Are You a Foreign Nurse Who Would Like to Work in the United States?

There is a known shortage of nurses in the United States. However, U.S. Immigration Laws do not, generally, make it easy for foreign-born nurses to obtain work authorization in the United States. However, there are some visa classifications which allow foreign-born or foreign-trained nurses to work or immigrate to the United States. The following are some of the most commonly asked questions:

1. I am a nurse. Will I be able to work in the United States?

U.S. Immigration Law only allows foreign nurses to work in the United States who are classified as "registered nurses". Licensed vocational nurses, licensed practical nurses, nursing aids, etc. are not allowed to work in the United States and there are no visa classifications available to them

2. I am from Canada. Can I get a visa to work in the United States?

The United States has a special arrangement with Canada and Mexico which allows for registered nurses from those two countries to work in the United States under a "TN" visa. In order to qualify for this visa, you must have three things:

a. An offer of employment in the United States to work as a registered nurse;
b. Be licensed in Canada (or Mexico); and
c. Have a California License.

3. Can I work in the United States if I am not from Canada or Mexico?

There are only two other potential nonimmigrant visas which will allow registered nurses to work in the United States:

a. H-1B Temporary Professional: This visa is not available to most RNs. It is only available to those who will be taking positions which require a four-year degree. The Immigration Service has determined that few nursing positions require an actual four-year degree, since most nurses can become registered nurses with only a two-year associate's degree. However, such occupations as Nurse Practitioners, Nurse Supervisors, Nurse Trainers, and other related occupations have been found to require four-year degrees. Therefore, persons coming to fill such positions can potentially be classified as H-1B temporary professionals.

b. H-1C, Nurses in medically under-served areas: In 1999, Congress passed an Act which allows for 500 nurses to enter the United States in designated shortage geographic areas at hospitals which have a minimum of 190 acute-care beds. This program is extremely limited and only about a dozen hospitals have qualified to hire nurses in the H-1C category.

4. If I do not fit within any of these classifications, is there any other way to work in the United States?

Actually, the easiest way to work in the United States is to apply for permanent residence. Unfortunately, this takes at least a year before a person can receive approval and immigrate to the United States. However, years ago, the Department of Labor recognized that there tends to be a chronic shortage of qualified registered nurses. For that reason, they facilitated the process to be able to immigrate to the United States.

2. How can I immigrate as a nurse to the United States?

First, you have to have arranged employment; that is, some hospital or healthcare facility must be willing to offer you a job as a RN. Second, as a practical matter, the facility must understand that they will have to wait at least a year before they will be able to obtain your services. Beginning the process to file for permanent residence does not authorize one to work in the United States, unless they fit within one of the previously mentioned nonimmigrant categories. Therefore, most nurses must wait outside the United States until the immigrant processing has been completed. Most employers do not want to wait a year before they can hire a RN. However, some hospitals and facilities, recognizing that they continue to have the chronic shortage of RNs are doing some forward thinking planning and concluding that while they need nurses immediately, they will still have a need for nurses at least a year from now and are willing to begin the process for permanent residence for qualified RNs.

3. What are the academic or licensure requirements to immigrate to the United States?

In order to immigrate to the United States, the immigrant must be a registered nurse in the countries where they obtained their nursing education, must have passed the Commission on Graduates of Foreign Nursing Schools (CGFNS) or hold a full and unrestricted license to practice professional nursing in the state of intended employment.

4. Will any nursing position qualify?

No, the Department of Labor has listed the nursing occupations which will qualify. The good news, however, is that most registered nursing positions, including General Duty Nurses, Nurse Instructors, Nurse Practitioners, and School Nurses, will qualify. In addition, the position must be full-time.

5. How do I begin the permanent residence process?

First, you must find an employer who is willing to go through the permanent residence process. Second, a complete set of papers and documentation must be assembled and submitted to the Immigration and Naturalization Service. In order to effectively process these papers, you may want to consult with an immigration attorney. However, some facilities who have done this on a regular basis may feel qualified to process these papers on their own.

© 2002 All Rights Reserved

Edward R. Litwin is a specialist in Immigration and Nationality Law, certified by the Board of Legal Specialization of the State Bar of California. He and his firm have helped thousands of people immigrate to the United States. He is available for consultation by appointment.

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