What are the 7 nursing levels in the Netherlands?

If you are thinking about making the professional leap to the Netherlands, one of the first things you need to understand is how its healthcare system works. Unlike other countries where nursing is divided into two or three main categories, the Dutch system is highly structured and tiered.

In the Netherlands, the responsibilities, autonomy and salary of a healthcare professional depend on their level of education and training. There are 7 main nursing and care levels. Here we explain what each one does and what is needed to reach them.

Level 1: Care Assistant (Zorghulp)

This is the most basic level within the Dutch healthcare system. Zorghulp professionals usually work in home care or in care homes for the elderly.

Duties: Their main role is to support patients with domestic tasks, keep the environment clean and provide companionship, ensuring a safe and pleasant environment for the patient.

Training: Requires a short vocational training course (MBO level 1).

Level 2: Care Helper (Helpende Zorg en Welzijn)

A step beyond level 1, these professionals have more direct contact with the personal care of the patient.

Duties: They assist with Activities of Daily Living (ADLs), such as bathing, dressing, feeding and mobilising patients. They also report basic changes in the patient's condition.

Training: Vocational training at level 2 (MBO 2), which typically lasts around two years.

Level 3: Nursing Assistant (Verzorgende IG)

The acronym IG stands for Individuele Gezondheidszorg (Individual Healthcare). This is a highly sought-after profile, especially in elderly care, psychiatry and community care.

Duties: They have greater autonomy. In addition to basic care, they can carry out low-complexity medical tasks, such as administering prescribed medication, dressing simple wounds and giving injections. They monitor patient development and liaise with doctors.

Training: Vocational training at level 3 (MBO 3), lasting three years. (Broadly equivalent to a healthcare assistant role in many Spanish-speaking countries, though with somewhat greater autonomy.)

Level 4: Registered Nurse — Vocational Level (MBO-Verpleegkundige)

From this level onwards, we are talking about registered nursing. To practise at Level 4, registration in the BIG register (the Dutch national register of healthcare professionals) is mandatory.

Duties: They perform complex clinical procedures, insert cannulas and catheters, and coordinate the patient care plan. They work in hospitals, clinics and home care.

Training: Vocational training at level 4 (MBO 4), lasting four years.

Level 5: Registered Nurse — University of Applied Sciences (HBO-Verpleegkundige)

Although in clinical practice an MBO nurse (Level 4) and an HBO nurse (Level 5) may perform very similar day-to-day tasks in a hospital, the difference lies in depth of knowledge and leadership.

Duties: In addition to direct clinical care, they manage highly complex cases, apply Evidence-Based Practice (EBP), lead teams and coordinate care across different medical disciplines.

Training: University of Applied Sciences degree (HBO), lasting four years. (This is the direct equivalent of a University Nursing Degree in countries such as Spain or others in Latin America.)

Level 6: Specialist Nurse (Gespecialiseerd Verpleegkundige)

These are nurses (generally with an HBO background, although some MBO nurses may also access this level) who have chosen to focus on a very specific clinical area after obtaining their registration.

Duties: They provide highly technical care within their specialist area. The most common branches include Intensive Care (ICU), Emergency Care, Oncology, Paediatrics or Anaesthesia.

Training: Requires postgraduate or specialist training that typically lasts an additional 1 to 2 years after the base registration, generally combining work and study (in-service training).

Level 7: Nursing Specialist (Verpleegkundig Specialist / Nurse Practitioner)

This is the highest level a nursing professional can aspire to in the Netherlands, sitting halfway between traditional nursing and medicine.

Duties: They have extensive clinical autonomy. They can diagnose, prescribe medication and perform certain medical treatments and interventions that were traditionally reserved for doctors. They act as the primary care provider (regiebehandelaar) in many care pathways.

Training: Requires a Master's degree in Advanced Nursing Practice (Master Advanced Nursing Practice), lasting two years.

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The Dutch system is designed to encourage professional growth. No matter which level you start at, with the right language skills, experience and training, the Dutch education and labour system allows you to progress and specialise at your own pace. Ready to take the next step in your healthcare career?