H-1Bs for Nurses:  What's the Magic Combination?

First in a Series

As the clock is ticking on the H-1B quota, USCIS informed there are more than 9,000 H-1B numbers still available, but remember that 6,800 of these numbers are reserved for citizens of Chile and Singapore under the Free Trade Agreements that the USA has with these countries. The real amount of remaining H-1B numbers is only about 2,600. The H-1B cap could be reached early in December.

Our phone has been ringing off the hook with last minute questions and requests for expedited handling.  Our healthcare clients who are eternally waiting for nurses in the retrogression pipeline want to file H-1B cases for desperately needed nurses.  They ask, "Why does it seem so complicated - most of our foreign nurses who are onboard, and those we want to hire, already have BSN degrees?"

Registered Nurses are generally not eligible for H-1B visas because all states permit nurses to be licensed with less than a 4 year bachelor's degree.  However, in certain instances, it may be possible to obtain an H-1B visa for a nurse where the petitioning employer can prove the following:
1)  A bachelors degree 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;
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.
What Positions Qualify and will meet the Requisite Requirements?
Category 1:  The first category of nurses who generally will be approved is the certified advanced practice registered nurse (APRN) category that includes:
        Clinical nurse specialists (CNSs)
        Certified registered nurse anesthetist (CRNAs)
        Certified nurse-midwives (CNMs)
        Certified nurse practitioners (NPs) fall within this category.
If an APRN position requires the employee to be certified in that practice, the nurse must possess an RN, at least a Bachelor of Science in Nursing, and some additional, graduate-level education. CNSs include Acute Care, Adult, Critical Care, Gerontological, Family, Hospice, Palliative Care, Neonatal, Pediatric, Psychiatric and Mental Health-Adult, Psychiatric and Mental Health-Child, and Women's Health nurses.  NPs include Acute Care, Adult, Family, Gerontological, Pediatric, Psychiatric & Mental Health, Neonatal, and Women's Health nurses.
Category 2:  The second category of nurses who may qualify for the H-1B are those in administrative positions requiring graduate degrees in fields such as nursing or health administration.
Category 3:  A final, more subjective group that may receive H-1B approval includes those who have a nursing specialty such as critical care and peri-operative nurses, or who have passed examinations based on clinical experience in school health, occupational health, rehabilitation nursing, emergency room nursing, critical care, operating room, oncology, and pediatrics, ICU, dialysis, cardiology -  but who are not APRNs.  
In the above instances, the employer must show that the nature of the particular position is so specialized and complex that one would normally expect the person performing the duties to have attained a bachelor's (or higher) degree, or its equivalent.
What is Required of the Employer?
1. The employer must offer a position as a Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), Certified Nurse-Midwife (CNM), or a Certified Nurse Practitioner (APRN-certified) Critical Care and the nurse holds the certification
2. The employer must offer a position working in an administrative position ordinarily associated with a Bachelors Degree, such as Charge Nurse or Nurse Manager or the more subjective group mentioned above in Category 3.
Remember, for citizens of Canada and Mexico, the TN visa or classification is available under the North American Free Trade Agreement (NAFTA) as an alternative to the H-1B visa for registered nurses and other professions listed in NAFTA.    

                                  What 's an Advanced Practice Nurse?

Advanced Practice Nurses (APNs) are Registered Nurses with advanced diadactic and clinical education, knowledge, skills and scope of practice.  Nurses practicing at this level are often educationally prepared at post-graduate level and may work in a specialist or generalist capacity. 

APN's utilize extended and expanded skills, experience and knowledge in assessment, planning, implementation, diagnosis and evaluation of the care required.  APNs demonstrate more effective integration of theory, practice and experiences along with increasing degrees of autonomy in judgements and interventions.

APNs form the basis for the role of Nurse Practitioner.  The Nurse Practitioner role is an expanded form of advanced practice nursing which is specifically regulated by legislation and by professional regulation.  Legislation may allow prescribing and referral, in addition to admitting privileges to healthcare facilities.

APNs use multiple approaches to decision making; manage the care of individuals and groups; engage in collaborative practices to achieve client outcomes; provide a supportive environment for colleagues; manage the utilization of staff and physical resources; engage in ethically justifiable nursing practice.

Next week we will discuss the Clinical Nurse Specialist and the Certified Registered Nurse Anesthetist.


If you have any questions pertaining to this information or are an employer and wish to discuss bringing H-1B nurses and other healthcare professionals onboard, please contact us for a free consultation at info@immigrationsolution.net  |  562 612.3996.