Job Seeker Resources September 5, 2025

From Global Nurse To U.S. RN: The Staffing Pathway

Hello everyone, and welcome to Onwards and Upwards! We’re so pleased you’re here with us today we’ve got a great show lined up.

We were experiencing a little technical difficulty, but I think we've got it worked out now.

My name is Holly Musselwhite, and I’ll be your host today. I'm the Senior Clinical Manager for AMN International. I primarily work with our direct hire nurses and a bit on the staffing side as well.

In just a few minutes, we’ll be bringing on our guests, some familiar faces and some new ones. Joining us today are Xavier, John, and Dee. Dee might be a familiar face, but I don't think Xavier has ever been on before. And John it's great to see you! I believe this is our first time meeting.

We’re excited to have you with us, and we encourage you to use the chat. Let us know where you’re watching from, and feel free to drop in any questions you have for our guests.

Also, if you’re interested in working with AMN International, this is your opportunity to take the next step. Just check out the link below and apply at: amnhealthcare.com/international.

Why International Nurses Choose the Staffing Pathway

Coming up today, we’re going to talk about why international nurses choose the staffing pathway. If you’ve ever been curious about that journey, we’re going to answer your questions and hear a real, true-to-life story from someone who’s been through it—John.

I don’t see any comments in the chat just yet, so go ahead and share where you’re signing in from. We usually get guests from all over the world, and we’d love to know where you're tuning in from.

As we move through today’s discussion, please don’t hesitate to post your thoughts and questions.

Alrighty—now that we have our guests all on screen, I’d like each of you to introduce yourselves. Tell us a bit about your background and, most importantly, why you do what you do. I always enjoy learning more about the people behind the stories before we dive into the details.

Meet the Guests: Real Stories from Nurses and Experts

Let’s start with John. After John, we’ll hear from Xavier, and then Dee. Alright—take it away!

John Edwin Cachuela:
Hello, good morning everyone. My name is John Edwin Cachuela. I’m a Filipino nurse currently practicing in the United States. I arrived here three years ago with the assistance of O’Grady Peyton International and AMN Healthcare.

I currently work as a Behavioral Health Nurse in a facility in Western Massachusetts. I’ve been a nurse for 15 years, with experience in pediatrics, occupational health, and medical-surgical nursing. But what I truly love and what I’m focused on now is psychiatric mental health nursing.

Thank you, and I look forward to sharing more about my journey.

Holly Musselwhite:
Thank you, John. I can’t wait to hear more about that. Xavier?

Xavier Garza:
Thanks, Holly. Hi everyone, I’m Xavier Garza, the Senior Director of Sales Operations for AMN International. I’ve been with AMN for just over eight and a half years.

In my role, I lead the teams that support all of our clinicians before they move to the U.S., helping with the logistical process every step of the way. In addition, my team also supports our clinicians on the staffing side once they start their assignments providing social support and ensuring a smooth experience.

Dee:
Thanks, Xavier.

Hello everyone good morning, good afternoon, or good evening, wherever you’re tuning in from! I see we’ve got someone from the UK, the Philippines it’s wonderful to have you all with us today.

It’s so good to see John here. I’ve been with the organization for just over 18 years, and for the past eight, I’ve been working in the International Division. Holly asked earlier: Why do we do what we do? And for me, the answer is nurses like John.

John was actually one of the very first international clinicians I met when I transitioned to the International Division at AMN Healthcare. We’ve stayed in contact ever since, and he has shared so many milestones with us—both personal and professional. He is truly a testament to what can be accomplished here in the United States.

I’m so excited for you to hear his story—it’s genuinely motivational. And if anyone out there is still debating whether or not to pursue this path, I believe John’s journey will help you make that decision. So thank you, John, for being here today. I’m thrilled to see you!

Holly:
Alright, before we dive into the rest of our content today, I want to take a moment to look at the comments and see where everyone is watching from.

Kelvin is watching from the UK—great to have you here!
Maros is tuning in from the Philippines.
Mega already has a question: "How much does it cost to be an IRIS nurse?" Thanks for that, Mega. We may need a little more detail to give you the best answer, so feel free to clarify, and we’ll try to address it later.
Cymar says hello!
Rami mentioned enjoying the discussion so far and is excited to hear more about John’s experience—me too!
I’m going to challenge my pronunciation here—Co… Konani? Apologies if I got that wrong—is watching from Johannesburg, South Africa. That’s quite a distance; we’re glad you could join us!
Ally from London is a cardiac ICU nurse and already past the NCLEX—amazing job, Ally! Only one document left: the American Heart BLS. You’re so close!
Samar is signing in from Germany.
Pia mentioned some visa delays—we might touch on that a bit later, Pia. I see you’re currently in New York, so you’re on the same time zone as I am. Thanks for joining!

Please keep sharing where you're watching from and feel free to drop any questions in the chat.

Now, let’s begin today’s discussion by learning more about your journey to the United States. John, I’d love to start with you.

The Journey to Nursing in the U.S.: John's Story

What inspired you to become a nurse in the U.S., and how did you discover AMN Healthcare International?

John:
Yes—beyond my passion for nursing and my desire for more financial freedom and independence, I was truly motivated to pursue a nursing career in the United States because of the endless opportunities available for nurses here.

That includes possibilities like becoming a travel nurse, pursuing non-bedside roles such as clinical management or telehealth, or even advancing to independent practice as a nurse practitioner or nurse specialist, like a hospitalist.

I actually gained these insights while I was still in nursing school. That was 15 years ago, and even back then, I was already having conversations with nurses who were working in the U.S. I spoke with colleagues and family members who had firsthand experience working as nurses here. In fact, one of my cousins, who was nearing the completion of her assignment about four years ago through AMN Healthcare and OGP, highly recommended the agency to me.

She sent me the link, and I applied right away—and that’s where it all began. Looking back, I’m confident I made the right choice. I have no regrets at all. And now, I’m living the American Dream.

Holly:
Awesome, John. Thank you for sharing that—we’re definitely going to learn more as we go along. I want to switch over for a moment and ask Dee

Top Reasons Nurses Are Choosing the Staffing Pathway

What are the top reasons international nurses are choosing the staffing pathway through AMN International right now?

Dee:
Absolutely—thank you, John, for sharing a part of your story.

So, especially right now, with all the questions around visa processing, delays, and retrogression, the staffing pathway is truly the best choice. Why? Because once all your documents are submitted—which usually takes about 10 days—you get your I-140 filed right away. That secures your all-important priority date.

Now, we can’t control what happens with the visa bulletin—we can all hope it moves in our favor, but there are no guarantees. What we always say is: control what you can control.
And what you can control is making the right decision today—by applying at amnhealthcare.com/international and choosing the staffing route.

We’ll talk more about this as questions come in, but choosing staffing helps you secure your place in line. That’s something you can take control of, starting right now.

Plus, because we’re currently in a retrogression period, you actually have the benefit of time. You don’t have to decide right away where you want to be long term in the U.S. You’ll have time to explore your options—and our expert recruiters and support teams are here to guide you every step of the way.

If you have questions, doubts, or hesitations, don’t hesitate to reach out. We’re here to help. So again:

Control what you can
Secure your place in line
Choose the staffing pathway and you can get to the U.S. and live your own American Dream—just like John.

Holly:
Thank you, Dee—that was really helpful. We’re going to dive deeper into all of that shortly.

I also see a quick question from Deep Sharma, asking:
“Where can I apply?”

The answer: You can apply at amnhealthcare.com/international. We really appreciate your interest—thanks so much for asking!

I also see more folks sharing where they’re signing in from:

Deepa from India—great to have you with us. If you're from India and have had a prior filing, the timeline for nurses from India can be quite extended. But even if this is your first time applying, there are still opportunities, and we’ll touch on that as well.

Holly:
Visa filing timelines are currently retrogressed even further back for some countries—but that doesn’t mean you should give up. If this is your dream, we’re going to walk you through the key steps in the process so you’ll have a solid understanding of how everything works.

Arlene, I’ve seen your name pop up here before—so glad to have you join us again from Jamaica.
Nitioma looks like you're signing in from Ghana—asking about pre-NCLEX programs. We might touch on that later in the show, but I can tell you now that passing the NCLEX is one of the most critical steps if you’re aiming to work as a nurse in the U.S.

John, I’ve heard you have some interesting insights to share about the NCLEX experience, and I’m looking forward to hearing more from you in a bit.

But first, let me switch gears for just a minute.

Xavier, I wanted to ask you—onboarding is a huge part of the support process for nurses immigrating to the U.S., and I know your team plays a big role in that.

Onboarding and Relocation Support for International Nurses

How early does onboarding begin for an international nurse once they’ve been matched with a facility?

Xavier:
Great question, Holly. It’s definitely a very exciting time for clinicians as they prepare to move from their home country to their assigned location in the U.S.

The timeline for when our team begins the relocation and onboarding process really depends on where the clinician is being placed, especially due to varying state licensing requirements.

Generally speaking, our team reaches out approximately six to eight weeks before a clinician is scheduled to start their assignment. During that time, it’s really a discovery phase—we learn all the details about what their relocation will look like.

For example, we’ll find out:

Are they traveling with family?
Will they be bringing pets?
Are they shipping household goods?
What are their preferences for housing?
What kind of community or school district would be ideal?

Once we gather this information, we schedule follow-up calls to reconfirm everything—because as we all know, plans can change, and we want to stay aligned with any updates.

Our goal is to make sure that when we start presenting housing options or researching the best school districts, it’s all tailored to each clinician’s needs. So again, it typically starts six to eight weeks before the expected travel date, and throughout that time, we stay in close communication.

We help coordinate housing, support the application process, and take care of the small details that can make a big difference—so that what could be a stressful international move becomes as smooth and stress-free as possible.

Holly:
Thanks, Xavier—that’s incredibly helpful. As you can see, a lot of planning, communication, and support goes into making this transition as seamless as possible.

Now, John, let’s go back to you.

What Sets AMN Apart for International Nurses

What made you feel that AMN was the right decision for your journey?

John:
Well, my cousin—hi Justin!—highly recommended AMN Healthcare to me. But I also did my own research. I looked into the organization’s history, read reviews from both current and former employees, and really took the time to learn about their background online.

Back then, AMN International was still operating under O’Grady Peyton International, a division of AMN Healthcare. I discovered that they had around 35 to 40 years of experience in the industry, which showed me they were well-established and knowledgeable in handling the entire process for international nurses.

I found many positive reviews, and at that time, they offered a pre-NCLEX program, which supported me in preparing for the exam. After I passed my NCLEX, they filed my petition right away. It took only seven months from passing the exam to starting my new adventure in the United States.

That quick timeline was possible because the visa bulletin was current—this was about three years ago. Signing with them really changed my life. I still can’t believe it sometimes—when I’m driving around, I just think: Wow, I’m really here in America, living my dream.

And just last month, I was able to bring my parents to visit. We traveled around the U.S., including New York, and I took them to the places I had always dreamed of showing them. I’m so grateful I was able to achieve this—not just for myself, but also for my family.

I’ve also been able to send my sister to school, and one of my sisters is now in Canada, working her way into the nursing field too. All of this happened because I pursued my career here in the U.S.

Holly:
That’s truly a powerful testament to the ripple effect one opportunity can have. Hearing how your journey has connected others—whether it’s inspiring a family member to pursue nursing or fulfilling a lifelong dream to visit the U.S.—it’s really heartwarming. Thank you for sharing those pictures and memories with us, John.

Staffing vs. Direct Hire: What Nurses Should Consider

Now Dee, for those tuning in who may be trying to decide between a staffing opportunity and the direct hire route, what should they consider?

Dee:
Such a great question—and one I really love discussing!

There are a few important things to consider. First and foremost:
If your main priority is to secure your priority date, then choosing the staffing pathway is the fastest way to do that. Why? Because with staffing, you don’t need to have selected a specific location or facility before your I-140 can be filed. That means your process can begin much sooner.

Now, I know I’ve seen some questions in the chat about the visa bulletin and what might happen in the next fiscal year. And the truth is—nobody really knows. It might retrogress further, it might stay the same, or it might move forward. That’s why it’s so important to control what you can control—and that means establishing your priority date as early as possible, regardless of what happens with the visa bulletin later.

Secondly, if finances are a concern—which is true for many nurses—then the staffing pathway with AMN Healthcare International offers significant financial support. Most of your processing costs are covered for you.

For example:

Your I-140 filing
Your Visa Screen, if you don’t already have one
An English preparation course, if needed

So if those costs are a barrier for you, staffing can remove much of that burden and still help you reach your goals.

Dee:
That’s something that can be really appealing—especially if finances are a challenge in getting started, because let’s be honest: it can be expensive.

By choosing the staffing pathway, AMN Healthcare International takes care of the majority of those costs for you.

In addition, the immigration process—all the forms, documentation, and filings—can be very confusing. John can definitely attest to that. It’s overwhelming and sometimes even daunting.

That’s why we’re here to support you every step of the way—from your Visa Screen application to your I-140 petition and everything in between.

So, as you're deciding between the staffing pathway (which is what today’s show is all about) and the direct hire pathway, keep in mind:
The staffing route is the fastest way to establish your priority date.
We offer full support throughout the process.
And here’s one more very important reason:

Sometimes—though we don't like it—job offers may be rescinded, depending on market shifts. If you're on the staffing pathway with AMN Healthcare International and that happens, we’ll simply find you another assignment.
Your I-140 petition remains active, and your process is not affected. It’s like having a safety net, which can offer huge peace of mind.

I know John will share more context based on his experience, but those are the top four reasons why now is the perfect time to choose the staffing pathway.

I’m excited to take more questions as we continue through the show—I hope that information was helpful to everyone!

Holly:
It absolutely was, Dee—thank you. That was great information.

We’ve had quite a few questions coming in, and while we want to cover as much as possible today, I’m going to quickly address a few of them.

One of the questions was from Aliza, who asked:
"What about hospital experience? Is at least two years still required? What if I have no experience?"

Dee, do you want to speak to that?

Dee:
Absolutely.

Right now, in the current environment, our clients are specifically looking for bedside experience. So, if you have at least one year of hospital experience and you’ve passed the NCLEX, then we want to hear from you!

If we look back about two years ago, things were a bit different—right after COVID, hospitals were more flexible with different types of experience. But now, they’re primarily looking for current bedside experience.

So if you're listening today and you’re not currently working at the bedside, we highly encourage you to start looking for opportunities to get that experience, because it will make your application much stronger.

So, the short answer is:
✅ Yes, you do need hospital experience—preferably bedside—and
✅ You should be actively working or have recent clinical experience to be competitive.

Holly:
Thank you for clarifying that!

Also, we got a lovely comment from Samar, who said:

"I don’t regret choosing AMN. They don’t abandon their hired nurses—even when failures happen. They’re eager to help and very considerate."

And that’s so true. Our entire team at AMN believes that your success is our success. We genuinely care about helping you succeed—and even if things don’t always go as planned, we’re here to support you, adapt, and keep things moving forward.

Holly:
From those experiences, Samar, we really appreciate that you chose us to be your partner in your journey. Thank you so much!

How AMN Prepares Nurses for Success Before Arrival

Now, Xavier—what role does your team play before a nurse even arrives in the United States?

Xavier:
Another great question, Holly.

As part of the onboarding process—as we mentioned earlier—our goal is really to stay in constant communication and ensure that the clinician feels well-prepared before arriving in the U.S.

That includes helping secure flights if needed, or if the clinician is booking their own flight, making sure it’s appropriate and aligned with their travel plans. We also answer any questions or concerns they may have and help them become familiar with the area they'll be moving to. After all, they’ll be setting down roots in this new community, and we want them to feel welcomed.

We also coordinate with the hospital where they’ll be working, so that they’re warmly received when they start their assignment.

So really, a lot of what we do is focused on clear communication—making sure all the T’s are crossed and I’s are dotted. That way, by the time they board the plane, they’re as prepared as possible for their new life in the United States.

Holly:
Thanks so much, Xavier. As you can tell, there’s a lot that goes into this process, just like Xavier described.

What’s really meaningful about working with a company like AMN Healthcare and the international team is the depth of experience they bring. That includes understanding which locations are ideal to fly into, which airports offer smoother immigration processes, and how to navigate things like interviews and paperwork.

These nuances really do matter. And that’s why choosing a partner with years of experience—who knows how to guide you through all of this—can make a huge difference.

Now, we’re going to move forward in our agenda and talk about settling in—and the type of support available during that stage.

John, I want to start with you: what was your arrival experience like, and what kind of support did you receive from AMN International?

John:
Actually, I received a lot of support from AMN.

From my pre-NCLEX preparation to my I-140 application, to being matched with a facility, and eventually to receiving my visa—the support was excellent throughout. I was really impressed with how well they support international nurses like me.

After getting my immigrant visa, I flew to the United States in April 2022 for my SS entry. I stayed in New York for two days, and then returned to the UK, where I was still working at the time, while I waited for my Massachusetts RN license to be ready.

While I was waiting for my license, Aurora from the relocation team helped me secure an apartment. When I officially moved to the U.S. in June 2022, the process was seamless. AMN even paid my initial rent, and I was able to repay it over six months—with no interest. That really helped me a lot financially.

When I arrived, they also assigned me a licensure officer—his name is Kevon (Hi Kevon!)—who assisted me with everything from getting groceries, setting up a bank account, to providing rides. He really helped me settle in.

John:
Kevon even introduced me to Chick-fil-A—so thank you so much for doing that, Kevon! I really appreciated all the help I received from AMN. Truly, thank you.

Holly:
It’s our pleasure. I have to say, that’s one of the unique aspects of the staffing side of things—the ability to truly connect you with all the resources and spend the time with you.

That’s something that sets staffing apart from direct hire, which Xavier may be able to touch on a bit more later.

Now, one thing we also want to understand is:
What are the key expectations AMN sets for nurses before they arrive in the U.S.?
How does AMN communicate what’s needed and how to prepare?

Xavier:
Absolutely, great question.

It really all starts with that initial phone call with your recruiter. In that conversation, we focus on understanding your motivations for coming to the U.S.—what’s important to you, whether you have family or friends here, and more.

It’s a crucial part of the process because this is a partnership. Yes, we want you to choose AMN Healthcare International to support you on your journey, but it's a two-way relationship—we each have responsibilities.

One of the key responsibilities we ask from you is to continue working at the bedside, ideally within your specialty and in a hospital we’ve mutually approved. If any changes happen—whether it’s a job change, a move, or anything else—it’s important that you communicate with us.

We’re not saying you can’t make changes. For instance, if you want to relocate to another country to practice nursing while waiting to arrive in the U.S., that’s often okay. We just want to stay in constant communication with you throughout the process.

Like I mentioned, everything begins with the recruiter, but by choosing the staffing pathway, you also gain access to each of our dedicated departments. We provide support not only from a financial standpoint, but also through hands-on guidance to make sure your process is as smooth as possible.

John mentioned our team’s extensive experience—over 40 years in this space. That experience translates into team members being assigned specifically to your case, ensuring that every “i” is dotted and every “t” is crossed. We do this to prevent any delays in your application caused by minor errors or questions.

When you choose the staffing pathway, you’re working with people who know immigration processing inside and out. You can feel confident that your journey will be as seamless as possible.

Then, once you've selected where you want to be—like John, who chose Massachusetts—you have full control over that decision. He may have had other options, but ultimately, he made the choice to be there.

And I know we’ll be getting into this shortly, but I want to emphasize:
There are a lot of misconceptions about the staffing pathway—particularly when it comes to where you’ll be working. Let me be clear:
That decision is 100% yours.

Holly:
For the most part—and John is a great testament to this—you choose to stay in your assigned location because you’ve built experience there. You’ve made friends, you feel happy, excited, and settled.

Throughout the entire process, you’re working closely with our team, and communication is key. We always make sure to keep you informed if anything changes or if there are updates regarding your process.

But again, this is a partnership. We both have responsibilities to ensure your journey is as smooth and seamless as possible.

Hopefully that helps! I’m excited to take more questions.

Holly:

Awesome, thank you! I’d like to direct the next question to Xavier.

Xavier, we heard from John earlier about the support he received. Can you share more about the systems in place to ensure international nurses and professionals don’t feel alone during those first few weeks and months—especially as they begin building the connections Dee mentioned?

Xavier:
Yeah, absolutely—great question.

And thank you again, John, for sharing earlier. I also want to give a shout-out to Cab, our amazing Community Liaison. That role is part of the initial support services we provide to every clinician on the staffing side.

When you arrive in the U.S., entering a completely new community or city can feel overwhelming. That’s why we assign community leads to welcome and support you in your new area.

These community leads help with practical tasks to get you ready for your assignment. That includes things like:

Getting a cell phone
Setting up a bank account
Visiting the Social Security office
Enrolling in BLS/ACLS courses if needed
Providing transportation support
Going to the department store or buying groceries
Helping enroll your school-aged children in local schools

You’ll receive this hands-on support during your first week or so in the U.S. It really helps make the transition smoother—from getting welcomed, settling into your new home, and starting your new life.

And yes, to John’s point—every community liaison seems to introduce people to Chick-fil-A! It's one of the best fast food spots here (though maybe don’t get too addicted right away!).

In addition to that support, we also recognize how important it is for your partner or spouse to feel settled too. That’s why we offer employment support for partners.

Our Clinician Support team works with your partner to:

Review and improve their CV/resume

Connect them with our career support partners

Assist with LinkedIn profile building

Help them find employment as soon as possible

And finally, throughout your assignment, every clinician is assigned a Clinician Support Specialist. This dedicated team member will be your consistent point of contact—providing social and emotional support throughout your journey.

So you're never alone. From day one, we’re with you every step of the way.

Holly:
Thanks, Xavier—and I think that really speaks for itself when we hear stories from nurses like John.

He made it over—I like to call it “making it over the hump”—that initial adjustment period, which can be really challenging. And yet, as you mentioned, there’s also that long-term support.

We’re all going to have bumps in the road, and having someone to reach out to—sometimes just someone who will listen or be an extra pair of ears—can make a big difference depending on what you're dealing with.

John, can you share a moment when the onboarding team really made a difference in your experience?

John:
Yeah, as Xavier mentioned earlier, we were assigned a Clinician Support Specialist, and they really maintained constant communication with us.

I remember there was a time when I had questions about taking time off because I really wanted to go back to the Philippines. And throughout that process, there was open communication between my Account Manager and the Clinician Support Specialist.

Any time I had questions, they were always available, and that really made a difference. I never had any issues during my assignment.

I also received support from other AMN Healthcare colleagues who were on assignment too—they were my greatest support system when I first started here in Massachusetts.

So honestly, I believe it was the consistent support from AMN Healthcare that helped me succeed. That’s why I was able to complete my assignment and choose to stay in the same facility where I’m currently working.

Holly:
Absolutely—thank you, John.

Building Trust and Long-Term Relationships

Dee, John’s shared so much about his experience. Can you summarize how AMN builds trust with candidates before and after they arrive in the U.S.?

Deirdre:
Absolutely! As I mentioned earlier, it all starts with that initial phone call—speaking with a recruiter about what you're looking for, your personal and professional goals.

One thing you can always expect from us—and I think John would agree—we're always going to tell it like it is.

If we're reviewing your background and it doesn't quite match the role or location you’re aiming for long term, we’ll guide you through that honestly.

Trust is essential, and sometimes we’ll have to share things you may not expect to hear—but it's always to help you understand what’s coming next.

Sometimes the process can take a while. John mentioned he got to the U.S. in seven months, which is amazing—but that’s not the current timeline right now.

As we go through different phases of the process together, we need that mutual trust and rapport so we can have honest conversations about what’s best for you and your family.

We want you to thrive, especially if you're coming here with your loved ones. We want you to stay long term.

Even after your initial commitment is complete, we want you—just like John—to say:

“You know what? I really like it here. My facility offered me a permanent position. I’m going to stay.”

That’s the goal. But we can't get there without building that trust—and that starts on day one.

So pick up the phone, give us a call—we’ll guide you in the right direction.

And like I said earlier, even after your commitment ends, we stay in touch. Once you’re part of the AMN family, you’re always part of the AMN family.

Let me give you an example—John. We've been through a lot together. I remember when he was taking his driving test, when he continued his education, when his parents were coming to visit—he kept us updated.

That’s why we do what we do.

John's been here for three years. His commitment to AMN is complete. He’s been very successful—but here he is, still engaged, still part of the community.

And that’s so important in choosing a partner to help bring you to the U.S.

John is the reason we do this—and he’s going to be a friend for life. I think you’re stuck with us, John!

Holly:
Oh my goodness. John, I’ve heard a little bit about how you’ve grown professionally since arriving—but I’d love to hear it from you.

Achieving Career Growth Through the Staffing Pathway

How has AMN helped you grow professionally since you got here?

John:
Well, four years ago, I was already talking to Deirdre about my plans before I even got to the U.S.

My ultimate goal has always been to become a Nurse Practitioner—and now I’m just two semesters away from completing my Master’s in Nursing, specializing in Psychiatric Mental Health Nurse Practitioner.

I’m really on my way to realizing my dream. I can’t wait to expand my nursing career and give back to my future patients here in the U.S.

Holly:
That’s amazing. So you're actually specializing in the area you currently practice in?

John:
Yes, exactly! Psychiatric nursing is my passion, as I mentioned earlier.

I started my program in 2024, so it’ll take me about two and a half years total. I’m halfway through and about to start my clinical rotation—which I’ll be doing at the same facility where I currently work.

I’ve made so many connections with the providers here. I talked to them, and they allowed me to do my clinicals in our facility and even with other locations under Baystate Health.

That’s one more way that AMN has really helped me grow and expand my career as a nurse here in the United States.

Holly:
Wow, congratulations on being so close to the finish line!

We’ll definitely want to hear from you again once you’ve completed the program—so we can celebrate with you!

Holly:
Alright, Dee—some people might be hearing John’s story and thinking, “That sounds like something I’d love to do.”

But it requires long-term planning and…

Security and the Staffing Model

So how does the staffing model create long-term security for an international nurse?

It all starts with securing that all-important priority date. I saw a question in the chat: How soon after your documents are completed is your I-140 filed? The answer is—immediately. Once you decide to partner with AMN International to come to the United States, the support begins right away.

There are a number of documents required to ensure that your I-140 petition is filed smoothly. We help you through that process. If you’re able to submit your documents in two days, your I-140 will be filed the next day. If it takes ten days, we file the day after that. It’s really all about how quickly you can provide what’s needed.

As Holly mentioned, this kind of support requires planning. You don’t just wake up one day and decide to move your entire family to the U.S.—it’s something you've likely been thinking about for a long time. And that’s why our goal is not just for you to arrive, but to thrive. If you’re bringing your family, we also help with spousal support, which Xavier spoke about. That’s going to be a key part of your journey too.

Once your process starts, you’ll begin to feel more confident and comfortable knowing that we truly have your best interests at heart. If you’re very location-specific, that may mean your process takes a bit longer. But that’s also the beauty of choosing the staffing route—you don’t need to choose a location right away. There are opportunities across the U.S., and what’s available today, August 8, 2025, might look very different in August 2026 or 2027, when you’re ready to arrive.

As John mentioned earlier, from day one you start to feel the support. And that’s important. Choosing the staffing pathway gives you a kind of safety net. In the unlikely event something happens with a position you’ve accepted, we’ll work to find you another—ideally in the same location or nearby. You have the advantage of time and our strong relationships with facilities across the country.

By choosing AMN International, you're not only backed by over 40 years of experience, but you also gain access to a wide variety of positions. And since motivations and priorities can change, that flexibility matters. Hopefully, that gives everyone peace of mind.

We’d love for you to join our next show and share your success like John is today. We’re so fortunate he chose AMN International. I still remember that first conversation when John, who was then in the UK, told us he wanted to become a nurse practitioner. And now, here he is—just two semesters away. That’s a true testament to what’s possible when you choose the right partner.

Future Goals – John’s Story

Thanks, Dee. I think that’s a great segue into asking John about what’s next. So, John, what are your future goals, and how is AMN going to help you get there?

John: As I’ve mentioned before, I really want to become a psychiatric mental health nurse practitioner, and AMN has really helped me realize that goal. Before I even finished my assignment with the facility I was placed in, I was given an offer to become a permanent employee. I accepted it because I truly appreciated the support I received—both from the facility and from AMN.

My manager is incredibly supportive, and my colleagues have been there for me since day one. All of that happened because AMN gave me options and placed me in a facility with a strong support system. I didn’t have any issues during my assignment, and I successfully completed my contract. That’s how AMN has helped me in my journey here in the U.S.—so thank you.

Visa Bulletin Concerns

It’s been our pleasure, John. I’d like to respond to a comment from Nohara in the chat, which mentions the visa bulletin and some concerns about it moving slowly.

Nohara, we completely understand your concern, and you’re right—there’s been a lot of speculation. While the movement isn’t as fast as it was during or right after COVID, we are still seeing forward movement. That’s why we continue to encourage people to apply. We’re working with hospital partners to plan and prepare well in advance, matching candidates like yourself with the best possible fit.

Even though the process isn’t as quick as it used to be, it is still happening. We continue to welcome nurses, and the dream is still very real. We know this can be discouraging at times, especially when it feels slow, but we want to remind you that progress is being made. You might not see it immediately, but it’s there.

We don’t have a crystal ball for how quickly the visa bulletin will move. Our team—along with our expert attorneys—will continue sharing updates through our Onwards and Upwards immigration shows. There’s another one coming up next week, where we’ll talk about projections and possibilities. But until the U.S. government issues new bulletins, we just keep moving forward.

We also stay in touch with our candidates and help them stay ready. You may wait a little longer than you’d like, but in the end, you’ll get here, and you’ll be able to achieve your dreams. That might even mean opening up opportunities for your family and friends, too.

And finally, we had a map showing all the different locations where we have partnerships. There are many—and more are added every day. We’re still seeing nurses begin their journey regularly; it’s just taking a bit longer than before.

Supporting Nurses for Success at the Facility

When nurses first arrive, there’s a lot going on—they're navigating a new environment, a new system, and sometimes even a new country. One of our biggest goals is to help them adapt and succeed, starting with making the entire onboarding and relocation process as smooth and stress-free as possible.

We want nurses to feel prepared and focused on their first day. That means ensuring their relocation is complete, their home is ready, their children are enrolled in school, and their families are supported—including assistance for their partners in finding employment, if applicable.

This strong start is made possible through the combined efforts of our relocation and onboarding team, our clinician support specialists, and especially our clinical managers. Every clinician is assigned a clinical manager—often a registered nurse themselves—who serves as the primary point of contact during the assignment. Whether it's answering questions or building confidence, our team is there every step of the way.

The most important thing is that nurses have support. Clinical support, emotional support, and practical support—it’s all part of the experience. We are here to walk with you, hand in hand, for as long as you need us. And that support never goes away.

Busting the Myths About International Staffing

Let’s address some common myths about international staffing—and share the reality:

Myth 1: You'll earn less money.

False.
You get to review your compensation details before accepting any assignment. Your pay will align with the cost of living in the area you choose, and your recruiter works with you to make sure it fits your needs.

Myth 2: You don’t have options.

False.
You’ll have several opportunities to choose from—sometimes even 10 or more. We have relationships with facilities across the U.S., and you’ll be shown everything you qualify for.

Myth 3: You don’t get to choose your location.

False.
You absolutely choose where you want to go. If you're aiming for a very specific area, it may take a bit longer—but the decision is always yours.

Myth 4: You must decide your location right away.

False.
Take your time. The key is to get your I-140 filed to secure your priority date. Everything else can be sorted as you progress.

Myth 5: You need English proficiency before applying.

False.
You do not need to pass an English exam to apply. We’ll enroll you in a preparation course with one of the best partners in the industry. While IELTS is highly recommended (accepted in more states than PTE), you don’t need English to start your journey.

Myth #7: "I’ll just be treated like a number."

Also false.
John, one of our nurses, shared that he and all his colleagues from AMN Healthcare chose to stay at the facility after completing their assignments. That sense of belonging and being part of a team was real—and lasting.

Being the “new kid on the block” can be tough, but it’s also a great opportunity to grow roots in a new community. Many of our nurses form strong bonds with their teams and find long-term homes where they started.

John’s Advice to Nurses Beginning Their Journey

John shared valuable advice from his own experience:

Start now. Don’t wait for your visa to be current. File your application early so you’re ahead of the line.
Prepare for your NCLEX and begin your English preparation as early as possible.
Research your options—whether it's staffing or direct hire, choose a reputable company like AMN Healthcare, with 40+ years of experience.
Keep your clinical skills sharp. Maintaining bedside experience helped John transition more smoothly.
Learn practical life skills. Cooking can help save on expenses. Driving gives you freedom and flexibility.
Stay positive. The process may be stressful, but trust it. Keep praying. Four years ago, John was in your shoes—today, he’s living the life he once prayed for.

Closing Thoughts

Thank you to John, Dee, and the entire team for the insights and encouragement. As John said, don’t wait—start your journey today by applying at amnhealthcare.com/international.