The vast majority of overseas RN’s enter the US with immigrant visas (also known as permanent residence or green cards). Some RN’s are eligible for nonimmigrant (temporary) visas, which are usually faster and easier to obtain.
An H-1B nonimmigrant visa is a temporary visa for professional workers in specialty occupations that normally require a bachelor’s degree as a minimum requirement. Most RN positions do not require a bachelor degree. Those higher-level positions such as administrative, supervisory or highly specialized occupations may be H-1B eligible. Examples of H-1B eligible are certified advanced practice nurses (APRNs), nurse practitioners, certified registered nurse anesthetists, and certified nurse-midwives. The H-1B visa is valid for three years and can be renewed for an additional three years.
If the job itself qualifies as a “specialty occupation” and the RN applicant is sufficiently qualified, the health care facility may petition for the H-1B on behalf of the nurse. The Department of Labor requires the filing of a "Labor Condition Application" (LCA) before the petition may be filed. Basically, the rules require the employer to "attest" that the RN will be paid the higher of the actual or prevailing wages, will not adversely affect other workers, and is not involved in a labor dispute. The nurse applying for the position must be properly licensed and must obtain a "visa-screen" certificate demonstrating that her education, licensing and training meets US standards, and that she possesses oral and written English skills appropriate to practice professional nursing in the US.
The visa screen requirement, which went into effect 7/26/04, can take many months to obtain, and the H-1B visa petition can be approved in 1-2 months, if a visa number is available.
Several years ago the USCIS (formerly INS) experienced a surge of fraudulent H-1B petitions filed by health care facilities claiming that the nurses they wanted to hire were all high-level supervisors or specialists, when in fact they were staff RNs. USCIS is now skeptical of all such H-1B visa petitions, so the professional duties of the position must be heavily and credibly documented. Spouses and dependent children may obtain H-4 visas as the dependents of the primary applicant for an H-1B visa. H-4s may study but not work without obtaining a separate work visa.
TN visas are available to Canadian nurses who are licensed registered nurses in a province or state and have an interim permit to practice in a US state. These TN visas are valid for up to one year at a time, with unlimited eligibility for one-year extensions, as long as the nurse promises to return to Canada. The TN process can be very fast and simple. No labor condition attestation or visa petition is required. As of July 26, 2005, however, Canadian RN’s may be required to submit a visa-screen certificate before obtaining a visa or entering the US. Spouses and dependent children may obtain TD visas as the dependents of the primary applicant for a TN visa. TDs may study but not work without obtaining a separate work visa.
The H-1C nonimmigrant visa is a temporary RN visa created in 1999 specifically for hospitals in medically underserved areas. Unfortunately only 500 such visas may be issued each year for the entire country, and the employer must meet the law’s rigorous attestation and recruitment requirements. Before a nurse may apply for an H-1C visa the hospital must receive permission from the Department of Labor. The hospital must be located in a federally-designated Health Professional Shortage Area as of March 30, 1997, have at least 190 acute care beds, have a qualifying percentage of Medicare and Medicaid patients, and must demonstrate its commitment to recruit and retain U.S. workers in order to remove its dependency on foreign RNs. This attestation process must be repeated every 12 months. Despite large investments of time and money, only ten hospitals in the US have been approved for H-1C visas. The regulations authorizing the issuance of H-1C visas expire in 2005. After that, H-1C visas will only be issued if Congress renews or extends the law.
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Permanent Visas for RN's 
