Working in the US as a Canadian is an easier move than you might think. Like any government process it can be tedious, but if you’re a lover of travel (or just striving towards some financial goals), coming to America might be one of the best things you’ve ever done........
I’ll share the main steps and some links to help get you there. A lot of people ask me how to get into travel nursing and the main deterrent I see is people become overwhelmed or don’t know where to start. A piece of advice: Don’t sweat the details. Go ahead and start the applications, take on the work as it comes. These visa screens, licenses, etc are just electronic forms the same as any other. There are clear instructions to guide you through from start to finish, and worst case scenario there’s always a help line you can call if you don’t understand what a form is asking. If this document starts to sound like jibberish, scroll to the end of this post for a review of some of the vocab.
Start your CGFNS VisaScreen. Here’s the link, just make an account and start it. This process can take 8-12 months (ick, snail mail) so the sooner you get crackin the better. Even if you just think maybe you might want to travel the US next year, do it now and keep your options open.
Get a state license. The non-negotiable part of this is to make sure the state will hire a nurse without a social security number (you can’t get a SSN until you have your TN visa, you can’t get a visa until you have a job offer). Common Canadian-friendly states include MN, WA, and NY. Depending on the state you choose you might need additional products from CGFNS, like a CES (Credentials Evaluation Service) - wait, confusing, isn’t this already part of my VisaScreen? That would make sense. But it’s not. Pay up.
Update courses while you wait. Your ACLS, BLS, PALS, etc need to be through the American Heart Association specifically. Luckily some courses moved online during COVID, I don’t know how long this will last, take advantage.
Find a nursing agency and get a job! This is where most people jump the gun. As soon as they decide to nurse in the US they want to find a recruiter to help guide them. The reality is that travel nursing is much more established and competitive in the states, and first-time Canadian nurses are more effort to place. Most recruiters aren’t going to give you the time of day unless you already have a visa screen and state license in hand. Once you have those documents, a recruiter will help you find a job that accepts first time travelers, and help you set up getting your Social Security Number and Trade NAFTA (TN) Visa.
Now if you’re just starting out, this information is probably overload /irrelevant at this time, but here’s the stuff I wish I knew as I was coming over, so save this for later.
Bank accounts - Ok turns out no matter what your credit is in Canada, you might as well be 18 again in the US. Here I was rocking into Chase super excited to get my hands on a Chase Sapphire only to find out I had no credit history. Oops. Do your research, I forget if any other companies offered a similar deal, but American Express offers a credit card application that takes into account your foreign credit history. You’ll also need a basic US checking account for your direct deposits. A US address is required to register so wait until you have housing set up.
Phone plans - Hindsight being 20/20 I probably should’ve bitten the bullet and changed my number, but I’ve had this number my whole life, my friends and family have it, my recruiters have it, it’s on my resumes - I’m lazy, sue me. Whether you keep your number or change it, of course get an international plan. Fun fact - some American apps can’t be downloaded on a Canadian Apple ID and vice versa (the MedVenture app is now available in Canadian regions, yay! Venmo still is not, boo). I also found issues with my Canadian phone number in signing up for some hospital covid symptom check-in systems.
Housing - As part of your discussion with your potential landlord, make sure they know that you’ll be coming over without a SSN to start. There’s a housing website here specifically for traveling healthcare professionals called Furnished Finder.
Health Insurance - Agencies usually offer health insurance packages that are active for the duration of your time working with them. If you plan on switching between companies or taking a lot of time off in between contracts, private insurance might make more sense for you.
Meeting People- MedVenture has changed my life in ways I couldn't imagine. I have made so many close friends on my first assignment in Austin utilizing the app, in turn, making my experience all worth-while. To download MedVenture app as a Canadian follow these steps: How to Download MedVenture as a Canadian
Taxes - We get the fun cross-border PLUS multi-state taxes! Unless you’re a wizard probably don’t do this yourself. Travel Tax seems to be the go-to for most travelers. I worked with them this year and they were phenomenal. Take a look at the documents they ask for at tax season, and save them as you go. You’ll love yourself later.
Things can become more complex, for example if your education doesn’t meet US standards or if you graduated before 2011 and didn’t write the NCLEX - you can find more information on the CGFNS website.
Not surprisingly, this process ain’t free. If you’re looking at the upfront costs involved and panicking, know that most agencies will reimburse you during your first contract - a great question to ask recruiters while you’re choosing an agency.
Cheat sheet for terminology and the process that no one explains:
CGFNS VisaScreen: looks at your schooling, current licensing, references, etc and evaluates if you meet US standards to qualify for your TN Visa. Once complete you get a certificate in the mail.
You take your VisaScreen certificate, identification documents and job letter and present them at the border when you cross. They give you your TN Visa (in the form of a passport stamp) and an I-94 (a record of your arrival to the states - can be a paper card or an electronic document)
TN Visa (aka Trade NAFTA Visa): allows Canadians to work in specific professional occupations, including nursing. This is a 3-year, non immigrant visa with unlimited renewals.
Social Security Number: the American equivalent of a SIN.
Only once you’re in the US can you set up an appointment at any Social Security Administration office. They review your TN Visa, I-94, and other documents. They also need a US mailing address, your social security card will come in the mail in a week-ish and finally you feel like a functioning member of society.
It’s been a year since I crossed the border (one of the best years of my life), feel free to hit me with any questions or updates in the comments or follow along on Instagram @meagansherryne.
Written By: Meagan Haayer, Canadian & Travel Medical Surgical Nurse