The Northern Marianas only hospital is losing 18 nurses after US Immigration rejected a request to extend their visas.
The Marianas Variety reported the nurses were due to leave this weekend.
Commonwealth Healthcare Corporation chief executive Esther Muna said the hospital made submissions to change the view of US Immigration but to no avail.
Head ICU nurse Rey Alejandre said the departing nurses all held vital positions.
They included five emergency nurses, three in the ICU, two in the neo-natal care and others in the operating theatre, surgical section and in paediatrics.
Ms Muna said the departures presented a problem and there were going to have to be changes to hospital operations.