The Nursing Relief for Disadvantaged Areas Act of 1999 introduced the H-1C visa which allowed foreign nurses to temporarily work in the United States. The time period was limited to three years with no extensions. The U.S. Department of Labor classified the registered nurse occupation as experiencing significant shortages. It was deemed that the nurse shortage was not only negatively affecting the United States but other countries as well. This worldwide shortage of nurses was predicted to become more prevalent in the upcoming years. To reduce the nurse shortage, hospitals throughout the U.S. have increased wages and limited work shifts to no longer than 12 hours among other improvements. While this has helped attract more individuals to the nursing profession, the shortage still continues. Many are concerned that despite recent changes that positively effected recruitment and retention, the fact that many of the current nurses are on the brink of retirement and the demand for medical care continues to increase, no easy solution exists. Demand for nurses heavily outweighs the supply of registered nurses.

Associations such as the ANA (American Nurses Association), which has the largest membership of registered nurses, has publicly voiced concerns about increasing the number of H-1C visas. The ANA maintains that an increase in H-1C visas could potentially lead to the exploitation of foreign nurses. Nurses from foreign countries might be forced to work unreasonable hours, or as aides to other nurses. The ANA claims that they have received surmounting complaints about the exploitation of foreign nurses in the United States. In addition, the ANA believes that the U.S. needs to address the nursing shortage by first concentrating their efforts domestically rather than trying to recruit foreign nurses. Because there is believed to be a worldwide shortage of nurses, taking a nurse away from his or her home country would only further compromise the situation. Others believe that the ANA is trying to disguise their true intentions of acting in the best interest of their members. While some of these claims may be valid, there are other reasons why foreign nurses may find the U.S. to be an attractive place to work. Working conditions, wages, and opportunities may be better in the United States than in their home countries. It is important to note that foreign nurses allowed to work in the U.S. must meet certain qualifications; thus, not just any nurse can work in the United States. Due to the nursing shortage that continues to exist in the United States, many believe that bringing in foreign nurses to work even temporarily serves to assist American hospitals and provide better medical care to its patients. The H-1C visa classification expired on June 13, 2005.

There is currently no separate nurse visa classification in the United States. However, there are two ways that foreigners wishing to work as registered nurses in the United States can apply:

1. H-1B Work Visa
2. TN Work Visa (NAFTA - North American Free Trade Agreement)

The H-1B Visa has been successfully used to employee registered nurses (RN) in different states. In order for the petitioning employer to hire a foreign RN, the registered nurse must qualify for a specialty occupation. Although general RNs will not typically be eligible for H-1B status, certain specialized nursing occupations are likely to require a bachelor’s or higher degree as the minimum requirement for entry into that specialized field. Consequently, those positions have a great chance of satisfying the H-1B requirements.

Canadian and Mexican citizens may work in the United States in a specialty occupation under the NAFTA agreement. This visa classification is called a TN visa. Working as an RN is on the NAFTA list of approved professional occupations. However, there are particular requirements such as professional skills and criteria that need to be satisfied.