Wednesday, April 30, 2008

RNs, READY FOR YOUR FLIGHT TO USA!

Last night Rep. Wexler (D - FL) introduced our legislation. It is HR 5924, and is co-sponsored by Rep. Sensenbrenner (R - WI). The Government Printing Office has not yet printed the legislation, but since the CTIHS has been instrumental in moving this bill, HLG is very familiar with the legislation. The key points of the legislation are: 1. Lifting of retrogression for Schedule A workers. Any immigrant visa quotas or caps are waived for all visa applications filed for Shortage Occupations (Schedule A occupations: Physical Therapists and Registered Nurses), provided that the I-140 is filed prior to September 30, 2011. 2. 20,000 primary beneficiary quota. While there is no retrogression for Schedule A cases filed before September 30, 2011, Consulates may not approve more than 20,000 primary beneficiary visas in any one year. There is no quota for the immediate family members of such beneficiaries. 3. Expedited Review. The USCIS must review -- and approve or issue an RFE -- on all Schedule A I-140 cases within 30 days of receipt. 4. Grant Fee. All primary beneficiary nursing visas issued under this legislation must pay a fee of $1500. Katrina-effected and HPSA employers do not have to pay the fee. 5. Grant Program. These fees will fund a Grant program. Schools of nursing may draw on this fund based on their student populations. The fees are to be used to attract, train, and retain nursing faculty, purchase educational equipment, expand infrastructure, and attract students. 6. Liberalized US Citizenship for some Health Care workers. Time spent by US Permanent Resident Health acre workers in a developing country will not be held against them in their endeavors to become US citizens. 7. Obligation Attestation. Immigrant visa applicants must attest that they do not owe their country of residence or origin a financial obligation. An obligation is defined as financial assistance that the intending immigrant incurred to defray the costs of education in consideration for a commitment to continue to work in that county. The fact that Rep. Sensenbrenner is co-sponsoring the legislation is particularly important. He is known as someone who is not soft on immigration. He was one of the first Congressmen to call for a fence on the US Southern border. He should signal to some members that this is the kind of immigration legislation that is positive for America. There is a very real chance of this legislation being passed this year.

Some people have mistakenly believed that family members are not eligible for visas under HR 5924. That is not the case. Let me be clear: family members may enter the US as derivative beneficiaries under HR 5924.

So time to cheer dear RNs and PTs. As I always insisted, I do now too and urge you to be really optimistic and start your process immediately and also be sure that you select a very reliable and reputed agency for your process because every minute is valuable and the faster the process the more your chances to reach America and get your dream job there.

Like to know about some reliable agencies or direct recruitment facilities? My own cousin Mrs. Maria Mathew RN, MSN is also into the business of recruiting people directly for her hospital in Texas. Or you can ask me for agencies that have offices in India or who are coming to India regularly for recruitment.

In any case, make sure that you file your I-140 as early as possible and in any case before 2010. Yes, we have a real chance to reach America shortly. Please do visit my blogsite regularly for latest information, and I will be happy to give you all that had anything to do with our immigration process, for or against us, presenting facts as they are.

My mobile number: 9958250569

Email: saji.dels@gmail.com

WANT TO BE MORE INTELLIGENT & YOUNG!

Shall we, today, think about our own brain, the source of all our progress, our knowledge and certainly the reality that makes our dreams come true?

Our brain is certainly the most amazing thing that we possess and it is more powerful and capable than any super computer man could ever make, or will ever make.

But we all have certain misconception about it, and I could correct some of it and I like to share it with you too.

Now we know that training can boost intelligence! That is we can train our brains and develop its powers to such greater heights that you will be wonderstruck someday. Yes, it is possible to train our brains to be more intelligent, increasing the brainpower we had at birth.

Until, now it had been widely assumed that the kind of mental ability that allows us to solve new problems without having any relevant previous experience is innate and cannot be taught. But now it has been proven that the fluid intelligence can be taught and increased.

The key to improving intelligence is carefully structured training in working memory--- the kind that allows memorization of a telephone number just long enough to dial it. You may have this experience, you may be dialing continually for gas refill and you go on dialing the number and you learn it and repeat the dialing but forget the moment you get through the call. To call the gas agency again, you need to look up your diary. This type of memory is related to fluid intelligence and appears to rely on the same brain circuitry.

A group of scientists conducted a study to establish this fact. Firs they measured the fluid intelligence of four groups of volunteers using standard test. Then they trained each in a memory task, a variation on Concentration, the child’s card game, in which they memorized simultaneously presented auditory and visual stimuli that they had to recall later.

The game was set up so that as the participants succeeded, the tasks became harder, and as they failed, tasks became easier (RNs are familiar with this type of test as NCLEX follows a similar test pattern). This assured a high level of difficulty but not as if in a printed question paper, and not so high as to destroy the motivation to keep working.

The four groups underwent training for half an hour daily for 8, 12, 17 and 19 days respectively and at the end of the 19th day they measured the fluid intelligence again, and believe me, the results were striking!

The intelligence level in the trained volunteers was much more than what it was before the training and also the trainers too noted that by giving training their intelligence level too increased.

Intelligence has always been considered principally an immutable inherited trait, but now we know we can certainly increase our intelligence with appropriate training.

So please keep on learning new things and especially languages. Keep on improving the languages you already know, for example, English. Polish and improve your grammatical ability and try to read as much as possible in English. Take up short term courses related to your profession, or learn technical things such as Computer Applications or simply participate in debates etc. Healthy interaction with others and sharing your view points on different subjects can help you increase your intelligence.

And for your children engage them in as many activities as possible, but make sure they enjoy them too. The abacus training is a great tool to develop intelligence in children. Learn driving, learn to type, any of these activities increase your brain activity and so your intelligence and such activities can make your brain really active and young and as a result your body too remains young and healthy.

Hope you enjoyed reading this article and I request you to keep on visiting my blog site regularly for many other useful articles.


Mobile Number: 9958250569
Email: saji.dels@gmail.com



Tuesday, April 29, 2008

VISA BULLETIN MAY-2008

May 2008 Visa Bulletin

Dear Friends, I am just giving you information regarding the May 2008 Visa Bulletin. Those of us who are Indians do not have much to cheer as our priority date still remains Nov-2001, but then there is a happy news as the priority date of our Philippines friends has reached 2006-March. I wish all RNs and PTs in Philippines a very good time, and may all their dreams come true.

But we too have something to cheer about, that is the movement of EB2 of India from December 2003 to January, 2004.

Though we, the EB3 categories, have not been mentioned, we cannot rule out surprises in the coming bulletins and so please keep on visiting my site and I will certainly be back with you with some really exciting information.


The Department of State has released the May Visa Bulletin. There was some forward movement in all categories including: All Chargeability went from July 1, 2005 to March 1, 2006; EB2 China went from December 1, 2003 to January 1, 2004; EB2 India went from December 1, 2003 to January 1, 2004; and EB3 Philippines went from July 1, 2005 to March 1, 2006.

So this is for the time being and as I was always insisting, please be optimistic and things will be all right soon.

Just go on with your preparations, and keep on visiting my site and also recommend it to your friends who are interested in American Immigration.

Keep my mobile number handy for any kind of clarification: 9958250569.

My email address: saji.dels@gamil.com

Monday, April 28, 2008

RNs be ready for a possible NVC interview soon!

Lofgren-Sensenbrenner bill to recapture GCs; Schedule A to come next?

Healthcare Immigration legislation is at a crucial juncture because of, among other reasons, the need to end the retrogression backlog. So please read on and start thinking really positive about your landing in US in the near future. I give you some really good news!

RNs and PTs, We have a real reason to smile!
If everything goes well, our long, long wait for visas will be over in a few months time, as there goes a really effective and near winning effort to recapture about 218000, unused visas, that the US immigration department could not exhaust before the last fiscal year, and the happy news is this that all of these visas are in the employment based categories, that is EB. Yes, there is a real chance for RNs and PTs to win a lions share of the same, as we are in great shortage there.
The importance of this bill and its chances at winning is because of the reason that it is introduced and supported by two very powerful men from both parties in the US,that is this move is bipartisan and so chances of getting it defeated is remote.
Another factor favoring us is the fact the back-logs are so great and they really want to reduce it.
On Wednesday Reps. Lofgren, Davis, and Sensenbrenner introduced H.R. 5882, to “recapture” employment-based (EB) green cards that Congress authorized in the past but that went unused before the end of past fiscal years due to government processing delays. Experts estimate that approximately 218,000 unused EB green cards will be brought back into supply for all employment-based workers.Significantly, HR 5882 has bipartisan support and has two "heavy hitters" (Lofgren and Sensenbrenner) leading the charge. Unlike past immigration proposals, this one has a real chance at passing.The long anticipated legislation targeted at Schedule A occupations -- PTs and RNs -- should be introduced next week. We'll have more information once the bill is formally introduced. Please keep on visiting my blog site and I am sure I will meet you there with more happy news.
Please keep my mobile number with you for any clarification any time: 9958250569. And my email is: saji.dels@gmail.com

Friday, April 25, 2008

ARE YOU ORALLY FIT?

HOW IS YOUR ORAL HEALTH!

The mouth is always full of germs. No matter how often you brush your teeth or rinse your mouth with mouthwashes. You cannot get rid of germs in your mouth. But in a healthy mouth these germs are under control and form an ecological balance. And on the other hand, in a mouth that is not hygienic and not at all maintained, it is just the opposite and is a breeding place for many diseases.

An invisible layer of germs is always present on your tooth surfaces. This layer is called the dental plaque. So plaque is invisible. But a dentist can make it visible with a disclosing solution. If brushing is inadequate, plaque accumulates and causes both tooth decay (cavities/caries) as well as gum diseases (periodontitis /pyorrhea)). In tooth decay, the germs in the plaque pick up food remnants, especially that of sugary or sticky foods, and produce acids. These acids attack the enamel, which is incidentally the strongest part of the human body to form a hole in the tooth. And I am sure you know what happens next! The intense pain starts, and you are left with no choice but either extract the tooth or go on pain killers. Both you will agree are not advisable or comfortable. But if you do not extract the tooth and go on some pain killer, the infection finally travels through the root canal and reaches the bone, where it forms an abscess.

The tooth, in most cases, still can be saved. You will need a technology called RCT here. It is the Root Canal Treatment. And other than forming abscess and forcing you to go for an RCT, the accumulated plaque on the surface of your teeth hardens into stony deposits called tartar or calculus. Now this is a very dangerous condition as it slowly begins to press on the gums, and the gums begins to recede up and up, revealing more and more of your teeth, and leaving you with what we call sensitive teeth, making your life a virtual hell. You cannot take hot, you cannot take cold, and you cannot even brush your teeth properly. And other than this, you begin to experience what is called “Bad Breath” which can go to the extent of becoming a social stigma and make you depressed and unhappy, draining all your confidence out of your system.

Now another conditions called Periodontitis starts here. You not only experience bad breath and its implications, but begins to notice that your gums bleed regularly and even brushing can be a painful exercise, and at this stage, bad breath really begin to emanate from your mouth, the moment you open your mouth and you can experience it yourselves, need not say about others, especially your colleagues etc. Of course, every tooth decay can lead to bad breath, but here the condition is very serious and may give you also many other sicknesses.

Now let me tell you what happens if you just ignore the receding of your gums! After a certain period of time, the bone will be dissolved and the teeth become loose and just fall off.

Now what is the solution? It is actually very simple. Just don’t let plaque accumulate on your teeth. But how? Simple! Brush twice a day at least with good toothpaste that has granules which are round in shape and do cut into your teeth every time you brush your teeth. I recommend AMWAY’S Glister tooth paste, as it is a very advisable one with very fine, round granules and it needs only a little quantity of the same for a thorough cleaning of your teeth. I will advise you to use Persona Tooth Brush also from AMWAY with Glister Tooth Paste, as you need a very good tooth brush too, as a bad choice of tooth brush can actually harm your teeth and gums.

And lastly, avoid eating sugary substances between your main meals and after every meal if possible brush your teeth, and it is especially advisable for those who already have symptoms of bad breath, caries etc. AND most importantly make it a habit to visit your dentist at least once in a year and for better results every six months. This should be the frequency of your child’s visit to the dentist also once he or she becomes 6+ and above

To order for AMWAY PRODUCTS, you may please contact me on 9958250569.
You can email me at: saji.dels@gmail.com

Thanks and I hope you enjoyed reading this, and I may be writing on more such useful subjects in the coming days, and so please keep on visiting my blog site.





BRAIN DAMAGING HABITS

BRAIN DAMAGING HABITS

Today let me talk to you about certain habits which may damage our brain and health in genera, hope you will find it really useful and ask many more to read it.

1. No Breakfast
People who do not take breakfast are going to have a lower blood sugar level.
This leads to an insufficient supply of nutrients to the brain causing brain degeneration.

2. Overeating
It causes hardening of the brain arteries, leading to a decrease in mental power.

3. Smoking
It causes multiple brain shrinkage and may lead to Alzheimer disease.

4. High Sugar consumption
Too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development.

5. Air Pollution
The brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.

6. Sleep Deprivation
Sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.

7. Head covered while sleeping
Sleeping with the head covered, increases the concentration of carbon dioxide and decrease concentration of oxygen that may lead to brain damaging effects.

8. Working your brain during illness
Working hard or studying with sickness may lead to a decrease in effectiveness of the brain as well as damage the brain.

9. Lacking in stimulating thoughts
Thinking is the best way to train our brain, lacking in brain stimulation thoughts may cause brain shrinkage.

10. Talking Rarely
Intellectual conversations will promote the efficiency of the brain
----------------------------------------------------------------------------------
The main causes of liver damage are:

1. Sleeping too late and waking up too late are main cause.
2. Not urinating in the morning.
3. Too much eating.
4. Skipping breakfast.
5. Consuming too much medication.
6. Consuming too much preservatives, additives, food coloring, and artificial sweetener.
7. Consuming unhealthy cooking oil. As much as possible reduce cooking oil use when frying, which includes even the best cooking oils like olive oil. Do not consume fried foods when you are tired, except if the body is very fit.
8. Consuming raw (overly done) foods also add to the burden of liver.
Veggies should be eaten raw or cooked 3-5 parts. Fried veggies should be finished in one sitting, do not store.

We should prevent this without necessarily spending more. We just have to adopt a good daily lifestyle and eating habits. Maintaining good eating habits and time condition are very important for our bodies to absorb and get rid of unnecessary chemicals according to "schedule."


Because:

Evening at 9 - 11pm : is the time for eliminating unnecessary/toxic chemicals (detoxification) from the antibody system (lymph nodes). This time duration should be spent by relaxing or listening to music. If during this time a housewife is still in an unrelaxed state such as washing the dishes or monitoring children doing their homework, this will have a negative impact on health.

Evening at 11pm - 1am : is the detoxification process in the liver, and ideally should be done in a deep sleep state.

Early morning 1 - 3am: detoxification process in the gall, also ideally done in a deep sleep state.

Early morning 3 - 5am : detoxification in the lungs. Therefore there will sometimes be a severe cough for cough sufferers during this time. Since the detoxification process had reached the respiratory tract, there is no need to take cough medicine so as not to interfere with toxin removal process.

Morning 5 - 7am: detoxification in the colon, you should empty your bowel.

Morning 7 - 9am : absorption of nutrients in the small intestine, you should be having breakfast at this time. Breakfast should be earlier, before 6:30am, for those who are sick. Breakfast before 7:30am is very beneficial to those wanting to stay fit. Those who always skip breakfast, they should change their habits, and it is still better to eat breakfast late until 9 - 10am rather than no meal at all.

Sleeping so late and waking up too late will disrupt the process of removing unnecessary chemicals. Aside from that, midnight to 4:00 am is the time when the bone marrow produces blood. Therefore, have a good sleep and don't sleep late.


TAKE CARE OF YOUR HEALTH.................

TELL YOUR LOVED ONES ALSO TO READ THIS BLOG AND ALSO THOSE YET TO COME………


And for the purest olive oil available in India, please call me on: 9958250569
or mail me at: saji.dels@gmail.com

Wednesday, April 23, 2008

IELTS! it is very easy to score a high band.



ENGLISH MANDATORY FOR ENTRY TO UK


We look toward greener pastures so that we have a more secure life and of course a great future! And that search generally takes us to the exploration of opportunities in European or American countries, where we find more freedom and better living conditions.

But now the question is how to make our journey to our dream destination a reality? And we will in most cases be blatantly told that a certificate to prove your English Proficiency be produced to start the process. And now a even the Credential Verification Service itself may make such a request. Needless to say about the Nclex RN examination, that requires among other things your IELTS certificate or TOEFL certificate, with adequate scores or bands. It is about the American Destination.

What about the European destinations? Even to apply for a registration with their medical council you need either IELTS or TOEFL.

Yes, Britain has imposed a law that requires an adequate knowledge of the English Language as a condition of entry on non-European skilled workers as well. The number of number of non-skilled workers who entered the UK last year was about 96,000. And the government has found out that more than 80% of them were incapable of passing even a Basic English Speaking Test, let alone a Written English Test.

Government estimates say most work-permit holders come from developing countries and the majority belongs to the healthcare sector and also to the Indian Sub-continent. According to reports, last years entrants included 51,000 from Indian sub-continent. The report also asserts that most of these people would not have been able to show they could speak the language fluently, or write it efficiently.

The new rule is going to affect skilled workers such as bankers, multinational company executives, software engineers, doctors, nurses, and teachers and accounting professionals, who are not really proficient in English, both in written and spoken English.

Every non-European potential migrant will now be tested for his/her ability to speak, write and understand English equivalent to Britain’s GCSE or class 10 grades of A to C. They will be required to furnish proof of their proficiency either by means of an internationally recognized English test like IELTS, TOEFL or by showing that they have a Bachelor’s Degree in English from a recognized university.

So now passing English Knowledge tests like IELTS or TOEFL becomes mandatory as most of the healthcare professionals do not hold a Bachelor’s degree in English. So you are going to be tested on four parameters: Speaking, Listening, Writing and Reading.
Now the big question is how to get the desired results in these exams! It is comparatively simple to achieve a very high score or band in these examinations if you first get the fundamental grammatical rules of English correctly. And I do not think the traditional Spoken English Classes or IELTS/TOEFL classes will do anything to give you the required amount of knowledge in English Grammar, which is the basis of success in these exams.

On the other hand from my 12 years of teaching English to students and nurses have found that it can be taught in very simple ways and anyone can learn it without spending a lot of time. All the nurses who attended my English Classes, known as “Dominic’s English Course” passed the IELTS examination at the first attempt itself with the required scores. (No one has so far taken the TOEFL examination from my classes).

Yes, I advice you to take “Dominic’s English Course” first and then take the help of a professional IELTS trainer or Coaching Centre, and you will certainly see how easy it is to clear these examinations with ease and confidence.

The reason for the great number of people failing in the IELTS examination is simply their deficiency in English Grammar and Basic/fundamental concepts. Once you have it, you are confident and ready to take the test.

ENGLISH COACHING THROUGH INTERNET

I offer you coaching in two ways. First the regular in-class training, where you are required to attend classes every day, and then the internet based training, where you get all your classes through internet, and you can converse with me through Yahoo messenger/ Skype etc., and attend personal contact programs may be once in a week for 2 hours or at my place or at pre-arranged locations if there are more than five people attending the same class.

I am not interested in postal tuition because learning a language without a teacher is a near impossibility. But internet is as effective as having a teacher because you can always chat, by typing or using voice. And when convenient, personal coaching can also be given.

My English course not only makes you a confident user of English Language, but you will also see that you are acquiring a new ability to understand any book on English Grammar after completing my course. Which in effect means you will be improving your English everyday, because you have the foundation and fundamental knowledge of this language. You will see you are asked to attend a professional IELTS class because I want you to understand exactly how the exam is being conducted, and not because you want to learn English. There is a big difference in attending an IELTS coaching with a hope to learn English and attending it just to learn the system. And the difference is failure or success, respectively.

You can contact me on my mobile number: 9958250569 or on the landline number: 011-22110173

You can email me at: saji.dels@gmail.com

You can visit me at:
DOMINIC’S ENGLISH LANGUAGE SCHOOL,
176-D, POCKET-E, GTB ENCLAVE,
OPPOSITE GTB HOSPITAL GATE NO. 8,
DILSHAD GARDEN, DELHI-110093

Wish you good luck in your IELTS examination and also in your immigration process.







Tuesday, April 22, 2008

Accountability in Immigration Repatriation Act of 2008

What is happening in the US and to our US immigration process!

Last month, in the US senate, a bill was introduced by Senator Arlen Specter of Pennsylvania. It was famously (and certainly not very famous for us who are looking for immigration to US) called “AIR”. Its full form is “Accountability in Immigration Repatriation Act of 2008’.

Now you may wonder what it has to do with your immigration process! Yes! It has everything to do with your immigration process as it can simply kill your American dreams or at least cause your American trip to get postponed indefinitely.

The “AIR” is a legislation that requires countries to take back illegal migrants who have been convicted of crimes in the United States. The eight countries which are going to be affected by this legislation are “India, China, Laos, Iran, Eritrea, Vietnam, Jamaica and Ethiopia”. These countries have refused to repatriate a total of over 1, 39,000 illegal migrants and the worst thing to be noted is this that out of these about 18,000 are dreaded criminals and most of them are of Asian origin.

Now the “AIR” introduced a bill to repatriate these illegal migrants to their own respective countries but a new legislation, which can rightly called the Companion of “AIR” has been introduced in the US senate by Congressman Charlie Dent of Pennsylvania Michael Castle of Delaware.

This new legislation puts India in a greater risk because the bill, if came into effect, could cause all the visa processes even at the level of NVCs to be suspended till the country agrees to repatriate all its illegal migrants.

Now we know it is not going to be any easy task for the Indian Government to take such an action and worse even to get such a bill passed in the Parliament, and hence our chances to get an interview call from the National Visa Center may remain a distant dream, at least for some time, I mean either till the Indian Government takes backs its illegal migrants in the US or the Bill is defeated in the US senate.

But still Nurses and PTs have an edge over others as they are declared to be a special category and are listed as “Having acute shortage and also essential service” as we are called schedule A category. We hope the efforts of senators to reintroduce the Recapturing of 61,000 unused visas may success and it may help in the fast clearing of the back logs and the Current Dates may jump to an earlier date. One thing to remember is AOS(adjustment of status) persons are not affected, and only persons like us who are in their own countries, the CPs (Consular Process)are affected.

The bill requires reports to Congress every 90 days on the countries which inhibit repatriation. Receipt of the report automatically triggers denial of foreign aid as well as suspension of all Visa Issuances to the listed countries. The administration an request a waiver from the congress but must justify such a waiver to be in national interest, and this is exactly our hope, though not a guaranty that a VISA will be issued to us in the normal course of time.

So be very careful about agencies promising immediate recruitment and 12 to 19 months immigration to the States, it is simply not possible, and all such claims need to be dealt with care. I do not think any agency in its right mind would risk spending huge amounts when there is no guaranty that the people they select from a country like India can ever hope to get a Visa or at least in the near future.

So please keep on visiting our blogsite and we will be very prompt to notify you of all the latest developments in the US Senate that affect our immigration plans and process.

As usual we request you to keep visiting our blogsite and urge you to keep your spirits up as things may get brighter soon.

Saturday, April 12, 2008

Complete US immigration process for RNs

PERMANENT RESIDENCE FOR NURSES RESIDING ABROAD

Today let us see what are the steps required by an RN to complete the immigration process to enter US successfully.

If the RN resides abroad, which means the nurse is not in the US, the following steps must be completed before the nurse may be employed in the U.S.:

1. The RN must be in possession of:
a. A diploma from a nursing school in her country;
b. An RN license in her country; and
c. A full and unrestricted license to practice professional nursing in the state of intended employment, or a certification issued by the Commission on Graduates of Foreign Nursing Schools (CGFNS), or evidence that she has passed the NCLEX-RN licensing examination but cannot obtain a license because she lacks a social security number.
Although some states require that foreign nurses pass the CGFNS examination before taking the state RN licensing (NCLEX) examination, the number of such states is on the decline. This is because, it now possible to take the NCLEX abroad. The examination is offered in Australia (Sydney), Canada (Montreal, Toronto and Vancouver), Great Britain (London), Hong Kong, India (Bangalore, Chennai, Hyderabad, Mumbai and New Delhi), Japan (Chiyoda-ku and Yokohama), Korea (Seoul), Germany (Frankfurt), Mexico (Mexico City), Philippines (Manila) and Taiwan (Taipei). In addition, RNs may take the NCLEX in Guam, Puerto Rico and Saipan.

2. RNs together with physical therapists are listed as shortage, or “Schedule A”, occupations in regulations (20 C.F.R. §656.22) issued by the Department of Labor. An employer who wishes to offer immigration to an RN is exempt from having to submit a PERM application to the Department of Labor.

The immigration process begins when an employer submits an immigrant visa petition (Form I-140) to the service center of the Citizenship and Immigration Services (CIS) having jurisdiction over the nurse’s place of intended employment. The petition must be accompanied by Labor Department form ETA-9089, by a posting notice, a prevailing wage determination and by various other documents. The petition should also be accompanied by a check for filing fees.

3. The CIS sends the approved visa petition to the National Visa Center (NVC) in Portsmouth, New Hampshire. 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 the 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.

4. 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. At this interview, the government will examine various documents including:

a. Applications for Immigrant Visas
b. Police Clearances
c. Birth Certificates
d. Marriage Certificate, if any
e. Divorce or Death Certificate of Spouse, if any
f. Valid Passports
g. Medical Examinations
h. Photographs
i. Recent job offer letter (or employment contract)
j. Financial information regarding employer
k. Government filing fees
l. Visa Screen Certificate


The Visa Screen Certificate requirement was imposed by §343 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA). It added “uncertified health-care workers” to the list of persons who are inadmissible to the U.S. See §212(a) (5) (C), INA.

A Visa Screen Certificate is issued only after the RN has demonstrated that (1) her education, license and training in her country are equivalent to education, licensure and training in the U.S. and that (2) her level of competence in oral and written English are appropriate to practice professional nursing in the U.S.

The CIS regulations provide that the only organization authorized to issue Visa Screen certificates to RNs is the Commission on Graduates of Foreign Nursing Schools (CGFNS), the organization which is listed in §343. The CGFNS is located at 3600 Market Street, Philadelphia, PA, 19104-2651; telephone: (215) 349-8767; fax: (215) 349-0026; e-mail: support@cgfns.org
The CIS's Visa Screen regulations provide that even if a foreign-born RN is educated, licensed and trained in the U.S., she still must obtain a Visa Screen certificate. However, such RNs may be able to obtain a certificate on a streamlined basis. Obtaining such a certificate requires a significant expenditure of time, effort and money (over $300) on the part of the nurse.
Unless the nurse was educated in an English-speaking country (U.S., Australia, New Zealand, Ireland, United Kingdom or Canada - all provinces except Quebec), she must achieve a certain minimum score on tests in written and spoken English administered by TOEFL (Test Of English As A Foreign Language), IELTS (International English Language Testing Service) or the TOEIC (Test of English in International Communications). Also, if the RN registered for the MELAB (Michigan English Language Assessment Battery) before November 27, 2002, this result may be sent to the CGFNS for Visa Screen purposes.
Passing scores for RNs on English exams are as follows:
IELTS: Academic Module or the General Training Module 6.5, Overall Band Score, 7.0 Speaking
TOEFL: Paper-Based 540; TOEFL Computer-Based 207; Test of Written English (TWE) 4.0; Test of Spoken English (TSE) 50.
TOEIC: 725; plus TWE: 4.0 and TSE: 50
Information about taking the TOEFL, IELTS and TOEIC examinations may be obtained from their web sites. They are all offered worldwide.
Passing scores for the MELAB were as follows: Final Score 79+; Oral Interview 3+.
Generally, the process of obtaining permanent residence may take between 12 to 18 months assuming that the immigrant visa quota from the RN’s country of birth is not backlogged. Currently, the quota for RNs is not backlogged.

Temporary Visas for Nurses

Although most RNs do not qualify for temporary working visas, it is possible to obtain temporary visas or work permits for nurses in the following categories:
Trade NAFTA Work Permits (TN Status) - For Canadian and Mexican Citizens Only
U.S. employers may apply for registered nurses who are citizens of Canada and Mexico to work in temporary "TN" status.
They may obtain Trade NAFTA (“TN”) status if:
1. They have an offer of employment from a U.S. employer for a period not to exceed one year;
2. They are licensed in Canada/Mexico and in the state of intended employment;
3. They are in possession of a Visa Screen certificate;
4. They have a proof of Canadian or Mexican citizenship; and
5. They pay a small fee to enter the U.S.
For Canadian citizens, TN status may be renewed on a yearly basis either by having the nurse reenter the U.S. with the documents listed above, or by requesting an extension of TN status from the USCIS.
While RNs who are Canadian citizens may obtain TN status without obtaining a visa or a petition, RNs who are citizens of Mexico must apply for TN visas at a U.S. consulate in Mexico only after their U.S. employers have obtained the approval of a TN petition for them in the U.S.
A TN nurse is not supposed to have any intention of remaining permanently in the U.S. This becomes an issue if a TN nurse decides to apply for permanent residence in the U.S.
H-1B Specialty Occupation Status
Traditionally, RNs have been considered “professionals” under U.S. immigration laws. From 1952 to 1989, U.S. employers could hire foreign-born nurses using “H-1” temporary visas. In 1989, the Immigration Nursing Relief Act (INRA) was enacted as a five-year pilot program. INRA provided that only health-care facilities with “attestations” approved by the Labor Department could obtain “H-1A” status to employ nurses on a temporary basis in the U.S. When INRA expired in the mid-1990s, Congress decided not to extend the law since there was no shortage of RNs in the U.S. according to the ANA.
Other occupations which formerly fell within the “H-1” category became part of the new “H-1B” category. The Immigration Act of 1990 provided that only those occupations for which a four-year university degree was a prerequisite for employment could qualify for “H-1B” status. However, in 1991, the “H-1B” category was amended to include certain foreign-born fashion models after extensive lobbying by that industry.
The H-1B category is an ineffective vehicle for most health care facilities who wish to employ RNs since the minimum entry requirement for most staff RN jobs is a two-year associate degree rather than a four-year bachelors’ degree. However, where a facility can justify that a four-year degree (or equivalent) is the minimum entry requirement for a job, such an RN may be granted an H-1B visa. An INS memorandum, dated November 27, 2002, explains the requirements for a registered nurse to obtain H-1B status.
Registered nurses need to be in possession of a Visa Screen certificate in order to obtain H-1B status.

We do hope that this information was helpful to you.