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Registered Nurse (R.N.) 

Immigration Options

REGISTERED NURSE

Are you a registered nurse looking to coming to the United States to work as a R.N.? If so, there are three potential ways you could make that dream a reality. In the past, the United States offered the H-1C visa but has stopped issuing this visa for over 10 years now (2009).

Now, there are three legitimate ways to immigrate to the United States to work as a nurse. You can apply for a H-1B Visa, a TN Visa or an EB-3 Visa. Let’s discuss each option in detail and begin to determine which category you may be eligible for. As always, please feel free to schedule a free consultation with our Law Office, we are here to help you as much as possible.

H-1B VISA

The H-1B visa classification allows a U.S. employer to petition for a temporary worker in a specialty occupation. The H-1B visa is available for a three-year period that may be extended for an additional three years. Please keep in mind that H-1B visas are available for a great amount of professions and as such it may be difficult in obtaining a H-1B visa because they are a cap-subject visa. The annual cap is 65,000 H-1B visas per year.

Most registered nurse (RN) positions do not qualify as a specialty occupation because they do not normally require a U.S. bachelor’s degree or higher degree in nursing (or its equivalent) as the minimum for entry into those particular positions.

Requirements for H-1B Classification in a Specialty Occupation

The H-1B visa classification allows U.S. employers (petitioners) to petition to hire employees (beneficiaries) to work in specialty occupations. The term “specialty occupation” means an occupation that requires: (1) theoretical and practical application of a body of highly specialized knowledge; and (2) attainment of a bachelor’s degree in the specific specialty (or its equivalent) as a minimum requirement for entry into the occupation in the U.S.

To qualify as a specialty occupation, the regulations require that the petition demonstrate that the position meets at least one of the following criteria:

  • A bachelor’s or higher degree or its equivalent is normally the minimum requirement for entry into the particular position;

    • Note: Most RN positions do not qualify as a specialty occupation for a H-1B visa because they do not require a bachelor’s degree

  • The degree requirement is common to the industry in parallel positions among similar organizations or, in the alternative, an employer may show that its particular position is so complex or unique that it can be performed only by an individual with a degree;

  • The employer normally requires a degree or its equivalent for the position

    • Note: Most RN positions do not qualify as a specialty occupation for a H-1B visa because they do not require a bachelor’s degree

  • The nature of the duties [is] so specialized and complex that the knowledge required to perform the duties is usually associated with the attainment of a bachelor’s degree or higher degree

For an H-1B petition to be approved, the petition must establish that the offered position meets all of the applicable statutory and regulatory provisions.

R.N. Eligibility

  • A U.S. employer must offer you a job.

    •  This means that an employer/employee relationship must exist. The reason for this is because the employer must file a USCIS Form I-129 Petition for Non-Immigrant Worker on your behalf.

    • A RN is an individual who has graduated from a state-approved school of nursing, passed the NCLEX-RN Examination and is licensed by a state board of nursing to provide patient care.  See NCSBN’s website.

  • You must have a Bachelor’s degree or higher.

    • The H-1B visa exists for nurses with a bachelor’s degree or higher. 12 years of relevant work experience can substitute for a formal education.

  • Employment in a Specialty Occupation

    • A specialty occupation is a job that requires a bachelor’s degree or higher. Some of these RN positions, depending on the facts of the case, may qualify as specialty occupation:

    • Addiction nurses

      • Duties: Care for patients who need help to overcome additions to alcohol, drugs, tobacco, and other substances.

    • Cardiovascular nurses

      • Duties: Care for patients with heart disease and people who have had heart surgery

    • Critical care nurses

      • Duties: Work in intensive care units (ICU) in hospitals, providing care to patients with serious, complex and acute illnesses and injuries that need very close monitoring and treatment

    • Emergency room nurses

      • Duties: Work as part of a team with physicians, other nurses and healthcare professionals to provide care, monitor health conditions, plan long-term care needs, administer medicine, use medical equipment, perform minor medical operations, and advise patients and their families on illness, care and continued care after a hospital stay.

    • Genetics nurses

      • Duties: Provide screening, counseling, and treatment of patients with genetic disorders, such as cystic fibrosis.

    • Neonatology nurses

      • Duties: Take care of newborn babies.

    • Nephrology nurses

      • Duties: Care for patients who have kidney-related health issues stemming from diabetes, high blood pressure, substance abuse, or other causes.

    • Oncology nurses

      • Duties: Combine their scientific knowledge, technical skills, and caring to help people living with cancer and their families throughout the cancer journey – from diagnosis and treatment to survivorship and end-of-life care.

    • Pediatric nurses

      • Duties: Work with patients from infancy to young adulthood, giving developmental screenings, immunizations, and treating common illnesses.

    • Peri-Operative (Operating Room) nurses

      • Duties: Have a hands-on role, directly assisting surgeons during a procedure. For instance, they may help to suction the incision site or suture a wound.

    • Rehabilitation nurses

      • Duties: Care for patients with temporary or permanent disabilities.

    • Other nurses

      • Duties: Have jobs in which they do not work directly with patients, but must still have an active registered nurse license.

Advanced Practice Registered Nurses - Advanced practice registered nurse defines a level of nursing practice that utilizes extended and expanded skills, experience and knowledge in assessment, planning, implementation, diagnosis and evaluation of the care required. Positions that require nurses who are certified APRNs will generally be specialty occupation due to the advanced level of education and training required for certification.

  • Certified Nurse-Midwife (CNM)

  • Certified Clinical Nurse Specialist (CNS)

  • Certified Nurse Practitioner (CNP)

  • Certified Registered Nurse Anesthetist (CRNA).

  • Be Paid the Prevailing Wage

    • The employer must pay you at least the prevailing wage for the specialty occupation in the area of intended employment

  • Licensure

    • You must meet the licensure for the state/national requirements for the specialty occupation

      • This includes having your transcript evaluated by a Nursing Commission such as CGFNS, ERES or IERF.

      • You must pass the English Proficiency test from Test of English as Foreign Language (TOEFL) or International English Language Testing System (IELTS).

    • You must take and pass the NCLEX.

      • For more information about this process contact us.

    • You must be licensed in the State that your Employer is sponsoring you to work

      • You must pass the state nursing licensing exam. States allow for licensure by endorsement which means that once a nurse is granted a valid license in their home state, they can apply and pay applicable fees in any other state and be granted a license in the new state. There are several publically available databases where state requirements and nurse licensure can be verified, including the National Council of State Boards of Nursing (NCSBN), Nursys Licensure Quick Confirm, and Nursys Licensure Verification.

      • Many states also participate in a licensure compact, which enables multistate licensure for nurses. The Nurse Licensure Compact (NLC) allows an RN and licensed practical/vocational nurse (LPN/VN) to have one multi-state license in a primary state of residency (the home state) and to practice in other compact states (remote states), while subject to each state’s practice laws and discipline. Under the NLC, foreign nurses applying for licensure in a compact state may declare either the country of origin or the compact state as the primary state of residency. If the foreign country is declared the primary state of residency, a single-state license will be issued by the compact state. To date, APRNs are not included in this compact. Therefore, APRNs must apply in each state in which they practice, unless exempted when employed in a federal facility.

Evidence to Establish a Position Qualifies as a Specialty Occupation

When submitting an H-1B petition, the petitioner must show by a preponderance of the evidence that the proffered position qualifies as a specialty occupation. As in other visa classifications administered by the USCIS, the preponderance of the evidence standard requires that a petitioner show that what it claims is more likely the case than not. This is a lower standard of proof than both the standard of “clear and convincing evidence,” as well as the “beyond a reasonable doubt” standard that applies to criminal cases.

In determining whether a petition meets the preponderance of the evidence standard, adjudicators will consider all of the evidence in the record of proceeding. Such documentation submitted by petitioners often includers evidence regarding:

  • The nature of the petitioner’s business

  • Industry Practices

  • A detailed description of the duties to be performed within the petitioner’s business operations

  • Advanced certification requirements

    • There are many advanced certifications available to nurses, including certifications for Critical Care Registered Nurse, Progressive Care Certified Nurse, Critical Care Registered Nurse e-ICE, Critical Care Clinical Nurse Specialist, Acute Care Nurse Practitioner, Certified Nurse Manager and Leader, Cardiac Medicine Sub-Specialty Nurse, and Cardiac Surgery Sub-Specialty Nurse

  • ANCC Magnet Recognized status

  • Clinical experience requirements

  • Training in the specialty requirements; and

  • Wage rate relative to others within the occupation

Officers must review each piece of evidence for relevance, probative value, and credibility, both individually and within the context of the totality of the evidence to determine whether the proffered position more likely than not qualifies as a specialty occupation. The duties of the position should be evaluated against the four regulatory criteria listed in 8 C.F.R. 214.2(h)(4)(iii)(A) with the understanding, again, that the required degree must be one in a specific specialty. While USCIS recognizes the OOH as one authoritative source of the duties and educational requirement of the wide variety of occupations that it addresses, the OOH is not always determinative. Other authoritative and/or persuasive sources provided by the petitioner will also be considered.

As such, the H-1B Visa is a viable option depending upon your qualifications If you want to determine if you are eligible feel free to contact us to set up a free consultation.

TN Visa

The TN Visa is another option available to come to the United States to work as a Nurse. However, the TN Visa is only available to Canadian and Mexican Nationals. For more information about TN visas please click here. As always, feel free to contact us to set up a free consultation.

EB-3

An EB-3 Green Card provides permanent residency within the U.S. An employer can file an I-140 Petition for Alien Worker on your behalf as a nurse if they are seeking to hire you. For more information about the EB-3 Green Card and application process please click here. As always, feel free to contact us to set up a free consultation.