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  • Writer's pictureNate Longoria

How Hospitals Can Address the Nursing Shortage Using the H-1B Visa as a Viable Solution

It’s no secret - the United States continues to grapple with a critical shortage of healthcare professionals nationwide. This is particularly felt in the Registered Nurse (RN) workforce as it experiences an aging population, increasing healthcare demands, limited capacity of nursing programs, and the impact of the COVID-19 pandemic. According to the Bureau of Labor Statistics’ Employment Projections 2021-2031, the Registered Nursing workforce is expected to grow by 6% from 3.1 million in 2021 to 3.3 million in 2031, an increase of 195,400 registered nurses. However, the Bureau also projects a staggering 203,200 openings for RNs each year through 2031, resulting in a significant nationwide deficit. With the increasing need for qualified nurses and the continued struggle to fill the void with U.S. workers, hospitals have been looking abroad for help.

One of the potential solutions to this problem lies in the utilization of H-1B visas for international nurses.

H-1B Visa Requirements for Nurses

A simplified way for hospitals to show that the RN positions are qualified for H-1B classification is to demonstrate that the position requires a Bachelor’s degree or an equivalent. A more specialized explanation of the H-1B visa classification involves understanding of what constitutes a specialty occupation. The term “specialty occupation” means an occupation that requires:

  1. Theoretical and practical application of a body of highly specialized knowledge; and

  2. Attainment of a bachelor’s or higher degree in the specific specialty (or its equivalent) as a minimum requirement for entry into the occupation in the United States.

While not all nurse positions qualify as a specialty occupation, such as entry-level RNs who obtained a two-year associate degree in nursing, many positions do, as more hospitals are requiring a minimum of a bachelor’s degree as part of their hiring process. This means that a hospital may still be able to demonstrate that a particular RN position qualifies as a specialty occupation if it can show one of the following:


  1. A baccalaureate or higher degree or its equivalent is normally the minimum requirement for entry into the particular position;

  2. The degree requirement is common to the industry in parallel positions among similar organizations or, in the alternative, a hospital may show that its particular position is so complex or unique that it can be performed only by an individual with a degree;

  3. The hospital normally requires a degree or its equivalent for the position; or

  4. The nature of the duties [is] so specialized and complex that the knowledge required to perform the duties is usually associated with the attainment of a baccalaureate or higher degree.

With more hospitals requiring a minimum of a bachelor’s degree for qualified nurses, the prospects of successfully obtaining an H-1B visa for registered nurses are on the rise.

Additionally, USCIS has recognized certain categories of registered nurses likely to require the minimum level of education needed to qualify as a specialty occupation. These categories include, among others:

  • Cardiovascular Nurses;

  • Critical Care Nurses; and

  • Emergency Room Nurses

USCIS also recognizes advanced practice registered nurse (APRN) positions, which are more likely to qualify as specialty occupations because of their more advanced level of education and training in the form of advanced skills, experience, and knowledge. APRN positions may include, among others:

  • Certified Nurse-Midwife (CNM);

  • Certified Clinical Nurse Specialist (CNS);

  • Certified Nurse Practitioner (CNP); and 

  • Certified Registered Nurse Anesthetist (CRNA)

It’s important to note that while the above-mentioned categories and APRN positions are more likely to constitute specialty occupations, USCIS reviews the facts of each case on a case-by-case basis, requiring hospitals to clearly show how each position meets the H-1B specialty occupation requirements.

Advantages Over Employment-Based Green Cards

While employment-based green cards (EB-3) have long been the norm for hospitals looking to hire international nurses, they come with several challenges that make H-1B visas a more attractive option for addressing the nursing shortage. The key benefits of using H-1B visas include:

  1. Faster Processing Times: H-1B visas generally have a quicker processing time compared to employment-based green cards, which can take up to several years to obtain. This speed is crucial in responding to immediate staffing needs in hospitals.

  2. Temporary Solution with Flexibility: While an employment-based green card provides permanent residency, not all international nurses may want to commit to permanent relocation. The H-1B visa is initially granted for three years and can be extended for another three years, providing flexibility to address short-term shortages while longer-term strategies are developed.

  3. Targeting Specific Hospital Needs: Hospitals can directly petition for H-1B nursing positions, allowing them to target and recruit highly qualified nurses from abroad. This direct relationship ensures that the needs of the hospital or clinic are precisely met without the long-term commitment required for the green card process.

  4. No H-1B Quota Limitations: While there is a cap on the number of H-1B visas issued annually, this cap does not apply to certain nonprofit organizations, including many hospitals and academic medical centers. This exemption can be leveraged to bypass quota limitations that affect other industries.

As seen, the H-1B visa may prove to be a practical and efficient solution for numerous positions involved in the nursing shortage in the U.S. Equipped with faster processing times, hospital flexibility, and the ability to meet immediate staffing needs, the H-1B visa offers distinct advantages over the more traditional employment-based green card process. Hospitals should invest in proper training and engage with legal experts to broaden their knowledge on how to best utilize the H-1B visa for nurses in response to current business needs. By leveraging this program, hospitals can better address their critical need for qualified nursing professionals and minimize the ever-growing deficit plaguing hospitals nationwide.

The information on this blog post/website is for general information purposes only, it is not legal advice applicable to a specific situation. Viewing it does not create an attorney-client relationship.


The information on this website is for general information purposes only, it is not legal advice applicable to a specific situation.  Viewing it does not create an attorney-client relationship.

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