7 Myths About Visa Retrogression and Hiring International Nurses
The demand for skilled nurses in the U.S. is soaring, and international nurse recruitment has become a valuable solution for filling critical staffing gaps. Yet, for many healthcare leaders, the visa process can feel like navigating a maze, especially when complicated by factors like retrogression. Many misunderstand how visas work and why retrogression occurs, which can create even more uncertainty. These misconceptions often prevent decision-makers from taking early action, leaving hospitals understaffed and overwhelmed.
How International Nurses Enhance Our Workforce
By bringing skilled, compassionate professionals from around the world into U.S. hospitals and facilities, organizations can address staffing challenges while laying the foundation for long-term success. With nursing degrees, English language proficiency, clinical experience, and licensing credentials that meet U.S. standards, they are ready to fill roles that might otherwise remain vacant.
Our 2021 Survey of International Nurses indicates 90% of international nurses have a BSN level education or higher. Their global backgrounds introduce different perspectives, innovative problem-solving approaches, and an understanding of culturally competent care.
Unlike short-term solutions like travel nursing, international recruitment is geared toward stability and continuity. International nurses often come with multi-year commitments and a genuine desire to integrate into the community and workplace. Over time, they build bonds with colleagues, develop rapport with patients, and contribute to a hospital's culture. These connections lead to higher retention rates, minimizing turnover-related costs and disruptions. Additionally, integrating international nurses into long-term staffing strategies helps organizations reduce reliance on contingent labor, ultimately lowering operational costs and promoting sustainable team dynamics.
7 Myths About Visa Retrogression
Myth 1: “If a nurse is qualified, they can get a visa quickly.”
Reality: Even the most qualified nurses face delays. The U.S. caps the number of employment-based EB-3 green cards available each year, as well as how many can be issued per country. This creates bottlenecks, especially for nurses from countries like China and India, where demand far exceeds supply. On top of this, processing backlogs mean applicants may wait months—even years—for their turn.
What You Can Do:
1. Start early: Visa issuance operates on a “first come, first served” basis. Filing petitions early secures your nurses’ place in line.
2. Consider alternatives: Explore other visa types, like the H-1B visa, or the TN visa for Canadian and Mexican nurses. While not a permanent solution, this option could expedite deployment for critical roles.
Myth 2: “Retrogression means visas are unavailable indefinitely.”
The word “retrogression” often sends chills down the spine of healthcare executives, but it doesn’t mean the door to hiring international nurses is shut, just slowed down. Retrogression occurs because the demand for visas exceeds the annual quota, creating delays. However, each year new visa numbers become available (at the start of the fiscal year in October) and applications continue to be processed. Retrogression is more of a traffic jam than a full stop.
What You Can Do:
1. Track priority dates: Use the State Department’s monthly Visa Bulletin to monitor visa availability and approximate timelines for your sponsored candidates.
2. Communicate with candidates: Transparency fosters trust. Keep international nurses informed of their visa status and expected timelines to reduce uncertainty and build confidence.
Myth 3: “Hospitals can’t hire international nurses during retrogression.”
This is a dangerous misconception. Retrogression may slow the visa approval process, but it doesn’t stop healthcare organizations from recruiting. Hospitals can file I-140 petitions, complete credentialing, and prepare nurses for deployment. Retrogression is on-going as demand for visas continues to exceed supply so that waiting for retrogression to resolve will leave you trailing behind competitors already building their pipelines. Remember, it’s all about the nurse's place in line, so it is important to continue recruiting to ensure a steady flow of candidates for the future.
What You Can Do:
1. Be proactive: Work with staffing agencies or legal partners to file petitions and complete the necessary steps during retrogression, ensuring you’re ready to act when visas are available.
2. Prepare your team: Integrating international nurses into your health system takes knowledge, experience and preparation. Leverage best practices from your industry and trusted workforce partners to streamline onboarding and long-term retention of international clinicians.
Myth 4: “Retrogression is permanent for certain countries.”
The idea that some countries are permanently stuck in retrogression is misleading. All countries are subject to retrogression, but some have longer wait times than others. While applicants from nations like China and India (who could wait 10+ years) face longer wait times due to higher demand, cutoff dates generally move forward based on visa number availability.
What You Can Do:
1. Diversify your recruitment efforts: Recruiting from a mix of countries reduces dependence on regions with long backlogs.
2. Plan for flexibility: Work with an experienced international staffing partner who understands retrogression fluctuations and can help you adapt quickly.
Myth 5: “Hospitals should wait until retrogression is over to start recruiting.”
Waiting is the worst mistake you can make. Retrogression is on-going as long as demand exceeds supply of visas. Because visas are issued in the order that petitions are filed, delaying recruitment puts you further back in the queue. Retrogression exacerbates these delays, making early action even more critical.
What You Can Do:
1. Think long-term: Develop a workforce strategy that includes international recruitment as an ongoing priority rather than a one-time fix.
2. Partner strategically: Collaborate with agencies with pre-established candidate pipelines, such as AMN Healthcare. Our established pipelines enable you to connect with nurses already in line for visas.
Myth 6: “The only visa option for international nurses is the EB-3 green card.”
While the EB-3 visa is the most widely used, it’s not the only pathway. Options like the TN visa (for Canadian and Mexican nurses) and H-1B visas (for advanced practice nurses) can provide quicker solutions in certain cases. However, each visa type has its own eligibility requirements and limitations.
What You Can Do:
1. Assess your needs: Determine which roles can be filled using alternative visa types and prioritize these applications to address immediate gaps.
2. Work with experts: Visa specialists can help identify the best options for your facility and recruit candidates who meet specific criteria.
Myth 7: “Retrogression only affects new nurse applicants.”
Do you think retrogression only impacts newly recruited candidates? Think again. It can also delay nurses already in the pipeline, who have an established priority date. If the cutoff dates move slowly and/or only periodically, it extends the time it takes them to be eligible for a visa number, complete a visa interview or receive permanent residency. These delays can have ripple effects on workforce planning and patient care.
What You Can Do:
1. Double down on domestic strategies: While waiting for visas, ensure other recruitment and retention programs are robust to bridge temporary gaps.
2. Maintain momentum: Continue filing petitions and preparing candidates, ensuring your organization is ready for the next wave of visa approvals.
Turning Myths into Opportunities
Understanding visa retrogression can empower your organization to make smarter, more strategic decisions. With proper planning and a proactive mindset, healthcare executives can mitigate the challenges posed by retrogression and secure the international talent needed to support and grow their workforce.
By partnering with experienced immigration and staffing experts like AMN Healthcare International, healthcare organizations can stay ahead of the curve. We help predict visa timelines, build transparent communication with candidates, and create a long-term strategy to address staffing needs.
Schedule a free consultation with an international nurse staffing expert or visit our International workforce solutions page to learn more.
