The theme for March at AOLA is Readiness.

We are intentional here. We are tactful here. We stay ready so we don’t have to get ready. We are passionate about healthcare, about nursing, and about women. And as a woman-founded company, it would be irresponsible not to acknowledge what this month represents.

March is Women’s History Month.

Nursing is overwhelmingly female. Globally and in the United States, women make up nearly 90 percent of the nursing workforce. International migration patterns reflect the same reality. Women are moving across borders to fill workforce gaps in aging healthcare systems.

And yet, many of those same women feel powerless while navigating immigration backlogs, retrogression, and licensing barriers.

Here is the tension that sits with me.

Nursing is one of the most trusted professions in America. Year after year, Gallup ranks nurses at the top for honesty and ethics. And yet, when it comes to immigration policy, workforce design, and compensation structures, nurses are rarely the ones shaping the framework.

We are the backbone of the system.

But we are not always in the rooms where the system is built.

I wrestle with whether that is by design, or whether nurses simply have not felt empowered or compelled to occupy those spaces.

Either way, the outcome is the same.

Highly skilled nurses, with years of bedside experience and strong clinical judgment, are often stuck in holding patterns. Some are waiting on visa timelines. Others feel stuck in roles they believe they have to accept because they do not see another path.

So the question becomes, how do we exert real influence over issues that directly affect our practice?

In the United States, nurses have gone on strike more frequently in recent years. I understand the intent behind that. Advocacy matters. Fair staffing matters. Compensation matters.

But I do not believe protest alone will impart the kind of structural change we say we want as a profession.

If we want durable change, we have to be present where policy is written. Where immigration quotas are debated. Where workforce models are designed. Where reimbursement structures are decided.

Let me be clear.

Nurses striking is not the problem. Nurses feeling unheard is the symptom.

But if we remain primarily reactive instead of structurally involved, we will continue negotiating from the outside.

Policy does not change because we are exhausted. It changes because we are present in drafting, advising, voting, and regulating.

Imagine if more nurses pursued roles in health policy, hospital administration, workforce planning, and legislative advising.

Imagine if more internationally educated nurses, once here, were supported not only into bedside roles but into long-term leadership pipelines.

That is systems influence.

And positioning for that influence starts far earlier than we realize.

There is a documented nursing shortage across the United States. Projections estimate hundreds of thousands of nurses will be needed over the next decade. At the same time, there is a wealth of highly trained nurses across the globe eager to contribute their clinical expertise in the U.S.

EB-3 backlogs have stretched for years for certain countries. Visa processing has slowed. But the demand has not disappeared.

What has slowed is the paperwork, not the need.

From the time of Florence Nightingale, nurses have positioned themselves in spaces that caused real change and propelled healthcare forward. Something as foundational as handwashing as an infection prevention practice was championed and normalized within nursing practice. That influence reshaped patient outcomes globally.

We have influence. We may simply underestimate it.

So now that we know there is a slowdown in visa issuance and processing, what can international nurses do?

Because you are still needed. And perhaps more than ever. Not only at the bedside, but in leadership, in education, and yes, in policy spaces.

What you do not want is to be unprepared when opportunity arrives.

I have seen nurses receive exam eligibility and panic because their English exam expired.

I have seen priority dates move and documents remain incomplete.

I have seen brilliant clinicians underperform on the Next Generation NCLEX because they prepared using outdated strategies.

That is not a competence issue.

That is a positioning issue.

Positioning is not glamorous. It does not trend. It does not feel urgent when your visa date looks far away.

But positioning is what separates stress from strategy.

If your English exam is valid for two years, positioning means you are tracking that timeline with precision.

If the NCLEX shifted to the Next Generation format in 2023, positioning means your study methods evolved with it.

If every state Board of Nursing has different requirements, positioning means you understand your chosen state thoroughly instead of relying on someone else’s experience from five years ago.

That is leadership.

And this is where Women’s History Month matters.

Historically, women in healthcare have had to be twice as prepared to be taken seriously. We have had to master our craft, advocate for ourselves, and navigate systems that were not designed with us in mind.

International nurses are doing that on two fronts. Clinically and immigration-wise.

You are not simply adapting to a new healthcare system. You are navigating federal immigration policy, state regulation, credential evaluation bodies, and hospital hiring structures simultaneously.

That is not small. And it is not easy.

You can approach that complexity as something happening to you.

Or you can approach it as a system you are learning to move within.

Leadership does not begin when you land in the United States. It begins when you decide that your preparation matters even if the visa bulletin is slow.

Women who move systems are not always loud. They are disciplined.

That is not to say they cannot be loud. We all know that well-behaved women rarely make history.

But whether you choose to raise your voice or move strategically behind the scenes, make sure you are positioning yourself in a way that honors your power as a woman, your intelligence as a clinician, and your integrity as a human being.

Because the system will shift.

And when it does, the prepared will not ask for a seat.

They will already belong in the room.