Nurse Registration in European Union Countries

All countries in the EU have a national or regional regulatory system for nurses. In the majority of countries a nurse is required to register his or her qualification with the regulatory authority (which may be a government ministry or a separate body) before being allowed to practice in that country.

European legislation to promote labour market mobility means that most basic nursing qualifications gained in one EU country are automatically recognised by these regulatory authorities in another EU country. They are the qualifications adhering to the Nurses in general care directive which lays down minimum EU requirements for content and length of nurse education.

Other basic nursing qualifications gained in the EU fall within the general systems directives. This means that the regulatory authority in another EU member state has the right to assess these nurses’ qualifications individually to determine whether they meet the requirements of that country. If they do not they can be asked to undertake a period of adaptation or supervised practice. This may also apply to nurses wishing to gain recognition for qualifications from outside the EU.

Employers and nurses should contact the regulatory authority in the relevant country to find out more about registering nursing qualifications. See appendix 5 for contacts in each country.

Good practice in developing and implementing supervised practice, adaptation and general induction programmes

Many IRNs must complete a period of adaptation or a supervised practice before they can be registered to practice in an EU country. However, even where an IRN immediately achieves registration, for example because their qualification is automatically recognised through the EU directives, EFN recommends that employers provide a period of induction that incorporates the key principles set out in this section.

What is a supervised practice or adaptation programme?

Programme aims

Adaptation or supervised practice courses vary in their design. However, the overall aim of the programme is to enable the supervised practice nurse or adaptation midwife to register through a process of professional development, and assessment of safe and effective clinical competence.

An adaptation or supervised practice programme consists of a theoretical component and a clinical placement. The theoretical element provides an opportunity for the IRN to become familiar with health care provision in that country; local policy and practice; and updating in any required areas. The clinical placement means it is possible to assess nurses’ clinical competence under supervision, and ensures they are able to deliver safe and effective care. Supervised practice nurses and adaptation midwives should not, at any time, be given responsibilities for which they have not been prepared.

Courses vary according to the organising authority and the needs of the nurses on the programme, as well as according to the country in which the nurses are registered.

General induction programmes

Whether or not IRNs are required to undergo an adaptation or supervised practice programme, EFN recommends that employers provide a general induction programme to life in the country the nurse is moving to. This should include information about the local area, including such things as access to health care, local places of worship, local shopping, information about staff, professional and cultural associations which may provide further support to IRNs. Employers should also consider the needs of the IRN’s family.

What language skills do IRNs need?

At present EU legislation relating to mutual recognition of qualifications does not specify that nurses must have certain language skills before their qualifications are recognised in another EU country.

The employer, as part of the recruitment process, has a responsibility to check that nurses are competent in the language(s) used in their work environment and able to communicate effectively with others. The individual nurse is also responsible for ensuring their language skills enable them to fulfil their professional role as a qualified nurse in the new health setting.

With reference to patient safety EFN strongly recommends that employers make sure IRNs are able to communicate effectively in the language of the host country.

European Union (EU) and European Economic Area (EEA) countries

EU countries
Austria, Belgium, Cyprus, Czech Republic, Denmark, Estonia, Finland, France,Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, United Kingdom

EEA countries
European Union countries, Iceland, Norway, Lichtenstein