A job offer from the UK, the Gulf, the US or elsewhere can feel like the answer to years of hard work. In the excitement, many nurses sign contracts quickly, sometimes without reading them fully or understanding what they mean. Problems that surface later include unexpected deductions, large repayment demands for leaving early, and different job conditions than promised. Taking time to read and question a contract protects you.
Key things to check
Job and employer
- The exact employer (a hospital, care home, or an agency?), and location.
- Job title and grade or band (e.g. NHS Band 5 vs a band 3 role while awaiting registration).
- The specialty or ward.
- Whether this employer is a licensed visa sponsor where required (e.g. on the UK government’s register of licensed sponsors).
Pay
- Gross salary, and what you’ll take home after tax and deductions.
- Unsocial hours or shift enhancements, overtime rates.
- Pay before and after registration (e.g. pre-NMC PIN vs registered pay).
- Pay progression.
- In the Gulf: basic salary vs allowances (housing, transport), end-of-service gratuity, and how they’re calculated.
See nurse salaries abroad compared and NHS pay scales.
Hours, leave and conditions
- Contracted hours per week and shift patterns.
- Annual leave, sick pay and maternity leave.
- Probation period.
- Accommodation: free, subsidised, or deducted from pay? For how long?
- Flights, visa fees, and health surcharge: who pays?
Repayment clauses and “bonds”
Some employers include clauses requiring nurses to repay relocation or training costs if they leave within a set period (often 1–3 years). Check carefully:
- How much, for how long, and whether the amount reduces over time (“tapered”).
- Whether the costs listed were actually paid by the employer.
- Whether the amount seems reasonable or punitive.
In the UK, the Code of Practice for international recruitment states that recruitment costs should not be charged to health and care workers, and repayment clauses should be proportionate and clearly explained; excessive clauses have been criticised by unions and regulators. Similar principles appear in the WHO Global Code of Practice. If something looks excessive, take advice before signing.
Red flags
- Being asked to pay large recruitment or placement fees.
- Pressure to sign immediately without time to read.
- The contract in a language you don’t understand, or a different contract on arrival.
- The employer or agent keeping your passport.
- Vague job details or no named employer.
- Promises of jobs “guaranteed” without exams or registration.
Where to get advice
- Nursing unions in the destination country (many offer advice to international nurses).
- Your home country’s government labour or migration agencies.
- Nurses already working for that employer.
- A qualified lawyer for complex cases.
Keep copies of everything you sign and all offer emails.
Related: Gulf nursing interview questions · NHS interview questions · Nursing in Germany
Based on the UK Code of Practice for the international recruitment of health and social care personnel and the WHO Global Code of Practice. General information, not legal advice.