Ways to Enter USA as a Nurse
After you have passed the necessary exams (usually the Commission on
Graduates of Foreign Nursing Schools exam CGFNS) and have been licensed by the
appropriate state agency, they will need to take the National Council Licensing
The NCLEX is typically taken after the nurses arrive in the U.S. with their
immigration visas, but it is possible to enter the U.S. to take the NCLEX on a
visitor visa (B-1 or B-2), and then return to the home country and wait for a
green card or work visa to be approved.
Most health care professionals, including nurses, will also need to complete a
screening program verifying their credentials in order to qualify for certain
I-140 - Employment-based Permanent Residency (Green Card)
The immigration method with the fewest requirements on the nurse and employer is
to apply for an employment-based green card. This allows a nurse to work in the
U.S. indefinitely, as long as the green card is renewed every ten years.
Nursing is one of the few professions that does not require a labor
certification to be filed before applying for an I-140 (unlike physicians), so
I-140`s can be approved in three to six months.
H-1B - For Positions Requiring at Least a Bachelor`s Degree
The H-1B visa can be used to hire skilled professionals that have at least a
bachelor`s degree and are filling a position that requires the same level of
Most registered nurses and nursing jobs do not meet this requirement, but if the
US employer is hiring foreign nurses for supervisory or management positions, or
for subspecialty areas that require a bachelor`s degree, an H-1B might be an
Additionally, if your facility hires nurses with bachelor`s degrees almost
exclusively, it is possible to make a case for using the H-1B to bring in
international nursing talent.
Depending on where your facility is located, approval of an H-1B visa can take
anywhere from two to six months.
H-1B`s last for three years, and can be renewed for another three.
Read more on:
Difficulties in Obtaining H1B Status for RNs
Who is the employer when a consulting company sponsors the H1B visa?
Can a consulting company hire nurses on an H1B Visa stating that the minimum
requirement for the job is an bachelor's?
See if you qualify for an H-1B
TN - For Canadian or Mexican Nurses
Registered nurses who are Canadian or Mexican citizens can work in the U.S. on
the TN visa, as long as they have a state or provincial nursing license. The TN
visa typically takes from one to six weeks to approve, and is good for one year.
It may be renewed in yearly increments an unlimited number of times.
H-1C - For Facilities in Underserved Areas
The H-1C visa was created in 1999 specifically for hospitals in areas with low
primary care physicians-to-patient ratios, typically in rural or inner-city
locations. Facilities must meet additional stringent standards, so stringent, in
fact, that the U.S. Department of Labor identified only 14 hospitals that
qualified to hire nurses on H-1C visas. These 14 hospitals face additional
restrictions: only 500 H-1C visas will be issued each year by the INS, and the
program limits the number of H-1C`s issued in each state to either 25 or 50,
depending on the state population.
H-1C visas are valid for three years, and usually take two to six months to
What is an H1B Visa?
The foreign worker:
A nonimmigrant in the H-1B category is an alien who is
coming temporarily to the U.S. to perform services in a "specialty occupation".
The alien is qualified through the appropriate degree, or through a combination
of education and experience equivalent to that degree. The worker may be entering
the U.S. for the first time or may already be working in the U.S., but pursuing
a change of employer.
The foreign worker must prove that he or she is qualified
for the specialty occupation and the particular job offered. One method is
to obtain a credentials evaluation of their foreign university degree, to show
that it is equivalent to that of a U.S. degree.
If the worker is already in
the U.S. and holds a valid nonimmigrant status, the H-1B visa can be extended
and revalidated in the U.S. If, on the other hand, the worker is not in lawful
status, or resides abroad, the H-1B visa must be obtained through a U.S. Consulate.
Since the H-1B visa is considered a temporary visa, there is a limitation
on periods of stay. The initial periods of stay may be approved for up to
3 years (usually depending on the occupation and/or the needs of the employer).
And after that, another 3 years are available, by filing forms for and extension
of stay. After the six years, the worker must spend one year outside the
U.S. before being entitled to another H-1B visa. However, many workers take
steps to obtain permanent residence (the Green Card) during their initial
Dependents of H-1B workers (spouses and children under 21) may be granted
an H-4 visa. Dependents with an H-4 visa are not permitted to work in the
The employer of a foreign worker:
To qualify as a U.S. employer, the
employer must have a U.S. taxpayer identification number.
When hiring an
H-1B worker, the employer must file a Labor Condition Application (LCA) with
the Department of Labor (DOL). This application requires the employer to
describe the position and the salary, as well as attest to facts concerning
the wage, working conditions, labor conditions and the giving of notice of
Once the LCA is approved, the employer then submits an I-129
Petition for nonimmigrant worker, along with related forms and supporting
documents, to the Immigration and Naturalization Service (INS). This form
documents that the job requires the services of a person in a "specialty occupation", and provides documentation that
the worker does, indeed, qualify for the job offered.
The employer of an H-1B
worker has certain responsibilities to meet. Once the I-129 is approved,
the employer must maintain wage and hour records, as well as information
concerning working conditions for similarly situated employees. Upon request,
these records must be provided to DOL?s Wage and Hour Division.
If the appropriate
records are not maintained, the employer could be liable for substantial
penalties and fines, even lose the right to apply for immigrant and nonimmigrant
visas for up to one year. If the worker is terminated any time during the
approved period of stay on the I-129, the employer is responsible for paying
for the worker?s return transportation to his or her foreign residence.
The H-1B Visa - What are the Steps and Processing
What are the steps and the
time involved in the H-1B process?
Answer: Approximately 6 - 10 weeks, if all goes well!
As soon as the prospective employer suspects they will be hiring a new
foreign worker, or need to extend an H-1B visa, the completion of the Prevailing
Wage Determination and Labor Condition Application can begin. Depending on the
state, obtaining the Prevailing Wage Determination varies in difficulty and time
involved (from a few days to 2 weeks or more).
In order to begin the Prevailing Wage Determination and the Labor Condition
Application, we will need the following information:
- Kind of the profession
- Job title and requirements (educational & experience)
for the job
- Salary to be paid
- Employer's name and address
- The physical address where the foreign worker will actually perform the
- Type of setting where job will be performed
What information/documentation is required to begin the processing of an
1. Information/Documentation needed from the
foreign worker , this is what
we need from the foreign worker in order to process his/her H-1B visa. There
may be items that the foreign worker does not have or is not familiar with.
Those items are not applicable and can be ignored/skipped.
If Spouse and Children are residing in the U.S. at the time we file for the
foreign worker's H-1B visa: items listed are needed in order to process their
If Spouse and Children are overseas when we file the H-1B, there is not
paperwork for us to file here in the U.S. Spouse and Children must appear at a
U.S. Embassy to apply for an H-4 Visa.
2. Information/Documentation needed from the
Employer , this is what we
need from the employer in order to process an H-1B visa. Once an employer is
established with us, we only need the information specific for each potential
new employee such as job title, detailed job description, salary offered, etc.
Once the Prevailing Wage Determination is obtained...the ETA 9035 - Labor
Condition Application (LCA) can be completed and posted at the work site (to be
left up for 10 consecutive days in two conspicuous places). As soon as the LCA
(or a notice of the filing) has been posted, we can then file the LCA with the
Department of Labor. In approximately 10 - 14 business days, the approved
(certified) copy of this form will arrive in our office. We will fax a copy of
the filed form to the employer, with instructions about giving a copy of the LCA
to the (prospective) employee.
As soon as we receive all the information/documentation from the foreign
worker and the employer, and while we wait for the approved LCA, the paperwork
for the petition can begin. When the all information has been transferred onto
the INS (Immigration and Naturalization Service) forms, authorized signatures
are obtained. When all forms are signed and the certified LCA arrives, all is
packaged and sent to INS.
Credentials Evaluation (Education/Work):
If an education credentials evaluation was
not obtained as a part of a licensure requirement (as in the rehab professions),
many times, the INS requires that an evaluation of the foreign workers credentials
be performed and added as supporting documentation to the visa application.
This evaluation is done to make sure that the foreign worker's degree is equivalent to a U.S.
degree. If an evaluation has not already been completed, we must have good,
readable copies of the foreign worker's degree certificate(s), transcripts or
mark sheets, any professional development course certificates and translations
of any documents that are not in English.
The more information provided to us, the faster the education evaluation may
be performed. Usually the cost for an education evaluation is approximately
$125.00, however in some cases it may cost more.
The credentialing process usually takes approximately 2 weeks to complete and
is customarily performed at the same time that the Department of Labor is
processing the LCA. Therefore, the credentialing process normally does not delay
Approximately 4 - 8 weeks:
In approximately 14 - 21 days after mailing
the I-129 Petition to INS, a
"Receipt Notice of Action", form I-797, is received in our office.
This means that INS has received the file and is beginning to process it. If
this notice is not received in at least 21 days after mailing, we will
investigate. If INS is satisfied with the file, they will send an "Approval
Notice of Action", form I-797, usually within 14 - 36 days of the Receipt
Notice. If we do not hear anything after 36 days, we will investigate!
Occasionally, between the Receipt Notice and the Approval Notice, a letter
from INS may be received requesting more information or clarification of a fact.
With the employer's cooperation and/or the cooperation of the foreign worker, we
simply comply with their request. If this happens, it can delay the process
another 10 -14 (or more) days.
Additional information that may be helpful during the hiring process:
General questions that may be asked of the foreign workers during an
interview to qualify a potential employee's immigration status.
General immigration terms that may be encountered during the immigration
When the Approval is received - Final Step!
If the foreign worker is residing in the U.S. and has maintained valid
immigration status, he or she may now go to work for the new employer.
If the foreign worker is outside the U.S., they may now go to the U.S.
Embassy listed on the I-129 Petition to have the visa issued and stamped, after
which, they may enter the U.S.
Please note that there are many, many situations and types of visas that a
person could experience. The above information will hopefully give you a brief
overview of the most common things you will need to know before applying for the
H-1B visa. Anytime you have questions about a particular situation, contact an
What is a Green Card and how do I get one?
What is a Green Card?
Permanent residence status, symbolized to many people
by the so-called "green card", which is actually pink, confers on
foreign nationals the right to live and work in the U.S. without time limitations.
The two most common ways to obtain permanent residence is by close family
ties to a U.S. citizen or permanent resident, or through employment with a
U.S.-based employer. For purposes of this discussion, the employment based
visa will be our focus. There are two main phases to the process.
Phase I: The alien must be sponsored by the employer, who files a petition with INS
to have the alien classified as a person qualified to immigrate.
Phase II: Once the alien is found qualified to immigrate, he or she may proceed to apply
for permanent resident status. This can been done through Consular Processing
or by Adjustment of Status.
Once the immigrant visa is issued, the permanent
resident may then travel freely on the visa, and my accept employment without
restrictions. It is not clearly stated, but we recommend that the foreign worker
remain employed by the sponsoring employer for at least six (6) months after
the visa is issued to show good intent regarding the employment relationship.
The above information has been taken from immigration related sources, readily
available to the public and should not be conceived as legal advice or legal
direction. Information shown is greatly condensed. If an H-1B visa is in your
future, be sure to contact an immigration specialist to assist in the process.