Europe’s Nursing Shortage: Why Europe Needs Healthcare Workers From Outside the EU

Written By William Lewis

A 2026 Guide for International Nurses Considering a Career in Europe

Europe is facing a healthcare workforce shortage that is becoming increasingly difficult to solve through domestic recruitment alone. Across the European Union and the wider European region, populations are ageing, demand for healthcare and long-term care is increasing, experienced nurses are approaching retirement, and many existing nurses are leaving the profession because of workload, stress, and difficult working conditions.

The result is a growing gap between the number of healthcare professionals European health systems need and the number they can train, recruit, and retain domestically. For nurses outside the European Union, this creates an important opportunity.

Germany, Ireland, France, Belgium, Austria, Sweden, Finland, Denmark, the Netherlands, Spain, Italy, and other European countries are increasingly dependent, to varying degrees, on internationally educated healthcare professionals. The World Health Organization's European office has estimated that the region could face a shortage of approximately 950,000 health workers by 2030. Between 2014 and 2023, the number of foreign-trained nurses working in the WHO European Region increased by 67 percent. In 2023, approximately 72 percent of nurses entering the region's health labour market had been trained outside the European Region.

This means international recruitment is no longer a niche part of European healthcare — it is becoming a structural component of workforce planning. For an internationally educated nurse in India, the Philippines, Indonesia, Nigeria, Ghana, Kenya, South Africa, Nepal, Pakistan, the Middle East, Latin America, or elsewhere, Europe increasingly represents a collection of potential career destinations. However, Europe is not one labour market. Every country has its own language, professional registration system, immigration rules, qualification-recognition process, salary structure, and recruitment priorities. Understanding those differences is essential for anyone considering a European healthcare career.

Why Is Europe Running Short of Nurses?

The European nursing shortage has several causes. The first is demographics. Europe has one of the world's oldest populations, and as people live longer, demand for healthcare and long-term care increases. Older patients are also more likely to experience multiple chronic conditions, disability, and complex care needs — increasing demand for nurses in hospitals, intensive care, emergency departments, elderly care, rehabilitation, mental health, community nursing, home care, palliative care, and specialist services.

At the same time, the nursing workforce itself is ageing. Many experienced nurses who entered the profession decades ago are now approaching retirement, and replacing them requires large numbers of new nurses. However, European countries are competing with other industries for younger workers, while nursing itself faces challenges involving workload, shift work, stress, and burnout. The World Health Organization has warned that inadequate nurse staffing can increase risks to patients while also contributing to stress, burnout, and nurses leaving the profession.

This creates a difficult cycle: more elderly patients require more healthcare; more healthcare demand requires more nurses; many experienced nurses are approaching retirement; existing nurses experience greater pressure; some leave the profession or reduce their hours; and the shortage then becomes even more severe.

Europe Is Already Recruiting International Nurses

International healthcare professionals are already deeply embedded in European healthcare systems. According to WHO/Europe, between 2014 and 2023 the number of foreign-trained nurses working in the European Region increased by 67 percent. Even more significantly, approximately 72 percent of nurses entering the region's health labour market in 2023 had been trained outside the European Region.

For candidates outside the EU, this is an important distinction: international nurses are not simply being discussed as a possible future solution — they are already filling positions throughout European healthcare systems. Ireland is an especially striking example; WHO reports that more than half of nurses working in Ireland are foreign-trained. Malta is another example of a smaller European country with a substantial dependence on internationally trained healthcare professionals. International recruitment has therefore become a normal part of healthcare workforce planning in many European countries.

Europe Does Not Have One Nursing Recruitment System

One of the biggest misconceptions among international candidates is that "Europe" has a single healthcare recruitment system. It does not. The European Union has mechanisms that facilitate professional mobility between EU countries, but a nurse trained outside the EU generally has to deal with the individual country's national regulatory and immigration system.

For a non-EU nurse, the process may involve professional qualification assessment, recognition of qualifications, language testing, professional registration, an employment offer, immigration permission, an adaptation programme, or a professional examination — and the exact combination varies by country. This means international nurses should not simply ask, "Does Europe need nurses?" The more useful question is: "Which European country needs nurses, accepts my qualification, accepts my language ability, and provides a realistic immigration pathway for someone from my country?"

Country-by-Country: The 27 EU Countries and the United Kingdom

For international candidates, it is useful to understand the situation across the 27 EU member states. The United Kingdom is also included here because, although it is no longer an EU member, it remains one of Europe's largest healthcare recruitment markets. The severity of nursing shortages varies between countries and regions, and a shortage does not automatically mean that every international nurse will find an easy route in. Nevertheless, these markets demonstrate the breadth of Europe's healthcare workforce challenge.

Germany is one of Europe's most important international nursing recruitment markets. Germany has approximately 1.8 million people working in nursing jobs subject to compulsory social insurance, with around 20 percent being foreign nationals. Official German information also identifies approximately 31,000 vacant positions in care facilities, and the Federal Employment Agency reported in 2026 that there were only around 57 unemployed nursing workers for every 100 advertised nursing vacancies. Germany therefore continues to need international workers despite domestic recruitment and training. For non-EU nurses, the biggest consideration is German language proficiency — professional recognition normally requires German-language competence, with B2 being an important benchmark. Germany is particularly relevant to nurses from India, the Philippines, Indonesia, Tunisia, Bosnia and Herzegovina, Turkey, and other countries, and operates government-supported international recruitment programmes such as the Triple Win programme.

France has one of Europe's largest healthcare systems and an ageing population, with nursing demand across hospitals, elderly care, community healthcare, and other settings. For non-EU nurses, however, France is not simply an English-language recruitment market — French language ability is essential for professional integration, and recognition of foreign qualifications can be complex. France may therefore be particularly attractive to internationally trained nurses who already speak French or who are prepared to invest in significant language training. For candidates from Francophone African countries, France can be particularly relevant, though ethical recruitment is extremely important given that many African countries themselves face healthcare workforce shortages.

Italy presents an interesting situation. The country has a large healthcare system and significant nursing workforce pressures, and Italian nurses are themselves increasingly recruited by other European countries — meaning Italy can simultaneously experience domestic shortages while losing healthcare professionals to other European labour markets. For non-EU candidates, Italy can therefore be an interesting market to monitor. Italian-language proficiency and professional recognition remain central requirements, and the country may be particularly relevant to nurses who already speak Italian or have a strong motivation to learn the language.

Spain has significant regional variation in healthcare workforce demand. Some parts of the country report shortages of nurses, doctors, and other healthcare professionals, and nursing has been identified among shortage occupations in several Spanish regions. For international nurses, Spain can therefore offer opportunities, although recruitment conditions are not uniform throughout the country. Spanish language proficiency is extremely important, and candidates should also understand that professional recognition and regional employment conditions matter. Spain may be particularly attractive to nurses who already speak Spanish or are prepared to learn it.

Ireland is one of Europe's most internationally dependent healthcare systems. WHO/Europe reports that more than half of nurses working in Ireland are foreign-trained, making Ireland particularly relevant to nurses from outside the EU. English is the major advantage: for nurses from countries such as India, the Philippines, Nigeria, Ghana, South Africa, Kenya, and other English-speaking or English-educated countries, Ireland can be an attractive destination. However, candidates still need to satisfy professional registration and immigration requirements, and Ireland also has significant housing and cost-of-living challenges, particularly around Dublin.

The Netherlands has a sophisticated healthcare system and significant demand for healthcare professionals. However, internationally trained nurses should not assume that English alone is enough — Dutch language proficiency is generally essential for clinical nursing practice. The Netherlands can therefore be attractive to candidates willing to invest in Dutch-language training, offering solid professional opportunities provided recognition and language requirements are investigated before beginning the recruitment process.

Belgium has healthcare workforce needs and a multilingual environment, which creates both opportunities and complications. Depending on where a nurse works, the relevant language may be Dutch, French, or German, so international nurses need to understand the linguistic requirements of the specific region and employer. Belgium can be particularly attractive for nurses who already speak French or Dutch, with professional recognition remaining essential throughout.

Austria has a substantial healthcare and elderly-care workforce requirement, and its geographical proximity to Germany makes it part of the broader German-speaking healthcare labour market. For non-EU nurses, German-language proficiency is therefore a central consideration, and candidates who have already reached B1 or B2 German may find Austria particularly interesting. Austria faces many of the same demographic challenges as Germany, including an ageing population, growing care demand, and experienced healthcare professionals approaching retirement.

Sweden has significant demand for healthcare professionals, including nurses, and Swedish labour-market statistics have identified shortages of nursing professionals. Sweden can be attractive to international professionals because of its healthcare system and working environment. However, Swedish language proficiency is a major consideration — a nurse may have excellent English and still be unable to practise independently without the required Swedish language ability.

Denmark has experienced healthcare workforce pressures, particularly as its population ages. Nursing is a regulated profession, and international nurses need to satisfy Danish authorisation requirements, with Danish language ability being particularly important. For non-EU nurses, Denmark can therefore be a realistic destination for candidates prepared to undertake substantial language preparation, and the country may be particularly attractive to nurses interested in Nordic healthcare systems.

Finland faces healthcare workforce pressures associated with demographics and an ageing population, and international recruitment is becoming increasingly relevant. However, Finnish and Swedish language requirements can represent a significant barrier. For candidates already proficient in Finnish or Swedish, Finland can be considerably more accessible; for candidates starting from zero, language preparation should be considered a major part of the migration plan.

Portugal has a substantial healthcare system and an ageing population. Nursing shortages exist in particular circumstances, although the Portuguese market should not be presented as uniformly short of nurses in every region. Portuguese language proficiency is essential for most clinical roles, making Portugal particularly relevant to nurses from Portuguese-speaking countries, including healthcare professionals from parts of Africa and other Portuguese-speaking regions.

Greece faces demographic pressures and has experienced significant healthcare workforce migration. The country has historically lost healthcare professionals to other European markets while simultaneously experiencing healthcare workforce pressures domestically. For international nurses, Greek language proficiency and professional recognition are important considerations, and Greece may be particularly relevant to candidates with existing Greek-language ability or a strong personal connection to the country.

Croatia has experienced significant emigration of healthcare professionals to other European countries, creating challenges for maintaining the country's domestic workforce. At the same time, Croatia has increasingly become a destination for migrant workers across several industries. For non-EU nurses, Croatia may offer opportunities, although it is generally a smaller healthcare recruitment market than Germany, France, or Ireland, and Croatian language ability remains an important consideration.

Slovenia has a relatively small population but faces many of the demographic pressures affecting Europe as a whole, and healthcare workforce sustainability is becoming increasingly important. International nurses may find opportunities where domestic recruitment cannot meet demand, though Slovenian-language proficiency and professional recognition are central requirements.

Czechia has a substantial healthcare system and has experienced workforce pressures in nursing and other healthcare professions. For international nurses, Czech language proficiency is generally important for professional practice. The country can be an attractive option for nurses who want to work in Central Europe, although its recruitment and recognition system differs from Germany or Austria.

Slovakia faces demographic challenges and healthcare workforce pressures, and like several Central and Eastern European countries, it has also experienced migration of healthcare professionals to higher-paying markets elsewhere in Europe. For international nurses, Slovak language ability and professional recognition are important.

Hungary has faced healthcare staffing challenges and workforce migration, with Hungarian nurses and other healthcare professionals historically seeking opportunities in other European countries. For a non-EU nurse, however, the Hungarian language represents a significant barrier, so candidates should assess language requirements carefully before considering Hungary.

Poland is one of Europe's larger healthcare labour markets. The country faces demographic pressures and has also experienced healthcare worker migration, responding by expanding healthcare education and attempting to strengthen domestic workforce supply. For international nurses, Polish-language proficiency is generally essential for clinical employment, making Poland particularly relevant to candidates who already speak Polish or are prepared to undertake serious language training.

Romania is particularly interesting because it has historically been both a source and destination of healthcare professionals. Romanian nurses and doctors have migrated to Western European countries in significant numbers, though WHO reports that Romania has reduced the scale of doctor migration in recent years through improved pay, training, and working conditions. For non-EU nurses, Romania is a smaller recruitment market than Germany or Ireland, but its experience demonstrates how healthcare migration can operate in multiple directions.

Bulgaria has experienced significant healthcare workforce migration, with healthcare professionals moving to countries offering higher salaries and different working conditions, creating domestic workforce pressures. For non-EU candidates, Bulgarian language requirements and the country's relatively smaller healthcare market mean it may not be the first European destination to consider, though opportunities can exist with specific employers and in particular locations.

Lithuania faces demographic pressures and has experienced migration of healthcare professionals, as its ageing population increases demand for healthcare and long-term care. For international nurses, Lithuanian-language requirements are a major consideration. Lithuania is a smaller market but may be relevant to candidates specifically interested in the Baltic region.

Latvia faces similar demographic challenges — its population is ageing while healthcare professionals have historically moved to other European labour markets. International nurses may therefore find selected opportunities, though Latvian-language requirements, professional recognition, and immigration procedures need to be carefully considered.

Estonia has one of Europe's smaller populations and faces significant demographic pressures, making its healthcare workforce strategically important. International recruitment is possible, but Estonian-language proficiency represents a major practical requirement for many clinical roles. For candidates interested in the Baltic region, Estonia may nevertheless be worth investigating.

Malta is one of Europe's most internationally dependent healthcare systems. Its small population makes the recruitment of international professionals particularly important, and Malta has developed healthcare workforce strategies addressing shortages, training, retention, and international recruitment. Malta is particularly interesting for international nurses because English is an official language, which can make the country substantially more accessible than many continental European destinations. However, Malta's small population means the total number of available positions is much smaller than in Germany, France, or Italy.

Cyprus has a relatively small healthcare workforce but also has an international dimension. English is widely used in the country, which can make it attractive to international healthcare professionals, though candidates should carefully investigate professional registration, language, and immigration requirements before applying.

Luxembourg is one of Europe's wealthiest countries and has a highly international population, along with a highly international healthcare workforce. However, its multilingual environment is extremely important — depending on the role and setting, healthcare professionals may encounter requirements involving French, German, or Luxembourgish. This makes Luxembourg attractive to multilingual healthcare professionals but potentially difficult for candidates who speak only English, and the healthcare market is also small compared with Germany or France.

The United Kingdom is no longer part of the European Union, but it remains one of Europe's largest healthcare recruitment markets. The NHS has historically depended heavily on international nurses, though the UK's immigration and international recruitment environment has changed considerably in recent years, and the number of overseas nurses entering the UK has fallen significantly from the peak years of international recruitment. Candidates should therefore not assume that the UK remains as open to international recruitment as it was several years ago. Nevertheless, the UK remains an important destination because English is the working language, nursing has a clear regulatory pathway, the NHS is a huge employer, and international recruitment is already deeply established. Non-EU nurses should always check current visa and NHS recruitment policies rather than relying on older information.

Europe Is Not One Big Opportunity

The country-by-country picture reveals something important: Europe has a nursing shortage, but this does not mean that every European hospital is desperate for nurses and will sponsor anyone. The reality is more complicated. Some countries have major shortages. Some have regional shortages. Some have shortages in particular specialties. Some have enough nurses nationally but struggle to staff rural areas. Some have shortages but strict language requirements. Some recruit internationally but have complicated recognition processes. Some are easier for EU citizens than non-EU citizens. This is why international candidates need accurate recruitment information before deciding where to apply.

Which European Countries May Be Most Accessible to Non-EU Nurses?

There is no universal ranking, because accessibility depends heavily on the individual candidate. However, several broad pathways can be identified.

The English-language pathway. Candidates with strong English may want to investigate Ireland, Malta, and the United Kingdom. These countries remove one of the biggest barriers faced by non-EU nurses — learning an entirely new European language — though professional registration and immigration requirements still apply.

The German-speaking pathway. Candidates willing to learn German can consider Germany, Austria, and Switzerland (although Switzerland is outside the EU). Germany is particularly significant because of its scale and established international recruitment infrastructure.

The French-speaking pathway. French-speaking nurses may investigate France, Belgium, Luxembourg, and Switzerland. This can be particularly relevant to nurses from Francophone Africa.

The Spanish-speaking pathway. Candidates with strong Spanish can investigate Spain, where regional labour-market differences make location particularly important.

The Nordic pathway. Candidates prepared to learn a Nordic language can investigate Sweden, Denmark, and Finland. The Nordic countries can offer attractive healthcare systems and working environments, but language preparation is usually a substantial part of the process.

Why Non-EU Nurses Are Becoming More Important

The European healthcare workforce is increasingly international, and the evidence demonstrates this clearly: foreign-trained nurses increased by 67 percent across the WHO European Region between 2014 and 2023, and in 2023, approximately 72 percent of nurses entering the region's health labour market had trained outside the European Region. This means the traditional idea that healthcare migration is simply Europeans moving between European countries is no longer sufficient. Europe's healthcare systems are increasingly connected to the global nursing workforce, with nurses from Asia, Africa, the Middle East, and other parts of the world becoming an important part of European healthcare.

Where Are Europe's International Nurses Coming From?

There is no single source country. Important international nursing source countries include India, the Philippines, Indonesia, Nigeria, Ghana, Kenya, South Africa, Nepal, Pakistan, Tunisia, Morocco, Egypt, and many others. The exact recruitment markets differ by destination. Germany, for example, has developed formal recruitment programmes involving India, Indonesia, the Philippines, and Tunisia. Ireland has historically recruited heavily from countries with English-language healthcare education. France has strong historical connections with Francophone countries. This creates an increasingly interconnected global healthcare labour market.

The Ethical Question

International recruitment creates significant opportunities, but it also carries responsibilities. A nurse moving from a lower-income country to Europe can improve their family's financial security, gain professional experience, and build a new life. However, their departure can also affect the healthcare system they leave behind — particularly where countries already have serious healthcare shortages of their own.

The World Health Organization therefore advocates ethical international recruitment and stronger cooperation between source and destination countries. International recruitment should not simply become a system where Europe takes healthcare workers from countries that can least afford to lose them. A better model is one where Europe creates legitimate opportunities for internationally trained professionals while supporting ethical recruitment, fair employment, and sustainable healthcare workforce development.

What Non-EU Nurses Need to Prepare

If you are considering Europe, preparation should begin before applying for jobs.

Your nursing qualification. Gather your nursing diploma, degree certificates, academic transcripts, clinical training records, professional registration documents, professional licence, and employment certificates. Keep original documents and certified copies where appropriate.

Your professional experience. Document your professional history carefully, including employer names, job titles, dates of employment, departments, clinical specialties, hours worked, and professional responsibilities. Specialist experience can be particularly valuable in areas such as intensive care, emergency nursing, operating theatre, oncology, paediatrics, mental health, elderly care, and community nursing.

Your language. Language should be treated as an investment rather than simply an obstacle. Depending on your destination, you may need English, German, French, Dutch, Spanish, Italian, Swedish, Danish, Finnish, or another European language. Do not wait until after receiving a job offer to begin thinking about language — for many candidates, language preparation is one of the longest parts of the migration process.

Professional recognition. Your nursing qualification does not automatically transfer simply because you are a registered nurse in your home country. The destination country may need to assess your education, clinical hours, curriculum, professional experience, professional registration, and standing. You may receive full recognition, or you may be required to complete additional education, an adaptation programme, or an examination.

Immigration. Non-EU citizens generally require appropriate immigration permission to work in an EU country. Requirements differ significantly, and a country may require an employment contract, a work permit, a residence permit, a recognition decision, proof of language ability, proof of accommodation, financial documentation, health insurance, and criminal-record documentation. Never assume that receiving a job offer automatically guarantees a visa.

What Should Candidates Look For in an International Recruiter?

A good international healthcare recruiter should be able to explain the entire process. Before signing an agreement, candidates should ask: Who is my employer? What is my gross salary? How many hours will I work? What shifts will I work? What language level is required? Who pays for language training? Who pays for professional registration? Who pays for the visa? Who pays for flights? Where will I live? How much will accommodation cost? What happens if my qualification is not recognised? What happens if I fail a language examination? Can I change employers? Are there recruitment fees? Are there penalties for leaving the contract?

The answers should be provided clearly and, where appropriate, in writing.

Europe Needs Nurses — But It Needs the Right Recruitment Model

The European healthcare workforce shortage is not simply a question of numbers. Europe needs qualified professionals who can successfully integrate into its healthcare systems — meaning correct qualifications, appropriate language skills, professional registration, clinical competence, cultural preparation, legal immigration, fair employment, and long-term retention. Recruiting 100 nurses who leave after six months is not a successful international recruitment strategy. Recruiting 100 nurses who remain in the healthcare workforce for years is far more valuable. This is why international recruitment is increasingly moving away from simple placement and towards long-term workforce planning.

What Does the Future Look Like?

The evidence suggests that international healthcare recruitment will remain important throughout the 2020s and into the 2030s. The European Commission has launched an EU-wide initiative with WHO/Europe to address nursing shortages, covering all 27 EU member states and focusing on attracting and retaining nurses, improving working conditions, developing recruitment strategies, and strengthening the nursing workforce. The European Labour Authority's EURES analysis also identifies persistent labour shortages across Europe and points to demographic change, skills mismatches, and limited labour mobility as structural causes.

Europe is therefore not simply experiencing a temporary post-pandemic recruitment problem. It is confronting a structural workforce challenge.

What This Means for a Nurse Outside the EU

If you are a qualified nurse outside the European Union, the current situation creates genuine opportunities — but the best destination depends on your circumstances. If you speak excellent English, Ireland, Malta, and the UK may be worth investigating. If you are willing to learn German, Germany and Austria become much more interesting. If you speak French, France, Belgium, and Luxembourg may be relevant. If you speak Spanish, Spain may be worth considering. If you are prepared to learn a Nordic language, Sweden, Denmark, and Finland may offer possibilities.

The important point is this: do not choose a country solely because you heard that it has a nursing shortage. Choose a country where your qualification, experience, language ability, specialty, financial expectations, immigration profile, and long-term career goals fit the actual labour market.

Conclusion

Europe has a serious healthcare workforce challenge. The European Union and wider European region are ageing, healthcare demand is increasing, nurses are retiring, and many existing professionals are experiencing workloads that make retention difficult. The World Health Organization estimates that the European region could face a shortage of approximately 950,000 health workers by 2030.

At the same time, international recruitment is already transforming European healthcare. Between 2014 and 2023, the number of foreign-trained nurses working in the European Region increased by 67 percent, and in 2023, approximately 72 percent of nurses entering the region's health labour market had been trained outside the European Region. Countries such as Germany, Ireland, and Malta are already heavily dependent on international healthcare professionals, while countries across Western, Northern, Southern, and Central Europe are confronting different combinations of shortages, demographic pressures, and workforce migration.

For nurses outside the EU, this creates a significant opportunity. But Europe is not a single destination — each country has its own requirements. The successful international nurse of the future will need more than a nursing qualification; they will need to understand language, professional recognition, immigration, clinical requirements, employment conditions, and cultural integration.

Europe needs international healthcare workers. But getting there requires preparation. The strongest candidates will not simply ask where there are vacancies — they will ask where their skills, qualifications, and ambitions fit best.

For healthcare employers and recruiters, the responsibility is equally clear. International healthcare recruitment should not simply move people from one country to another. It should build sustainable careers, strengthen healthcare systems, and ensure that international mobility benefits the healthcare professional, the employer, the patient, and, wherever possible, the communities from which healthcare professionals originate. That is the future of responsible global healthcare recruitment.

Sources and Further Reading

William Lewis
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