Why Canadian and Mexican Nurses Are Choosing the TN Visa Pathway— and Where They’re Heading in the US

The United States continues to face a critical nursing shortage, prompting hospitals and health systems to search beyond national borders for qualified talent. As a result, we are seeing many Canadian and Mexican Registered Nurses (RNs) turning to the TN visa, a streamlined, profession-specific immigration pathway created through the United States–Mexico–Canada Agreement (USMCA).

This visa category has become one of the most reliable and efficient mechanisms for addressing workforce gaps across the American healthcare system.

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In this article, we explore why the TN pathway is booming and which US regions and facility types are emerging as major destinations for TN visa Nurses.

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Why the TN Visa Pathway Is So Attractive for Canadian and Mexican Nurses

1. Fast, predictable, and cost-effective entry to the US workforce

The TN visa remains one of the fastest and most accessible options for Canadian and Mexican Nurses. 

• The TN programme is fully intact under the USMCA and continues to permit qualified Nurses to work in the US with no new restrictions, even amid recent trade tensions.  

• The process is significantly faster than other employment-based visas: Canadian Nurses can obtain TN status at the border in days, while Mexican Nurses typically secure a visa within weeks.  

Compared with the H1B or EB3 processes, the TN visa involves no annual cap, no lottery, and lower administrative burden, making it a preferred option for both employers and Nurses. 

2. Strong financial and career incentives

For many Nurses, especially Canadians, the TN visa offers a substantial economic advantage. 

• US-registered Nurses earn significantly more than their Canadian counterparts, with take-home pay in the US up to 40% higher after taxes, in some comparisons.  

• Nurses gain access to cutting-edge healthcare environments, diverse clinical practice settings, and expanded opportunities for career development across American health systems.

3. A solution aligned with ongoing U.S. healthcare shortages

Healthcare facilities across the United States—particularly those outside major metro areas—continue to experience long-term staffing challenges driven by: 

• An aging population

• Retirements and burnout, post-COVID

• Insufficient numbers of new nursing graduates

Rural and underserved hospitals are under the most pressure, making internationally trained Nurses an essential part of their workforce strategy. 

• Rural hospitals are “hit the hardest” and often cannot maintain operations without recruiting Canadian healthcare workers. 

4. Straightforward qualification criteria

Canadian and Mexican Nurses qualify for TN status when they have: 

• Canadian or Mexican Citizenship  

• A US job offer for a role designated under the USMCA (including Registered Nurse) 

• Valid RN licensure, a nursing degree or diploma, and passing NCLEX results (plus Visa Screen certification for most applicants). Because nursing is an explicitly recognised profession within the treaty framework, the TN category provides a clear and uncomplicated pathway for qualified Nurses to work in the US 

Where Are Canadian and Mexican TN Nurses Going? US Hotspots & Demand Regions

While TN Nurses are placed across the United States, certain patterns are emerging/driven by staffing shortages, facility needs, and regional recruitment strategies. 

1. Rural and Underserved Regions Across the US

The strongest documented demand comes from rural hospitals, which face the most severe workforce shortages. 

• Rural and underserved areas struggle more than major cities to recruit US Nurses, creating a pull toward TN-eligible talent from Canada and Mexico.  

• Many of these hospitals rely on international Nurses to keep critical departments open. 

Hotspot states with significant rural-care demand include: 

• Missouri

• West Virginia

• Tennessee

• Ohio

(These states are identified widely as health shortage regions; TN visa placement agencies confirm they regularly support facilities across the United States, including those with the highest staffing needs.)  

2. States with Rapid Population Growth and Expanding Health Systems

High-growth states continue to expand healthcare networks faster than they can hire locally. These states frequently partner with TN-visa staffing agencies: 

• Indiana

• Maryland

• New York & Pennsylvania

Though not named explicitly in sources, population growth and high vacancy rates in these states align with national nursing-shortage data and the placement patterns indicated by TN staffing agencies serving healthcare systems across the United States.

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3. Border States with Proximity Advantages

Mexican Nurses particularly benefit from geographic and logistical ease when working in US border regions, especially after passing the NCLEX and securing state licensure. Common destinations include: 

• Texas

• California

• Arizona

• New Mexico

TN visa agencies support placements across many of these states’ hospitals, skilled nursing facilities, and long-term care centres.  

4. Northern US Regions Near the Canadian Border

Canadian Nurses often choose areas that offer: 

• Short travel times to home 

• Similar cultural/environmental settings 

• Lower relocation burden 

Recruitment agencies and immigration law partners regularly assist placements in states such as: 

• New York

• Michigan

• Minnesota

Though specific destinations were not explicitly listed, the presence of major immigration law practices in border cities like Buffalo and ongoing cross-border recruitment activities indicate continued demand. 

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The Bottom Line: TN Visa Nurses Are Filling a Critical Staffing Gap

The TN visa has become a cornerstone solution for US healthcare systems struggling to fill essential nursing roles. Canadian and Mexican Nurses benefit from: 

• Fast, predictable visa processing 

• Strong earning potential 

• Career-advancing clinical experience 

• A clear, treaty-based legal pathway 

US hospitals, in turn, gain access to a pipeline of highly trained, English-proficient, and long-term nursing talent. 

As shortages persist, rural and underserved regions, as well as high-growth states, are expected to remain the primary hotspots for TN visa nursing recruitment. With the TN pathway firmly supported under the USMCA, its importance in stabilising the American nursing workforce will only continue to grow. 

ID Medical and Aya Healthcare are dedicated to supporting valued Healthcare Professionals across the world, connecting them with the organisations who need them to deliver excellent patient care.

If this article has been of interest to you and you feel you could benefit from our services, please reach out today and we can help you with the next steps in your journey. We have relationships with Healthcare Organisations across the United States and can put you in touch in a very short timeframe. 

Putting people front and centre is at the heart of what we do. Working with us, you will have a dedicated recruitment consultant, who, with the support of our skilled teams, will support all your career needs.