You have had the position advertised for months and are wondering whether you are offering too little or searching in the wrong place. The answer is in the statistics of the Federal Employment Agency, and it is more uncomfortable than any critique of your advert: for every 100 registered positions for qualified nurses, there are arithmetically 57 unemployed. The market you are searching in cannot fill your position — no matter how well you search.
The market in four figures
In the 2025 annual average, around 20,000 positions for qualified nurses were registered with the Federal Employment Agency. Against them stood roughly 7,000 unemployed qualified nurses — for every 100 registered positions there are thus arithmetically 57 unemployed. The unemployment rate among qualified nurses stands at 1.1 percent (Source: Federal Employment Agency, Labour Market Situation in Nursing Occupations, 2025 annual average).
Two points of context make the figure tangible. First, an unemployment rate below three percent counts among labour market researchers as de facto full employment — at 1.1 percent, the remainder consists mostly of short transitions between two jobs. The duration shows the same: unemployed qualified nurses end their unemployment after an average of 134 days (Source: Federal Employment Agency, 2025). Whoever becomes available is quickly gone again. Second, the situation in the helper segment is exactly reversed — there, around 1,500 registered positions face roughly 48,000 unemployed. The bottleneck sits exclusively at the qualified level, and that is exactly where your open position sits.
What the ratio says — and what it does not
The unemployed-to-vacancy ratio is the most honest indicator of whether a market can supply a position. It sets the number of registered unemployed in an occupation against the registered positions in the same occupation. Below 100, there are arithmetically fewer available people than open positions — the competition then no longer runs for the job, but for the person. For qualified nurses it stands at 57 to 100, and that in the annual average, not in a seasonal peak (Source: Federal Employment Agency, 2025).
What the figure does not say: that 57 of these people would be candidates for your position. The statistic knows nothing of shift and location preferences, specialist further training or part-time wishes. The actually reachable pool for a concrete position in a concrete town is smaller than the ratio suggests — the 57 are the upper bound of optimism, not its base.
And the prospect of relief? Training numbers are rising — around 63,900 people began nursing training in 2025 — but only around 35,300 graduates arrived in the same year (Source: Federal Statistical Office, press releases No. 231/2026 and 276/2025). Today’s intake becomes tomorrow’s qualified nurse in three years at the earliest. Until then, the market stays as it is.
What the vacant position actually costs
Across all occupations, a skilled position stays vacant for an average of 183 days (Source: Federal Employment Agency, April 2025 to March 2026). Half a year in which the costs do not pause — they change shape. We deliberately give no blanket euro amounts here — every facility calculates differently — but the items are the same everywhere, and with your own figures they can be quantified in minutes.
First, the extra work in the existing team. The shifts of the missing nurse do not disappear; they migrate into overtime, supplements and stand-in bonuses — and into the exhaustion of those who step in. The most expensive consequential damage appears on no payslip: when the strain drives the team into resignations, one vacancy becomes a second.
Second, temporary staffing. It bridges reliably and costs a multiple of your own hourly staff cost for doing so — deployed permanently, it is the most expensive way of not filling a position.
Third, the service itself. In inpatient care, occupancy and staffing ratios are linked: whoever cannot hold the qualified-staff quota may not be able to offer beds or routes. Then the vacant position costs not salary but revenue — month after month, for as long as the vacancy lasts.
Fourth, the silent items. Every vacancy binds management time: rebuilding rotas, running interviews, answering the twentieth query about the advert. Add induction costs when constantly changing stand-ins move through the wards, and a quality risk that only shows up in the inspection report or the complaint. None of these items has its own line in the accounts — taken together they are often larger than the most visible one, the temporary staffing invoice.
Why more search effort does not solve the problem
At this point a sober look at the usual reflexes is worthwhile. The advert on more portals raises visibility among the same 57. The signing bonus shifts the moment at which a nurse changes provider — not the number of nurses. The recruitment consultant accelerates the redistribution, for a fee that adds one more item to the vacancy costs. None of this is wrong; it is merely the optimisation of a game whose total is fixed.
Advert, bonus, consultant — all three redistribute the same 57 available people per 100 positions. One of them may sign with you; the statistic wins anyway, because your hire is another provider’s new vacancy. For the sector as a whole, it is a zero-sum game with rising premiums.
Only two routes can enlarge the market. The first is the international recruitment of qualified nurses with recognition — that it is long since normality is shown by the employment figures: every fifth nurse today holds a foreign passport. The second is training, whether domestically or with trainees from abroad — the only route that creates new qualified nurses instead of redistributing existing ones. What it costs and what it brings back, we have calculated here.
The calculation that pays off
How does a provider proceed in practice? The first step is not an advert but an inventory: which positions have been open for how long, what does the bridging actually cost per month, and which of the vacancies can realistically be filled from the domestic market — say, because a nurse is returning from parental leave — and which cannot? That separation is the whole trick. For the first group, the classic route remains worthwhile. For the second group, every further month of domestic search is a decision for the most expensive of all options: waiting.
Insert your own figures; it takes only three: the monthly extra costs of bridging (overtime, supplements, temporary staffing), the lost revenue from beds that cannot be occupied or routes that cannot be driven, and the number of months your position has already been open. The sum is the price of waiting.
Against it stands the price of acting. An international recruitment runs through seven steps: first, the needs analysis — you submit your staffing requirements, and the active search begins once the complete needs analysis and the signed placement contract are in place. Second, candidate search and pre-qualification, around two to four weeks. Third, candidate presentation via a document portfolio with a video or interview option. Fourth, document collection and legalisation. Fifth, the administrative procedure — the work permit takes around six to eight weeks. Sixth, the visa procedure and flight booking, around four weeks. Seventh, arrival, registration and starting work.
In nursing, the recognition procedure is added; in our experience the total is four to six months from contract. That is not a fast route, and whoever promises you 48 hours is promising too much. But it is a route with an end, while the domestic search in this market has none. Whoever lays the price of waiting and the price of acting side by side usually makes the decision by themselves.
The information in this article is for orientation and does not replace legal advice. For the record: we deliberately give no success figures from our own placements in this article — what we describe is the market situation, not a result we cannot yet show.
Further reading
- What a nursing trainee costs — and what they bring back
- Nursing trainees from abroad: what your organisation needs
- International nurses are the norm
Sources
- Federal Employment Agency: Blickpunkt Arbeitsmarkt — Labour Market Situation in Nursing Occupations. 2026. https://statistik.arbeitsagentur.de/DE/Statischer-Content/Statistiken/Themen-im-Fokus/Berufe/Generische-Publikationen/Arbeitsmarktsituation-in-Pflegeberufen.pdf (accessed 27 August 2026)
- Federal Statistical Office: Nursing training 2025 — number of new trainees rises for the third year running. Press release No. 231. 2026. https://www.destatis.de/DE/Presse/Pressemitteilungen/2026/07/PD26_231_212.html (accessed 27 August 2026)
- Federal Employment Agency: Vacancy duration by qualification level, April 2025 to March 2026. (Statista compilation, project pool file; no freely accessible individual URL verified)
