07.11.2024 Gabriele Strasser 2316

Best practice: Nursing staff from abroad at Albertinen Hospital

Nursing staff from various countries such as Portugal, Mexico, Iraq and Syria work at the Albertinen Hospital in Hamburg. On the occasion of the campaign "Keep in touch - show attitude", we spoke to Nursing Director Alberto Correia about recipes for success in recruiting and integrating nursing staff from abroad. 

Mr. Correia, you are the Director of Nursing at Albertinen Hospital and employ many young people from Portugal and other countries. How did this come about?

Alberto Correia: At Albertinen Hospital, like most hospitals, we are faced with the challenge of recruiting specialist staff. About 12 years ago, we started to recruit staff from abroad. With the help of our cooperation partner, through whom we have good relationships with Portugal, Italy and Spain, we initially concentrated on Portugal, because I was born in Portugal myself and therefore have a connection to the country and its people.

How do you recruit specialists? What were the first steps?

Initially, I traveled to Portugal myself with our cooperation partner and recruited specialists at the universities. In this context, I presented our hospital and motivated young people to come to us. I now send colleagues who have been to these universities themselves. 

This creates authentic testimonials: they have embarked on the journey themselves, know the opportunity that lies behind it, know what is going well and also talk about any teething troubles. After all, challenges and obstacles are also worth mentioning and should be reported. It is important to me to give future colleagues an authentic impression, as this is the only way we can create realistic expectations and prevent possible disappointment. Recruiting is successful. Once again this year, two colleagues were able to arouse the interest of 80 Portuguese nursing staff in us and in working with us during a recruiting trip.

How do foreign colleagues integrate successfully? And when does the integration process start?

Onboarding and integration begin before the colleagues arrive in Germany. I conduct the interviews in advance, so it's an advantage that I don't need a translator. For many, the initial inhibition threshold is already overcome by the fact that they can communicate with me in their native language while they are still at the beginning of their German language skills. To help with integration on site, we have practical instructors on leave who accompany the new nursing staff at the start of their professional activity with us and gradually train them in a structured manner over a period of three months. 

However, integration is also individual in each case. My experience shows that Portuguese nursing staff experience few challenges when integrating in Germany. One reason for this is that Portugal is also part of Europe. Many people from Portugal also live in Hamburg and there are many Portuguese cafés and restaurants. 

Are there still difficulties with integration?

The first year can be exhausting. The nursing staff have to learn the language in all its nuances and are faced with the challenge of carrying out different nursing tasks than they are used to in Portugal. In addition, they are far away from their family and friends.

We try to support them as much as possible in these challenges. The arrival in Hamburg and their language course then takes place privately in clubs. The new arrivals meet other Portuguese people and get to know the city. They are given contact persons who have been through the same and similar experiences. People who can provide guidance and act as role models.

When I go around the house and ask: "How are you?", I hear that they feel at home in Hamburg. Sometimes colleagues say: "I'm going back, I miss my family and friends". But only very few of them actually leave.

You recruit not only in Portugal, but also outside the EU. What are the special features here?

We are now also recruiting in Mexico, and this year we were able to recruit a total of 14 new colleagues. The figure for 2025 is already 21 colleagues. Recruitment in this country brings with it other challenges. 

And unlike in the EU, the certificates and bachelor's degrees of nursing staff are not recognized. They have to have their exams recognized again in Germany. This takes a year, during which they have to learn German and then take the written, oral and practical exams. The hurdle is much higher both for them and for us as a company. They need an employer and people who will do everything they can to ensure that they pass their exam and are recognized in Germany.

I have released practical instructors with pedagogical training, one full-time employee and 2 colleagues working part-time at 50%. They make sure that the young people from Mexico are well received and integrated.

What is the mix in your company? And how do the different groups harmonize? Are there sometimes cultural difficulties and how do you deal with them?

At the end of last year, 110 colleagues out of a total of around 800 nursing staff were from abroad. There are sometimes cultural difficulties, but less so with colleagues from Portugal. 

We also have many colleagues with a migration background in training, for example from Iran, Iraq, Syria or Afghanistan. The cultural context is always different. For example, topics such as closeness and distance as well as touch are part of the tasks of nursing staff in Germany. I once spoke to a trainee who found it difficult when he had to help an elderly lady with her personal hygiene. Another found it challenging to receive instructions from a female superior. In such cases, I offer a one-to-one conversation where we can sort it out together. This can sometimes be challenging, but a solution is still possible.

We do not recruit in the Middle East, but we are now integrating colleagues who have trained in these countries and have come to Germany as part of the asylum process. We don't have to actively search, the nursing staff are already in Germany because they have fled. 

However, it is important to remember that these people do not come to us voluntarily. They are fleeing war and have sometimes experienced traumatic things. The lives of a young Portuguese man who has studied and wants to go out into the world and someone fleeing the war in Syria are significantly different. 

Are there any support services for foreign nursing staff to prevent initial difficulties from the outset?

We offer various services at different levels in the house: For language support as part of courses, for successive professional skills development, for advice and support as part of their changed life path and for their arrival in a foreign country. We also benefit from our various cooperation partners. 

Of course, we have structures in place ourselves, such as chaplains or experienced colleagues from the Department of Psychiatry and Psychotherapy, who also take care of the psychosocial needs of our employees in individual cases.

Do you have team-building measures to help employees grow together?

Yes, for example at hospital level or even at Group level. What's special about us in nursing is that team building also consciously takes place within the teams. Colleagues have breakfast together on the ward, they not only work together, but also meet in private.

Persistent difficulties in teams can also be an indication that outside help is needed - also in the form of supervision and coaching for the pme teams -Familienservice to see where the team stands and to work out solutions together. So far, however, this has never been about the integration of colleagues from abroad, but about other issues.

Do the different backgrounds occasionally lead to conflicts?

Less with registered nurses who have consciously chosen the profession and have already grown into it than with trainees who have not sufficiently reflected on their career choice. With colleagues from Portugal or Mexico, it doesn't matter which country they come from or what their cultural background is. It's more about technical issues. I occasionally have conversations with some young people in which I encourage them: "Please let's talk about what profession you have chosen and what it means to you to work in a hospital in Germany". 

Does that mean you first seek out a conversation and see where the shoe pinches?

Definitely, yes. Young people need guidance. I was in Afghanistan myself for years on a project. There are cultural differences in every country. And when a person has grown up, they can't simply discard their origins. I try to explain in conversation that many things are different here in Germany.

Do you have any recommendations for other companies in your sector that would like to recruit more from abroad? Are there any guarantees of success?

It is important to have the attitude that I want to retain people in the long term - instead of giving in to the pressure to get as many people as possible who can work quickly. This also includes letting people arrive, investing time and giving them space for this big step and their development.

Value creation and appreciation are inseparable for me. I think in a humanistic and value-oriented way. Because many care workers don't just leave their country and their family voluntarily. This also applies to the Portuguese. Portugal is a beautiful country, but the conditions for care workers are suboptimal in many respects. There are too few jobs - and they are poorly paid. 

The rest is hard work: I have to create resources, I need time for induction, resources for people on leave who take care of integration so that our new nursing staff don't just "run along and watch" and have sole responsibility for a group of patients on the third day. That's not how it should be.  

You work with people from different religions. How do you generally deal with religious symbols?

We are a Christian house, we have a church in the hospital, Bibles in the rooms and many religious symbols and offerings. At the same time, we have a deep respect for all other religions. Women with headscarves or bindis work here, that's not an issue at all. In addition to religions, the topic of spirituality is also relevant for us. However, a necessary condition for us when practising religions is that hygiene requirements must be observed and arms must remain uncovered, for example. 

For me, the essence of professional interfaith relationships is mutual respect. For example, if a patient wants to pray before an operation because they are afraid, I do not expect the nurse in charge to pray aloud with the patient if they refuse to do so for personal reasons. However, I do expect the patient to be given the space and resources to do so and also to be given someone to pray with them.  

Thank you very much for the interview, Mr. Correia!