JULY 2026 ISSUE

Introduction and summary

“The biggest motivation is my love for the job that keeps me going despite every obstacle I’ve been put through,” said Alondra, a Deferred Action for Childhood Arrivals (DACA) recipient and an emergency department nurse who has to cross state lines from her home in Missouri to Illinois to provide health care services to Americans and work in her dream job. Alondra is a proud Missourian, yet federal law restricts her from obtaining a nursing license absent specific state authorization. Currently, Missouri does not allow DACA recipients to practice nursing, but Illinois does.

Alondra’s experience highlights both the benefits and limitations of DACA. Since its creation in 2012, DACA has provided more than 800,000 undocumented immigrants who arrived in the United States as children and meet certain requirements—including periodically passing criminal and national security background checks—with the opportunity to work and live without fear of deportation. DACA is not a durable legal status and does not provide a pathway to citizenship, but it does provide a temporary work permit and Social Security number that can open doors for recipients to enter professions including nursing, teaching, food services, and many others, although with state-based limitations on certain professions that require licenses. For Alondra, this has meant turning years of education, commitment, and persistence into a nursing career through which she provides essential care to every patient she serves, yet living each day with the uncertainty of DACA. A 2021 estimate found that about 34,000 DACA recipients work in health care. And a 2020 estimate found that approximately 3,400 DACA recipients serve as registered nurses in the United States, delivering vital care at a time when demand for registered nurses far outpaces supply.

A 2020 estimate found that approximately 3,400 DACA recipients serve as registered nurses in the United States.CAP, "A Demographic Profile of DACA Recipients on the Frontlines of the Coronavirus Response" (2020).


America faces a persistent nursing shortage that is projected to worsen in the coming years as a result of retirements, limited education opportunities, and an aging American population that will require services, among other factors. Additionally, with the passage of the One Big Beautiful Bill Act, graduate nursing students will face additional limits on student loans. The act eliminated PLUS loans—which could have covered up to the full cost of attendance, inclusive of tuition fees and living costs, for graduate students—and limited the amount of federal loans graduate students can borrow. A proposed rule by the U.S. Department of Education would exclude nursing from the definition of a professional degree, which carries higher loan limits.10 As a result, graduate nursing students will have new, lower loan limits over the course of a graduate degree program, potentially making it more difficult to grow and sustain the nursing workforce.

Registered nurses, the cornerstone of the health care profession, provide vital services to hospitals, physicians’ offices, outpatient care centers, and skilled nursing facilities as well as in behavioral health settings such as homes, schools, universities, prisons, and private employer settings. They deliver and coordinate patient care while educating patients and the community about a range of health conditions.

In addition, nurses who are DACA recipients possess language skills and cultural knowledge that are invaluable when trying to build trust with patients whose primary language is not English. Yet despite the integral role that nurses such as Alondra play in serving their patients, DACA’s protection from deportation is limited and fragile. DACA recipients live in constant uncertainty as DACA continues to face legal challenges, along with actions from the Trump administration that target immigrants—including the Department of Homeland Security (DHS), which administers DACA, repeatedly urging recipients to self-deport.

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DACA recipients live in constant uncertainty as DACA continues to face legal challenges, along with actions from the Trump administration that target immigrants—including the Department of Homeland Security (DHS), which administers DACA, repeatedly urging recipients to self-deport.MALDEF, “Summary and Practical Effects of the Fifth Circuit Decision in the DACA Case” (2025) NPR "DHS is urging DACA recipients to self-deport" (2025).
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In recent months, hundreds of DACA recipients have been detained and caught in the crossfire of the Trump administration’s extreme immigration policies and persistent efforts to weaken and limit DACA.16 Exact figures are unclear DHS has sent conflicting data to members of Congress. In one letter, DHS reported that 261 DACA recipients had been arrested and 86 had been removed from the country between January 1, 2025, and November 19, 2025.17 In another letter, DHS stated that 270 DACA recipients had been arrested and 174 DACA applicants were removed from the United States between January 1, 2025, and September 28, 2025.


News coverage of arrests and deportation of DACA recipients further illustrates that these actions have become disturbing and recurrent. Maria de Jesus Estrada Juarez, a 42-year-old mother, was ordered to be returned to the United States by a federal judge after she was detained and subsequently deported after her green card interview appointment. And following the detention of Juan Chavez Velasco, a DACA recipient who was detained by ICE on his way to deliver milk to his newborn baby in the hospital, the Trump administration reiterated its position that immigrants “who claim to be recipients of Deferred Action for Childhood Arrivals (DACA) are not automatically protected from deportations” and said DACA recipients who self-deported would receive “$2,600 and a free flight.” Velasco had submitted his DACA renewal in November 2025 and his DACA expired in March 2026 while he was in detention and his renewal application still pending. He has since been released from detention.23 Furthermore, across the country, DACA recipients are facing renewal processing delays by U.S. Citizenship and Immigration Services (USCIS) that can leave recipients without DACA as their renewals are pending, increasing the risk of job loss and leading to an even greater risk of deportation.


In addition, a recent decision from the Board of Immigration Appeals has made it easier to deport DACA recipients, putting them at an even greater risk of removal. To ensure that Alondra and hundreds of thousands of DACA recipients like her can continue building their lives and contributing to the United States, Congress must pass legislation providing a pathway to citizenship for Dreamers and other long-term undocumented immigrants. The long-overdue legislation would strengthen the nation and allow states to better serve their communities by removing unnecessary barriers that prevent DACA recipients from living and working where they call home. By passing such legislation, lawmakers would recognize DACA recipients’ indispensable contributions and secure their ability to remain in the country while pursuing their dreams.

Drawing from in-depth video interviews conducted in spring 2025 with three DACA recipients who are registered nurses, this report examines the critical role of nurses with DACA working in hospitals at a time when the country is experiencing a growing nursing shortage. It highlights the unique legal and professional barriers DACA recipients face and presents targeted policy recommendations to ensure recipients can continue providing care for Americans, including removing state-level barriers to allow DACA recipients to enter the nursing profession and advancing a pathway to citizenship. To protect the privacy of the featured DACA recipients, the report uses only their first names. The full interviews are on file with the author.


The United States’ persistent nursing shortage


The United States has more than 3.3 million registered nurses. The U.S. Bureau of Labor Statistics projects that employment of registered nurses will grow by 5 percent from 2024 to 2034, faster than the average of all other occupations, with an average of 189,100 job openings every year. Despite the growth, the Health Resources and Services Administration estimated that in 2026, the United States faces a shortage of 263, 870 registered nurses and projected a registered nursing shortage for more than a decade. The United States has long had a nursing shortage, but it was further exacerbated by the COVID-19 pandemic. After the pandemic, thousands of nurses retired, pursued other career options, or left the industry altogether as a result of challenging working conditions. The nursing occupation faces burnout and other stressors that have led registered nurses to exit the industry. This decline in the number of nurses relative to the rising demand for care will affect millions of Americans—including in rural hospitals, which not only face a shortage of nurses due to post COVID-19 pandemic retirements but also struggle to recruit nurses. Another factor driving the nursing shortage is that nursing programs cannot keep pace with demand due to faculty shortages. These capacity constraints limit the number of students entering the profession, making it critical to retain nurses who complete their training and to address the educational bottleneck to meet growing workforce needs.


Additionally, an aging American population intensifies the need for nurses. By 2060, nearly one-quarter of the U.S population, approximately 94.7 million people, will be 65 years old or older and will require more age-related health services. As people age, they are more likely to develop chronic conditions, further driving the need for a sustainable nursing workforce. As the demand for nurses surges, DACA recipients who are nurses continue to play a role in alleviating the shortage, making their continued participation in the workforce particularly significant.


Meeting the moment: DACA recipients in the nursing workforce


DACA recipients are playing a crucial role in the nursing industry as the United States continues to grapple with an ongoing nursing shortage. They are strengthening care in rural areas, using their skills to connect with patients who do not speak English and to bridge communities through storytelling and their lived experiences. Nurses with DACA help address nursing shortages in rural communities Across America, more than 66 million Americans live in rural areas, where they face limited health care access and are disproportionately affected by the nursing shortage. Rural communities have a hard time recruiting nurses because of isolation, limited housing availability and few professional growth opportunities. These challenges are compounded by the threat of widespread rural hospital closures. One-third of rural hospitals are at risk of closing, including 300 rural hospitals at immediate risk of closure due to financial instability worsened by the BBB, which cut essential financial resources to rural communities. As hospitals disappear and staffing shortages persist, rural patients will need to travel long distances for care, face longer wait times, and experience worse health outcomes.


Jazmine, a travel medical-surgical registered nurse, brings essential care to rural communities that face some of the nation’s most severe nursing shortages. She arrived in the United States from Mexico when she was 6 years old and received DACA when she was 15. She always knew she wanted to give back to the country that gave her many opportunities and became inspired to become a nurse after her high school teacher told her, “You could be a good nurse.” She earned her certified nursing assistant credential in high school and later completed an associate degree in nursing while working in a nursing home.

While reflecting on working in a rural community, Jazmine said: I drive there because there is a crucial need, there are not many people that are nurses. … I want to go help there rather than [stay] at a hospital that’s 10 minutes away from me. [A]s a DACA nurse, you strive to be a good nurse, but you strive 10 times harder to show that you aren’t just a good nurse but a nurse who cares for these people … [and] genuinely wants to help out.

Jazmine’s commitment demonstrates the vital role DACA recipients play in the nursing workforce in rural areas as rural hospitals continue struggling to attract talent. Nurses such as Jazmine help fill these gaps, ensuring that people in rural areas receive the care they need. Without a permanent solution for DACA recipients, communities risk losing dedicated nurses such as Jazmine at a time when and in places where their services are most needed.


DACA recipients improve health care services through language diversity


The United States has a diverse population that collectively speaks more than 500 languages. Census data show that many people speak a language other than English at home, with the most common languages being Spanish, Chinese, Tagalog, Vietnamese, and Arabic. Effective communication is essential in health care settings when providers and patients share a language, it can improve the accuracy of clinical decision-making, leading to positive effects on patient satisfaction and health outcomes.

Language barriers, however, can contribute to lower quality of care, misunderstanding of treatment or preventive care, and overall patient dissatisfaction, underscoring the importance of a multilingual workforce. Notably, nearly 20 percent of nurses speak a language other than English, reflecting the growing multilingual strengths of the workforce. DACA recipients are well-positioned to help strengthen the workforce. Many are multilingual and able to communicate directly with patients who do not speak English, improving the quality and efficiency of care.

For example, Jazmine—who speaks both English and Spanish—said she often cares for patients who speak Spanish. “You can see the relief in my patient’s face after they realize I speak Spanish and their symptoms will be understood.” Even her co-workers rely on her Spanish language skills to provide patient care. Having a nurse who speaks the same language as the patients facilitates efficient, more appropriate treatment by allowing patients to communicate symptoms more accurately, reducing the risk of misdiagnosis, and improving adherence to treatment orders.
You can see the relief in my patient’s face after they realize I speak Spanish and their symptoms will be understood.--Jazmine, DACA nurse


Similarly, Ingrid, a nurse who works in oncology in North Carolina and is a DACA recipient, grew up translating English medical jargon for her Spanish-speaking parents to care for her sister with cerebral palsy. Now, she assists Spanish-speaking patients because she knows the difference it can make. She states, “[A]nytime there is a Spanish-speaking patient, I take them under my wing. I am able to more freely comprehend their diagnosis and educate them on the importance of keeping up with their health. [I am] able to tell them specifically their care plan, what medication to take in depth.” While hospitals have a translation system, she shares that it can be impersonal and difficult to create a trusting patient-nurse relationship. One example she shared was when a Spanish-speaking patient came in with abdominal pain and was diagnosed with cancer. Ingrid walked her patient through the diagnosis and elaborated on available options. She then went one step further to provide emotional support for her patient who was processing this devastating news and stayed to pray in Spanish with her patient. The ability to share the information in Spanish and Ingrid’s cultural background helped create a meaningful moment with her patient during a very hard time. Reflecting on her journey, Ingrid said, “I love my job. I would not see myself doing anything else besides nursing.”

• Bridging differences and engaging American communities While DACA recipients in the workforce are providing critical health care services, they are also sharing their experiences and educating Americans about immigration policy through their personal stories. Patients receiving their care are often unaware of the immigration challenges Alondra, Jazmine, and Ingrid face. However, sometimes their patients ask about their backgrounds. All three shared that when asked, they take time to talk to inquisitive patients about their birth countries and their immigration status and to educate patients about DACA. They explain both the opportunities DACA has provided for them to become nurses and the challenges they face. For Jazmine, this means sharing her story beyond her patients and using social media to educate the public about DACA and the opportunities it has provided her and thousands of others.

Although DACA was created nearly 14 years ago, Jazmine encounters people around her who do not know about it, which gives her an opportunity to share her story. By speaking about her experiences, she builds understanding and challenges negative stereotypes often tied to immigrants. The lived experiences of these nurses who have DACA, their language skills, and their cultural awareness help increase vital care to patients and highlight the essential contributions immigrants make to the health care workforce, as well as help shape a more informed and positive perception of immigrants within local communities.


Navigating obstacles as nurses and DACA recipients


Within the workforce, nurses may face staffing shortages and unsafe working conditions. Staffing shortages increase the likelihood of stress, physical exhaustion, burnout, job dissatisfaction, and emotional fatigue among nurses, which can affect patient care. Heavy workloads and insufficient support are major factors in nurses’ decision to leave the profession, further deepening staffing shortages. Additionally, nurses may face unsafe working conditions that lead to burnout. Nurses face workplace violence at an alarming rate and are at a higher risk of violence compared with other professions.

A 2023 survey from the professional association National Nurses United found that 8 out of 10 nurses surveyed have experienced at least one form of workplace violence. On top of the challenges many nurses face, DACA nurses navigate additional hurdles to maintain work authorization, meet state licensing requirements, and access higher education.


Explaining work permit and renewal issues to employers


Aside from challenging working conditions, DACA recipients face unique barriers throughout their education and career trajectory as they navigate renewing their work permit every two years, a process that currently requires a minimum fee of $555. USCIS recommends renewing DACA 120 days to 150 days before expiration to help ensure timely processing. However, even when following this timeline, recipients run the risk of agency delays beyond their control. The uncertainty of the DACA renewal timeline adds additional stress for nurses on top of an already demanding profession. These delays significantly disrupt the lives of DACA recipients and their family members. When a renewal is not processed on time, a recipient’s work permit expires, putting the recipient’s employment at risk.56 Delays can happen unexpectedly—but while recipients are familiar with the renewal timeline and challenges, hiring and human resource managers may not be as familiar with the process. At times, managers do not understand how the renewal process works and the time it takes to receive approval and for the physical work permit to arrive.


State licensing laws can be barriers for nurses with DACA


Among the barriers unique to DACA recipients seeking to become registered nurses are state nursing license requirements. Under the Personal Responsibility and Work Opportunity Reconciliation Act, DACA recipients are not eligible to receive state or local public benefits, including professional licenses, by default. However, the statute authorizes states to enact laws offering eligibility for state and local benefits, including professional licenses, to DACA recipients and other individuals who are not “qualified” immigrants, nonimmigrants, or people paroled into the United States. State policies on professional licenses vary across the country, both in terms of access and the types of licenses available. Some states allow individuals regardless of status—including DACA recipients—to obtain a broad range of licenses, while others limit access to certain professions or have not made licensure available.