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The Current State of International Nurse Recruitment
Date Posted: 14/Apr/2013


As someone who has been involved in international nurse recruitment for quite some time, it always surprises me how many people I talk to who seem confused about the current options. Lots of folks still talk about visa retrogression and many even seem to be confused about the meaning of this term and the relevance for international nurse recruitment.
Of course, visa retrogression generally refers to the wait times for immigrant visas, which are currently around 5 years for employment based candidates from most countries with Bachelor’s degrees in all professions, from accounting to chemical engineering to nursing.
Based on these wait times, many hospital HR managers seem to conclude that they have to wait over 5 years from the time they sponsor a candidate for a visa, to the time the foreign worker can commence employment in the United States.
However, nothing could be further from the truth. Several work visas are currently available for international nurses who meet all applicable qualifications including H-1B visas, TN visas for nurses from Canada and Mexico and E-3 visas for Australian nurses.
It think it is also important to understand that the vast majority of international nursing professionals coming to the United States do not start their employment on an immigrant but rather a work visa, and apply for the immigrant visa once they have established a certain amount of work history in the US.
Once the immigrant visas has been applied for, international professionals on H-1B visas are allowed to continue their employment in the US until their immigrant visas have been successfully processed. Therefore, the wait time for such immigrant visas – while frustrating for the candidates – does not have any negative consequences for their ability to work for their US employer. Subsequently, I would argue that the continuing talk about visa retrogression is rather misleading and counterproductive.
It is true that immigrant visas specifically designed for international nurses coming to the US were available several years ago, and some people still hope for the return of such visas. Instead of hoping for the return of such immediate immigrant visas – the availability of which brought with it its own set of problems – it might be more beneficial for US hospitals interested in recruiting international nurses to focus on and to understand the visas currently available to them and qualified international nursing professionals.
The main work visa available to international nurses is called H-1B. Some people maintain that such visas cannot be used for international nurses. However, hundreds of H-1B visas have successfully been applied for and approved by USCIS for international nurses employed in a clinical setting.
Unfortunately, not many immigration lawyers in the US truly understand and have the necessary experience to successfully process such visas. However, we are aware of various law firms who are in a position to help hospitals to understand the requirements for successful nurse visa sponsorship.
One of the main requirements to qualify for an H-1B visa as a foreign professional is to have a Bachelor’s degree in their chosen field of employment, which includes international nurses. International nurses without a Bachelor’s degree could still qualify for an H-1B visa if they have a high level of nursing experience in addition to their foreign nursing degree. The requirements for E-3 visas are similar in nature while the TN visas are even less restrictive.
Since a Bachelor’s degree in nursing or a high level of work experience is required for the H-1B visa, the prospective US employer of foreign workers subsequently needs to be able to proof to US immigration that their current workforce – including US workers – in a certain area of employment in which the foreign worker is to be employed meets the same requirements.
In other words, if a US hospital intends to recruit international nurses with a BSN degree into a certain hospital department such as ICU, it has to be able to show that the nurses currently employed in such ICU department meet the same standards of either having a BSN degree or a high level of work experience.
Such a requirement may seem cumbersome to some and not all US hospitals will be able to fulfill these requirements. However, those hospitals who are able to meet these requirements will find the process rather straight forward. 
Besides, due to the relatively small numbers of international nurses who have been recruited by US health care facilities in the last few years, there is a large pool of highly qualified candidates interested in nursing opportunities in the United States.
One should also keep in mind that these visa requirements for both international nurses and US hospitals will only help to increase the standard of nursing practice in the US, by only allowing highly qualified international nurses in certain specialty areas to enter the US workforce. 
About the Author: Thomas A. Simon is president of European Medical Staffing Ltd., ( based in Austin, Texas.


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