A U.S. company, such as a hospital or clinic, would submit an I-129 petition to the United States Citizenship and Immigration Services in order to get an H-1B visa for a foreign nurse (USCIS). The agency makes the decision about whether or not to grant the worker’s employer’s request for H-1B status.

U.S. Immigration for Nurses: Obtaining Work visas and Green Card

There is a significant demand for nurses in the United States. The U.S. government offers numerous options for foreign nurses who wish to relocate there. Certain types of immigrants receive preferential treatment under U.S. immigration law by having a variety of choices available to them for temporary work visas and permanent residency/a green card.

Foreign nurses are one of the immigrant types who get this preference because there is a shortage of medical professionals in the United States. The U.S. government has established various procedures that can facilitate their ability to work and reside in this country.

Foreign-born nurses can either work temporarily or can obtain a green card. H-1B visa is a popular visa for foreign nationals to work in the US temporarily. The H-1B is a visa category that allows employers to hire foreign professionals to work in “specialty occupations” that require at least a bachelor’s degree or the equivalent.

1. Obtaining an H-1B visa for a foreign nurse:

To obtain the H-1B, the employer, such as a hospital or medical clinic, should file an I-129 petition with the United States Citizenship and Immigration Services (USCIS) on behalf of an employee.

The USCIS examines the application and the employee’s qualifications to approve the visa. The employer is responsible for submitting a complete petition and proving the job opportunity falls under the “Speciality Occupation” category that requires specific skills and qualifications.

1.1. What kinds of nurses can qualify for H-1Bs?

The USCIS clarified that regular registered nurse positions are not eligible for H-1B visas unless the state in which the nurse is seeking licensure requires a bachelor’s degree.

Advanced practice registered nurses (APRNs) will generally qualify for H-1B visas because these are advanced level positions requiring more education and training than the typical Registered Nurse.

An employer may require that the prospective employees hold advanced practice certification as one of the following: clinical nurse specialist (CNS), certified registered nurse anesthetist (CRNA), certified nurse-midwife (CNM), or certified nurse practitioner (APRN[1]certified).

If the APRN position also requires that the employee be certified in that practice, then the nurse will be required to possess an RN, at least a Bachelor of Science in Nursing (BSN), and some additional graduate-level education.

1.2. The following positions that will normally qualify for an H-1B visa:

1. Clinical Nurse Specialists (CNS): Acute Care, Adult, Critical Care, Gerontological, Family, Hospice and Palliative Care, Neonatal, Pediatric, Psychiatric, and Mental
   Health-Adult, Psychiatric, and Mental Health-Child, and Women’s Health
2. Nurse Practitioner (NP): Acute Care, Adult, Family, Gerontological, Pediatric,
   Psychiatric & Mental Health, Neonatal, and Women’s Health.
3. Certified Registered Nurse Anesthetist (CRNA); and
4. Certified Nurse-Midwife (CNM)

1.3. To qualify for an H-1B visa, an employer of a nurse must show the following:

1. A bachelor’s or higher degree (or its equivalent) is normally the minimum requirement for entry into the position.
2. The degree requirement is common to the industry for parallel nursing positions (i.e., employers in the same industry require their employees to hold the degree when they are employed in the same or a similar position).
3. The employer normally requires a degree or its equivalent for the position or the nature of the position’s duties is so specialized and complex that the knowledge required to perform the duties is usually associated with the attainment of a bachelor’s or higher degree (or its equivalent).
4. Employers who can meet these requirements and can show they are paying the prevailing wage for the job can apply for an H-1B visa.

2. Obtaining a U.S. Green Card as a Foreign Nurse:

To acquire permanent residency status, the United States employer should sponsor the foreign national for a Green Card.

The employer must first offer the employee a full-time, permanent nurse position. And the employer must complete a process known as “Labor Certification” on behalf of the worker.

The labor certification process is done using a system called Program Electronic Review Management (PERM). This application must be finished before leaving for the United States, and a visa must be obtained before immigrating legally.

2.1. Labor Certification Process for Foreign Nurses

1. The labor certification process is different and easier for nurse positions. A nurse position falls under the “Schedule A” category job position.
2. The U.S. government has identified Schedule A positions as those for which additional people are required. Since the U.S. government is already aware of the labor shortage for Schedule A employment, employers are not required to post advertisements for these positions (a typical PERM requirement).
3. To file the PERM for a foreign nurse, the employer requires to complete and submit the ETA Form 9089 along with an I-140 petition to USCIS. The ETA Form 9089 is submitted to the Department of Labor for all non-Schedule A positions.
4. Once the I-140 is approved, the nurse can apply for a U.S. green card by filing the I-485, adjustment of status application, with USCIS. The employer must post a notice in the place of business that gives ‘Notice of the Labor Certification’ filing to the other employees.

3. Certification by the CGFNS

All foreign nurses must prove to the USCIS that they are “certified” to work in the medical field in the United States. The foreign nurse must be certified by the Commission on Graduates of Foreign Nursing Schools (CGFNS).

The applicant must send all their qualifications and educational credentials to CGFNS. The CGFNS will review these documents and issue a certification for the candidate. The certification confirms the following:

1. The state has validated that the nurse’s foreign license is genuine, and the nurse has a current, unrestricted license in the U.S. state where he or she will work.
2. The nurse has passed the NCLEX, which is required for nursing licenses in the United States.
3. The nurse has a degree in nursing from an English-speaking course.
4. The country where the nursing program was located had been approved by the United States as a place to receive medical training, and
5. The nursing program had already started by November 12, 1999, or before.

The employer must include the CGFNS certificate with every visa or green card petition filed on the nurse’s behalf.