Temporary Visas for Nurses

Although most RNs do not qualify for temporary working visas, it is possible to obtain temporary visas or work permits for nurses in the following categories:
Trade NAFTA Work Permits
Nurses who are citizens of Canada are exempt from visa requirements. They may work in the U.S. in Trade NAFTA (“TN”) status if:

1. They have an offer of employment from a U.S. employer for a period not to exceed one-year;

2. They are licensed in Canada and in the state of intended employment;

3. They have a proof of Canadian citizenship; and

4. They pay a small fee to enter the U.S.

TN status may be renewed on a yearly basis either by having the nurse reenter the U.S. with the documents listed above, or by requesting an extension of TN status from the INS Service Center in Lincoln, Nebraska.
A TN nurse is not supposed to have any intention of remaining permanently in the U.S.

Nurses who are citizens of Mexico may also qualify for TN status. However, for Mexican RNs, the procedure is considerably more complex than for Canadians. The employer must submit a Labor Condition Application (“LCA”) to the Department of Labor and a nonimmigrant visa petition (form I-129) to the INS Service Center in Lincoln, Nebraska. Once the LCA and the petition are approved, the RN must apply for a TN visa at a U.S. consulate in Mexico.

At the present time, the VisaScreen requirement is waived for all nonimmigrant nurses. However, when proposed INS regulations issued on October 11, 2002 become final, the VisaScreen requirement will apply to persons employed as RNs on temporary visas.

H-1B Specialty Occupation Status

Traditionally, RNs have been considered “professionals” under U.S. immigration laws. From 1952 to 1989, U.S. employers could employ foreign-born nurses using “H-1” temporary visas. In 1989, the Immigration Nursing Relief Act (INRA) was enacted as a five-year pilot program. INRA provided that only health care facilities with “attestations” approved by the Labor Department could obtain “H-1A” status to employ nurses on a temporary basis in the U.S.

Other occupations which formerly fell within the “H-1” category became part of the new “H-1B” category. The Immigration Act of 1990 provided that only those occupations for which a four-year university degree was a prerequisite for employment could qualify for “H-1B” status. However, in 1991, the “H-1B” category was amended to include certain foreign-born fashion models.
Although a commission appointed by the Secretary of Labor recommended that INRA be extended, Congress allowed the law to expire in 1995. Thereafter, health care facilities could no longer petition for additional foreign-born RNs to obtain H-1A visas. The last H-1A visas expired in 1997.

The H-1B category is an ineffective vehicle for most health care facilities who wish to employ RNs since the minimum entry requirement for most staff RN jobs is a two-year associate degree rather than a four-year bachelors’ degree. However, where a facility can justify that a four-year degree (or equivalent) is the minimum entry requirement for a job, such an RN may be granted an H-1B visa. An INS memorandum, dated November 27, 2002, explains the requirements for a registered nurse to obtain H-1B status in detail.

H-1C Registered Nurses In Medically Underserved Areas
In November 1999, the President signed the Nursing Relief for Disadvantaged Areas Act of 1999 (NRDAA). The law provides an opportunity for certain hospitals in medically underserved areas to employ up to 500 nurses nationally in temporary “H-1C” status.

The law requires hospitals to obtain attestations from the Department of Labor as a condition of submitting visa petitions for H-1C nurses to the INS. In order to obtain an attestation, a hospital must fulfill a number of conditions: be located in a federally-designated Health Professional Shortage Area as of March 30, 1997, have a minimum of 190 acute care beds, have a qualifying percentage of Medicare and Medicaid patients, etc.
In response to a request under the Freedom of Information Act, the Labor Department responded on October 16, 2001, that 17 hospitals had submitted attestations. They reported that 10 had been approved, two were being held at the request of the employer, and five had been denied. Only one hospital had appealed the denial of its attestation, and this appeal was withdrawn on June 4, 2001.