U.S. immigration is like a door on a windy day - sometimes it blows open, and sometimes it blows shut.
For the moment, immigration policies are relatively favorable for foreign-born RNs and their employers.
This is due in large part to a law that was passed in May 2005 that created 50,000 additional green cards for RNs, physical therapists, their spouses and children. The law was passed because the wait times for green cards for nurses from the Philippines, India and Mainland China had backlogged 3 years.
Given the current nurse shortage, this was deemed unacceptable by Congress, and thanks to the extra visas, the backlogs were eliminated.
However, it appears the 50,000 green cards will only last to the end of 2006, and unless more are made available, the backlogs will return.
Hospitals, medical groups, and foreign nurses should therefore make every effort to begin the immigration process as quickly as possible.
The following are suggested guidelines for obtaining green cards on behalf of foreign-born nurses:
RNs Residing Abroad
In some cases, employers recruit RNs who are living abroad in countries such as the Philippines, India, and elsewhere. Before an employer can sponsor a foreign-born RN to come to the U.S., the following documents are needed:
- A diploma from a nursing school in her country;
- an RN license in her country; and
- a full and unrestricted license to practice professional nursing in the state of intended employment, or a certificate issued by the Commission on Graduates of Foreign Nursing Schools (CGFNS), or evidence of passing the NCLEX-RN licensing examination.
Again, these documents are needed before an employer can sponsor a nurse. Additional documents, which are described below, are required for the nurse to begin employment in the United States.
Most states also require foreign nurses to pass the CGFNS exam before taking the state RN licensing exam (NCLEX).
Meanwhile, the National Council on State Boards of Nursing (NCSBN) is expaniding its international reach. As of January, 2005, it became possible to take the NCLEX abroad in Hong Kong; London, England; or Seoul, South Korea.
Within the next year, it will be possible to take the NCLEX in Australia, India, Japan, Mexico, Canada, Germany and Taiwan as well as the three locations named above. In addition, RNs residing abroad may take the NCLEX in Guam and Saipan. (More information about NCLEX-RN can be found at the NCSBN Web site: www.ncsbn.org
Existing state prerequisite requirements for licensure must be met in order for the nurse to be eligible to sit for the NCLEX exam at an international site.
"Schedule A" Occupations
RNs and PTs are deemed "shortage" or "Schedule A" occupations by the U.S. Department of Labor.
Employers seeking to hire workers in "Schedule A" occupations, such as registered nursing, should submit their applications directly to the Citizenship and Immigration Service (CIS), completely bypassing the Department of Labor, and thereby saving time.
The immigration process begins when an employer submits an immigrant visa petition (Form I-140) to the CIS service center having jurisdiction over the nurse's place of intended employment. The petition must be accompanied by Labor Department's Form ETA-9089, a posting notice, a prevailing wage determination, and various other documents. The petition should be accompanied by a check for filing fees.
The CIS sends approved visa petitions to the National Visa Center (NVC) in Portsmouth, NH.
The nurse (or her attorney) receives a "fee bill" asking for all government processing fees to be paid in advance of processing her application and those of her immediate family members.
After fees are paid, the NVC forwards a packet to the nurse or her attorney containing biographical information forms to be completed by her and her family members, and a list of documents which must be submitted.
Next, the RN or her attorney sends the signed and completed forms and documents to the NVC, which then schedules an appointment for an Immigrant Visa for the RN and her family at the U.S. Consulate or Embassy where they will have their interviews for permanent residence.
Prior to the interview, the nurse must present various documents including the following:
- application for immigrant visa
- police clearance
- birth certificate
- marriage certificate, if applicable
- divorce decree or death certificate of spouse, if applicable
- valid passport
- medical examination results
- recent job offer letter (or employment contract)
- financial information regarding employer
- government filing fee
- VisaScreen Certificate