Clinical Adaptation, Sociotechnical Integration and Well-Being of Filipino Migrant Nurses Across Healthcare Settings in Germany: A Narrative Literature Review
DOI:
https://doi.org/10.5281/zenodo.22858492Keywords:
Filipino migrant nurses; clinical adaptation; sociotechnical integration; occupational well-being; internationally educated nursesAbstract
Germany’s increasing reliance on internationally educated nurses, particularly from the Philippines, highlights the need to understand their clinical adaptation, sociotechnical integration, and occupational well-being. Guided by Locsin’s Technological Competence as Caring in Nursing framework and Sociotechnical System Theory, this study reviewed empirical and theoretical literature concerning Filipino migrant nurses working in German healthcare settings. A narrative literature review and thematic evidence synthesis were conducted using Medline/PubMed, CINAHL, Scopus, Web of Science, Google Scholar, and institutional repositories. Of 25 initially identified sources, 21 core sources were included, comprising 16 Germany-specific and five international or comparative studies and reports. Findings were organized into four themes: recruitment and governance, clinical adaptation, sociotechnical integration, and occupational well-being. Evidence indicated that Filipino and internationally educated nurses encounter challenges involving credential recognition, language and communication, professional role adjustment, perceived deskilling, workplace discrimination, and adaptation to German healthcare practices. Clinical adaptation and occupational well-being were influenced by staffing levels, employer and colleague support, psychological safety, workload, and equitable treatment. Evidence concerning migrant nurses’ integration with digital technologies, workflows, and artificial intelligence remains limited, as most German studies focus on the general nursing workforce. No identified study simultaneously examined clinical adaptation, sociotechnical integration, and occupational well-being among Filipino migrant nurses in Germany. These findings emphasize that professional integration should be viewed as an organizational and sociotechnical process requiring structured credentialing, culturally responsive orientation, mentoring, psychologically safe workplaces, equitable workloads, and digitally oriented clinical education. Further empirical research examining these interconnected dimensions is needed to support sustainable professional integration.
Downloads
References
Beqiri, P., Siqeca, F., Karahoda, R., Hajrullahu, V., Agahi, O., & Brajshori, N. (2025). Understanding the impact of migration on the work ability of nurses: A cross-sectional comparison between Germany and Kosovo. Nursing Reports, 15(6), 203. https://doi.org/10.3390/nursrep15060203
Can, E., Konrad, C. M., Khan-Gokkaya, S., Molwitz, I., Nawabi, J., Yamamura, J., Hamm, B., & Keller, S. (2022). Foreign healthcare professionals in Germany: A questionnaire survey evaluating discrimination experiences and equal treatment at two large university hospitals. Healthcare, 10(12), Article 2339. https://doi.org/10.3390/healthcare10122339
Hanrieder, T., & Janauschek, L. (2025). The ethical recruitment of international nurses: Germany's liberal health worker extractivism. Review of International Political Economy, 32(4), 1164–1188. https://doi.org/10.1080/09692290.2025.2450399
Hillmann, F., Walton-Roberts, M., & Yeoh, B. S. A. (2022). Moving nurses to cities: On how migration industries feed into glocal urban assemblages in the care sector. Urban Studies, 59(11), 2294–2312. https://doi.org/10.1177/00420980221087048
Hubner, U., Ammenwerth, E., Flemming, D., Schaubmayr, C., & Sellemann, B. (2010). IT adoption of clinical information systems in Austrian and German hospitals: Results of a comparative survey with a focus on nursing. BMC Medical Informatics and Decision Making, 10, Article 8. https://doi.org/10.1186/1472-6947-10-8
International Labour Organization. (2026). Artificial intelligence (AI) in the nursing profession in Germany (ILO Working Paper 161).
Khouri, A. M., Zoellick, J. C., Peppler, L., Schenk, L., & Schneider, A. (2026). Exploring burnout: An online survey among diverse nursing teams in Germany. International Journal of Nursing Studies Advances, 10, Article 100661. https://doi.org/10.1016/j.ijnsa.2026.100661
Kwiatkowska-Ciotucha, D., Zaluska, U., & Kozyra, C. (2021). The perception of occupation by hospital nurses in Poland and Germany in terms of the risk of excessive stress and burnout as well as possible coping and preventive solutions. International Journal of Environmental Research and Public Health, 18(4), Article 1797. https://doi.org/10.3390/ijerph18041797
Luna, J. J. (2025). Peaks and valleys: A qualitative study of lived experiences of first-time registered Filipino nurses in Germany. Pantao: International Journal of the Humanities and Social Sciences, 4(3). https://doi.org/10.69651/PIJHSS0403470
Mina, F. A., Jr. (2026). International nurses' integration in Germany: A viewpoint on global health equity and public health resilience. International Journal of Education, Research, and Innovation Perspectives, 2(6). https://doi.org/10.5281/zenodo.20689736
OECD. (2023). Health at a glance 2023: OECD indicators. OECD Publishing.
OECD. (2025). International migration outlook 2025. OECD Publishing.
Peppler, L., Feisst, M., Schneider, A., Apelt, M., & Schenk, L. (2023). Beyond one-sided expectations of integration: Rethinking international nurse migration to Germany. European Journal of Public Health, 33(Suppl 2), ckad160.1484. https://doi.org/10.1093/eurpub/ckad160.1484
Rajpoot, A., Merriman, C., Rafferty, A. M., & Henshall, C. (2024). Transitioning experiences of internationally educated nurses in host countries: A narrative systematic review. International Journal of Nursing Studies Advances, 6, Article 100195. https://doi.org/10.1016/j.ijnsa.2024.100195
Rodriguez, L. B., Galsim, G. C., Lao, M. K., & Dempster, H. (2025, May 19). Hundreds of nurses trained through Philippines-Germany Global Skill Partnership. Center for Global Development.
Roth, C., Berger, S., Krug, K., Wensing, M., & Goetz, K. (2021). Internationally trained nurses and host nurses' perceptions of safety culture, work-life-balance, burnout, and job demand during workplace integration: A cross-sectional study. BMC Nursing, 20(1), Article 58. https://doi.org/10.1186/s12912-021-00581-8
Schilgen, B., Handtke, O., Nienhaus, A., & Mosko, M. (2019). Work-related barriers and resources of migrant and autochthonous homecare nurses in Germany: A qualitative comparative study. Applied Nursing Research, 46, 57–66. https://doi.org/10.1016/j.apnr.2019.02.008
Swakowska, K., Olejniczak, D., Poniatowski, L. A., & Staniszewska, A. (2025). The relationship between employee motivation and professional burnout among nurses in Germany: An analytical study. International Journal of Occupational Medicine and Environmental Health, 38(6), 586–595. https://doi.org/10.13075/ijomeh.1896.02638
Zwergel, M., Schmidt, P. F., & Hamel, K. (2024). Academically educated nurses from third countries: Professional self-concept versus working life in Germany. A qualitative study using the example of migrant nurses from the Philippines. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen, 187, 88–94. https://doi.org/10.1016/j.zefq.2024.04.005
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
