How to Immigrate and work in the U.S. as a Nurse?

H-1B Visa

If you wish to work as a professional nurse temporarily in the United States, you need to apply for an H-1B visa. An H-1B visa is a standard temporary work visa for foreigners who have been offered a position in the United States in a “specialty profession,” such as nursing.

US Green Card

You could also be sponsored for a green card by your employer in the United States. First, they must offer you a permanent nursing position in the United States. A labor certification (PERM) process must also be completed on your behalf by this employer.

This visa application must be completed before traveling to the United States, and a visa must be secured before lawfully arriving.

TN Visa

Nurses from Mexico and Canada are eligible to apply for TN Visa. Nursing professionals from Mexico and Canada can work in the US with a TN visa if they have a job offer, a license to practice in their home country and pass the NCLEX and state licensing examination.

H-1C visa

For foreign nurses intending to work in the United States temporarily, the H-1C nonimmigrant temporary worker classification is intended to allow them to fill a shortage area for health professionals, as determined by the Department of Labor (DOL).

To address this shortage of nurses crisis in the United States, the H-1C nonimmigrant category was created in 1999. Applying for an H-1C nonimmigrant visa requires coordination between the USCIS and the Department of Labor. DOL must provide attestation to petitioning hospitals confirming that they meet the requirements before filing for an H-1C visa with USCIS. For example, hospitals must be located in a “health professional shortage region,” among other conditions.

Can I Immigrate and Work in the United States Temporarily as a Nurse?

If you are a foreigner and wish to work in the United States temporarily as a nurse (without obtaining a green card), you may be able to acquire an H-1B visa. An H-1B visa is a desirable temporary work visa for foreigners who have been offered a position in the United States in a “specialty vocation.”

To get an H-1B visa as s nurse, the employer in the United States, like a hospital or medical clinic, should file an I-129 petition with USCIS (Citizenship and Immigration Services). H-1B visas are approved or denied by this agency based on the employer’s request for an H-1B visa.

Your potential employer would have to show that your nursing profession is a specialized occupation. For this, the USCIS employs a four-branched test; the position must satisfy one of the four branches:

• A bachelor’s degree or higher, or its equivalent, is usually required for admittance into the role.
• The degree required for the work is industry standard, or the job is so complex or unusual that someone with a degree can only complete it.
• The employer usually requires a degree or its equivalent.
• Because the nature of the specific activities is so specialized and complicated, the knowledge necessary to accomplish the duties is often connected with a bachelor’s or higher degree.

Typically, USCIS focuses on the first pillar, determining if a bachelor’s degree is necessary for the nursing position. Because many states do not need a bachelor’s degree for a standard registered nursing post, obtaining an H-1B visa as a nurse might be challenging. Most states, however, demand a shorter qualification procedure for this profession. Talk with your employer and check the criteria for the registered nurse position in the state where you want to work.

Although it may be tough to get an H-1B as a registered nurse, practically every state demands at least a bachelor’s degree for clinical nurse or nurse practitioner roles. As a result, you would have a greater chance of obtaining an H-1B visa.

Again, make careful to research the state’s criteria for any nursing employment offered by a U.S. business. Whether the employment is a specialized profession, your qualifications are less important than the qualifications required for the job. For example, assume you have a master’s degree in nursing and are offered registered nurse employment in California by a U.S. firm. However, a bachelor’s degree is not required in California to become a registered nurse. As a result, even if you have a master’s degree, it is highly doubtful that USCIS will consider this employment to be a specialist occupation.

Can I Get a Green Card in the United States as an immigrant Nurse?

Your company in the United States may also be keen to support you as a sponsor for a green card. However, the company must first give you a full-time, permanent job as a nurse. Second, on your behalf, your employer must perform a procedure known as “labor certification” (PERM). This PERM process is pretty different for nursing positions than other professions.

A nursing position is designated as “Schedule A.” Schedule A positions are those for which the United States government has determined that more personnel are required. Companies are not required to publish advertising for Schedule A employment (a typical PERM requirement) because the US government is already aware of a labor shortage in these areas.

USCIS handles PERM for foreign nurses, not the Department of Labor, which reviews ETA Form 9089s for all non-Schedule A positions. The ETA Form 9089 is completed by the employee of the foreign nurse, along with an I-140 petition, which is submitted to USCIS.

The foreign nurse can apply for a U.S. green card by submitting the I-485, adjustment of status application, with USCIS from the date USCIS approves their I-140 and their priority date has become current (meaning there is a visa number available if a wait had been imposed due to an annual limit of such visas running out). (For more information, see How to Determine Your Priority Date for Immigration Purposes).

Although PERM advertisement standards do not apply to Schedule A employment, the Posting-Notice obligation applies. Your U.S. employer must publish a notice in the workplace informing the other employees of the labor certification filing.

What are the Documents for an I-140 Employment-Based Immigration Petition in the US?

As specified in 20 C.F.R. 656.22(c), supporting documents must be supplied with the I-140 (2). The following are examples of supporting evidence:

• Filled out PERM labor certification paperwork (the PERM recruiting procedure, however, is not required).
• An advertisement for a job opening. This ad must provide a job description, working hours, and pay rate. The notification must be placed on the job site for at least 10 business days.
• Evidence shows the petitioning company has the financial means to pay the nurse’s wage. Copies of yearly reports, federal tax filings, or audited financial statements must be provided as proof of this competence. If the US company employs 100 or more people, the USCIS may accept a statement from the organization’s financial officer.
• Applicants must have a CGFNS certificate or nurse license from the state where they will work or must have passed the NCLEX and demonstrate that they cannot obtain a permit because they lack a social security number.
• Diploma or degree in nursing.
• Nursing registration/licensure in the nation where the degree was acquired is required. The CGFNS certificate demonstrates that the nurse has completed a three-step assessment of their nursing skills:
  • A credentials evaluation
  • Passing an English language proficiency exam
  • Passing the CGFNS qualifying exam

Note: Following completion of these requirements, the Commission on Graduates of Foreign Nursing Schools will grant the nurse a CGFNS certificate. This certification program aims to act as a predictive evaluation method for determining whether nurses will be able to achieve the standards for U.S. licensure if admitted to the nation. The nurse is excluded from earning a CGFNS credential if they have already completed the NCLEX-RN test.

What is a VisaScreen? When Do Health-Care Employees Need One?

Healthcare professionals seeking an occupational visa for the United States can take advantage of Visa Credentials Assessment Service. It is necessary to submit the VisaScreen certificate to USCIS before adjusting status and to a US consulate before issuing a US permanent residency visa. However, neither the certificate nor approval of the I-140 application are required at the start of the adjustment process.

Employers and sponsors now can apply on behalf of their RNs who are already present in the U.S. The process is usually more straightforward for these nurses. A petition for Alien Worker and Adjustment of Status filed within 90 to 120 days of filing will result in immediate work authorization (comparatively faster than through consular processing). At USCIS regional service centers, adjustment applications generally take 18 to 24 months. A nurse must still show a VisaScreen Certificate before completing the adjustment of status process.

Finally, nurses must satisfy the requirements of the Petition for Alien Worker and State Board of Nursing in the state for which they intend to practice nursing. Additional limiting criteria may vary among the state’s department of professional regulation.

Steps for Immigrating to the U.S. as a Foreign Nurse

Foreign-educated nurses must accomplish eight critical stages to work as an RN in a U.S. hospital.

Meet the Education Requirements for Nurses in the United States

To begin with, overseas educated nurses must fulfill minimum educational criteria. These are some examples:

• Successful completion of an authorized Registered Nursing program: Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN) (BSN)
• Registration as a Registered Nurse (RN)
• At least two years of experience working as a registered nurse (RN)

Nurses with a license to practice in the United States must have a license to practice.

Complete a course for Foreign-Educated Nurses (FEN).

While the above-mentioned are essential, most states additionally need foreign-educated nurses to take a refresher course for Foreign-Educated Nurses (FEN).

The course is divided into 120 hours of classroom instruction and 120 hours of clinical practice under the guidance of a competent Registered Nurse.

Complete English Language Proficiency Examinations

After completing the initial schooling requirements, certain foreign-educated nurses must pass an English test, such as TOEFL, TOEIC, or IELTS. This varies by country of origin, and findings are forwarded directly to the state nursing board.

Nurses who attended nursing school in the U.K., Australia, New Zealand, Canada (excluding Quebec), or Ireland are excluded, as are those who spoke English in nursing school and had textbooks published in English.

Take and pass the NCLEX-RN Exam

After verifying that you fulfill the academic and language criteria, you should apply for the NCLEX in the state where you want to work. Again, Pearson Vue registration is needed and costs $200, plus extra overseas expenses.

Request that the CGFNS evaluate your credentials

Allow the Commission on Graduates of Foreign Nursing Schools (CGFNS) to verify that you fulfill the minimum requirements and are qualified to take the NCLEX.

There are three main credentialing reports:

• Credentials Evaluation Service Professional Report
• CGFNS Certification Program
• Visa Credentials Assessment

Find a Nursing Recruiting Agency or Employer in the United States.

The next step is to apply for a work visa. These nurses have numerous possibilities, but a staffing agency must sponsor them. Again, working with an independent staffing recruiter and agency rather than directly with a hospital is preferable for international nurses.

Agencies are well-versed in assisting nurses working in the United States, and they have processes to guarantee that all information and paperwork is done correctly.

Acquire Your Nursing Employment Visa, often known as a “Work Visa”

Obtain one of the three available visas (TN visa, Permanent work visa, and H-1B visa) we have already mentioned.

Find a Registered Nursing Job in the United States

Many career advisers urge nurses to perform focused job searches on job boards specialized in their field. Start by looking through the available openings on the nurse.org job board. If you have a specific hospital in mind, you could check their website to see if they have any openings.

Is Any Nurse Position Eligible?

No, the Department of Labor has identified the nursing jobs that will be eligible. However, the good news is that most registered nursing roles will qualify, such as General Duty Nurses, Nurse Instructors, Nurse Practitioners, and School Nurses. Furthermore, the position must be full-time.

Are All Nurses permitted Immigrate to the U.S. as a Nurse?

Sadly, not all foreign-educated nurses can work in the United States. These nurses include, but are not limited to:

• Nurses with no more than two years of experience
• Nurses who do not have a four-year nursing degree
• People who have violated the law
• Nurses who a respected nursing agency does not sponsor

What are the Benefits of Immigrating to the U.S. as a Nurse?

The United States of America offers the best work benefits for nurses who immigrate to the U.S. Here are 6 reasons that nurses immigrate to the U.S. for work.

Progression in One’s Career

Nursing occupations in the United States provide excellent job stability. With a vast range of job routes to choose from, there is plenty of possibility for progress. Employers in the United States give nurses contracts for up to 30 months or 2.5 years at a hospital with the prospect of permanent placement. They are not required to return to their home nation after that. And they are typically free to hunt for work and develop a life and career in the United States.

Excellent Pay

Because of its wealth of resources, the United States is affectionately known as the “Land of Milk and Honey.” That means registered nurses are highly respected and in high demand. Per the Bureau of Labor Statistics, they receive a median annual pay of US$73,300 as of May 2019. (BLS). This makes the U.S. one of the top-paying countries globally for nurses, and career prospects are excellent.

Visa for Permanent Residency (The Green Card)

In the United States, the employer’s green card or permanent residency visa allows a nurse to stay in the nation eternally. Furthermore, if an EB-3 (green card) visa is issued, the nurse’s family members can travel to the United States, such as the husband and children under 21. The spouse is not obliged to work in the nursing industry. When they arrive, they may be able to find work. In other countries, migrant workers must achieve a specified pay band or position to be eligible for equivalent benefits.

High Living Standards

Nurses in the United States have access to high-quality public services and a good living level. Most businesses are kind, and they assist the nurse in covering the expense of lodging for the first month. They will also cover the cost of the housing security deposit. In addition, some companies in the United States incorporate cash rewards in their perk packages. This guarantees that nurses are well-cared for when they arrive.

Retirement Plan 401(k)

Nurses working in the United States are eligible for a complete 401(k) savings plan. This allows people to save money and earn interest while working. But, of course, that implies they’ll have enough money for retirement. The ideal part is that these savings are tax-free.

Inclusion and Diversity

Working in the United States requires nurses to interact with individuals from all areas of life. Employers place a premium on variety and inclusion in the workplace, which helps to guarantee that all employees are treated equally and respectfully, regardless of their origin, culture, sex, or religion. This provides nurses with a sense of comfort and security, allowing them to focus on providing exceptional care to their patients.

What Types of Nurses are In High Demand in The U.S.?

Here is a list of the most in-demand types of nurses:

Licensed practical nurses (LPN)

Licensed practical nurses (LPNs) collaborate alongside registered nurses and physicians to offer basic quality nursing care. Many new nurses begin their careers as LPNs to gather clinical experience before moving to an associate (ASN) or bachelor’s degree (BSN).

As the population continues to age, there is a greater demand for LPNs and their roles in long-term care settings, including rehabilitation institutions, residential treatment homes, and hospices. Based on the Bureau of Labor Statistics, jobs for LPNs is predicted to grow by up to 9% by 2030.

Registered nurse (RN)

Registered nurses (RNs) are critical in assisting healthcare institutions in providing quality treatment to a varied and expanding patient population. Based on the Bureau of Labor Statistics, RN positions are predicted to expand by 9% until 2030.

BSN-prepared nurses are in high demand in the job market and can rise to leadership positions faster than ASN nurses.

Travel nurse

Registered nurses who serve as travel nurses assist hospitals and healthcare companies in filling manpower shortfalls. Travel nurses, for instance, may fill in for nurses on maternity or sick leave, or they may be called to another country to assist with an emergency scenario such as a national disaster.

If you desire to serve people while also traveling the world, a job as a travel nurse may be for you.

Med-surgical nurse

A med-surg nurse works on a hospital’s medical/surgical floor. Because they frequently care for numerous patients at once, med-surg nurses must have excellent time leadership and operational abilities. In addition, to operate successfully with numerous healthcare team members, including physicians and surgical personnel, they must also be competent communicators.

A job as a med-surg nurse may be a good fit for you if you enjoy a quick working atmosphere where no two days are the same.

Emergency room nurse

Emergency department nurses give immediate treatment to patients in hospitals who have suffered potentially fatal injuries or diseases. Because ER nurses frequently collaborate with emergency medical personnel and first responders. They must have good communication, critical thinking, and teamwork skills to coordinate treatment and disseminate information across various teams.

You can work as an ER nurse in a number of settings, from Level 1 trauma centers to rural medical centers, and in several nursing specializations, from trauma to pediatrics. ER nurses are registered nurses who must have a minimum of an ASN.

Many ER nurses have a BSN and can pursue further qualifications for special treatment, including advanced cardiac, pediatric, and infant life support.

Oncology nurse

From early diagnosis to symptom management, oncology nurses are engaged in many facets of cancer diagnosis and therapy. They are most commonly hired in hospitals, although they can also work for home care groups, specialized medical facilities, and ambulatory centers.

While cancer affects people of all ages, the National Cancer Institute reports that those between the ages of 55 and 84 account for 69 percent of new cases. As a result, oncology nurses will become an ever more significant element of the healthcare industry as the baby boomer generation grows older and the pool of elderly cancer patients grows.

Nurse informatics specialist

Nursing informatics is a developing subject that combines nursing science with information technology to improve hospital and big medical facility systems and operations. While doing standard nursing responsibilities, a nursing informatics expert acts as a critical “technology liaison” for the hospital staff.

Their responsibilities may include, for example, assessing data to detect and decrease the risk of medical mistakes or reviewing and implementing new workflow procedures to improve patient care. As a nurse informatics expert, you are an important component of a hospital’s nursing and information technology teams.

Nurse manager

Nurse managers are skilled nurse leaders who supervise a team of nurses and other healthcare professionals. They contribute to improved patient outcomes and enable an organization to reach a higher level of care.

To successfully manage teams and coordinate patient care, competent nurse managers must have a mix of strong leadership, critical thinking, and communication abilities. If you want to help improve the quality of patient care, being a nurse manager may be the job for you.

Nurse educator

Demand for experienced nurse educators is increasing as more students seek admission to nursing degree programs. In addition, nurse educators plan and administer training courses for nursing students and practicing nurses in academic settings.

Nurse educators assist in training nursing staff and other health professionals in a hospital or other medical environment. In addition, as seasoned nursing practitioners, nurse educators may identify opportunities to enhance systems and reduce hazards to the patient, nurse, and hospital.

Nurse anesthetist

A nurse anesthetist is a subset of advanced practice registered nurses (APRNs) who are qualified and trained to provide anesthesia to patients. They can give treatment in various settings, such as hospitals, doctor’s offices, rural and underprivileged communities, and the military. They can also serve as teachers, researchers, or administrators in non-clinical contexts.

Per the Bureau of Labor Statistics, jobs for nurse anesthetists are predicted to expand by 13% by 2030, with a median yearly salary of $174,790. In addition, U.S. News listed Nurse Anesthetist #15 on its list of Best Healthcare Jobs for 2021 due to fast-growing employment and several professional progression prospects.

Nurse midwife

Nurse midwives are high-quality practice registered nurses who specialize in prenatal, family planning, and obstetric care. They frequently act as primary caretakers for women and their babies. They can also help with general health care for new moms and newborns, such as diet and illness prevention education.

Per the Bureau of Labor Statistics, jobs for nurse midwives are predicted to expand by 11% until 2030. A nurse midwife’s annual pay is $105,030.

Nurse practitioner

Nurse Practitioners (NPs) offer high-quality care in health promotion, prevention, wellbeing, disease prevention, and the diagnosis and treatment of acute, chronic, and episodic diseases. Family Nurse Practitioners (FNPs) are a subset of nurse practitioners who deal with patients of all ages.

Nurse practitioners are rapidly becoming the front line of patient treatment in certain rural or medically disadvantaged locations. The typical yearly compensation for a nurse practitioner is $109,820, per the Bureau of Labor Statistics, and the need for NPs is predicted to climb by 52% by 2030.

Indians Immigrating to The U.S. as Nurses

Indian nurses pursuing EB-3 visas are mindful of the lengthy wait times connected with this US visa type. However, pending legislation in the United States might soon correct this situation. The final action dates for Indian EB-3 visas did not change a single day between January 1, 2019, and the most recent US Visa Bulletin. Therefore, it is reasonable that Indian RNs are dissatisfied. However, two pieces of US legislation provide hope to perpetually wait for people.

These two articles of US legislation are as follows:

• Healthcare Workforce Resilience Act: Four U.S. senators introduced this act on April 30, 2020. This act responds to the evidenced shortage of US healthcare workers in the middle of the coronavirus pandemic. This act would permit the recapture of 25,000 professional nurses’ immigrant visas and would allow these visas to be issued irrespective of per-country limitations.
• The Fairness for High Skilled Immigrants Act: This act would cancel per-country caps and remove the backlog of retrogressed Indian EB-3 visas.

Let’s Sum Up

To legally immigrate to the U.S., you must complete the government standards detailed here. In addition, a Registered Nurse Immigrant Visa (“Green Card”), TN visa, or an H-1B visa will be required. Before receiving an occupational visa in the United States, nurses must undergo a screening procedure.

The visa library team is ready to answer your questions about immigrating to the U.S. as a foreign nurse. If you like to know more about other U.S. work visas, check the sidebar on the left.

FAQs

I am a nurse. Can I Get a Green Card in the US?

Yes, your US company might also be interested in sponsoring you as a candidate for a US Green Card.

Are All Nurses Eligible to Immigrate to the U.S. as a Nurse?

Not all foreign-educated nurses can work in the United States.

Can an Indians nurse immigrate to The U.S.?

Indian nurses pursuing EB-3 visas are mindful of the lengthy wait times connected with this US visa type. However, pending legislation in the United States might soon correct this situation.