Specialized Canadian nurses stress over rules preventing them from working in U.S.

After years of being approved for work visas under the NAFTA agreement, advanced practice nurses and advanced clinical nurse practitioners have been told by U.S. Customs and Border Protection that they no longer qualify.

'Everybody is asking, what does this mean for them?' says Canadian nurse

Nurse Patti Kunkel of LaSalle, Ont., worries that rule changes at the U.S. border could prevent her from working at Detroit's Henry Ford Hospital. (Meg Roberts/CBC)

Some Canadian nurses working in U.S. hospitals are distraught after learning they can no longer renew their work visas.

After years of being approved to work abroad under the North American Free Trade Agreement (NAFTA), advanced practice nurses and advanced clinical nurse practitioners, known collectively as specialized nurses, have been told by U.S. Customs and Border Protection they no longer qualify.

At a news conference Thursday, staff at Henry Ford Hospital in Detroit said they are doing everything they can to get their nurses approved to work.

Patti Kunkel, an advanced clinical nurse practitioner from LaSalle, a small community near Windsor, Ont., works at Henry Ford. She and her colleagues worry the changes will affect them.

"Everybody is asking, what does this mean for them?" she said during the news conference.

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At least one Henry Ford nurse was turned away at the border on Friday, according to hospital officials. 

U.S. Customs and Border Protection issued a statement saying it has "not had any policy changes that would affect TN status." The statement attributes any challenges to "improper paperwork presented by the traveller."

"Another common issue is the lack of proper documents needed to grant a TN non-immigrant classification," according to the statement.

Marc Topoleski, immigration lawyer for the Henry Ford Hospital, scoffed at the response, saying it does not explain what nurses are experiencing.

"This is not what is happening in reality," he told CBC News. "The language in this briefing ... does not reflect what is actually happening in practice at the border right now."

High demand

Canadian nurses work in the U.S. under non-immigrant NAFTA professional (TN) visas. 

They fill important positions that have not been staffed with Americans because of the lack of a skilled workforce, according to Topoleski.

"There's a huge demand for them in the Metro Detroit region, and there just aren't enough people coming out of school to fill those positions," he said.

"Nurses from Canada have been a wonderful way for them to come into the United States to support U.S. health systems in providing patient care to Americans."

Immigration lawyer Marc Topoleski says Detroit hospitals rely on Canadian nurses to care for American patients. (Meg Roberts/CBC)

In a statement, MP for Essex Tracey Ramsey called the situation "completely unacceptable" and called on the federal government to raise concerns with Washington.

"Many families' jobs and livelihoods are at stake," she added.

TN visas widely used

An estimated 30,000 to 40,000 Canadians work in the U.S. with TN visas, which allow experts in certain fields — like economics and science — a fast track, provided they have a job offer.

Topoleski said the changes at the border stem from new U.S. immigration policies, but officials from the Cross Border Institute at the University of Windsor disagree.

The changes come from border security enforcing existing NAFTA regulations that have not been enforced before, according to Laurie Tannous, a special adviser to the institute.

"There is no NAFTA or legal challenge to what they are doing," she said.

There were far fewer specialized nurses needed in the U.S. when NAFTA rules were written, Tannous said.

The nurses have been advised they need to apply for H1B visa status, which is for more specialized employment. But those applications can cost between $3,000 and $4,000 US depending on the applicant, according to Topoleski.