OCTOBER 2025 | 23 THE OKLAHOMA BAR JOURNAL Statements or opinions expressed in the Oklahoma Bar Journal are those of the authors and do not necessarily reflect those of the Oklahoma Bar Association, its officers, Board of Governors, Board of Editors or staff. to billion-dollar hospital systems. Ms. Hernandez graduated with highest honors from the TU College of Law and served as the editor-inchief of the Tulsa Law Review. She is an active member of the American Immigration Lawyers Association. ENDNOTES 1. S. Srakocic, “Understanding the American Nursing Shortage,” Healthline website (2021), http://bit.ly/4mQH98U (last visited Nov. 2, 2024). 2. M. Hoover, I. Lucy and K. Mahoney, “Data Deep Dive: A National Nursing Crisis,” U.S. Chamber of Commerce website (2024), http://bit.ly/3JNcmLw (last visited Nov. 2, 2024). 3. Srakocic, supra note 1. 4. A. Azar II and K. Sebelius, “To Solve the U.S. Nursing Shortage Crisis, the Country Must Change its Immigration Policies,” Time (2023), http://bit.ly/427lpx6 (last visited Nov. 2, 2024). 5. The term “nurses” is used generically in this article but refers to professionals who typically have either an associate’s degree (ADN) or a bachelor’s degree in nursing (BSN). The term does not include licensed practical nurses or certified nursing assistants. 6. Hoover, et al., supra note 2. 7. A. Feeney, “The U.S. Nursing Shortage: A State-by-State Breakdown,” NurseJournal (2024), http://bit.ly/4mZ8o11 (last visited Nov. 2, 2024). 8. Srakocic, supra note 1. 9. Azar and Sebelius, supra note 4. 10. Hoover, et al., supra note 2. 11. Additional websites related to shortages and current numbers: http://bit.ly/46nBfpR; http://bit.ly/3HWMgVU; http://bit.ly/4nb83YM; http://bit.ly/3I89E2B; http://bit.ly/47YVyLy; http://bit.ly/3VzS4HT. 12. Hoover, et al., supra note 2. 13. AAIHR, “The H-1D Act,” American Association of International Healthcare Recruitment website (2024), http://bit.ly/3Vyj6iP (last visited Nov. 2, 2024). 14. Srakocic, supra note 1. 15. Webster’s Dictionary defines baby boomers as those who were born in the U.S. following the end of World War II, between 1946 and 1964; www.merriam-webster.com (last visited May 25, 2025). 16. Srakocic, supra note 1. 17. R. Rosseter, American Association of Colleges and Nursing, “Fact Sheet: Nursing Shortage” (2024), http://bit.ly/4mRidhz (last visited Nov. 2, 2024). 18. Hoover, et al., supra note 2. 19. PB de Cordova, ML Johansen, IB Grafova, S. Crincoli, J. Prado, M. Pogorzelska-Maziarz, “Burnout and intent to leave during COVID-19: A cross-sectional study of New Jersey hospital nurses,” J Nurs Manag. 2022; 30 (6): 1913-1921. 20. Srakocic, supra note 1. 21. Hoover, et al., supra note 2. 22. Id. 23. Id. 24. J. Egan, “Immigration Restriction Cuts Nurse Supply,” SHRM website (2023), http://bit.ly/4gedNij (last visited Nov. 2, 2024). 25. Id. 26. G. Morris, “7 Key Challenges Faced by Nurse Educators Today,” NurseJournal (2023), http://bit.ly/4gaHLnc (last visited Nov. 2, 2024). 27. Hoover, et al., supra note 2. 28. Rosseter, supra note 17. 29. Srakocic, supra note 1. 30. Hoover, et al., supra note 2. 31. Id. 32. Id. 33. NCSL, “Barriers to Work: Improving Access to Licensed Occupations for Immigrants with Work Authorization” (2023), http://bit.ly/46bllgS, (last visited Nov. 2, 2024). 34. LE Masselink and CB Jones, “Immigration policy and internationally educated nurses in the United States: A brief history,” Nurs Outlook, 2014; 62(1):39-45. 35. Id. 36. Kaiser Family Foundation, “The Growing Role of Foreign-Educated Nurses in U.S. Hospitals and Implications of Visa Restrictions” (2024), http://bit.ly/4ngLAcJ (last visited Nov. 2, 2024). 37. Hoover, et al., supra note 2. 38. Exchange Visitor Program, http://bit.ly/4m6kTqj (last visited Nov. 2, 2024). 39. Masselink, supra note 35. 40. Id. 41. Id. 42. Id. 43. Id. 44. N. Ruiz, “Key Facts about the U.S. H-1B Visa Program,” Pew Research Center (2017), https://bit.ly/45VJObn (last visited Nov. 2, 2024). 45. Id. 46. “There are some situations, however, where the petitioner may be able to show that a nursing position qualifies as a specialty occupation. For example, certain advanced practice registered nurse (APRN) positions normally require a U.S. bachelor’s or higher degree in a specific specialty as the minimum for entry into these particular positions.” USCIS Policy Memorandum, Feb. 18, 2015, No. PM-602-0104. 47. Masselink, supra note 35. 48. Id. 49. Id. 50. Id. 51. Id. 52. Id. 53. Other employment options may exist for those participating in temporary exchange programs or those who receive approval for an entrepreneur or investment-based visa. See U.S. Citizen and Immigration Services (USCIS) website, “Working in the United States,” http://bit.ly/4m9AuW6 (last visited Nov. 2, 2024). 54. USCIS, “Students and Employment,” http://bit.ly/4p4pVpY (last visited Nov. 2, 2024). 55. Id. 56. Id. 57. U.S. Department of Homeland Security, “F-1 Optional Practical Training (OPT),” http://bit.ly/3HXUixL (last visited Nov. 2, 2024). 58. USCIS, “Optional Practical Training (OPT) for F-1 Students,” https://bit.ly/42hZt2l (last visited Nov. 2, 2024). 59. USCIS, “Optional Practical Training Extension for STEM Students (STEM OPT),” https://bit.ly/3Kbwp6m (last visited Nov. 2, 2024). 60. U.S. Department of Homeland Security, “Eligible CIP Codes for the STEM OPT Extension,” https://bit.ly/3VKqVly (last visited Nov. 2, 2024). 61. Immigration and Customs Enforcement, “DHS STEM Designation Degree Program List,” https://bit.ly/4nlQRjg (last visited Nov. 2, 2024). 62. HPSAs are determined by the U.S. Health Resources and Services Administration, which is governed by the U.S. Department of Health and Human Services. HPSAs are calculated based on factors such as the population-to-provider ratio of a given area, the percentage of that population below 100% of the federal poverty level and travel time to the nearest source of care. For reference, most counties in Oklahoma are considered HPSAs, including all of Tulsa County. See https://bit.ly/4m6yZYE (last visited Nov. 2, 2024). 63. USCIS, “Permanent Workers,” https://bit.ly/4mbjP4u (last visited Nov. 2, 2024). 64. K. Gaines, “How to Work in the U.S. as a Foreign-Educated Nurse” (2024), https://bit.ly/4noFkzT (last visited Nov. 2, 2024). 65. Azar and Sebelius, supra note 4. 66. Masselink, supra note 35. 67. CGFNS International, “VisaScreen: Visa Credentials Assessment,” https://bit.ly/41Fsp4g (last visited Nov. 2, 2024). 68. “Notice of Approval of New Credentialing Organization for Healthcare Workers for Certain Immigration Purposes,” 89 Fed. Reg. 85,229 (Oct. 25, 2024). Note that Josef Silny & Associates is mentioned in n. 1. 69. See rate information at: www.jsilny.org, www.cgfns.org/support/fee-schedule and https://myiee.org/pricing. 70. U.S. Dept. of Labor, “Prevailing Wage Information and Resources,” https://bit.ly/45Z2h72 (last visited Nov. 2, 2024). 71. U.S. Department of Labor news release Jan. 12, 2021, “Final Rule to Reform Prevailing Wages for Foreign Worker Programs to Prevent Potential Abuses,” https://bit.ly/41Jds0W (last visited Nov. 2, 2024). 72. U.S. Dept. of Labor, supra note 71. 73. U.S. Dept. of Labor, “Permanent Labor Certification,” https://flag.dol.gov/programs/perm (last visited Nov. 3, 2024). 74. U.S. Citizenship and Immigration Svcs., “I-140, Immigrant Petition for Alien Workers,” https://www.uscis.gov/i-140 (last visited Nov. 3, 2024). 75. Id. 76. U.S. Citizenship and Immigration Svcs., “Adjustment of Status Filing Charts from the Visa Bulletin,” https://bit.ly/46c3oit (last visited Nov. 3, 2024). 77. U.S. Citizenship and Immigration Svcs., Policy Manual, Vol. 6, Ch. 7, Schedule A Designation Petitions, https://bit.ly/3IgpZlZ (last visited Nov. 3, 2024). 78. U.S. Dept. of State, Visa Bulletin, https://bit.ly/4mb6Bot (last visited Nov. 3, 2024). 79. Id. 80. U.S. Citizenship and Immigration Svcs., “Visa Availability and Priority Dates,” https://bit.ly/3JN8muC (last visited Nov. 3, 2024). 81. Id. 82. Id. 83. Id. 84. Id. “By statute, these annual visa limits may be exceeded when certain immigrant visas from the previous fiscal year’s allocation were not fully used.” 85. U.S. Citizenship and Immigration Svcs., “Employment-Based Immigration: Third Preference EB-3,” https://bit.ly/46abVCu (last visited Nov. 3, 2024).
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