are there in nursing documentation? Openly addressing such topics creates realistic expectations and alleviates fears.
Support during the recognition process: Since these are regulated professions, the qualifications acquired abroad must be officially recognized. This formal process can be complex – but this is where the expertise of the German partner comes in. They assist in compiling the necessary documents, coordinate adaptation courses or professional examinations if necessary, and maintain close contact with the recognition authorities. This ensures that the qualified professionals are authorized to work as equivalent nursing professionals as quickly as possible.
Coordination with employers in Germany: Parallel to this, matching takes place with German hospitals, nursing homes, or outpatient services. German recruiters present profiles of selected candidates to employers – often supported by digital interviews or even by organizing on-site trial work days. This allows both sides – employer and applicant – to assess whether the candidate is a good fit, both professionally and personally, before signing an employment contract. This transparency builds trust and commitment.
Of course, such a project is not a sure-fire success . Typical challenges in recruiting nursing staff from abroad should be openly identified:
Language barriers and specialized communication: Despite passing a language test, some newcomers feel insecure, for example, on the phone or when completing nursing documentation. Medical terms and abbreviations are tricky even for native speakers—on-the-job coaching is needed. Many Albanian nurses report that specialized terminology and written documentation pose initial hurdles when entering the profession through nursing job postings in Germany .
Bureaucracy and waiting times: From visa application to recognition, many months often pass. This waiting period can be grueling – both for the candidates and the waiting employers in Germany. Patience and good project management are required to keep track of all deadlines and applications. Improvements are being made politically (keyword: accelerated skilled worker procedure ), but until then, close support from the placement agents helps avoid wasting any time.
Emotional stress and homesickness: Going abroad is a big step for caregivers. A new country, a foreign language, and the first time away from family and friends – it can be exhausting. Without a stable social network, homesickness and frustration are a threat. This makes it all the more important to prepare candidates emotionally: What to do if they feel homesick? How do you quickly make contacts in Germany? Some programs even connect you with fellow countrymen in the destination region before you leave or organize sponsorships to ensure no one is left alone.
Different care cultures: Even as Europe grows closer together, differences in care systems still exist. Workflows, hierarchies, and the role of the nurse may be defined differently. Misunderstandings can arise if, for example, a nurse from Serbia is accustomed to uncritically following medical orders, while in Germany, independent action is expected—or vice versa. Such cultural differences must be bridged through training and open dialogue.
Return or emigration tendencies: Not every placement is permanent. Some skilled workers return home after a few years or emigrate to a third country, perhaps because relatives live there or the pay is better. This risk always exists, but experience shows that it decreases if integration is truly successful, the new colleagues feel valued, and perhaps even have the opportunity to bring their families with them.
How can these stumbling blocks be overcome and collaboration be successful? Some best practices have emerged:
Comprehensive information & expectation management: From the very beginning, all partners—from the candidate to the local agency to the German employer—should communicate clearly what to expect. Realistic timelines, transparent terms and conditions, and open discussions about challenges build trust. Experience shows: the better a caregiver knows what to expect in Germany before departure, the smoother the adjustment process will be.
Quality over quantity: It’s not about placing as many people as possible as quickly as possible, but rather the right people. Motivation and suitability are just as important as references. In selection interviews—ideally conducted in person by a well-coordinated team of German and local staff—soft factors should be considered: Will the person fit into the German team? Do they have the resilience and empathy needed for everyday nursing practice? It’s better to select fewer candidates but develop them intensively than to place masses without quality.
Intensive preparation & qualification: The importance of language courses and professional qualifications cannot be overestimated. Some placement projects also provide nursing staff with further professional training in their home country – for example, with a multi-day course on German nursing standards. This helps candidates feel more confident in their professional skills. At the same time, employers in Germany should be prepared: Integration workshops help local teams better understand cultural differences and warmly welcome new colleagues.
Mentoring and long-term support: Once nurses have arrived, they shouldn’t be left alone. Mentoring programs, regular interim evaluations, and simply listening to the concerns of new employees pay off. Nursing managers play a key role: They create an inclusive work environment and actively promote integration. An appreciative environment where questions are allowed and mistakes are viewed as learning opportunities builds long-term loyalty among professionals.
Networking: It’s motivating for the Albanian and Serbian partners to see that they’re part of a larger network. Exchanging ideas with other recruiting agencies in the region, perhaps with similar partnerships with Germany, can help share experiences. Why not organize best-practice meetings where success stories are celebrated and challenges are learned? Working together, the wheel turns faster than if everyone works alone.
This German-Western Balkan cooperation in nursing is more than just business. It’s an investment in people and in the future. Every nurse from Tirana or every caregiver from Novi Sad who finds their way to Germany represents a story of courage and change – and demonstrates how important the placement of foreign nursing staff in Germany is for both sides in building bridges between our countries.
For Albanian and Serbian recruiting agencies, partnerships with Germany offer not only economic advantages but also a boost to their image: They demonstrate that they can operate successfully internationally while simultaneously contributing to solving a social problem. German institutions, in turn, gain knowledge of and appreciation for new cultures through this collaboration and gain loyal, grateful employees who often approach their work with great enthusiasm.
Ultimately, the motto is: Hand in hand for care. When everyone pulls together – the scouts on site, the trainers in language courses, the administrators in the offices, and the colleagues on the ward – then bureaucracy and distance suddenly become a joint project. A project that changes lives: for the patients in Germany who receive loving care. For the nurses who can realize their dreams. And for the recruiting professionals in Albania and Serbia who can be proud to be part of these success stories.
The task may be daunting, but the message to potential partners in the Western Balkans is clear: Be bold, let’s break new ground together! The first chapters of this collaboration have already been written – with commitment, passion, and a clear vision, we can add many more success stories.
