Hiring specialty nurses

Healthcare organizations continue to struggle with the nursing shortage, especially across some specialties. Many organizations look to foreign-educated nurses or international students educated in the U.S. to help augment the nursing supply, however, the nurses must obtain work authorization from the US Citizenship and Immigration Service (USCIS).

The H-1b visa classification allows a U.S. worker to employ a foreign worker in a specialty occupation. A specialty occupation – by immigration standards – means an occupation that requires at least a bachelor’s degree or equivalent. Many healthcare occupations qualify: physical therapists, medical technologists, occupational therapists and speech language pathologists. Yet RN positions are different because RN positions don’t normally require a bachelor’s degree. Instead, RN’s usually take one of three educational paths: a bachelor’s degree, an associate’s degree or a diploma from an approved nursing program.

A Changing Industry

The USCIS has recognized the nursing industry has been changing in the last few decades. One change is the increase in magnet status. The American Nurses Credentialing Center (ANCC) Magnet Recognition Program recognizes healthcare organizations that advance nursing excellence. Achieving magnet status indicates a nursing workforce meets high standards of education and quality. The USCIS has noted “the private sector is increasingly showing a preference for more highly educated nurses” and specialties are becoming more common.

As a result, the USCIS has recently issued guidance to help its officers recognize some nurse specialties that may qualify for H-1b. The guidance lists cardiovascular nurses, critical care nurses, emergency room nurses, genetics nurses, neonatology nurses, nephrology nurses, oncology nurses, pediatric nurses, peri-operative nurses and rehabilitation nurses as some of the RN positions that may qualify as specialty occupations for H-1b work authorization.

Also advanced practice registered nurses can qualify for H-1b’s because of the advanced level of education and training required for certification. Some APRN occupations include Certified Clinical Nurse Specialist (CNS), Certified Nurse Practitioner (CNP), Certified Registered Nurse Anesthetist (CRNA) and Certified Nurse Mid-Wife (CNM).

International Visas

Aside from the H-1b visa, Canadian and Mexican citizens have a more attractive visa option to work in the U.S. in the nursing industry. The TN visa under the North American Free Trade Agreement (NAFTA) doesn’t have a bachelor’s degree requirement. A nurse may qualify for TN based on a nursing diploma or associate’s degree, along with a U.S. license.

As the need for nurses continues, healthcare organizations will need to explore all avenues for staffing, including foreign-educated workers and international students educated in the U.S. The H-1b visa or the TN visa may be the right answer.

Sherry Neal is an attorney who counsels healthcare organizations on immigration employment issues with Hammond Law Group in Cincinnati, Ohio.