Access Barriers and Success Factors for the Social Integration of Nursing Professionals in Rural and Urban Areas of Baden-Württemberg

The project investigates the social and structural conditions that influence the successful integration of nursing professionals from third countries in Baden-Württemberg. In light of the growing shortage of skilled workers in the care sector and the increasing recruitment abroad, it analyzes both existing barriers to integration and key factors that contribute to success. Combining qualitative and quantitative methods, the project explores the experiences, needs, and mobility perspectives of newly arrived nursing professionals in rural and urban regions. It also examines recruitment structures and legal frameworks that either support or hinder the social integration of these professionals. By involving key actors such as employers, recruitment agencies, and the nurses themselves, the project aims for a comprehensive understanding of integration dynamics. The findings will serve as a basis for evidence-based recommendations to strengthen long-term retention and successful participation of newly migrated nursing professionals.

The project addresses knowledge gaps regarding social and structural prerequisites for the successful social integration of nursing professionals from third countries, particularly with regard to effects on individual migration considerations.

1. Identify social and structural factors that enable or hinder the social integration and longer-term intentions to stay of nursing professionals from third countries in Baden-Württemberg.
2. Analyze recruitment practices, legal frameworks, and individual living experiences to better understand how integration processes unfold in rural and urban contexts.
3. Develop evidence-based policy recommendations that improve recruitment procedures, support integration, and strengthen the longer-term retention of internationally recruited nursing staff. 

In order to map complex life situations and integration processes, a triangulated research design was chosen that takes individual and collective factors into account and combines three different qualitative and quantitative approaches: 
We conducted 16 expert interviews with individuals from care institutions and local actors in the field of integration, held two focus groups with trainees, and carried out and evaluated an online survey. A total of 232 immigrant care workers in Baden-Württemberg participated in the online survey. 

• Many respondents view their arrival as positive overall, but also encounter considerable challenges. In addition to language barriers, these include finding accommodation and bureaucracy, such as complicated recognition procedures, delayed visa processes or uncertainties about residence status. All of this makes their arrival more difficult. 
• The nursing staff surveyed do make use of the advisory services available, but specific responsibilities are often unclear and municipal support services are not networked with each other. 
• Only about half of those surveyed work in accordance with their qualifications and experience. Many report being overworked and lacking training.  
• Discrimination in the workplace and in public is part of everyday life for many, but is rarely reported. 
• The physical environment shapes their arrival. Many respondents would like to live in small or medium-sized towns and particularly appreciate the proximity to their workplace, good bus and train connections and affordable rents. 
• While most respondents have no plans to move in the short-term, their intentions in the long-term are less certain. Intentions to stay depend heavily on feeling 
  appreciated at work, having legal security, having a high life satisfaction and having the possibility of family reunification.

• Strengthening a “welcome culture” in institutions and communities, as well as recognizing transnational living realities are central areas of action. 
• There is often a lack of clear responsibilities and systematic coordination of support services at the local and state levels. It is also essential to raise awareness about existing counseling services in order to support migrants and institutions alike. 
• In view of the diverse integration processes and associated needs, measures should be made reliable, transparent, and accessible close to places of residence. 
• Migrants' access to regular housing market structures as a condition for their well-being and their longer-term intentions to stay should be supported by
  institutions and actors in local communities and civil society. 
• The recognition of qualifications and advanced language courses as part of working hours should be supported.  

"Third-country nationals" are persons who hold the nationality of a country that is neither a member of the European Union (EU) nor the European Economic Area (EEA). 

• Yula, Esra; Rischke, Ramona; Yanaşmayan, Zeynep; Käferstein, Melinda (2025): Willkommen in der Pflege? Perspektiven auf das Ankommen und Bleiben von Pflegekräften aus Drittstaaten in Baden-Württemberg. DeZIM Project Report 18, Berlin: Deutsches Zentrum für Integrations- und Migrationsforschung (DeZIM). 
• Kordel, Stefan; Rischke, Ramona; Weidinger, Tobias; Yanasmayan, Zeynep (2025) Policy Paper, Soziale Teilhabe von Pflegekräften mit Migrationsbiographie in Stadt und Land.