How to Hire Nurses from Abroad in Italy (2026): Employer Guide

8 min

The Nursing Shortage in Italy: Is Foreign Hiring Practical?

Italian healthcare facilities face a severe deficit of registered nurses. National health system estimates indicate a structural shortfall of over 65,000 nurses across the country. The shortage is most acute in northern and central regions with dense networks of private clinics, residential care homes (RSA), and public hospital trusts, including Lombardy, Piedmont, Veneto, Emilia-Romagna, and Lazio. High retirement rates, limited domestic training capacity, and cross-border emigration to Switzerland, Austria, and the United Kingdom have left local recruitment channels unable to cover daily staffing requirements.

Hiring non-EU nurses is a viable strategy to keep units open and compliant with legal nurse-to-patient ratios, but it is not a quick fix. Italy has specific statutory procedures for professional qualification recognition and work authorization. While temporary legal derogations have periodically simplified entry for foreign healthcare professionals, employers must navigate a process involving the Ministry of Health (Ministero della Salute), local prefectures, and professional orders. Foreign recruitment requires active project management, a realistic multi-month timeline, and early investment in language preparation.

Qualification Recognition and Legal Pathways

To employ a non-EU nurse in Italy, you must satisfy two separate requirements: verifying their professional qualification and obtaining immigration authorization. The specific steps depend on whether you use the standard legal path or applicable temporary derogation provisions.

Ministry of Health Recognition: Under standard procedures, foreign nursing degrees must be formally recognized as equivalent to the Italian Laurea in Infermieristica. The candidate submits their degree curriculum, academic transcript, professional licence, and good standing certificate to the Ministero della Salute. If approved, the Ministry issues a recognition decree (decreto di riconoscimento).
Professional Registry Registration: Once recognized, the nurse must pass an Italian language and professional regulation exam to register with the provincial order of nurses (OPI - Ordine delle Professioni Infermieristiche). OPI registration is a mandatory statutory requirement for independent practice under standard rules.
Temporary Derogation Rules: Italian legislation (originally enacted under Article 13 of Law Decree 18/2020 and updated through subsequent annual decree extensions) has allowed health authorities and private accredited facilities to hire non-EU nurses temporarily based on degree evaluation alone, bypassing mandatory OPI registration during the validity of the measure. Employers must check the active status of these derogation rules directly with the Ministero della Salute or their Regional Health Authority (Regione) before initiating contracts.
Immigration Entry Authorization (Nulla Osta): Healthcare professionals are generally processed outside standard annual entry quotas under Article 27 of the Consolidated Immigration Act (Testo Unico sull'Immigrazione - D.Lgs. 286/1998) or under dedicated healthcare quotas within the Decreto Flussi. The employer submits the application for authorization to hire (Nulla Osta al lavoro) through the Ministry of Interior's online portal (ALI) to the competent Prefectural Immigration Office (Sportello Unico per l'Immigrazione - SUI).
Consular Visa and Resident Permit: Once the SUI issues the Nulla Osta, the candidate applies for an entry visa for subordinate employment (visto per lavoro subordinato) at the Italian embassy or consulate in their home country. Within eight days of arriving in Italy, the worker must visit the SUI to sign the contract of stay (contratto di soggiorno) and apply for their residence permit (permesso di soggiorno).

Expected Timeline: From Offer to First Shift

Employers should plan for an overall timeline of 6 to 11 months from making a conditional offer to the nurse's first working day on the unit. Delays occur primarily in document translation, Ministry review, and consular processing.

Document Preparation and Translation (1 to 2 months): The candidate must obtain transcripts, course descriptions, and police checks from their home country, followed by official translation into Italian and legal verification (Apostille or consular legalization).
Qualification Recognition (3 to 5 months): Evaluation by the Ministero della Salute takes several months. If the Ministry requests supplementary practical exams or adaptations, this phase extends further.
Nulla Osta Processing (2 to 3 months): Once documents are in order, the SUI processes the employer's request for work authorization.
Visa Issuance and Travel (1 to 2 months): Embassy scheduling and visa stamping vary significantly by country of origin.
Post-Arrival Registration (1 to 2 weeks): Signing the contract of stay at the SUI and submitting the residence permit application takes place immediately upon entry, allowing the nurse to start work under provisional rules while the physical card is printed.

Pay Standards, Collective Agreements, and Housing Duties

Italian employment law strictly regulates pay and conditions through National Collective Labour Agreements (Contratto Collettivo Nazionale di Lavoro - CCNL). You cannot pay a foreign nurse less than the rate established for local staff in the equivalent category.

Applicable CCNL Rates: For private accredited hospitals and clinics, salaries are typically governed by the CCNL AIOP or CCNL ARIS. Residential care facilities often use CCNL UNEBA or CCNL Cooperative Sociali. Public sector institutions follow the CCNL Sanità. Gross starting salaries for entry to mid-level nurses range between 1,900 EUR and 2,400 EUR per month for 36 to 38 weekly hours, excluding night, weekend, or hazard shift allowances.
Housing Obligations: To secure the SUI Nulla Osta, the employer must submit proof of suitable accommodation (idoneità alloggiativa) for the incoming worker. While Italian law does not mandate that the employer pay for housing long-term, custom and practical necessity require employers hiring from abroad to secure initial housing (such as a dedicated apartment or host facility) for at least the first 1 to 3 months. Providing temporary housing support significantly reduces early turnover.
Language Proficiency: Safe nursing practice in Italy requires Italian at a B2 level under the Common European Framework of Reference for Languages. Even if a legal pathway permits temporary entry without formal language testing, employers should invest in or require B2 Italian language training prior to entry.

Estimated Costs for Italian Employers

Budgeting accurately helps prevent unexpected recruitment costs. The breakdown below outlines typical per-hire expenses for bringing a non-EU nurse to Italy.

Official Application and Administrative Fees: 100 EUR to 250 EUR (revenue stamps, SUI processing, and permit fees).
Translation and Legalization of Documents: 400 EUR to 900 EUR (sworn translations, Apostille fees, and consular attestation, depending on the country of origin).
Ministry of Health Recognition Application Fee: 150 EUR to 300 EUR.
Relocation and Inbound Travel: 400 EUR to 1,200 EUR (one-way flight and local transport).
Initial Accommodation Support (1 to 3 months): 1,000 EUR to 3,000 EUR (deposit and subsidized rent, depending on regional real estate costs in areas like Milan or Rome versus smaller provinces).
Language Training Support (optional but recommended): 500 EUR to 1,200 EUR per candidate.
Estimated Total Direct Cost per Nurse: 2,550 EUR to 6,850 EUR.

Legal Compliance: Candidate Zero-Fee Rules

Under Italian labor law (specifically Legislative Decree 276/2003) and international labor standards (ILO General Principles), candidates must never be charged fees for job placement, administrative handling, or contract issuance. Legitimate Italian employers cover all official authorization fees, internal processing costs, and relocation assistance directly.

Employers that work with third-party agencies or intermediaries abroad must demand full transparency regarding candidate sourcing. If an agency demands placement money, illegal deposits, or debt-deduction agreements from nurses, the employer faces significant legal liabilities, potential labor inspection penalties, and severe reputational damage. Ensure your contracts explicitly state that candidates pay zero fees to access employment.

Sourcing Candidates Directly Through Workuro

Workuro offers a direct alternative to traditional recruitment intermediaries. We maintain a open registry where non-EU nurses publish their profiles, verified credentials, language skills, and country preferences, including candidates explicitly seeking relocation to Italy.

As an employer, you can search the registry, filter candidate profiles based on qualifications and language level, and contact workers directly to conduct interviews and negotiate offers. Workuro is not a recruitment agency: we do not charge per-hire commissions, we do not interfere in employment contracts, and we never charge workers to publish a profile or accept a job offer. Employers use the platform directly for a fixed access fee.

Please note that our registry is young and continuously growing. While you will not find hundreds of thousands of candidate profiles, the workers registered on Workuro are actively seeking international opportunities and managing their own migration paths. You retain direct control over your hiring process, selection criteria, and legal compliance from day one.