Nurse salary in the UK, Ireland, Germany, the Netherlands and the USA: official pay scales compared

On official pay scales, a newly registered staff nurse earns £32,073 a year in England (NHS Agenda for Change Band 5, 2026/27), €38,166 a year in Ireland (HSE staff nurse scale, 1 June 2026), €3,510.30 a month in a German municipal hospital (TVöD P 7 entry step, from 1 May 2026) and, in a Dutch general hospital, a monthly salary set by the function group the hospital gives the post, for example €3,228 to €4,346 in group 45 (Cao Ziekenhuizen, 1 August 2026). In the USA there is no national scale; the Bureau of Labor Statistics gives a median of $97,550 a year for registered nurses in May 2025.

In gross terms, the USA is highest, followed at the top of the scales by Ireland. But gross figures are a poor guide to what you keep. Tax and social contributions, the length of the working week, allowances, rent and, in the Netherlands, whether your salary meets the residence permit threshold all change the comparison. This guide gives each country's official figures with the year, explains what is and is not included, and sets out the costs that sit behind them. We do not convert currencies, because exchange rates move daily and conversion hides those differences.

• Official sources only. UK figures are from NHS Employers, Irish from the HSE consolidated salary scales, German from the VKA's TVöD tables, Dutch from the Cao Ziekenhuizen and US from the BLS Occupational Employment and Wage Statistics. We say which year each figure is for.
• Annual or monthly. The UK, Ireland and the USA quote annual pay; Germany and the Netherlands quote monthly pay. Do not multiply German or Dutch monthly figures by 12 and compare directly: the Netherlands pays a separate holiday allowance and Germany has annual special payments under the collective agreement, which we have not added because they depend on your contract.
• Scales and statistics are different. A scale tells you what you will be paid at a given step. The US figure is a median across all experience levels and settings, so a new nurse may earn less.
• Not every employer uses the scale. Private hospitals, care homes and agencies in all five countries can set their own pay. University medical centres in the Netherlands and church or private hospitals in Germany use other agreements.

The sections below go through each country in more depth. For the registration route that comes first, see our comparison of the best country in Europe for international nurses.

NHS nurses in England are paid on Agenda for Change. NHS Employers published the 2026/27 rates effective from 1 April 2026. Newly registered nurses usually start at Band 5 and move to the intermediate point after two years and the top after a further two. Specialist and senior roles are graded at Band 6, 7 or above.

London weighting and other extras

In London and the surrounding area you receive a High Cost Area Supplement: 20% of basic salary in inner London (minimum £5,794, maximum £8,746), 15% in outer London and 5% in the fringe. NHS Employers' table puts a Band 5 entry nurse in inner London at £38,488. Unsocial hours payments for nights, weekends and bank holidays are paid on top. Scotland, Wales and Northern Ireland set their own scales, so check with your employer there.

Before registration

Until you pass the OSCE and join the NMC register you are not paid as a registered nurse. NHS Employers' scales do not set a band for that period, so your employer decides; ask for it in writing. Our NHS pay band explorer shows every point, and the NHS take-home pay calculator estimates pay after tax. The UK nurse route covers registration.

Nurses in HSE and voluntary (Section 38) hospitals are paid on the HSE consolidated salary scales. The rates effective from 1 June 2026 include the 1% increase under the Public Service Agreement 2024-2026. You move up one point a year, and the top points include long service increments.

Allowances

The HSE pay document lists a location allowance (€2,798 a year at the latest rate) for nurses working in areas such as emergency departments, theatres, intensive care, maternity and medical and surgical wards, and a specialist qualification allowance for nurses with a relevant qualification working in that specialty. Night, weekend and public holiday premiums are extra. The HSE says new appointees start at the minimum point of a scale, with incremental credit applied for recognised relevant service in Ireland and abroad, so ask how your overseas experience will be counted. Use the HSE take-home pay calculator to estimate net pay, and see the Ireland nurse route.

Municipal hospitals pay nurses under the TVöD, using the nursing table (Anlage E). Registered nurses with at least three years' training are in P 7. New staff usually start at step 2; in P 7 and P 8, step 3 follows after three years. The VKA's table rates valid from 1 May 2026 are:

All figures are gross monthly pay. Nurses in P 5 to P 16 also receive a nursing allowance (Pflegezulage) of €141.82 a month from 1 May 2026. Shift, night and weekend supplements are paid on top under the agreement. Church hospitals, private hospital groups and university hospitals apply their own agreements, so the same job can pay differently. During an adaptation period before recognition, your pay is set by your employer and contract, not by P 7.

Germany's EU Blue Card does not apply to nursing, according to Make it in Germany, so the salary does not need to meet the Blue Card threshold; the usual permit is the skilled worker route under § 18a. See the route for nurses in Germany and our German recognition page.

Nurses in general hospitals are paid under the Cao Ziekenhuizen. The agreement does not fix a group for nurses: each hospital grades the post into a function group (functiegroep), and you move up a step each year. The table effective from 1 August 2026, for a 36-hour week, gives these gross monthly ranges:

Holiday allowance and irregular-hours supplements are paid on top. University medical centres, mental health care and elderly care have their own agreements.

The permit threshold

If you need a highly skilled migrant permit, your salary must meet the IND threshold: in 2026, €5,942 gross a month if you are 30 or over, and €4,357 if you are under 30. The over-30 figure is above the top of function group 50, so ask the hospital which group your post is in and which permit it will use before you accept. The BIG register page covers registration, and the Netherlands country guide the permits.

There is no national nursing pay scale in the US. Employers set pay, which varies by state, metro area, setting, shift and experience. The Bureau of Labor Statistics reports these figures for registered nurses from its May 2025 Occupational Employment and Wage Statistics:

• Median annual wage $97,550 ($46.90 an hour). The lowest 10% earned less than $68,940 and the highest 10% more than $137,470.
• By industry: government $110,780; hospitals (state, local and private) $100,220; ambulatory health care services $91,230; nursing and residential care facilities $84,300; educational services $78,620.
• BLS projects employment of registered nurses to grow 6% from 2025 to 2035.

Because US health insurance, retirement contributions and paid leave depend on the employer, compare the whole package, not just the hourly rate. Your sponsoring employer must also meet Department of Labor prevailing wage rules. Our NCLEX-RN guide and US nurse route explain how to get there.

No single official source compares take-home pay for nurses across these five countries, so we describe the differences rather than invent a figure.

• UK. Income tax and National Insurance are deducted, plus NHS Pension contributions if you join the scheme. Health and Care Worker visa holders do not pay the immigration health surcharge, which removes a large cost other migrants face.
• Ireland. PAYE income tax, the Universal Social Charge and PRSI are deducted, plus pension contributions in public employment. Rents in Dublin and other cities are high relative to pay.
• Germany. Income tax and social insurance contributions (health, long-term care, pension and unemployment) are deducted, and the total deduction is generally a larger share of gross pay than in the UK. Health insurance is included in those contributions.
• Netherlands. Income tax and national insurance contributions are deducted together, and health insurance is a separate monthly premium you pay yourself. Pension contributions under the sector scheme are also deducted.
• USA. Federal income tax, state income tax in most states, and Social Security and Medicare (FICA) are deducted. Health insurance premiums depend on the employer's plan.

Cost of living varies more within each country than between them: London, Dublin, Amsterdam, Munich and US coastal cities are expensive, while other regions are much cheaper. When you compare offers, set the salary against local rent for the city of the job, not the national average.

• UK: automatic progression within a band at the intervals NHS Employers sets, and promotion to Band 6 or 7 for specialist, senior or charge nurse roles. Your overseas experience does not normally move you to a higher band on arrival.
• Ireland: one point a year on a 13-point scale, with incremental credit available for recognised service abroad, and promotion to clinical nurse manager or specialist grades.
• Germany: steps in the TVöD table depend on years of relevant experience, and completed specialist further training (for example intensive care) can move you to P 9.
• Netherlands: annual steps within the function group, and a higher group for posts the hospital grades higher, such as specialised or senior nursing.
• USA: employer pay ladders, shift differentials and specialty certification; advanced practice roles such as nurse practitioner require further graduate education and licensure.

1. Ask which scale, band, step or function group applies, both before and after registration.
2. Ask how your overseas experience will be counted for incremental credit or step placement.
3. Check which allowances apply to your ward (location, specialist, shift and London weighting).
4. Check who pays for exams, flights, visas and accommodation, and whether there is a repayment clause if you leave early.
5. Check that the salary meets the permit rules: the Dutch IND threshold, the UK Health and Care Worker rules using NHS pay scales, or Ireland's Critical Skills rules, which use the public pay agreement rate for HSE and Section 38 posts. Our sponsorship salary checker helps for the UK.

If you are coming from the Gulf, remember that Gulf packages often include housing and tax-free salary; European pay is taxed and housing is your cost, so compare net income after rent rather than headline figures.