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AIMS Public Health

2025, Volume 12, Issue 2: 399-417. doi: 10.3934/publichealth.2025023
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Integration of Albanian nurses in Germany: Employment challenges and opportunities - A descriptive study

  • 1.
    Faculty of Technical Medical Sciences, University of Medicine, Tirana, Albania
  • 2.
    Department of Nursing, RE-ALIS GmbH, Speyer, Germany
  • 3.
    Faculty of Medicine, University “Our Lady of the Good Counsel”, Tirana, Albania
  • 4.
    Directory of Teaching, Future Center, Tirana, Albania
  • 5.
    Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
  • Received: 02 January 2025 Revised: 06 March 2025 Accepted: 18 March 2025 Published: 08 April 2025

  • Nurse migration from low- and middle-income countries to high-income nations is a significant global phenomenon. This study aimed to examine the opportunities and challenges faced by Albanian nurses during their work integration after migrating to Germany. A descriptive cross-sectional quantitative study was conducted using convenience sampling with a snowball recruitment technique. A total of 162 Albanian nurses working in Germany, mostly female and married, participated in the survey. The findings revealed that the overall integration process was satisfactory, particularly regarding the recognition of professional qualifications, respect from colleagues, patients, and families, career opportunities, and autonomy at work. The host institutions supported integration through mentorship programs, language training, procedural training, and education on the German healthcare system. However, nurses reported challenges in medical terminologies, telephone communication, and healthcare documentation. The participants expressed the need for more comprehensive pre-departure information to facilitate smoother transitions. The study highlights the pivotal role of managers and institutions in the integration process and in creating inclusive and equitable work environments. Germany serves as a model for implementing effective integration activities for migrant nurses. Albania must adopt stronger strategies to retain nurses within the country and enhance its human capital by improving the working conditions and providing career development opportunities. Future research is recommended to explore the integration processes of Albanian nurses across other European countries. Subsequent studies should concentrate on identifying and addressing potential barriers to integration while fostering opportunities for collaboration between the origin and destination countries. Such research can contribute to academic, political, and social frameworks that enhance the migration experience for migrant nurses.

    Citation: Alketa Dervishi, Simon Jäger, Blerina Duka, Etleva Kika, Valbona Bezhani, Ardit Lena, Dhurata Ivziku. Integration of Albanian nurses in Germany: Employment challenges and opportunities - A descriptive study[J]. AIMS Public Health, 2025, 12(2): 399-417. doi: 10.3934/publichealth.2025023

    Related Papers:

  • Nurse migration from low- and middle-income countries to high-income nations is a significant global phenomenon. This study aimed to examine the opportunities and challenges faced by Albanian nurses during their work integration after migrating to Germany. A descriptive cross-sectional quantitative study was conducted using convenience sampling with a snowball recruitment technique. A total of 162 Albanian nurses working in Germany, mostly female and married, participated in the survey. The findings revealed that the overall integration process was satisfactory, particularly regarding the recognition of professional qualifications, respect from colleagues, patients, and families, career opportunities, and autonomy at work. The host institutions supported integration through mentorship programs, language training, procedural training, and education on the German healthcare system. However, nurses reported challenges in medical terminologies, telephone communication, and healthcare documentation. The participants expressed the need for more comprehensive pre-departure information to facilitate smoother transitions. The study highlights the pivotal role of managers and institutions in the integration process and in creating inclusive and equitable work environments. Germany serves as a model for implementing effective integration activities for migrant nurses. Albania must adopt stronger strategies to retain nurses within the country and enhance its human capital by improving the working conditions and providing career development opportunities. Future research is recommended to explore the integration processes of Albanian nurses across other European countries. Subsequent studies should concentrate on identifying and addressing potential barriers to integration while fostering opportunities for collaboration between the origin and destination countries. Such research can contribute to academic, political, and social frameworks that enhance the migration experience for migrant nurses.



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    Acknowledgments


    No funding was received for this research. The authors want to acknowledge all the Albanian nurses that contributed to this research for their insights.

    Authors' contribution


    Conceptualization, A.D., S.J.; methodology, A.D., D.I; software, D.I.; formal analysis, A.D., B.D., and D.I.; investigation, E.K., V.B.; data curation A.D., E.K., V.B.; writing—original draft preparation, B.D., A.D. and D.I.; writing—review and editing, A.D., S.J., B.D., D.I.; visualization, A.L.; project administration, A.D., S.J. All authors have read and agreed to the published version of the manuscript.

    Conflict of interest


    The authors have no conflicts of interest.

    [1] World Health OrganisationState of the world's nursing report—2020 (2020). [cited 2024 December 14]. Available from: https://www.who.int/publications-detail-redirect/9789240003279.
    [2] (2024) World Health OrganizationBilateral agreements on health worker migration and mobility: Maximizing health system benefits and safeguarding health workforce rights and welfare through fair and ethical international recruitment. Geneva: World Health Organization. [cited 2024 December 14]. Available from: https://www.who.int/publications/i/item/9789240073067.
    [3] Boniol M, Kunjumen T, Nair TS, et al. (2022) The global health workforce stock and distribution in 2020 and 2030: A threat to equity and ‘universal’ health coverage?. BMJ Glob Health 7: e009316. https://doi.org/10.1136/bmjgh-2022-009316
    [4] WHOGlobal code of practice on the international recruitment of health personnel (2010). [cited 2024 December 14]. Available from: https://www.who.int/publications/i/item/wha68.32
    [5] INSTATDemographic and social indicators, migration and migrant integration, Albania (2022). [cited 2024 December 14]. Available from: https://www.instat.gov.al/en/themes/demography-and-social-indicators/migration-and-migrant-integration/#tab2
    [6] Esipova N, Pugliese A, Ray J (2018) More than 750 million worldwide would migrate if they could. Washington DC: Gallup World. [cited 2024 December 14]. Available from: https://www.sipotra.it/wp-content/uploads/2019/02/More-Than-750-Million-Worldwide-Would-Migrate-If-They-Could.pdf.
    [7] King R, Gëdeshi I (2020) New trends in potential migration from Albania: The migration transition postponed?. Migr Dev 9: 131-151. https://doi.org/10.1080/21632324.2019.1608099
    [8] Council Recommendation of 22 May 2017 on the European Qualifications Framework for lifelong learning and repealing the recommendation of the European Parliament and of the Council of 23 April 2008 on the establishment of the European Qualifications Framework for lifelong learning (2017/C 189/03). Off J Eur Union 60: 15-28. [cited 2024 December 14]. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32017H0615(01)
    [9] UISH Professional ProfilesProfilet professionale (2023). [cited 2024 December 14]. Available from: https://urdhriinfermierit.org/botime/
    [10] (2023) Albanian Ministry of HealthAnnual report on the distribution of the health workforce in Albania. Tirana, Albania: .
    [11] UISHStrategy 2022–2027 (2022). [cited 2024 December 14]. Available from: https://urdhriinfermierit.org/wp-content/uploads/2023/10/Strategjia-kopertine-uish-2022-2027.pdf
    [12] Krasniqi M, Kalaja R, Trebicka B, et al. (2025) The impact of migration considerations on healthcare professionals in Albania: A statistical analysis. J Lifestyle SDGs Rev 5: e03264-e03264. https://doi.org/10.47172/2965-730X.SDGsReview.v5.n02.pe03264
    [13] Duka B, Dervishi A, Grosha E, et al. (2025) Inequalities in the distribution of the nursing workforce in Albania: A regional analysis using the Gini Coefficient. Nurs Rep 15: 30. https://doi.org/10.3390/nursrep15020030
    [14] Krasniqi M, Kalaja R, Trebicka B, et al. (2024) Migration of healthcare professionals in Albania: Insights from a survey of doctors and nurses. Libr Prog Int 44: 225-229. [cited 2024 December 14]. Available from: https://www.bpasjournals.com/library-science/index.php/journal/article/view/3945
    [15] PortaliPortali Infermierë për Shqipërinë. [cited 2024 December 14]. Available from: https://infermierepershqiperine.al/
    [16] VKM Nr.424 datë 26.06.2024 Për miratimin e strukturës së pagave, niveleve të Pagave dhe shtesave mbi paga. Botuar në Fletoren Zyrtare me Vendimin Nr.110 datë 01.07.2024. [cited 2024 December 14]. Available from: https://www.kryeministria.al/newsroom/vendime-te-miratuara-ne-mbledhjen-e-keshillit-te-ministrave-date-26-qershor-2024/
    [17] Federal Ministry of Labour and Social AffairsA guide to labour market access and promotion. Refugees. Clients of employment agencies and job centr. Referat EF3 - Europäischer Sozialfonds: Information, Public Relations. Bundesministerium für Arbeit und Soziales (BMAS), Bonn (2019). [cited 2024 December 14]. Available from: https://www.esf.de/portal/DE/Impressum/inhalt.html.
    [18] Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbHSustainable recruitment of nurses (Triple Win) (2012). [cited 2024 December 14]. Available from: https://www.giz.de/en/worldwide/41533.html
    [19] Kordes J, Pütz R, Rand S (2020) Analyzing migration management: On the recruitment of nurses to Germany. Soc Sci 9: 19-36. https://doi.org/10.3390/socsci9020019
    [20] Zander-Jentsch B, Busse R (2018) Entlastung für die Pflege?: Personaluntergrenzen im Krankenhaus. CNE Pflegemanagement 5: 6-9. https://doi.org/10.1055/s-0044-100580
    [21] Rand S, Pütz R, Larsen C (2019) Die Herausbildung eines globalisierten Pflegearbeitsmarktes in Deutschland, In Betriebliche Integration von Pflegefachkräften aus dem Ausland, Innenansichten zu Herausforderungen globalisierter Arbeitsmärkte. Christa Larsen, Sigrid Rand and Minna-Kristiina Ruokonen-Engler : 20-59. [cited 2024 December 14]. Available from: https://www.boeckler.de/pdf/p_study_hbs_416.pdf
    [22] Smith JB, Herinek D, Woodward-Kron R, et al. (2022) Nurse migration in Australia, Germany, and the UK: A rapid evidence assessment of empirical research involving migrant nurses. Policy Polit Nurs Pract 23: 175-194. https://doi.org/10.1177/15271544221102964
    [23] von Elm E, Altman DG, Egger M, et al. (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. PLoS Med 4: e296. https://doi.org/10.1371/journal.pmed.0040296
    [24] Etikan I, Musa SA, Alkassim RS (2016) Comparison of convenience sampling and purposive sampling. Am J Theor Appl Stat 5: 1-4. https://doi.org/10.11648/j.ajtas.20160501.11
    [25] Sadler GR, Lee HC, Lim RSH, et al. (2010) Recruitment of hard-to-reach population subgroups via adaptations of the snowball sampling strategy. Nurs Health Sci 12: 369-374. https://doi.org/10.1111/j.1442-2018.2010.00541.x
    [26] (2024) World Medical AssociationDeclaration of Helsinki: Ethical principles for medical research involving human participants. Helsinki, Finland: WMA General Assembly. [cited 2024 December 14]. Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki/
    [27] Kamau S, Koskenranta M, Kuivila H, et al. (2022) Integration strategies and models to support transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments: An umbrella review. Int J Nurs Stud 136: 104377. https://doi.org/10.1016/j.ijnurstu.2022.104377
    [28] Pressley C, Newton D, Garside J, et al. (2022) Global migration and factors that support acculturation and retention of international nurses: A systematic review. Int J Nurs Stud Adv 4: 100083. https://doi.org/10.1016/j.ijnsa.2022.100083
    [29] Castagnone E, Salis E (2015) Workplace integration of migrant health workers in Europe. Comparative report on five European countries. WORK→INT Research Report, Turin, FIERI . [cited 2024 December 14]. Available from: https://workint.fieri.it/wp-content/uploads/2015/09/Comparative-research-report_FINAL.pdf
    [30] Regional Cooperation Council.Balkan Barometer 2020: Public opinion analytical report. Sarajevo, Bosnia and Herzegovina (2020) . [cited 2024 December 14]. Available from: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.rcc.int/download/docs/2020-06-Balkan-Barometer-Public-Opinion_final.pdf/bf27f9fc10de8a02df9db2b60596f0cd.pdf
    [31] Gëdeshi I, King R (2022) Albanian returned asylum-seekers: Failures, successes and what can be achieved in a short time. J Balk Near East Stud 24: 479-502. https://doi.org/10.1080/19448953.2021.2015657
    [32] Dahl K, Nortvedt L, Schrøder J, et al. (2022) Internationally educated nurses and resilience: A systematic literature review. Int Nurs Rev 69: 405-415. https://doi.org/10.1111/inr.12787
    [33] Dhëmbo E, Çaro E, Hoxha J (2021) “Our migrant” and “the other migrant”: Migration discourse in the Albanian media, 2015–2018. Humanit Soc Sci Commun 8: 1-10. https://doi.org/10.1057/s41599-021-00981-w
    [34] Göler D, Krišjāne Z (2024) Migration as a tool for social resilience: Lessons from two case studies. Comp Popul Stud 49: 1-24. https://doi.org/10.12765/CPoS-2024-01
    [35] Krasniqi L (2023) Cultural resilience in the face of globalization: An anthropological exploration of traditional societies' adaptation strategies and identity dynamics. Interdisc J Pap Hum Rev 4: 31-38. https://doi.org/10.47667/ijphr.v4i4.281
    [36] Nortvedt L, Lohne V, Dahl K (2020) A courageous journey: Experiences of migrant Philippine nurses in Norway. J. Clin Nurs 29: 468-479. https://doi.org/10.1111/jocn.15107
    [37] Ramji Z, Etowa J (2018) Workplace integration: Key considerations for internationally educated nurses and employers. Adm Sci 8: 2:1-18. https://doi.org/10.3390/admsci8010002
    [38] Villamin P, Lopez V, Thapa DK, et al. (2024) Retention and turnover among migrant nurses: A scoping review. Int Nurs Rev 71: 541-555. https://doi.org/10.1111/inr.12861
    [39] Motala MI, Van Wyk JM (2019) Experiences of Foreign Medical Graduates (FMGs), International Medical Graduates (IMGs) and Overseas Trained Graduates (OTGs) on entering developing or middle-income countries like South Africa: A scoping review. Hum Resour Health 17: 1-16. https://doi.org/10.1186/s12960-019-0343-y
    [40] Ivziku D, Badolamenti S, Giannetta N, et al. (2024) International nursing students and clinical learning environments: A convergent mixed-methods study. Nurse Educ Pract 80: 104144. https://doi.org/10.1016/j.nepr.2024.104144
    [41] McGrath P, Henderson D, Holewa H (2013) Language issues: An important professional practice dimension for Australian international medical graduates. Commun Med 10: 191-200. https://doi.org/10.1558/cam.v10i3.191
    [42] Schmitz-Pranghe C, Oruč N, Mielke K, et al. (2020) Making sure that the emigration of healthcare personnel from Albania and BiH works for all: What Germany can do. Bonn: Bonn International Center for Conversion (BICC). BICC Policy Brief 8: 7. [cited 2024 December 14]. Available from: https://nbn-resolving.org/urn:nbn:de:0168-ssoar-71225-9.
    [43] Rajpoot A, Merriman C, Rafferty AM, et al. (2024) Transitioning experiences of internationally educated nurses in host countries. A narrative systematic review. Int J Nurs Stud Adv 6: 100195. https://doi.org/10.1016/j.ijnsa.2024.100195
    [44] Buchan J, Catton H, Shaffer F (2022) Sustain and retain in 2022 and beyond. Int Counc Nurses 71: 1-71. [cited 2024 December 29]. Available from: https://www.intlnursemigration.org/wp-content/uploads/2022/01/Sustain-and-Retain-in-2022-and-Beyond-The-global-nursing-workforce-and-the-COVID-19-pandemic.pdf
    [45] Saric J, Kiefer S, Peshkatari A, et al. (2021) Assessing the quality of care at primary health care level in two pilot regions of Albania. Front Public Health 9: 1-11. https://doi.org/10.3389/fpubh.2021.747689
    [46] Kaleshi E (2021) Effects of migration and human capital formation in Albania. Eur J Soc Sci Educ Res 8: 93-109. https://doi.org/10.26417/864jjj42q
    [47] Romiti A, Del Vecchio M, Cavicchi C, et al. (2024) Cooperation between Italy and Albania to face nurses' shortage: Insights. In Economic Growth, Prosperity and Sustainability in the Economies of the Balkans and Eastern European Countries: Proceedings of the 15th International Conference on the Economies of the Balkan and Eastern European Countries (EBEEC) in Chios, Greece, 2023 . Cham: Springer Nature 409-437. https://doi.org/10.1007/978-3-031-58437-4_21
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