Abstract

The health and care sector is one of the employment areas that has grown particularly strongly in recent years. In view of the acute need for workers in the nursing professions, it is particularly important that foreign employees have been making a significant contribution to meeting the personnel requirements in the nursing professions for several years. Our study provides an overview of the development of foreign employees in the nursing professions - differentiated by nationality (EU and third countries) and the level of requirements of the job. With the further development of the Skilled Immigration Act (2023), legal changes to the labor migration of people from third countries came into force in Germany from November 2023. In Germany, however, a formal recognition process to check the equivalence of the foreign professional qualification is still necessary for nursing staff, as for other regulated professions. Increasing numbers of people from countries outside the EU are now working in nursing, with many nursing staff having nationalities from the nursing recruitment countries (including Bosnia-Herzegovina, the Philippines, Vietnam) and European countries outside the EU (Turkey, Serbia, Albania). In nursing, the proportion of skilled workers is particularly high among employees from the Western European EU countries (EU-14 countries 1). Among geriatric nurses, it is mainly people from the nursing recruitment countries and Turkey who are relatively frequently employed as skilled workers. The labor market in the nursing sector is still dominated by women and part-time workers. 82 percent of employees are female and a good half of nursing staff work part-time (part-time rate of employees overall: 30%). The wages of employees in geriatric nursing are still significantly lower than those of nursing staff. In comparison, nursing staff from the EU-14 countries receive the highest wages. These people are comparatively often employed as specialists in hospitals - here the remuneration is generally higher than in the area of ​​inpatient and outpatient geriatric care. The effects of demographic change are also reflected in the increase in older employees in nursing. As can be seen from the age structure and nationality of the nurses, foreign nursing staff are significantly counteracting the unfavourable demographic development among German nursing staff. The number of older employees at assistant and specialist level with German nationality has increased sharply in the last ten years. At the same time, the proportion of young employees among all employed foreigners has increased significantly. Foreign specialists are rarely represented in nursing. But due to the high percentage increase in older German employees, the shortage of skilled workers in this group is likely to become even more severe in the coming years. At the same time, the regional importance of foreign employees in nursing and geriatric care professions varies. In eastern Germany, foreign nursing staff are underrepresented almost everywhere, apart from Berlin and the districts close to Berlin. In the western districts, the distribution is more even overall. The majority of foreign nurses and geriatric care workers work in metropolitan and urban regions (e.g. Munich, Frankfurt/Main, Stuttgart, Nuremberg).