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In previous decades, nurses wishing to immigrate to the U.S. could do so in as little as six months. In recent years, however, that process has become longer and more complicated. Foreign nurses not only must meet nursing standards, but also must meet immigration requirements.

Filipino nurses must first graduate from an accredited school of nursing in the Philippines. They then must work with the Commission on Graduates of Foreign Nursing Schools and the International Commission on Healthcare Professions (CGFNS/ICHP), an immigration-neutral, nonprofit organization that ensures that nurses educated abroad are eligible and qualified to work as nurses in the U.S.

The CGFNS/ICHP offers nurses educated in foreign countries the opportunity to take qualifying exams in their own country before coming to the U..S. Applicants may also use a service that evaluates education and licensing obtained outside the U.S. to make sure they meet American standards. Some recruiting companies, like International MedLink, offer training courses to help foreign nurses make the transition to the U.S. health care system.

Filipino and other foreign nurses must pass English-proficiency tests. Texas requires foreign nurses to pass such an exam before taking the NCLEX-RN. In Texas and other states, nurses must also pass a criminal background check that requires them to submit a fingerprint card.

Besides using programs offered by CGFNS, foreign nurses can obtain a license to work in Texas through an endorsement process. A nurse who obtains a license in another jurisdiction can have that license certified as giving them the necessary education and training to work as a nurse in Texas. Other states have similar requirements.

DeCesare says nurses in the 1990s were allowed to work in the U.S. using an H1-A temporary work permit, which allowed nurses to emigrate in only six months. The law that allowed that expired in 1995, forcing foreign nurses to apply for admittance to the U.S. under an EB-3 permit, an employment-based permit that falls under the permanent visa category.

The EB-3 process normally takes 18 months to two years, but a recent change in the way the U.S. government handles certain visa applications means foreign nurses would have to wait as long as three years to work here.

That may convince some Filipino nurses to give up on the idea of coming to the U.S. But as long as the nursing shortage continues and Filipino nurses can earn many times more here than at home, nursing professionals say, Filipino nurses will continue to play an important role in meeting U.S. health care needs.

Scott Williams is a freelance writer.

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