Nurses make up the most numerous category of health workers in nearly all EU countries. The key role they play in providing care in hospitals, long-term care facilities and the community was highlighted during the COVID‑19 pandemic. Pre‑existing shortages of nurses were exacerbated during the peaks of the epidemic, particularly in intensive care units and other hospital units as well as in long-term care facilities (OECD, 2023[1]).
The demand for nurses is expected to continue to rise in the coming years due to population ageing while about one‑fourth of nurses on average across EU countries are aged over 55 and therefore approaching retirement age (see Chapter 1 on health workforce challenges). Increasing the retention rate of nurses in the profession is a growing concern to avoid exacerbating current and future shortages. Concerns about growing shortages have prompted many countries to increase the number of places in nursing education programmes, and the number of new nurse graduates has increased at least slightly over the past decade in most EU countries (see indicator on “medical and nursing graduates in Chapter 8”). However, young people’s interest in pursuing a career in nursing has decreased in many countries following the pandemic (OECD, 2024[2]).
On average across EU countries, there were 8.4 nurses per 1 000 population in 2022, a rise from 7.3 in 2010 (Figure 7.15). These include nurses with a level of qualifications meeting the EU Directive on the recognition of professional qualifications (“professional nurses”), as well as other categories of nurses who may have a lower level of qualification (“associate professional”) in those countries where such categories exist. Among EU countries, the number of nurses per capita was highest in 2022 in Finland, Ireland and Germany, with at least 12 nurses per 1 000 population. Outside the EU, the number was highest in Switzerland, Norway and Iceland, with all these countries having at least 14 nurses per 1 000 population. Over one‑third of nurses in Switzerland and Iceland are “associate professional” nurses trained at a lower level and therefore performing tasks requiring lower qualifications. In some countries that have below average numbers of nurses such as Italy and Spain, a large number of healthcare assistants (or nursing aids) provide assistance to nurses and patients. Greece has the lowest number of nurses per capita among EU countries, but the data only include nurses working in hospitals.
Between 2010 and 2022, the number of nurses per capita has increased at least slightly in most EU countries. However, it has decreased in Latvia and Hungary, two countries that already had a low density in 2010, thereby widening the gap with the EU average. The Hungarian Government has increased substantially the remuneration of nurses in recent years to increase attractiveness and retention in the profession (see indicator “Remuneration of nurses”).
The overwhelming majority of nurses in EU countries are women, accounting for over 85% of all nurses in 2022. A few countries have been more successful in attracting more men into nursing. For example, in Italy, nearly one fourth (23%) of nurses in 2022 were males. Attracting more males into nursing is a challenge to increase the size of the potential pool of new recruits. It requires addressing the persistent stereotype that views nursing as a profession suited primarily for women and efforts to improve the working conditions and pay rates of nurses (see indicator “Remuneration of nurses”).
Nurses greatly outnumber physicians in most EU countries. In 2022, there were more than two nurses per doctor on average across EU countries. The nurse‑to-doctor ratio reached nearly four in Finland and Luxembourg, although the data for Luxembourg relate to 2017 only (Figure 7.16). The ratio was much lower in Southern European countries, Latvia and Bulgaria.
Several countries have started to implement more advanced roles for nurses to improve access to care, including “nurse practitioners” and “family and community nurses” roles. Evaluations of nurse practitioners in primary care in several countries show that advanced practice nurses can improve access to services and reduce waiting times, while delivering the same quality of care as doctors for a range of patients, including those with minor illnesses and those needing routine follow-ups. These evaluations also find a high patient satisfaction rate (Brownwood and Lafortune, 2024[15]).
