Nurse: conditions of access and exercise in France

Verified 01 September 2026 - Entreprendre Service Public / (Prime Minister), Ministry of Health

  • Regulated paramedical profession
  • APE Code : 86.90D / APE Code in 2027: 8694G
  • NACE European Code 86.90
  • Social contributions : to be paid to theUrssaf: titleContent
  • Social security scheme : Social security for the self-employed (SSI) or General Social Security Scheme, depending on the mode of exercise
  • Social protection : CPAM: titleContent (illness), CARPIMKO: titleContent (retirement)

Definition

A registered nurse is a key player in the health system. He works with people throughout their care journey and can practice in many areas of activity. The profession is governed by the Public Health Code, which defines its missions and the specific competencies of the various nursing specialties.

The nurse is a health professional whose missions are defined by the Public Health Code. It carries out health care, prevention, coordination and education activities, in compliance with professional and ethical rules.

1. Care delivery, organization and evaluation

The nurse performs nursing care aimed at maintaining or restoring people's health. In this capacity, he:

  • implements care within its own role, including prevention, clinical evaluation, monitoring and comfort
  • performs care on medical prescription or as part of protocols, including technical procedures (injections, infusions, dressings, samples, etc.)
  • participates in primary care, particularly in a logic of access to care and continuity of care
  • evaluates the patient's needs and adapts care accordingly.

2. Comprehensive support for the person

The nurse provides comprehensive patient care, including:

  • physical, psychological and social support
  • information, advice and support for patients and their families
  • therapeutic education and participation in the autonomy of individuals.

3. Participation in public health activities

Nurses contribute to public health policies by:

  • participating in prevention, screening and health promotion activities
  • involved in health education programs
  • participating in the management of health crises and the continuity of the public health service

4. Coordination and continuity of care

The nurse plays a central role in the organization of care pathways:

  • it coordinates the interventions of the various health professionals
  • it ensures continuity and safety of care
  • he is a privileged interlocutor for the patient, his family and the care teams.

5. Expanded expertise and changing practices

In the context of recent developments in health law:

  • nurses can have their skills expanded, particularly in terms of supervised prescribing, renewal of treatments or performing specific procedures.
  • some practice in advanced practice (API) with enhanced skills in patient follow-up, coordination and treatment adaptation.

6. Training, transmission and research

The nurse contributes to the development of knowledge and skills:

  • it participates in the initial and continuing training of students and professionals
  • it ensures the updating of its practices according to the data acquired from science
  • they may participate in nursing research activities

7. Organization and management of care activities

The nurse participates in the organization of the care system:

  • he ensures the management of the care file and the traceability of the acts
  • he participates in the planning and organization of care
  • in liberal practice, he also ensures the administrative and financial management of his activity

8. Frameworks and venues

The nurse can practice in various contexts:

  • health facilities (public or private)
  • medico-social structures,
  • private practice (cabinet or home)
  • school health, occupational health, prevention structures, etc.

After graduation, a registered nurse may access training leading to one of the specialties recognized by the Public Health Code. In this case, he continues to perform the general tasks of the nursing profession, to which are added competences, tasks and, where appropriate, specific acts specific to his specialty.

Registered Anesthesiologist Nurse (IADE)

The Registered Anesthesiologist Nurse (IADE) is a Registered nurse of the State with the State Diploma of Nurse Anesthesiologist, specializing in the areas of anesthesia, resuscitation, emergency care and pain management.

As a nurse, the IADE carries out the general missions of the nursing profession. It also implements the missions specific to its specialization provided for in the Public Health Code.

As such, he carries out its activities under the exclusive control of an anesthesiologist-intensive care physician, who has previously examined the patient, established in writing the anesthetic strategy and is present on the site in order to be able to intervene at any time.

It is the only one authorized to:

  • practice general anesthesia
  • practice local-regional anesthesia and reinjections when a device has been put in place by an anesthesiologist-resuscitator
  • practice intraoperative resuscitation
  • perform the necessary care and actions to implement these techniques
  • performing, in the post-operative monitoring room, procedures relating to general anesthesia and local-regional anesthesia techniques as well as continuing intraoperative resuscitation
  • carry out the transport of stable ventilated, intubated or sedated patients treated as part of inter-hospital nursing transport

It can also intervene, under the exclusive control of an anesthesiologist-resuscitator, in the management of postoperative pain by practicing local-regional anesthesia techniques.

The sanitary transport are carried out primarily by the nurse anesthesiologist with a state diploma.

State Registered Operating Room Nurse (IBODE)

The state-certified operating room nurse (IBODE) is a State-certified nurse holding the State Diploma of Operating Room Nurse, specializing in the management of the patient in the operating room.

As a nurse, IBODE carries out the general missions of the nursing profession. It also implements the activities and acts specific to its specialization provided for in the Public Health Code.

As such, he shall carry out the following activities as a matter of priority :

  • manage the risks related to the activity and the operating environment
  • develop and implement an individualized care approach in the operating room and associated sectors
  • organize and coordinate nursing care in the intervention room
  • ensure the traceability of activities in the operating room and associated sectors
  • participate in the development, application and control of procedures for the disinfection and sterilization of reusable medical devices for the prevention of nosocomial infections
  • perform, in the intraoperative period, the activities of circulant, instrumentalist and operative aid in the presence of the operator

It is also only authorized to perform the following acts :

  • performing the surgical installation of the patient
  • set up and fix the susaponeurotic drains
  • perform subcutaneous and cutaneous closure
  • help with exposure, hemostasis and aspiration during surgery
  • provide assistance for acts of a particular technical nature, determined by order of the minister responsible for health

State Registered Nurse Nurse (IPDE)

The State Registered Nursing Nurse (IPDE) is a State-certified nurse with a State diploma in childcare, specializing in the care of newborns, children and adolescents.

As a nurse, the PUER carries out the general missions of the nursing profession. It also implements the missions specific to its specialization provided for in the Public Health Code.

As such, the procedures concerning children from birth to adolescence are provided as a priority by the nursing nurse, in particular:

  • the follow-up of the child in its development and its living environment
  • monitoring the infant's diet
  • prevention and early detection of maladaptations and disabilities
  • the care of the newborn in intensive care
  • the installation, monitoring and discharge of the newborn placed in an incubator or under phototherapy

Access

The nursing profession is regulated. This means that certain conditions regarding training and registration (or declaration) with the National Order of Nurses must be met.

If these conditions are not met, the practice of nursing is illegal. This is a usurpation of title punished by one year's imprisonment and €15,000 of fine.

To practice nursing in France, the person concerned must have the necessary qualifications.

The recognition of those qualifications is determined in particular by reference to the geographical area in which the diploma was obtained.

Specific procedures for the recognition of these qualifications may be necessary depending on the nationality: French, national of an EU Member State(UE) or the(EEE), a third-country national.

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French

To practice nursing, it is mandatory to hold a State Diploma in Nursing (DEI).

Training in the State Diploma of Nursing has a duration of 3 years, and is based on the alternation between theory (guided works and guided personal works) and practice (clinical training in the form of internships).

IED training is provided by the Nursing Training Institutes (NTI) :

FYI  

In 2026, there are 337 IFSIs in France.

A nurse of French nationality who has obtained his diploma in a Member State of(UE), the(EEE) or in Switzerland, may, as the case may be, automatic recognition or having to engage a specific approach for the professional recognition of his diploma in France :

A French nurse who has obtained his diploma in a Member State of(UE), the(EEE) or in Switzerland can practice in France thanks to the Directive 2005/36/CE of the European Parliament and of the Council of 7 September 2005.

Please note

For a list of diplomas that allow automatic recognition of professional qualifications for nurses, please refer to the case of the UE/EEE national presented in this sheet.

To practice in France, he must therefore make a application for registration to the Departmental or Interdepartmental Council of the Order of Nurses of his place of practice:

Various supporting documents must be attached to the file, including the copy of the nursing degree of the country in which it was obtained.

Please note

It is not possible to apply to several councils of the Order of Nurses.

Warning  

Any diploma obtained outside a Member State of the(UE), the(EEE) or Switzerland is not recognized in France.

There is a specificity for people who have obtained their nursing degree in Quebec. The Ordre des infirmiers et infirmières du Québec (OIIQ) and the Ordre des infirmiers de France have entered into a Mutual Recognition Arrangement (MRA) for professional qualifications.

As a holder of a nursing degree from Quebec, it is possible to obtain a license to practice in France, by applying to the National Council of the Order of Nurses.

National of a UE, EEE and Switzerland

The national nurse member of the(UE), the(EEE) or Swiss nationality has two possibilities:

  • or it decides to carry out an exercise in France permanent (talking about free establishment)
  • or he decides to exercise temporarily and occasionally his nursing profession in France (we are talking about freedom to provide services)
Permanent exercise (free establishment)
Degrees automatically recognized

Diplomas, certificates and qualifications automatically recognized for the practice of nursing in France are the following:

Tableau - Diplomas giving entitlement to practice nursing in France and throughout the UE

Country

Title of the diploma

The body that issues the diploma

Professional title

Reference date

Germany

Zeugnis über die staatliche Prüfung in der Krankenpflege

Staatlicher Prüfungsausschuss

Gesundheits- und Krankenpflegerin/Gesundheits- und Krankenpfleger

29/06/1979

Andorra

Bachelor in Infermeria (Bachelor in Nursing)

University of Andorra

Infermera / Infermera

-

Austria

  1. Diplomierte Gesundheits- und Krankenschwester, Diplomierter Gesundheits- und Krankenpfleger
  2. Diplomats « Diplomierte Krankenschwester, Diplomierter Krankenpfleger »
  1. Schule für allgemeine Gesundheits- und Krankenpflege
  2. Allgemeine Krankenpflegeschule
  • Diplomacy Krankenschwester
  • Diplomierter Krankenpfleger

01/01/1994

Belgium

  • Diploma gegradueerde verpleger/verpleegster/Diploma in nursing/Diplom eines (einer) graduierten Krankenpflegers (-pflegerin)
  • Diploma in de ziekenhuisverpleegkunde/Brevet d'infirmier(ère) hospitalier(ère)/Brevet eines (einer) Krankenpflegers (-pflegerin)
  • Brevet van verpleegassistent/Brevet d'hospitalier(ère)/Brevet einer Pflegeassistentin
  • De erkende opleidingsinstituten/Recognized educational institutions/Die anerkanten Ausbildungsanstalten
  • De bevoegde Examencommissie van de Vlaamse Gemeinschaft/The competent teaching panel of the French Community/Der zuständige Prüfungsausschüß der Deutschsprachigen Gemeinschaft
  • Hospitaller(ère)/Verpleegassistent(e)
  • Hospital nurse/Ziekenhuisverpleger(-verpleegster)

29/06/1979

Bulgaria

Диплoмa зa виcшe oбpaзoвaниe нa oбpaзoвaтeлнo-квaлификaциoннa cтeпeн «Бaкaлaвъp » c пpoфecиoнaлнa квaлификaция «Meдицинcкa cecтpa »

Yнивepcитeт

Meдицинcкa cecтpa

01/01/2007

Cyprus

  • Δίπλωμα Γενικής Νοσηλευτικής
  • Πτυχίο Νοσηλευτικής Τεχνολογικού Πανεπιστημίου Κύπρου
  • Πτυχίο Νοσηλευτικής Ευρωπαϊκού Πανεπιστημίου Κύπρου
  • Πτυχίο Νοσηλευτικής Πανεπιστημίου Λευκωσίας - BSc in Nursing
  • Πτυχίο Γενικής Νοσηλευτικής
  • Νοσηλευτική Σχολή
  • εχνολογικό Πανεπιστήμιο Κύπρου
  • Ευρωπαϊκό Πανεπιστήμιο Κύπρου
  • Πανεπιστήμιο Λευκωσίας University of Nicosia
  • Σχολή Επιστημών Υγείας, Πανεπιστήμιο Frederick

Νοσηλευτής(τρια)

Γενικής Νοσηλευτικής

01/05/2004

Croatia

  1. Svjedodžba ‘medicinska sestra opće njege/medicinski tehničar opće njege’
  2. Svjedodžba ‘prvostupnik (baccalaureus) sestrinstva/ prvostupnica (baccalaurea) sestrinstva’
  1. Srednje strukovne škole koje izvode program za stjecanje kvalifikacije ‘medicinska sestra opće njege / medicinski tehničar opće njege’
  2. Medicinski fakulteti sveučilišta u Republici Hrvatskoj
    Sveučilišta u Republici Hrvatskoj
    Veleučilišta u Republici Hrvatskoj
  1. medicinska sestra opće njege/medicinski tehničar opće njege
  2. prvostupnik (baccalaureus) sestrinstva/ prvostupnica (baccalaureus) sestrinstva

01/07/2013

Denmark

Bevis for uddannelsen til professionsbachelor i sygepleje

Professionshøjskole

Sygeplejerske

29/06/1979

Spain

  1. Título de Diplomado universitario en Enfermería
  2. Titulo de Graduado/a en Enfermería
    • Ministerio de Educación y Cultura
    • El rector de una Universidad
  1. El rector de una Universidad
  1. Enfermero/a diplomado/a
  2. Graduado/a in Enfermería

01/01/1986

Estonia

  1. Diplom õe erialal
  2. Õe põhikoolituse diplom
  3. Õe põhiõpe diplom
    • Tallinna Meditsiinikool
    • Tartu Meditsiinikool
    • Kohtla-Järve Meditsiinikool
  1. Tallinna Tervishoiu Kõrgkool
  2. Tartu Tervishoiu Kõrgkool

õde

01/05/2004

Finland

  1. Sairaanhoitajan tutkinto/Sjukskötarexamen
  2. Sosiaali- ja terveysalan ammattikorkeakoulututkinto, sairaanhoitaja (AMK)/Yrkeshögskoleexamen inom hälsovård och det sociala området, sjukskötare (YH)
  1. Terveydenhuolto-oppilaitokset/ Hälsovårdsläroanstalter
  2. Ammattikorkeakoulut v Yrkeshögskolor

Sairaanhoitaja v Sjukskötare

01/01/1994

France

  • State Diploma of Nurse
  • State diploma in nursing issued under Decree No. 99-1147 of 29 December 1999

The Ministry of Health

Nurse

29/06/1979

Greece

  1. Πτυχίο Νοσηλευτικής Παν/μίου Αθηνών
  2. Πτυχίο Νοσηλευτικής Τεχνολογικών Εκπαιδευτικών Ιδρυμάτων (Τ.Ε.Ι.)
  3. Πτυχίο Αξιωματικών Νοσηλευτικής
  4. Πτυχίο Αδελφών Νοσοκόμων πρώην Ανωτέρων Σχολών Υπουργείου Υγείας και Πρόνοιας
  5. Πτυχίο Αδελφών Νοσοκόμων και Επισκεπτριών πρώην Ανωτέρων Σχολών Υπουργείου Υγείας και Πρόνοιας
  6. Πτυχίο Τμήματος Νοσηλευτικής
  7. Πτυχίο Τμήματος Νοσηλευτικής Πανεπιστήμιου Πελοποννήσου
  1. Πανεπιστήμιο Αθηνών
  2. Τεχνολογικά Εκπαιδευτικά Ιδρύματα Υπουργείο Εθνικής Παιδείας και Θρησκευμάτω
  3. Υπουργείο Εθνικής Άμυνας
  4. πουργείο Υγείας και Πρόνοιας
  5. Υπουργείο Υγείας και Πρόνοιας
  6. ΚΑΤΕΕ Υπουργείου Εθνικής Παιδείας και Θρησκευμάτων
  7. Πανεπιστήμιο Πελοποννήσου

Διπλωματούχος ή πτυχιούχος νοσοκόμος, νοσηλευτής ή νοσηλεύτρια

01/01/1981

Hungary

  1. Ápoló bizonyítvány
  2. Ápoló oklevél
  3. Okleveles ápoló oklevél
  1. Szakképző iskola
  2. Felsőoktatási intézmény
  3. Felsőoktatási intézmény

Ápoló

01/05/04

Ireland

  1. Certificate of Registered General Nurse
  2. B.Sc. in Nursing Studies (General) approved by the NMBI
  3. B.Sc. in Children's and General (Integrated) Nursing approved by the NMBI
  1. An Bórd Altranais (The Nursing Board) [up to 1.10.2012];
    Bórd Altranais agus Cnáimhseachais na hEireann (The Nursing and Midwifery Board of Ireland) [from 2.10.2012]
  2. Third-level Institution delivering the B.Sc. in Nursing Studies approved by the NMBI [as of September 2002]
  3. Third-level Institution delivering the B.Sc. in Children’s and General (Integrated) Nursing approved by the NMBI [as of September 2006]

Registered General Nurse (RGN)

29/06/1979

Italy

  1. Diploma di infermiere professionale
  2. Diploma di laurea in infermieristica
  1. Scuole riconosciute dallo Stato
  2. Università
  1. Professional nurse
  2. Nurse

29/06/1979

Latvia

  1. Diplomas by māsas kvalifikācijas iegūšanu
  2. Māsas diploms
  1. Māsu skolas
  2. Universitātes tipa augstskola pamatojoties uz Valsts eksāmenu komisijas lēmumu

Māsa

01/05/2004

Lithuania

  1. Aukštojo mokslo diplomas, nurodantis suteiktą bendrosios praktikos slaugytojo profesinę kvalifikaciją
  2. Aukštojo mokslo diplomas (neuniversitetinės studijos), nurodantis suteiktą bendrosios praktikos slaugytojo profesinę kvalifikaciją
  3. Bakalauro diplomas (slaugos bakalauro kvalifikacinis laipsnis ir bendrosios praktikos slaugytojo profesinė kvalifikacija)
  4. Profesinio bakalauro diplomas (slaugos profesinio bakalauro kvalifikacinis laipsnis ir bendrosios praktikos slaugytojo profesinė kvalifikacija)
  1. Universitetas
  2. Kolegija
  3. Universitetas
  4. Kolegija

Bendrosios praktikos slaugytojas

01/05/2004

Luxembourg

  • State Diploma of Nurse
  • State Diploma of Graduate Hospital Nurse
  • Vocational training certificate - Specialty: Nurse in charge of general care
  • Ministry of National Education, Vocational Training and Sports
  • Technical High School for Health Professions

Nurse

29/06/1979

Malta

Lawrja jew diploma fl-istudji tal-infermerija

Università ta' Malta

Nurse Registrate tal-Ewel Livell

01/05/2004

Netherlands

  1. Diploma's verpleger A, verpleegster A, verpleegkundige A
  2. Diploma verpleegkundige MBOV (Middelbare Beroepsopleiding Verpleegkundige)
  3. Diploma verpleegkundige HBOV (Beroepsopleiding Verpleegkundige)
  4. Diploma beroepsonderwijs verpleegkundige – Kwalificatienlevel 4
  5. Diploma hogere beroepsopleiding verpleegkundige – Kwalificatienlevel 5
  1. Door een van overheidswege benoemde examencommissie
  2. Door een van overheidswege benoemde examencommissie
  3. Door een van overheidswege benoemde examencommissie
  4. Door een van overheidswege aangewezen opleidingsinstelling
  5. Door een van overheidswege aangewezen opleidingsinstelling

Verpleegkundige

29/06/1979

Poland

  • Dyplom ukończenia studiów wyższych na kierunku pielęgniarstwo z tytułem ‘magister pielęgniarstwa’
  • Dyplom ukończenia studiów wyższych zawodowych na kierunku/specjalności pielęgniarstwo z tytułem ‘licencjat pielęgniarstwa’

Instytucja prowadząca kształcenie na poziomie wyższym uznana przez właściwe władze

Pielegniarka

01/05/2004

Portugal

  1. Diploma do curso de enfermagem geral
  2. Diploma/carta de curso de bacharelato em enfermagem
  3. Diploma/Carta de curso de licenciatura em enfermagem
  1. Escolas de Enfermagem
  2. Escolas Superiores de Enfermagem
  3. Escolas Superiores de Enfermagem; Escolas Superiores de Saúde

Enfermeiro

01/01/1986

Czech Republic

  • Diplom o ukončení studia ve studijním programu ošetřovatelství ve studijním oboru všeobecná sestra (bakalář, Bc.)
  • Diplom o ukončení studia ve studijním programu Všeobecné ošetřovatelství
  • Diplom o ukončení studia ve studijním oboru diplomovaná všeobecná sestra (diplomovaný specialista, DiS.), accompanied by the following certificate: - Vysvědčení o absolutoriu
  • Vysoká škola zřízená nebo uznaná státem
  • Vyšší odborná škola zřízená nebo uznaná státem

Všeobecná sestra

01/05/2004

Romania

  1. Diplomă de absolvire de asistent medical generalist cu studio superioare de scurtă durată
  2. Diplomă de licență de asistent medical generalist cu studii superioare de lungă durată
  3. Certificate of Professional Competence (de assistant medical generalist)
  4. Certificate of calificare level 5
  5. Certificate of calificare profesională nivel 5
  1. Universități
  2. Universități
  3. Ministerul Educației Naționale

General Medical Assistant

01/01/2007

United Kingdom

A qualification approved by the Nursing and Midwifery Council or one of its predecessor bodies as attesting to the completion of training required for general nurses by Article 31 and the standard of proficiency as required for registration as a Registered Nurse – Adult in its register

Education institutions approved by the Nursing and Midwifery Council or one of its predecessor bodies

Registered Nurse – Adult

29/06/1979

Slovakia

  1. DIPLOM ošetrovateľstvo »magister » (‘Mgr.’)
  2. DIPLOM ošetrovateľstvo »bakalár » (‘Bc.’)
  3. DIPLOM diplomovaná všeobecná sestra
  1. Vysoká škola v Univerzita
  2. Vysoká škola v Univerzita
  3. Stredná zdravotnícka škola

Sestra

01/05/2004

Slovenia

Diploma, s katero se podeljuje strokovni naslov ‘diplomirana medicinska sestra / diplomirani zdravstvenik’

  1. Univerza
  2. Visoka strokovna šola

Diplomirana medicinska sestra/Diplomirani zdravstvenik

01/05/2004

Sweden

Sjuksköterskeexamination

Universitet eller högskola

Sjuksköterska

01/01/1994

Switzerland

  1. Diplomierte Pflegefachfrau, diplomierter Pflegefachmann
    Registered Nurse and Registered Nurse
    Infermiera diplomata e infermiere diplomato
  2. Bachelor of Science in Nursing
  3. Diplomierte Pflegefachfrau HF, diplomierter Pflegefachmann HF
    Registered nurse ES, registered nurse ES
    Infermiera diplomata SSS, infermiere diplomato SSS
  1. Schulen, die staatlich anerkante Bildungsgänge durchführen
    Schools that offer State-recognized training courses
    Scuole che propongono dei cicli di formazione riconosciuti dallo Stato
  2. Schulen, die staatlich anerkante Bildungsgänge durchführen
    Schools that offer State-recognized training courses
    Scuole che propongono dei cicli di formazione riconosciuti dallo Stato
  3. Höhere Fachschulen, die staatlich anerkante Bildungsgänge durchführen
    Graduate schools that offer state-recognized training courses
    Scuole specializzate superiori che propongono dei cicli di formazione riconosciuti dallo Stato

Pflegefachfrau, Pflegefachmann

Nurse, nurse

Infermiera, infermiere

  1. 01/06/2002
  2. 30/09/2011
  3. 01/06/2002
Listed diplomas obtained before the reference date

A diploma awarded in a Member State ofUE: titleContent/EEE: titleContent before the reference date fixed for that state, may allow to practice in France, provided that the diploma is accompanied by a certificate confirming that the beneficiary fulfills all the conditions laid down in Directive 2005/36/CE.

This certificate must be issued by the competent authority of the State of origin and certify:

  • the diploma complies with European regulations (Directive 2005/36/CE on the recognition of European qualifications)
  • the holder of the diploma has practiced effectively and lawfully as a nurse for 3 consecutive years during the 5 years preceding the issue of the certificate
Diplomas obtained in the former Soviet republics

Diplomas of nurses responsible for general care issued by the former Czechoslovakia, the former Soviet Union or the former Yugoslavia, as well as training begun before the date of independence of the Czech Republic, Slovakia, Estonia, Latvia, Lithuania, Croatia or Slovenia, may be recognized in France provided they are accompanied by a certificate issued by the competent successor State (Czech Republic or Slovakia for the former Czechoslovakia; Estonia, Latvia or Lithuania for evidence of formal qualifications issued by the former Soviet Union; Croatia or Slovenia for evidence of formal qualifications issued by the former Yugoslavia).

This certificate must certify that the training certificate shall have the same legal validity that diplomas currently awarded in that State.

Diplomas obtained in Poland or Romania

The diplomas awarded for nursing training started in Poland before the reference date (01/05/2004) are not in line with European requirements. They may, however, be recognized in France if the competent Polish authority issues a certificate confirming that the person concerned has effectively and lawfully practiced the profession of nurse responsible for general care in Poland for the minimum periods fixed by order of the Minister for Health.

If the Polish diploma is issued before the reference date (01/05/2004) but the training is completed before that date, it may be recognized in France provided that the training certificate includes a special upgrading program enabling it to be assimilated to a certificate appearing in the table.

The diploma in nursing issued by Romania before the reference date (01/01/2007) and therefore not in accordance with European requirements may not be recognized in France except:

  • if the diploma certifies that the person concerned has effectively and lawfully practiced, for at least three consecutive years during the five years preceding the certificate, the activities of nurse responsible for general care
  • or if the holder of the diploma has followed a special upgrade program validated by the competent Romanian authority
Special case of diplomas not listed in the Annex to Directive 2005/36/CE

The nursing diplomas of theUE: titleContent/EEE: titleContent not listed in the table do not have automatic recognition. They may, however, allow the practice of nursing in France:

  • if the State of the UE or EEE which issued the diploma recognized as equivalent to the diplomas listed in the table (Case 1)
  • if the nurse succeeds in a aptitude test or an adaptation period (Case 2)

Case 1: Recognition by a UE/EEE

UE/EEE nursing diplomas that are not listed in the table may be used to practice in France if they are accompanied by a certificate issued by the State which issued the diploma. That certificate must certify that the evidence of formal qualifications attests to training which complies with the minimum requirements laid down by European legislation and that it is assimilated, in that State, to the diplomas listed. In this case, the recognition of the diploma is automatic.

Case 2: aptitude test or adaptation period

When a diploma issued in a UE/EEE State does not allow automatic recognition, the person concerned may apply for a license to practice (AE) in France within the framework of the general system for the recognition of professional qualifications.

The Dreets: titleContent then examines the candidate's training and professional experience and compares them with the requirements of the French State Nursing Diploma.

If significant differences in training are found, the administrative authority may impose a compensation measure, which may take one of the following forms:

  • one proficiency test
  • or a adaptation course carried out in a health facility

After passing the test or validating the adaptation internship, authorization to practice nursing in France may be granted.

Please note

To challenge the non-recognition of the nursing diploma, an appeal can be filed on the European platform Solvit.

Submit a complaint to Solvit

Temporary exercise (freedom to provide services)

Nationals of EU Member States(UE) or Parties to the Agreement on(EEE), may execute professional acts on a temporary and occasional basis in France. This also applies to businesses who are legally practicing as nurses in one of these countries, other than France.

To practice nursing temporarily and occasionally in France, the person concerned must practice as a nurse responsible for general care in a Member State of theUE: titleContent or theEEE: titleContent.

The execution of these acts requires a prior declaration. Therefore, he does not need to be registered with the College of Nurses.

In order to make his prior declaration, he must file a file of declaration of performance of services in France to the National Council of the Order of Nurses :

Declaring freedom to provide services for the nursing profession

Warning  

must be addressed before the first provision of services.

As from the receipt of the declaration, the National Council of the Order hasone month to inform the provider that he can start the provision of services without prior verification of his professional qualifications.

Where verification of the professional qualifications of the person concerned is necessary, the national council must inform him that he must take an aptitude test in order to demonstrate that he has acquired the missing knowledge and skills. If he/she meets this test, the provision of services may start within one month of the decision on the aptitude test. If not, he is informed that he cannot start the provision of services.

Within one month of receipt of the declaration, the national council must also inform the provider of the reasons for the delay, indicating the missing documents and information.

The decision shall be taken within 2 months of the resolution of the difficulty and, at the latest, within 3 months of the date on which the provider was informed of the existence of the difficulty.

In thelack of response from the National Council of the Order within these deadlines, the provision of services may begin.

The temporary and occasional nature of the provision of services shall be assessed on a case-by-case basis, in particular on the basis of its duration, frequency, periodicity and continuity.

Once the prior declaration has been validated by the National Council of the Order of Nurses, the nurse providing services is subject to the conditions of practice of the profession, the professional rules applicable in France and the disciplinary jurisdiction of the Order of Nurses.

The nurse service provider must renew its declaration once a year whether it intends to provide services on a temporary or occasional basis in France in a new year.

SOLVIT is particularly involved in the recognition of professional qualifications.

SOLVIT may be used if the 2 following conditions are met :

  • The public administration of one UE has not respected its rights under EU law as a company of another UE.
  • A legal action has not yet been initiated (the administrative appeal is not considered as such).

Submit a complaint to Solvit

After 10 weeks, SOLVIT presents a solution:

  • If this solution resolves the dispute concerning the application of European law, the solution is accepted and the case is closed.
  • If there is no solution, the case is closed as unresolved and referred to the European Commission.

Third-country national

A national of a State which is not part of a State of the (UE) or the (EEE) shall apply for an individual authorization to practice (AE).

The procedure varies depending on the country that issued the diploma:

The diploma was obtained in a UE or EEE State

If the diploma was obtained in a UE or EEE country, the Commission for Authorization to Practice (CAE) may be directly referred to it.

The application for authorization to practice (EA) must be dematerialized with the Dreets: titleContent the region in which the person concerned wishes to practice. The request is addressed to the regional prefect via the regional DREETS:

Please note

Several regions use a « Simplified Approaches » online approach (the form varies by region).

The Dreets: titleContent then examines the candidate's training and professional experience and compares them with the requirements of the French State Nursing Diploma.

Once the file is complete, it is usually presented before a regional authorization committee (CRAE)which studies the level of training and professional experience of the applicant.

The committee issues an opinion to the DREETS, which then takes the final decision whether or not to authorize the exercise in France. Such authorization, if granted, valid for the whole of french territory without geographical limitation.

The opinion delivered may also require the follow-up of a adaptation course in a registered establishment or a proficiency test assessing missing competencies.

If significant differences in training are found, the commission may impose a compensation measure, which may take one of the following forms:

  • one proficiency test
  • or a adaptation course carried out in a health facility

After passing the test or validating the adaptation internship, authorization to practice nursing in France may be granted.

The diploma was not obtained in a UE or EEE State

A diploma, certificate or evidence of formal qualifications not issued by a Member State ofUE: titleContent or a State Party to theEEE: titleContent may enable the profession of nurse to be practiced, where:

  • that he was recognized by one of those States and that its holder has acquired 3 years full-time professional experience in this state, and attested by it
  • the holder is a third-country national married to a UE citizen or holder of long-term resident status or of refugee statusand that his diploma is awarded by a third country and recognized by a Member UE of the State

Example :

For example, an out-of-UE national of Moroccan nationality, who holds a diploma in nursing obtained in Morocco, recognized by Spain (where he worked three years full-time as a registered nurse), may apply for authorization to practice in France.

Warning  

Compliance with these conditions makes it possible to right to apply for authorization to practice (EA) in France, but does not imply automatic recognition of the diploma.

The application for authorization to practice (EA) must be filed with the Dreets: titleContent the region in which the person concerned wishes to practice. The request is addressed to the regional prefect via the regional DREETS:

Please note

Several regions use a « Digital Approach » online approach (the form varies by region).

The DREETS then examines the candidate's training and professional experience and compares them with the requirements of the French State Nursing Diploma.

Once the file is complete, it is usually presented before a regional authorization committee (CRAE) which studies the level of training and professional experience of the applicant.

Please note

Depending on the situation of the person concerned, the procedure may require proof of residence (long-stay visa, etc.).

The committee issues an opinion to the DREETS, which then takes the final decision whether or not to authorize the exercise in France. Such authorization, if granted, valid for the whole of french territory without geographical limitation.

The opinion delivered may also require the follow-up of a adaptation course in a registered establishment or a proficiency test assessing missing competencies.

If significant differences in training are found, the commission may impose a compensation measure, which may take one of the following forms:

  • one proficiency test
  • or a adaptation course carried out in a health facility

After passing the test or validating the adaptation internship, authorization to practice nursing in France may be granted.

Warning  

These steps can take several months or even years. The objective is to verify that the level of competence is equivalent to the French State Nursing Diploma.

There is, however, a situation that makes it easier for the person concerned to enter the nursing profession, particularly if he or she has obtained a nursing degree in Quebec:

There is a specificity for persons who have obtained their bachelor's degree in nursing in Quebec. The Ordre des infirmiers et infirmières du Québec (OIIQ) and the Ordre des infirmiers de France have entered into a Mutual Recognition Arrangement (MRA) for professional qualifications.

As a holder of a nursing degree from Quebec, it is possible to obtain a authorization to practice in Franceby applying to the National Council of the College of Nurses.

If none of the above conditions is met, the person concerned must resume his studies in order to have a recognized diploma and be able to practice in France.

To do this, he must take the entrance selection tests at the Institutes for Nursing Education (IFSI) to obtain the State Diploma of Nursing (DEI).

The duration of graduate study before graduation is 3 years. An exemption from schooling of 2 years instead of 3 years, may be granted by the Director of the IFSI, after consulting his technical board. The decision is made on the basis of the level of initial training held by the candidate.

Warning  

Proficiency in French (minimum level B2) is required to enter an IFSI and successfully complete nursing training.

To learn more about IFSI registration as a third-country national, you can consult this sheet:

Where the person concerned is already holder of an out-of-UE/EEE degree in medicine or midwifery or holder of a diploma in advanced medical science, he is authorized to appear directly before the jury of the State Diploma of Nursing, subject to the following conditions:

The persons holding an authorization to practice the profession of doctor or midwife in France or abroad and the individuals with advanced medical science education shall be entitled to appear directly before the jury of the State Diploma in Nursing, where they fulfill the following conditions:

  • (1) Have validated the UE teaching units 3.1. S1 and UE 3.1. S2 " Reasoning and clinical nursing approach under the conditions provided for by the training reference annexed to this order;
  • (2) Have completed two full-time nursing internships of a total duration of fifteen weeks allowing the validation of the acquisition of skills 1, 2, 4 and 9 defined in Annex II to this order. By way of derogation, persons holding an authorization to practice the profession of maïeuticien in France or abroad must have completed a five-week internship allowing the validation of the acquisition of skills 1 and 4 defined in Annex II to this Order.
    The modalities of the internships are determined by the director of the institution after decision of the section competent for the pedagogical treatment of the individual situations of the students.
  • 3° Have completed and validated a written and personal work of 15 to 20 pages, or about 50,000 signs, centered on a problem specific to the nursing profession.

3° Have completed and validated a written and personal work of 15 to 20 pages, or about 50,000 signs, centered on a problem specific to the nursing profession.

The a person with an out-of-UE/EEE degree in medicine or maieutics may pursue nursing studies on an accelerated basis (6 months), by carrying out internships in a hospital environment.

To do this, the person concerned must appear directly before the jury of the State Diploma of Nurse when he meets the following 3 conditions:

  • Have validated the UE teaching units 3.1. S1 and UE 3.1. S2 " Reasoning and clinical nursing approach under the conditions provided for by the training framework annexed to the order of 31 July 2009 relating to the State nursing diploma.
  • Have completed 2 full-time nursing internships of a total duration of 15 weeks allowing the validation of the acquisition of skills 1, 2, 4 and 9 defined in Annex II of the Order of 31 July 2009 on the State Diploma of Nursing. There is a derogation for persons holding an authorization to practice the profession of maieutician in France or abroad: they must have completed a 5-week internship allowing the validation of the acquisition of skills 1 and 4 defined in Annex II of the order.
  • Have completed and validated a written and personal work of 15 to 20 pages, or about 50,000 signs, centered on a problem specific to the nursing profession.

The applicant must attach the following supporting documents to his/her application to the training institution of his/her choice:

  • Copy of ID
  • Original degree held and the relevant authorization to practice
  • Curriculum vitae (CV)
  • Cover letter

Warning  

To register, you must submit a file of application and pass a oral before a jury composed of the IFSI director, the pedagogical coordinator and a health executive. This oral is used to assess the level of French, motivation and professional project.

Please note

The nurses who wish to practice a specialty must, after obtaining the State nursing diploma, undergo further training leading to the State diploma of the specialty concerned.

They must therefore undergo training in 2 years to exercise asRegistered Nurse Anesthesiologist (IADE) or State Registered Operating Room Nurse (IBODE), and training of 1 year to exercise asState Registered Nurse Nurse (IPDE).

To practice nursing in France, two situations must be distinguished and depend on the status of the professional:

On the one hand, all nurses with a diploma in France must be registered at the table of the College of Nurses. Once registered, the nurse has the right to exercise throughout the national territory.

Second, a national of a Member State of(UE), the(EEE) or Switzerland, holder of a diploma recognized in its country, can practice in France without registration on the Table, within the framework of a temporary or occasional activity. He must then perform a declaration of freedom to provide services (LPS) with the National Order of Nurses before practicing.

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Establishment in France (permanent)

Any nurse wishing to practice the profession permanently in France must register with the Ordre des infirmiers.

1. Entry on the roll of the Order

The nurse must therefore proceed to his inscription on the board of the departmental council of the Order of Nurses from the place of his professional practice:

Subscribe to the register of the order of nurses

This inscription constitutes the essential condition for the exercise of the profession. It allows the Order to verify that the professional complies with the conditions necessary for the exercise, in particular:

  • possession of the required diploma or authorization
  • respect for the principles of morality and probity (by accessing the criminal record bulletin number 2)
  • proficiency in the French language and the system of weights and measures
  • the absence of a pathological condition making exercise dangerous
  • adherence to the ethical rules of the profession

When registering, the nurse must declare that he has read the code of ethics and undertake in writing and under oath to respect it.

Please note

Each nurse can only be registered on a single departmental listbut this registration does not geographically limit the possibilities of exercising on French territory.

Following the sending of the file deemed complete by the professional, the departmental council pronounces the registration in a maximum period of 3 months. Once the registration is confirmed, the professional receives a registration notification in the week.

The silence kept by the departmental council of the Order of Nurses on an application for registration on the roll of the Order is equivalent to a decision rejection.

The decision to refuse registration may be the subject of a hierarchical redress before the (inter)regional council of the Order of Nurses, in a one month delay from the notification of the decision.

If the decision of the (inter)regional council is not favorable, the person concerned may appeal to the National Council of the Order of Nurses.

As a last resort, if the National Council of the Order of Nurses confirms the refusal of registration, a contentious appeal may be brought before the Council of State in a 2 months delay from the notification of that decision.

Who shall I contact

Please note

The nurses practicing a specialty (State-registered nurse anesthetist, State-registered operating theater nurse or State-registered nurse for childcare) must, when they are registered with the National Order of Nurses, declare their specialty diploma so that it is registered in addition to their state nursing diploma.

2. Assignment of the RPPS number

As soon as the registration on the board of the Departmental Council of the Order of Nurses is validated, the nurse is automatically assign a number RPPS: titleContent. This unique number, personal and national, replaces the old ADELI identifier.

The RPPS number allows in particular:

  • identify the professional in all his administrative and digital procedures
  • access secure online services, such as the app e-CPS and the professional health card (SPC)
  • to certify its official registration with the Order and, by extension, its legal right to exercise

The assignment of the RPPS number is automatic and included in the College's registration process : no additional registration with the regional health agencies (ARS) is required.

Please note

Upon receipt of this number, the nurse can activate his digital tools via the e-CPS application and use it in his professional practice.

To learn more about thee-CPS application :

The professional health card (CPS) also exists in physical form. It is a physical smart card used with a reader, while the e-CPS is its dematerialized version on smartphone. Each can be used independently, but they are based on the same professional identity and provide access to the same digital health services.

3. Payment of the Ordinary Membership Fee to the Order

Once registered with the Order, the nurse is liable for an annual fee set by the National Council of the Order of Nurses. This contribution is mandatory.

For know the amount of the contribution, refer to the following contribution grid:

The National Order of Nurses also provides a FAQs on the Ordinary Contribution :

The ordinal caduceus shall be sent after receipt of the contribution.

Freedom to provide services (temporary exercise)

The nurse who is a national ofUE: titleContent or theEEE: titleContent who wishes to practice temporarily or occasionally in France must make a declaration of freedom to provide services with the National Council of the College of Nurses, before the first service is provided:

Declaring freedom to provide services for the nursing profession

Once the declaration phase has been completed, the file is forwarded to the National Council of the National Order of Nurses.

The board is composed exclusively of elected nurses who check the diploma, qualifications, morality, any contracts as well as the level of linguistic knowledge.

The National Council of the College of Nurses shall decide whether or not to register the provision of services in a one month delay from the receipt of the complete file.

Upon receipt of the notification of registration, the nurse may begin practicing in French territory.

Where the examination of the file reveals a difficulty likely to cause a delay in its decision (incomplete file, verification of qualifications, etc.), the national council shall inform the provider of the reasons for the delay and shall have at the latest maximum period of 3 months from the moment the claimant was informed of the existence of the difficulty. In the absence of a timely response from the Board, the provision of services may commence.

Please note

When the the provision of services is carried out within the framework of a specialty (State-registered nurse anesthetist, State-registered operating theater nurse or State-registered nurse-nursery), the declaration of freedom to provide services must specify the specialty practiced and the relevant evidence of formal qualifications.

The occasional and temporary provider is not subject to the obligation to register in the register RPPS: titleContent and is not liable for the ordinary contribution. However, it must ensure that its professional indemnity insurance covers the exercise of his profession in French territory in the context of the freedom to provide services.

Exercise

We present you the obligations and steps to be accomplished for theliberal exercise. It involves the compliance with various obligations and administrative procedures :

The practice of nursing, which falls within the scope of regulated liberal profession, must be carried out under conditions compatible with professional and ethical requirements.

The activity may be carried out:

  • in a room for professional use
  • in mixed-use premises (residential and professional), provided that the lease or condominium by-law does not preclude it
  • at the patient's home

When the activity involves the reception of patients, the premises must be adapted to this use, in particular in terms of accessibility, confidentiality and safety of care and sterilization of medical devices and disposal of care waste.

Please note

One living space can be converted into a professional space, subject to compliance with the urban planning regulations of the condominium and, where applicable, obtaining authorization for a change of use.

In some municipalities (notably those with more than 200,000 inhabitants, Paris and the municipalities of the small crown except urban free zones), a prior authorization to change the use of the dwelling into a business premises may be required.

Nurse Zoning and Installation Conditions

The installation of registered private nurses is subject to regulatory rules defined by the national agreement concluded with the Health Insurance.

The territory is divided into several zones, depending on the level of staffing of nurses:

  • areas that are severely underfunded
  • under-resourced areas
  • intermediate areas
  • highly endowed areas
  • over-endowed areas

 Installation conditions vary depending on the area:

  • Underfunded and severely underfunded areas : the installation is facilitated and may be eligible for financial aid.
  • Intermediate and highly endowed areas : the installation is free (provided that, in certain areas on the periphery of over-endowed areas, at least two thirds of the activity is carried out in the installation area).
  • Areas over-endowed : the installation is only possible under special conditions, including: Replacement of a nurse permanently ceasing his activity in the area or taking over an existing practice.

FYI  

These rules condition access to the agreement with the Health Insurance. It is essential to consult the updated map before any installation.

Cartohealth make available a set of indicators in each territory to target the location of installation:

Cartosanté - Where in liberal in one click

Please note

The specialized nurses may practice in the same places as registered nurses, subject to the specificities of their activity. The Registered Nurse Anesthesiologists (IADE) and the State-certified operating room nurses (IBODE) are mainly practicing in health facilities or structures authorized to perform anesthesia or surgery. The Registered Nurse Nurses (IPDE) they may also work in institutions, maternal and child welfare centers (PMI), nurseries, child welfare services or in private practice.

The rules on nursing zoning mainly concern nurses practicing in private practice and therefore only apply in practice to specialist nurses practicing in private practice.

The nurse may exercise:

  • under the scheme agreed with the Health Insurance
  • out of convention
1. Convention

To be covered by a contract, the nurse must declare its activity to the French primary health insurance fund (CPAM) of its place of practice, in particular by sending a certificate of registration to the roll of the Order.

After validation, it adheres to thenational convention of liberal nurses, which lays down the conditions of exercise, the billing procedures and the applicable tariffs.

The bills are invoiced in accordance with General Classification of Professional Acts (NGAP).

The nurse is affiliated to the licensed medical practitioners and auxiliaries (PAMC).

Health Insurance allows you to file an installation file in liberal :

Nurse, installation in liberal: registration with the Health Insurance

2. Non-treaty exercise

The non-contracted nurse freely sets his fees. The procedures are not covered by the Health Insurance.

The choice of legal form of exercise is a decisive step.

It determines the organization of the activity, the tax and social security system, as well as the conditions of practice in the light of professional rules.

The nurse may exercise:

  • as an individual (liberal)
  • in commonwithin legal frameworks (businesses or groupings)
  • as an employee in a public or private facility (hospital, clinic, EHPAD, etc.)
  • in form mixed (combining self-employed and salaried activity)

Please note

The use of nurses' salaries is possible in certain settings, in particular in business, subject to compliance with ethical standards, in particular professional independence in the performance of care acts and must not lead to a commercial exercise of the profession.

Regardless of the status chosen, the nurse must in particular:

  • be registered on the roll of the Order
  • take out professional liability insurance
  • adhere to the professional code of ethics

Warning  

When the nurse is practicing as a business (SELARLU, SELASU, SCP, SISA, etc.), the business itself must be listed separately on the roll of the Order.

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Individual Liberal Exercise

The nurse may exercise his activity alone in the liberal form. This is a regulated liberal activity. It has the choice between several legal forms.

1. Individual business

A nurse who practices alone, performs care and bills for his actions. This necessarily implies a legal framework, even in the absence of complex formalities. In the majority of cases, this is the status ofindividual business.

Warning  

The private nurse cannot practice under the micro-company system. Indeed, its regulated activity falls under the social regime of the health professions, with affiliation to the CARPIMKO: titleContent, which excludes the application of micro-BNC diet.

2. SELARLU

The business of private practice with single-person limited liability (SELARLU) is a legal form for regulated liberal professions. It combines the status of the private practice business (SEL) and that of the single-member company with limited liability (EURL), allowing a single partner to practice under a corporate structure.

The SELARLU is based on SARL regulations, adapted to the requirements of the liberal professions. The sole shareholder, a natural person practicing the profession, holds the entire share capital. The business must comply with the ethical standards applicable to the profession and be registered as a business with the College of Nurses.

This structure offers a limited liability, protecting the personal assets of the partner.

3. SELASU

The Simplified single-person private practice business (SELASU), is a French legal form allowing a liberal professional to exercise his activity within the framework of a commercial business with a single partner. It combines the advantages of simplified business by shares (SASU) and the system of businesses for private practice (SEL).

SELASU allows regulated liberal professions to practice under a corporate structure while maintaining their professional independence. The sole shareholder holds all the shares and exercises the powers of a business president.

The responsibility of the partner is limited to the amount of its contributionsthus protecting his personal assets.

Joint practice (in a business of common practice of nursing)

The nurse has the possibility to exercise his activity in common, involving a pooling of activity and fees. The partners thus exercise the profession via the creating a business :

For this, it has several possibilities:

1. SALT

The nurse can createone SALT (liberal practice business): business can take different forms:

  • SELARL (private practice business with limited liability ): this is an SEL modeled on the SARL. This status is mainly intended for nurses who wish to benefit from the Social scheme for self-employed persons (TNS) in order to reduce the amount of social security contributions, while maintaining a relatively simple legal structure for carrying out their liberal activity.
  • SELAS (simplified liberal exercise business by shares), modeled on the SAS. This status is mainly for nurses who are looking for social protection higher thanks to the diet employee-equivalent and which have a sufficient turnover to pay higher social security contributions.
  • SELCA (business of liberal practice in limited partnership by shares): it is a SEL in the form of a SCA.
  • SELAFA (anonymous private practice business): this is a SEL in the form of a SA.
2. SCP

The nurse also has the possibility to create a SCP (professional civil business). It is a civil business allowing several professionals to practice the same profession together, with pooling of resources, the patient and fees, which are perceived by the business and then distributed among associates.

Warning  

The nurse must be enrolled in the College in his or her personal capacity, and the business of practice must also be registered.

Individual exercise in groups

The nurse who wishes to practice as an individual is not necessarily alone. He may decide to practice in a group, but no fee sharing. Here again, it has several possibilities:

1. SCM

It can create aSCM (civil business of means): in this type of business, the nurses each carry out their activity as individual, in all independence and under their own responsibility. The purpose of the CMS is not the practice of the profession, but only the pooling of material resources or services (premises, equipment, secretariat, etc.) to facilitate the activities of its members. Each partner retains its own patient base and collects its fees directly, while participating in the expenses of the business in accordance with the terms laid down between the partners.

Please note

In the CMS, nurses are personally responsible for their actions, while managers are responsible, individually or jointly and severally as the case may be, towards the business or towards third parties, either for violations of laws and regulations, or for violations of the statutes, or for mistakes committed in their management.

The College of Nurses provides access to a model of statuses as well as a commented model of statuses for a SCM :

2. Liberal collaboration among nurses

The nurse can also opt for liberal collaboration between nurses. This collaboration is based on a contract between a registered nurse and a collaborating nurse. The employee exercises the profession in a independent in the office of the holder, under his own responsibility and preserving thefull fee. In return for the use of the resources of the firm and its organization, the employee generally pays a fee to the holder.

The College of Nurses provides a model of collaboration contract as well as a commented collaboration contract :

3. Exercise contract with common costs (or cost-sharing agreement)

The nurse can opt for a exercise contract with common costs. The common-cost practice contract (or cost-sharing agreement) is an agreement whereby several individual self-employed nurses pool their operating expenses (premises, equipment, secretarial services, staff, etc.) without pooling patients or fees, each maintaining its professional independence and its own patient base.

This agreement falls within the scope of the ordinary contract law and must comply with the prohibition of condoning and fee-sharing prohibited by the ethical rules of nursing.

In addition, the agreement must provide for an objective cost-sharing key (not indexed to each person's turnover, otherwise it will be reclassified as a disguised fee-sharing).

Finally, it must remain distinct from any organization that can be assimilated to a common practice structure at the risk of a reclassification into de facto business.

The College of Nurses provides templates for the off-business joint exercise :

Employee exercise

The private nurse has the opportunity to enter into an employment contract with another nurse who will have the status of employee, which implies the existence of a relationship of legal subordination to his employer.

The salary of a nurse by a Liberal colleague is authorized by Addendum 6 to the National Convention of Liberal Nurses (Article 12):

  • he must prove to the local health insurance body that he has been employed for 18 months, or a total of 2400 hours of actual working time, in the 6 years preceding the exercise as an employee of a liberal colleague.
  • this activity must have been carried out in a care facility, a healthcare structure or within a health cooperation group as defined in Article 8a: "Principles" of amendment 6.

The employee nurse will have to refer to this amendment to know all the necessary steps.

The general framework of the employment relationship is submitted to respect the Labor Code, the Public Health Code, the Code of Ethics for Nurses, and possibly the collective agreement which is applicable to the company's sector of activity. The employer has an obligation to comply with this agreement. The title of the collective agreement must appear on the pay slip.

FYI  

Depending on the sector of activity to which the employer belongs, several collective agreements may apply:

One simulator allows to find your collective agreement with the company's name or Siret number.

The trader must register the company. This procedure must be done online on the website of the Window of company formalities :

Window of company formalities

The registration of the company is a formality which has the effect of giving legal status to the company.

This declaration informs all the organizations concerned by the launch of the activity (Insee, social organizations, Urssaf, public finance center, etc.).

As soon as the application for registration is accepted,Insee: titleContent assigns:

  • One number Siren : it corresponds to the national identifier of the company. This number is issued to the company when it is registered in the SIRENE directory. This directory lists the identity of all companies established in France regardless of their status. It provides access to all legal and financial information that corresponds to the company. The Siren is made up of 9 digits, attributed by the INSEE, as part of the company's registration. Each number is unique and corresponds to a single company.
  • One number Siret : it is allocated by theInsee: titleContent when registering the company in the SIRENE directory (national register). The Siret number is composed of 14 digits including:
    • the first 9 correspond to the SIREN number. They identify the company through the legal entity that is responsible for its management
    • the last 5 correspond to the Internal Ranking Number (NIC): it is these last 5 digits of Siret that will differentiate it from Siren.

It is also during the registration of the company that the Insee assigns the professional its code APE (8690D for nursing activity).

For carry out the procedures for declaring the start of activity, the Urssaf shall make available a step-by-step guide to:

Please note

To learn more about creating a company, you can consult our « I create » folder in which are included various sheets dedicated to the launch of the company and in particular the formalities for registration of a business or a individual business.

When the exercise is carried out via an exercise business (SCP, SEL, etc.), the business must be the subject of a inscription on the roll of the National Order of Nurses :

Any application for registration of a business (SCP, SEL, etc.), must be made collectively, signed by all the partners, and sent to the (inter)departmental council in which the business' head office is located by registered letter with acknowledgement of receipt, or deposited on site against receipt.

Warning  

SCMs (civil businesses of means) are not required to register with the Order because they do not directly practice the profession.

The application file includes a form to be completed and documents required by regulation. The Order will decide on the application for registration within a maximum period of three months from receipt of the complete file.

The Order makes available business-specific application forms for registration on the Order's roll.

For the SCP :

Application form for registration of a professional civil business (CPS) on the National Order of Nurses

For the SALT :

Application for registration of a business of liberal practice (SEL) on the Roll of the National Order of Nurses

For the SPFPL :

Application form for registration of a business of professional financial participation (SPFPL) on the Roll of the National Order of Nurses

For the SISA :

Application form for the registration of an interprofessional ambulatory care business (IACS) on the National Order of Nurses

Nurses have theobligation to take out professional liability insurance (RCP) before you start exercising.

This applies to all nurses, whether temporary or permanent, and whether they are:

  • private nurses
  • associate nurses of a business of nurses
  • nursing students

FYI  

Nurses employed in a health facility are not obliged to take out CPR insurance. They are covered by the insurance of the establishment that employs them.

CPR covers the different risks linked to the practice of the professional activity (injury to a patient or colleague, damage to medical equipment, etc.).

It also guarantees the damage caused to third parties in the course of carrying out the activity

  • Poor dosages of drugs
  • Mishandling when auscultating a patient
  • Accidents caused by medical equipment
  • Accidents caused by negligence or omission
  • Accidents related to bad advice or misjudgment

Warning  

Professionals who do not comply with this obligation to insure are exposed to both criminal (fine of up to €45,000) as disciplinary (prohibition of the practice of nursing). In addition to all these sanctions, there is also the risk of having to take personal damages and interest.

Depending on how you do your business, it may also be useful to take out a car insurance or one insurance for professional premises. For more information, see our fact sheet on insurance of the business.

Please note

The specialized nurses as a private practitioner, they are subject to the same obligation to take out professional indemnity insurance. They must, however, ensure that their contract covers the specific acts, activities and responsibilities of their specialty, including anesthesia for registered state anesthesiologists (RSNAs), operating theater activities for registered state anesthesiologists (RSNAs) or care of newborns, children and adolescents for registered state nursing nurses (RSNAs).

The activity of the nurse is covered by the « PamC » scheme, which is the social scheme for self-employed workers exercising a health profession as Practitioners or Medical Auxiliaries with agreements.

To know all the rules concerning this social system, it is possible to consult the file relating to the arrangements for ‘ PamC ».

The nurse must pay social security contributions to the Urssaf from the beginning of his activity.

However, in practice, no contributions or social contributions are required during the first 90 days which follow the launch of its activity.

Since the income is not yet known at the start of the activity, the contributions are first calculated on a flat-rate basis for the first 2 years (at the same rates as those applicable during the course of business). They are then adjusted and regularized according to the real revenues of the fiscal year.

Please note

Contributions must be paid online in one of the following ways:

  • Either every month : payment is made on the 5th or 20th of each month, by direct debit.
  • Either every quarter : payment is made by direct debit, telepayment or credit card on 5 February, 5 May, 5 August and 5 November.

Contributions to the basic pension, supplementary pension, invalidity-death and old-age social benefit schemes shall be paid to the CARPIMKO: titleContent.

Please note

Remuneration received in respect of corporate mandate in an SELARL or a SELAS falls under the equivalent employees.

As a private nurse, adherence to CARPIMKO: titleContent is mandatory.

She is automatic from the moment the trader has registered his activity with the Window of company formalities as a liberal independent.

Affiliation takes effect on 1er the day of the calendar quarter following the commencement of liberal activity.

Example :

If the activity starts on April 3, the affiliation takes effect on April 1er July.

To learn more about theaffiliation with the Carpimko :

For contact the Carpimko :

Who shall I contact

The nursing profession requires respect for the code of ethics for nurses. It specifies all the rights and duties of nurses according to their modes or places of exercise.

In particular, it specifies the patient relations, the other members of the profession and the other health professionals.

Example :

For example, the nurse must respect in all circumstances the principles of morality, probity, loyalty and humanity essential to the practice of the profession.

To know in detail all the rights and duties of the profession, the College of Nurses provides a code of ethics commented :

The code of ethics for nurses has evolved torelaxing the rules on public information. Nurses can now communicate more widely about their professional activity, in particular on their professional documents, in directories for the public, on their plaque or via a website.

As such, they are allowed to mention information such as their skills, professional practices, their background or the modalities of their exercise.

However, this option remains strictly regulated: the information disseminated must be fair, honest, verifiable and not be comparative or misleading. They must not in any way be akin to a commercial or advertising approach.

In order to support professionals in this evolution, the National Council of the Order of Nurses has adopted recommendations specifying the conditions under which this information may be issued :

Warning  

Failure to comply with the code of ethics may result in disciplinary sanctions pronounced by the competent disciplinary chamber of the Order of Nurses.

The combination of the practice of nursing with another activity must respect the principles of dignity, of quality requires his professional practice and that the other professional activity is not excluded by the regulations in force.

Thus, occupations exhibitingself-weighting are prohibited: this means that they should not take advantage of the skills that are recognized to them. Consequently, a nurse cannot, for example, be a manufacturer or seller of medical devices (dressings, medical equipment, etc.).

The nurse at theprohibition on converting the exercise of one's profession into a commercial activity. He therefore does not have the possibility, for example, to market to his patients.

Likewise, it is forbidden to try to obtain for himself or for others an advantage or unjustified profit. For example, he cannot use an elective, political or union mandate, or an administrative function to increase his patient base.

The nurse, if he wishes, can carry on business in a mixed manner, i.e. both as an employee (e.g. in a health facility) and as a private individual (own practice or business of nurses).

There is therefore nothing to prevent a nurse who wishes to carry out an additional activity, as long as he or she meets all of these criteria.

Warning  

Complementary activity does not exempt the nurse from respecting the ethical rules applicable to his profession. In particular, it must ensure that this activity is compatible with the dignity of the profession, the requirements of its professional practice and that it does not create a situation of conflict of interest or undue advantage.

For more information, the National Order of Nurses provides a factsheet on cumulation of activities in the public and private sectors :

Please note

In the context of the liberal practice, the principle laid down for the practice of nursing is that of single place of exercise, declared as his professional residence when he entered the roll of the order. The nurse may apply to the (inter)departmental Council of the Order of Nurses for authorization to practice at one or more distinct sites, if the needs of the population so require and when there is a deficiency or insufficiency in the provision of care that is detrimental to the needs of patients or to the continuity of care.

In order to guarantee the quality of the care he provides and the safety of the patient, the nurse registered with the National Order of Nurses (ONI) must refresh and hone skills throughout your career, regardless of his status (liberal, salaried, etc.) or his mode of practice.

Since 1er january 2023, nurses are subject to theperiodic certification requirement. Continuing Professional Development (CPD) remains operational in 2026 and is an important component of this certification. The autonomous CPD obligation is intended to disappear as of 2027 for the professions with orders. The CPD actions carried out in 2026 will be fully taken into account in the periodic certification.

CPD

CPD (Continuing Professional Development) has as its objectives " maintaining and updating skills and improving practices » nursing professionals:

1. Three-year obligation

This is a three-year obligation. Over a period of 3 years, each nurse must provide proof of DPC path comprising at least two of the three types of actions following:

  • continuing education
  • assessment of professional practices
  • risk management

This route must also include at least one action under the priority national guidelines.

2. Organization of the mechanism

The system is managed by the National Agency for Continuing Professional Development (ANDPC). The latter:

  • registers the bodies wishing to issue CPD shares, in accordance with criteria defined by decree
  • publishes on its website the actions of DPC, which it has previously verified, in the light of the priority national guidelines of DPC

Please note

Only the actions validated and referenced by ANDPC can meet the CPD obligation.

3. Financing

ANDPC compensates the follow-up of DPC actions, in respect of the loss of income caused by this follow-up, for either directly to the nurse or to the employer:

  • registered private nurses
  • salaried nurses working in a health center that has an agreement with the Health Insurance

For nurses practicing in a other establishment (hospital, clinic, EHPAD, health and social services, etc.), funding is provided by the employer (skills development plan) or the skills operator (OPCO Health).

For everything CPD information, the professional may contact ANDPC:

Who shall I contact

Periodic Certification

Periodic certification is mandatory since 1er January 2023 for the prescribed health professions, including nurses.

Concerning the periodicity :

  • the cycle of ordinary law is 6 years
  • the transitional period for professionals practicing at 1er january 2023 is 9 years (until 2032)
Content of the obligation

Certification is based on a minimum program of actions, defined by a reference system specific to the nursing profession, validated by ministerial decree after consulting the High Health Authority.

This program is structured around 4 axes:

  • updating knowledge and skills
  • improvement of professional practices
  • quality of the relationship with patients
  • taking into account the health of the professional

The reference framework provides for a minimum number of actions to be carried out over the whole cycle, with some actions being able to fall under several axes. The actions carried out under the CPD can be taken into account as part of the periodic certification.

Traceability of actions

The actions must be recorded in an individual account accessible via the online service " Ma Certif'Pro Health », being rolled out progressively from 2026.

Control and monitoring by the Order

Ordinary bodies are responsible for ensuring compliance with the periodic certification requirement.

As such, they:

  • ensure continuous follow-up of registered professionals
  • support professionals in fulfilling their obligations

In the event of a risk of non-compliance, a preventive alert can be addressed to the nurse. This approach aims to allow early regularization, without disciplinary character.

At the end of the cycle, the Order verifies the implementation of the action program:

  • if the obligation is fulfilled: issue of a certificate and start of a new cycle
  • if it is not: the nurse is asked to regularize his situation

Warning  

In case of persistent non-compliance:

  • one disciplinary procedure can be committed
  • the failure to fulfill obligations may also, where appropriate, be examined underoccupational insufficiency

These measures are taken as a last resort, the system being based primarily on support for professionals.

The setting of fee rates depends on your conventional situation :

  • She is free if you do not have a contract with the Health Insurance: the nurse can fix his fees as he wishes, but the acts are not reimbursed by the Health Insurance. In addition, the nurse does not have access to the remote transmission devices.
  • She is fixed if you have an agreement with the Health Insurance: in this case, the nurse must respect the rates set by the General Classification of Professional Acts (NGAP), which lists the refundable instruments and their pricing. It must also apply the National Convention of Private Nurses.

A nurse who practices as a private practitioner and receives patients hasobligation to display, in a visible and legible manner in the places where patients are received (waiting room for example):

  • the fees charged
  • their reimbursement rate by the Health Insurance (if you have an agreement)

It is also required to display other information, one of the following texts, corresponding to your contractual situation:

Example :

If you have a contract, it is necessary to display the following text

« Your healthcare professional charges fees in accordance with the Health Insurance rates. These rates may not be exceeded, except in the case of an exceptional requirement on your part, regarding the time or place of the acts practiced. If your healthcare professional offers to perform certain procedures that are not reimbursed by the Health Insurance, he must inform you. In the case provided above where your healthcare professional can freely determine his fees or excess fees, he determines the amount with tact and measure. »

Example :

If you do not have a contract, it is necessary to display the following text

« Your healthcare professional is not covered by the Health Insurance; he/she freely determines the amount of his/her fees. The reimbursement of the Health Insurance is based on the authority rates, the amount of which is much lower than the reimbursement rates for health professionals under contract. If your healthcare professional offers to perform certain procedures that are not reimbursed by the Health Insurance, he must inform you. »

Please note

The nurses who practice only at home are not required to physically display their rates, but must clearly inform the patient of the costs of the procedures. This information can be given orally or in writing, and compliance with conventional rates remains mandatory for registered nurses.

Registration with the College of Nurses entails the following obligations:

  • Report any change in the professional activity (place of practice, mode of practice or cessation of activity)
  • Send the certificate of completion of training DPC (Continuous Professional Development) in case of request
  • Pay the membership fee to the College of Nurses annually

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