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For many nurses dreaming of a career in the United States, one of the most confusing terms you’ll encounter is “retrogression”. It’s a word that often sparks concern, uncertainty, and plenty of misinformation. 

The good news? Retrogression does not mean your U.S. nursing journey is over. Understanding what it is and how to prepare can help you make smarter decisions and avoid costly delays. 

What is retrogression? 

Retrogression occurs when the number of people applying for U.S. immigrant visas exceeds the number of visas available in a particular category or country. 

Many internationally-educated nurses apply through the EB-3 employment-based immigration pathway. When demand becomes higher than the number of visas allocated, applicants may need to wait longer before they can move forward with their visa processing. 

The U.S. Department of State publishes a monthly Visa Bulletin that shows which applications can proceed based on their priority date. 

Why does retrogression affect nurses? 

The United States continues to experience nursing shortages, which creates strong demand for qualified international nurses. However, visa allocations are limited by law. 

As a result, nurses from countries with high numbers of applicants may experience longer waiting periods between filing paperwork and receiving final visa approval. 

Common myths about retrogression 

Myth 1: “I should wait until retrogression ends before starting my application.” 

Reality: Waiting can actually place you further behind. Many immigration professionals recommend starting your preparation early so that your documents, credentials, and testing requirements are ready when opportunities arise. 

Myth 2: “Retrogression affects everyone equally.” 

Reality: Processing timelines can vary depending on factors such as country of chargeability, priority date, and visa availability.  

Myth 3: “There is nothing I can do while waiting.” 

Reality: There are many productive steps you can take during retrogression. Let's talk about some of them here.

What should nurses do during retrogression? 

Use this time to strengthen your application: 

• Complete your English language testing requirements.
• Prepare licensing and credential evaluation documents.
• Gain additional clinical experience where possible.
• Research potential employers and recruitment partners.
• Stay informed about monthly Visa Bulletin updates. 

Nurses who use waiting periods strategically are often better positioned when visa movement resumes.

Focus on what you can control

Retrogression is a reality of the U.S. immigration system, but it does not change the long-term demand for qualified nurses.

Rather than focusing on delays you cannot control, concentrate on building a complete and competitive application. Every document prepared, test completed, and requirement met brings you one step closer to your goal.

Key takeaway

Retrogression may affect timing, but it does not eliminate your opportunities. Nurses who stay informed, continue preparing, and monitor official updates are often in the best position to succeed when their priority date becomes current.

We have more articles to support you on your nursing journey, so keep checking our inspiration and advice page for more. 

Planning to work as a nurse in the United States? The earlier you prepare, the smoother your journey is likely to be. 

Many delays occur because applicants discover missing documents or requirements late in the process. Creating a readiness plan can save you significant time later. 

Use this checklist to help prepare for your future U.S. nursing career. 

1. Confirm your nursing credentials 

Gather and organize your: 

• nursing diploma or degree
• professional licenses
• academic transcripts
• employment records

Having these documents readily available can help streamline future application processes. 

 2. Understand the U.S. nursing pathway 

Take time to learn about: 

• employment-based immigration pathways
• licensing requirements
• credential evaluation processes
• state-specific requirements

Getting a clear understanding of the process helps you to set realistic expectations.

3. Prepare for English language testing

Many nurses need to demonstrate English proficiency as part of their pathway. Starting your preparation early can improve your confidence and give you flexibility when booking test dates.

4. Build your professional experience

Continue developing your clinical skills and maintain your professional practice where possible. Experience can strengthen your profile and may increase your employment opportunities.

5. Create a personal document tracker

Keep copies of important documents in a secure location and track:

• expiration dates
• license renewals
• passport validity
• testing results

Being organized reduces stress later in the process.

6. Stay updated on visa and immigration changes

Immigration policies and visa availability can change over time. Make sure you follow official government updates and reputable industry resources so you can be sure you have accurate information when making decisions.

TruMerit (formerly CGFNS) is a good source of up-to-date and relevant information.

7. Develop a financial plan

The cost of an international career move can often add up, with expenses for testing, documentation, licensing, and travel. Creating a savings plan early can help reduce financial pressure and keep your goals on track.

Why preparation matters

Successful applicants often begin preparing months or years before they receive employment opportunities. The more requirements you complete in advance, the better positioned you may be when the right opportunity becomes available.

Key takeaway

Working as a nurse in the United States is a long-term goal that requires planning, patience, and persistence. Focus on the steps you can take today. Every document organized, every skill developed, and every requirement completed brings you closer to achieving your professional ambitions.

We have more articles to support you on your nursing journey, so keep checking our inspiration and advice page for more. 

One of the most common questions asked by nurses considering employment in the United States is: 

“Do I need hospital experience before I can apply?” 

The answer is not always straightforward. Requirements can vary depending on the employer, healthcare facility, staffing agency, and state. 

Understanding the difference between immigration requirements and employer requirements is critical.

Immigration requirements vs. employer requirements 

 Many nurses assume that hospital experience is a mandatory requirement for US immigration. Eligibility and employer hiring criteria are often separate considerations. 

 While immigration pathways focus on professional qualifications and documentation, individual employers may establish their own separate hiring standards.

Why employers value clinical experience 

Healthcare employers often prefer candidates who have clinical experience, as it can help demonstrate that they can adapt quickly to patient care environments and clinical workflows. 

 Relevant experience may demonstrate: 

• clinical competence 
• confidence in patient care 
• familiarity with healthcare systems 
• ability to work in high-pressure environments 
• professional maturity.

Some employers may require specific amounts of recent bedside nursing experience, while others may offer opportunities to nurses with more limited experience.

Common areas of experience sought by employers 

Depending on staffing needs, employers may seek nurses with backgrounds in: 

• medical-surgical nursing 
• critical care 
• emergency nursing 
• operating theatre services 
• long-term care 
• specialty nursing fields.

 Demand can vary significantly by location and employer. 

What if you have limited experience? 

If you are early in your nursing career, don’t assume your US plans are impossible. Instead: 

• continue building skills – seek opportunities to develop clinical confidence and broaden your patient care experience.  
• Prepare other requirements – focus on completing English language testing, credential evaluations, and licensing requirements.  
• Research potential employers – different employers have different expectations. Understanding these requirements early can help you plan your career development effectively.  
• Speak with trusted recruitment partners – reputable recruiters can provide guidance on current market expectations and employer preferences. 

Avoid making decisions based on rumors 

One of the biggest challenges for aspiring US-bound nurses is the amount of conflicting information available online. It's important that you always verify information through official sources and trusted industry professionals before making major career decisions, so you can be assured that those decisions are based on accurate information. 

Key takeaway

Hospital experience can strengthen your application and expand your employment options, but requirements vary widely. The most effective approach is to understand your target employers, build your professional skills, and ensure your application remains as competitive as possible.

We have more articles to support you on your nursing journey, so keep checking our inspiration and advice page for more.