If you are interested in using your nursing education and experience to work as a nurse in the United States, we have a helpful guide to show you what this process can look like. We will walk through the steps of how to become a registered nurse in the USA. If you want assistance with this process, including courses to help you pass your exams and career services to help you find a job with an American employer, Vista College can help with our US Nursing Career Opportunities Program.
Why Should You Consider Becoming a Registered Nurse in the U.S.?
The path to become an RN in the USA is well worth it if you are interested in working in the United States. Now is an excellent time for foreign-educated nurses to seek employment in the U.S because the need for nurses is continuously growing at a pace that exceeds the average growth rate for other careers. This growth is due to a variety of reasons, including an aging population that needs increasing levels of medical care.
As the need for nurses increases, some areas are left with shortages of nursing professionals. Many nurses are also reaching retirement age, and some states do not have enough new nurses to take their places. This creates an opportunity for foreign-educated nurses who want to fill a need in the U.S.
According to a U.S. government report on the supply and demand projections of the nursing workforce, the U.S. expects to experience the greatest undersupply of nurses in California. Other states that are likely to experience a need for RNs that exceeds the number of American nurses in the state include Texas, New Jersey, and South Carolina.
Nurses from countries outside the U.S. may have a variety of motivations for moving to the United States for work. Maybe you have family in the U.S., or you are ready for a fresh start in a new place. Whatever your reasons for wanting to work in the U.S., you may be able to find a hospital, nursing home, or other healthcare facility in the U.S. that is thrilled to have you join their team.
How to Become an RN in the USA as a Foreign-Educated Nurse
If you want to know how to work in America as a nurse, the first thing to note is that you need some basic nursing qualifications and experience. This is good news for nurses who have nursing experience and education in their home country. Rather than having to start from scratch with an American nursing program, you can use your existing qualifications as a springboard to becoming a nurse in the U.S.
To begin the process we outline below, you must first:
- Have a nursing degree from an accredited Registered Nursing program
- Be licensed as a Registered Nurse (RN)
- Have at least two years of professional experience as an RN
If you have a license as a practical nurse or licensed vocational nurse, you will not be able to transfer that licensure to the U.S. In these cases, you may want to achieve your RN license and two years of experience in your home country before pursuing a position in the U.S., or seek a position in an American nursing education program.
1. Pass a Language Proficiency Test
For many foreign-educated nurses, the first step to work as a nurse in America is passing a language proficiency test to demonstrate you can communicate in English well enough to work in the U.S. The exception to this requirement is if you attended nursing school in a predominately English-speaking country and the course material was in English.
The test you take depends on your country of origin, though the most common is the Test of English as a Foreign Language (TOEFL). Other possible English proficiency tests include the Test of English for International Communication (TOEIC) and the International English Language Testing System (IELTS). Your results will remain valid for two years, so you can complete this step early in the process.
If your English language skills are limited, you may need to take part in an educational program or tutoring to help develop your English proficiency before taking the test. Also, keep in mind that not everyone in the U.S. speaks English, so being multi-lingual can be an asset to you in a nursing position. For instance, if you speak Spanish as a first language, you may be called on to translate for a Spanish-speaking patient.
2. Get a CGFNS Certificate
If you already know which U.S. state you want to work in, you should check to see whether that state requires a certification from the Commission on Graduates of Foreign Nursing Schools (CGFNS). If you are not sure which state you will work in, it is smart to get your CGFNS certification since many states require it. This certification acknowledges that your skills meet the standards of licensing in the U.S.
This organization has a three-step process for certifying foreign-educated nurses, though some states will only require credentials evaluation and not the exam:
- Credentials evaluation: This step involves sending in several important documents so the commission sees you have a nursing education and license. You will request your institutions to send in copies of your secondary school diploma, license verification, and transcripts or academic records from your nursing school. Note that all documents must be in English, so you may have to translate them yourself or have them translated.
- CGFNS Qualifying Exam®: The CGFNS Qualifying Exam is offered at more than 40 locations globally, three times a year. The exam includes 260 questions, and you complete it in one sitting, with a break included. The exam covers the information you need to know to work as a nurse in America, including all the traditional clinical areas of nursing practice, from infant care to adult care and community health nursing.
- English language proficiency exam: If you already passed an exam to test your English language proficiency, then this step is redundant. Refer to our explanation above of English language proficiency tests. The CGFNS accepts passing scores from the following tests: TOEFL, both internet-based (TOEFL iBT) and paper-based (TOEFL PBT), TOEIC, and IELTS.
3. Study and Pass the NCLEX-RN© Exam
The National Council Licensure Examination (NCLEX) is the exam state boards in the U.S. used to ensure people who have received a nursing education are ready to begin practicing. There is an exam for practical nurses and one for registered nurses. The NCLEX-RN is what foreign-educated RNs would take to get their license to practice in the U.S.
You will first need to apply to your nursing regulatory body (NRB) and register with Pearson VUE to get an Authorization to Test (ATT). Then, you can schedule a date to take the exam. You do not have to travel to the U.S. to take the NCLEX. The exam is offered in several countries, including Mexico and Canada.
The test includes mostly multiple-choice questions and may also include other question formats like fill-in-the-blank or drag-and-drop. The content of the exam is focused on nursing concepts and will thoroughly test your knowledge. Most nurses will want to spend time studying for this exam rigorously before taking it. With a program like the U.S. Nursing Career Opportunities Program from Vista College, you can take online courses to prepare for the exam so you feel confident on exam day and have a higher likelihood of passing.
4. Find a Nursing Job in the U.S.
Once you have proven your qualifications and passed the necessary tests, it is time to seek a nursing position in the U.S. As we mentioned, there are likely to be hospitals and other healthcare facilities in need of nurses, but without a legal right to live and work in the U.S., you have to find a position with an employer who is willing to sponsor a work visa.
It may take some skill to make connections with American employers from your home country. However, you may be able to participate in a program or agency that can help you find an ideal placement. Working with an independent staffing recruiter and agency tends to be much easier than trying to work with a hospital directly.
In the U.S. Nursing Career Opportunities Program, we use our network to help match our applicants with open job positions and confirm employers are willing to sponsor a visa. This service can simplify the process of finding open and appropriate positions for you.
5. Obtain a Visa
There are a few visa options that allow you to work legally in the U.S. If you are working with a staffing agency, they can help you determine the best avenue for you. Let’s look at three possible options:
The preferred choice for some nurses who want to work in the U.S. is a Permanent Resident Card, more commonly known as a Green Card. A Green Card is the best option if you wish to permanently immigrate to the United States since it is a requirement to naturalize as a U.S. citizen.
A Green Card remains valid for 10 years, at which point you can renew it if necessary. If you start out with a work visa, you may be able to apply for a Green Card once you are living in the U.S.
The TN Visa is specifically for Canadian or Mexican residents who want to work in the U.S. This visa is also only valid for people in a qualified profession, per the North American Free Trade Agreement (NAFTA) list. Fortunately, a registered nurse is a qualifying position. You must have a full- or part-time job lined up with a U.S. employer.
Once granted, the TN Visa remains valid for three years initially. You can request to extend this validity by a year at a time indefinitely, but if you are working toward permanent residence, you should try to obtain a Green Card.
The H-1B Visa is a temporary working visa that is designed only for professionals who work in a specialty in their field. In nursing, this could include nurse practitioners, critical care nurses, cardiology nurses, and emergency room nurses. The U.S. Nursing Career Opportunities Program from Vista College can help you obtain an H-1B Visa.
H-1B Visas are issued in limited quantities, but this is an option for some nurses. The H-1B Visa is valid for three years, and you can renew it for another three years.
6. Relocate to the U.S.
Once you have a job waiting for you and a Green Card or visa, you are ready to make the move to the U.S. In the U.S. Nursing Career Opportunities Program, we help guide and support nurses through the process of moving to their new home in the U.S. We can also make the transition to working in an American hospital or other care facility easier. By helping nurses enhance their skills and develop a better understanding of how to be a nurse in America, we assist foreign-educated nurses to be prepared for the needs of U.S. nursing facilities.
Moving to a new country can present a bit of culture shock, even if you speak and understand English fluently. Most immigrants or visitors take comfort in finding people from their home country in their community with whom they can share meals, holidays, and other special things that remind them of home. You may also want to try new things and travel to new places within the U.S.
Enjoy a Rewarding Career as a Nurse in the U.S. With Help From Vista College
Whether you are just beginning your nursing career or looking to take it to the next level, Vista College can help. We offer the U.S. Nursing Career Opportunities Program for nurses in Mexico and beyond who already have a degree and experience in their home country but want to get licensed in the U.S.
Through this program, we can help you prepare for your English language proficiency test, study for the NCLEX exam, sharpen your skills, and look for a nursing position in the U.S. As a member of our program, you may be able to start working in the U.S. in less than a year.
We also offer programs to help students earn a Vocational Nurse Diploma or a Practical Nurse Diploma. Our educational programs are designed to be effective and convenient so you can get the most out of them and open up new career opportunities quickly. Whatever your nursing career ambitions, we can help prepare you to achieve them.