Tell the employer which requirements remain unresolved and have the proposed activities assessed. An orientation date should not be treated as permission to begin work or practise without the necessary basis.
Ask which event the start date depends on
Keep board, certification and immigration communications together but track their progress separately. Request a realistic update when one step changes. Do not describe work as an informal visit simply to avoid confronting an unfinished requirement.
Work backward from the first activity the hospital expects, not merely from its orientation date. List citizenship review, the employer document, credential, certification, practice permission, travel, and onboarding responsibilities. TN is limited to Canadian or Mexican citizens performing prearranged professional activity in a profession listed in Appendix 2 to Annex 16-A of the USMCA for a U.S. or foreign employer; self-employment is unavailable. A Canadian citizen may request TN admission at an eligible port of entry or preclearance location, or a prospective employer may file Form I-129, but neither option converts incomplete licensing or certification into permission to practise. The common mistake is renaming productive training as observation when the hospital actually expects work.
Hypothetical example: A London cardiac intensive-care nurse is invited to mandatory orientation while the certification issuer still awaits a transcript. The nurse gives the hospital a precise status update, obtains a detailed employment letter, confirms the registered-nurse credential basis, and asks which orientation modules involve patient care, systems access, or compensated duties. Travel and a lawful work start are postponed or structured only after individualized review. The calendar changes when the transcript arrives; it cannot excuse unfinished requirements.