Nurses

IMMIGRANT VISA: REGISTERED NURSE IS A SCHEDULE “A” OCCUPATION

The Department of Labor (DOL) maintains a schedule of occupations in its regulations for which a labor certification procedure is not required.  The schedule of pre-certified occupations is referred to as Schedule A.  This applies to Professional or Registered Nurses (RN), together with Physical Therapists, which have been deemed occupations in shortage in the U.S., where there are not sufficient U.S. workers who are able, willing and qualified.

Who qualifies?

The Professional or Registered Nurse must:

1. Possess a diploma from a nursing school in her country, and
   an RN license from country of origin, and passed the examination given by the Commission on Graduates of Foreign Nursing Schools (CGFNS). Please see this link for more information: http://www.cgfns.org/cgfns/index.html
2. Or, must have a full, unrestricted license to practice nursing in the state of intended employment.  Please see this link for more information: http://www.ncsbn.org/
3. Or, evidence that the nurse has passed the NCLEX-RN licensing examination but cannot obtain a license because the nurse lacks a social security number.

Overview of the Process

1.  If the qualified RN is outside the U.S.:

• The sponsoring employer must file an Immigrant Petition with USCIS for the RN;

• Once the Immigrant Petition is approved, the petition is sent to the National Visa Center (NVC). 

If there is no backlog for immigrant visas from the RN’s native country, the NVC       forwards a packet to the RN or attorney containing forms to be completed by the

nurse and accompanying family member/s, if any.  This packet also contains the

list documents which must be presented at the RN’s interview for permanent

residence. If there is a backlog, NVC will wait until the RN’s priority date is current before a packet is forwarded for completion. After completion of NVC requirements, the RN will be scheduled for an interview at a U.S. Embassy/Consulate abroad.

As of January 2005, the Visa Bulletin published by the Department of State indicate that  visa availability under the E31 and E32 categories (including RN’s) for applicants from mainland China, India, and the Philippines has regressed to January 1, 2002.  This means that applicants from the above countries will have to wait until their priority date becomes current before they can submit an Application to Adjust Status to a Permanent Resident or before they can be interviewed at their local U.S. Consulate/Embassy to become eligible for Permanent Resident status.

2. If the qualified RN is in the U.S.:

• The sponsoring employer must file an Immigrant Petition with USCIS.
• If there is no backlog for immigrant visas from the RN’s country of birth (the “priority date” is “current”), an Application for Adjustment of Status may be filed concurrently with the Immigrant Petition.  Otherwise, an Application for Adjustment of Status to a Permanent Resident can be filed once the USCIS approves the Immigrant Petition and the RN’s priority date is current.
• The Nurse may start work as soon as the RN receives work authorization, which is an application filed together with the Application for Adjustment of Status.
• However, a RN will not qualify for permanent residence until she/he can present a VisaScreen Certificate to USCIS.

The VisaScreen Certificate certifies that the foreign national’s education, training, experience and license are comparable to that required of an American healthcare worker, meet all legal requirements for entry into the United States under the requested visa classification. The VisaScreen also certifies that the healthcare worker possesses a defined minimum level of English competence and that the Nurse has passed the CGFNS exam or the NCLEX exam.

A VisaScreen Certificate is issued only after the RN has demonstrated that:

1) the RN’s education, license and training in her/his country are equivalent to education, licensure and training in the U.S., and,

2) the RN’s level of competence in oral and written English are appropriate to practice professional nursing in the U.S.

Please see attached link for more information on the VisaScreen Certificate:

http://uscis.gov/graphics/howdoi/Health_Cert.htm

http://www.cgfns.org/cgfns/index.html

NONIMMIGRANT VISA: H-1B, Specialty Occupation

Generally, RN positions are not eligible for H-1B status.  An alien is eligible for H-1B status if he or she is in a specialty occupation.  A specialty occupation is generally one that requires a bachelor's or higher degree or its equivalent.  If a state requires a license for certain occupations, attainment of the full state licensure would satisfy the specialty occupation requirement. 

However, it is important to note that certain Advanced Practice Registered Nurses (APRN) or specialized nursing positions are H-1B eligible. Nursing positions that require certified advanced practice registered nurses (APRN) can be H-1B equivalent.  Some positions that fall within this category are clinical nurse specialist, certifiednurse practitioner, certified registered nurse anesthetist and certified nurse-midwife.  All of these positions normally require that the nurse be certified in that practice, in possession of an RN, at least a Bachelor of Science in Nursing (BSN) and additional graduate level education (i.e. master’s degree).

Moreover, certain nurses in administrative positions, such as an upper-level “nurse manager” in a hospital, may qualify for H-1B status since these positions normally require a bachelor's degree.  Nursing Services Administrators generally hold an RN as well as a graduate degree in nursing or health administration.

In addition, certain nursing specialties require a higher degree of knowledge and clinical experience than a typical RN position and may be H-1B equivalent.  Such specialties include school health, occupational health, rehabilitation nursing, emergency room nursing, critical care, operating room, oncology, and pediatrics.

It is important to note that each H-1B petition is evaluated on a case-by-case basis. In making its decision, USCIS considers the totality of requirements for the position as well as the individual’s qualifications.