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New Rules Require Screening for Commuting Mexican, Canadian Nurses
By Mark E. Dixon
Canadian and Mexican nurses will soon have to jump through the same hoops to work in the United States as nurses from other countries. Unless the U.S. Department of Homeland Security (DHS) delays implementation of new immigration rules, all foreign nurses will be required to successfully complete a screening program (U.S. VisaScreen™) before receiving an occupational visa.
And, close as they are, DHS regards Canada and Mexico as foreign as Pakistan and the Philippines.
Reaction from nursing groups is mixed: The National Council of State Boards of Nursing (NCSBN) has claimed that 10,000-15,000 nurses will no longer be able to work in the United States, worsening the nursing shortage. NCSBN, the American Organization of Nurse Executives and the American Hospital Association each requested a delay. AHA also proposed exemptions for healthcare professionals already licensed in the United States or who received their training in this country.
Bipartisan support for delay also came from 14 U.S. senators who warned DHS of the new rules' adverse impact in states that rely on foreign nurses to staff hospitals and nursing homes. "We are also concerned that implementation of the regulation will disrupt the delivery of healthcare services along northern border states because many of the hospitals near the border employ Canadian nurses who commute across the border each day," wrote the senators.
The American Nursing Association opposed delay, noting "that this law was established back in 1996 and its implementation has been put off long enough."
Previously, Canadian and Mexican nurses were exempt from the requirement if their purpose was to work in the United States, but not permanently move here. Under the terms of the 1994 North America Free Trade Agreement (NAFTA), non-immigrant nurses from those two countries were eligible for "TN" (Trade NAFTA) status enabling them to be admitted to the United States to engage in "business activities at a professional level" in certain fields, such as nursing.
Other affected professionals include physical therapists, occupational therapists, speech language pathologists, medical technologists, medical technicians and physician assistants.
The rules - Section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 - officially took effect in September 2003, but U.S. Citizenship and Immigration Services could issue waivers for those seeking temporary visas and NAFTA status for up to one year. For non-immigrant healthcare workers, the requirement now kicks in on July 26, 2004.
Screening includes an assessment of the education of the applicant to confirm that it is comparable to a U.S. graduate in the same profession; verification that licenses are valid and unencumbered; successful completion of an English language proficiency examination; and - for nurses only - verification that he or she has passed either the NCSBN licensure exam (NCLEX-RN) or the qualifying exam of the Commission on Graduates of Foreign Nursing Schools. Practical or vocational nurses must pass the NCLEX-PN exam.
Mark E. Dixon is a freelance writer and editor.