Healthcare Immigration Primer: Registered Nurses
TEMPORARY OPTIONS: Registered Nurses are generally not eligible for H-1B status because the position generally does not require at least a Bachelor's degree or the equivalent. However, it is possible to obtain H-1B status for a Registered Nurse if the position requires a Bachelor's degree or the equivalent. H-1B status provides temporary employment authorization in the United States for individuals from any country for any specialty occupation. A specialty occupation is one which normally requires at least a Bachelor's degree or the equivalent.
A Registered Nurse who is a Canadian Citizen is eligible for TN status. [Note: Residency status in Canada is not sufficient for TN eligibility.] TN status is available to Canadian citizens with an offer of employment in the United States in one of forty-three listed occupations.
GREEN CARD OPTIONS: Because Registered Nurses have been designated by the U.S. Department of Labor as a 'Schedule A occupation', they are exempt from the labor certification process ("PERM") required for most employment based immigrant visas. Therefore, the green card process for a Registered Nurse will be either the Schedule A I-140 Petition (Consular Processing) if they are outside of the United States or the Schedule A I-140 Petition (Adjustment of Status) if they are already physically present in the United States.
CURRENT ISSUES: Because some Employers do in fact require a Bachelors degree or the equivalent for some Registered Nurse positions, some Registered Nurses are eligible for H-1B status. The USCIS has acknowledged that certain Advanced Practice nurses as well as some specialty nurse positions (such as Critical Care and Peri-Operative) may be eligible for H-1B status.
To qualify as a specialty occupation [according to 8 CFR ß214.2(h)(4)(iii)(A)], the position must meet at least one of the following criteria:
A baccalaureate or higher degree or its equivalent is normally the minimum requirement for entry into the particular position
The degree requirement is common to the industry in parallel positions among similar organizations or, in the alternative, the 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
The nature of the specific duties are so specialized and complex that knowledge required to perform the duties is usually associated with attainment of a baccalaureate or higher degree.
The USCIS takes the position that each year of education is equivalent to three years of experience. Thus, for example, an employer that normally requires a Bachelor's degree in Nursing or an Associate's degree and at least six years of experience is able to attest that the position normally requires a Bachelor's degree or the equivalent.