How to Work as a Registered Nurse in the USA

The United States is experiencing a significant shortage of healthcare professionals, with nurses at the top of the list. In fact, according to recent statistics, the US Bureau of Labor Statistics anticipates a need for over 200,000 new registered nurses each year until 2029. This surge in demand not only underscores the vital role nurses play in the American healthcare system but also highlights the opportunities awaiting international nurses seeking to build their careers in the USA.

Navigating the process of becoming a registered nurse in the USA may seem overwhelming, but fear not! This guide breaks down the journey into simple, actionable steps, empowering you to pursue your dream of working as a nurse in the US with confidence.

Step 1: Meeting the Basic Requirements

To kickstart your journey, ensure you meet the following requirements:

  • Education: Graduate from an accredited nursing education program.
  • Licensure: Obtain your license as a Registered Nurse (RN).
  • Experience: Have at least two years of experience working as an RN.

Step 2: Getting Your Credentials Evaluated

The Commission on Graduates of Foreign Nursing Schools (CGFNS) is your one-stop shop for getting your international nursing credentials recognized in the USA. They evaluate your academic and professional credentials to ensure they meet US standards. This evaluation is often a mandatory step for obtaining your nursing license and work visa for the US.

Remember, always check with your desired State Board of Nursing to confirm their specific credential evaluation requirements.

Step 3: Completing an English Language Proficiency Exam

Demonstrating English language fluency is a crucial step for international nurses seeking to work in the USA. Here’s a breakdown of the most common English language exams accepted, along with score requirements:

  • International English Language Testing System (IELTS): IELTS is a standardized test for English language proficiency for non-native English language speakers. The IELTS test has two choices: Academic and General Training. For nurses, Academic IELTS with an overall band score of 6.5 and 7 in speaking is required for US immigration purposes. IELTS is also accepted by most US Boards of Nursing for RN licensing.

  • Test of English as a Foreign Language (TOEFL): This widely recognized exam assesses your general English proficiency across reading, listening, speaking, and writing. While score requirements can vary by state, a minimum total score of 550-600 on the paper-based test or 80-90 on the internet-based test (iBT) is generally required for nurses wanting to relocate to the US.
  • Occupational English Test (OET): Unlike IELTS and TOEFL, the OET is an English test specifically designed for healthcare professionals. It assesses your ability to use English in real-world nursing situations. The minimum score required on the OET is a Grade of C+ in Reading, Writing, and Listening, and a Grade B in Speaking.
  •  Pearson Test of English (PTE): The PTE is a computer-based exam that measures your English skills across reading, writing, listening, and speaking.  Generally, a minimum overall score of 55 with no score below 50 in any of the individual skills is required.

Please note that English language proficiency test and score requirements can vary by state and specific healthcare facility. Always check with the relevant Board of Nursing or employer for their specific requirements. Some states may offer exemptions from these exams if your nursing education was conducted entirely in English or if your country is considered English-speaking.

Step 4: Passing the NCLEX-RN Licensure Exam

The NCLEX-RN is a nationwide examination for the licensing of nurses in the United States.  It plays a vital role in ensuring patient safety and upholding the high standards of nursing practice in the USA. By passing the NCLEX-RN, you demonstrate that you possess the knowledge, skills, and judgment necessary to function as a competent RN in the US. Please note, the application process for licensure can vary by state. You’ll need to contact the Board of Nursing in your desired state of practice to obtain specific instructions and application forms.

Outside the US, the NCLEX is offered internationally in the following countries: Australia, Brazil, Canada, England, Hong Kong, India, Israel, Japan, Mexico, Philippines, Puerto Rico, South Africa, South Korea, Taiwan and Turkey.

Step 5: Finding a Nursing Job

Now that you’re nearing the finish line, it’s time to secure your dream nursing position in the US! The good news is that the demand for skilled nurses is high, and many US healthcare facilities are actively seeking international talent. This opens a world of possibilities for you, with opportunities across various states and specialties.

At Global Nurse Force, we’ve helped over 20,000+ healthcare professionals secure life and career-enhancing opportunities across the globe. We currently have hundreds of jobs available for nurses throughout the US. We can find the best opportunity for you – one with higher pay, more benefits and better hours.

Step 6: Obtaining a Work Visa

Obtaining a work visa is essential for legally working as a Registered Nurse in the USA. To ensure you choose the most suitable visa option, here’s a breakdown of some common visa categories:

  • H-1B Visa (Temporary Work Visa): The H-1B visa is a temporary work visa that allows internationally educated nurses with a bachelor’s degree in nursing to work in the US for three to six years. It’s reserved for specialty nursing roles that require advanced education and skills beyond the standard RN designation. Nurses can bring their spouses and children as dependents on their H-1B visa.

US Citizenship & Immigration Services received over 750,000 registrations for the 85,000 H-1B visas that are available in 2024. It is very difficult for US hospitals to bring in international nurses on H-1B visas if the facility is subject to the H-1B visa cap.

Fortunately, Global Nurse Force works with many non-profit hospitals which are affiliated with institutions of higher education that are exempt from the H-1B visa cap. These employers can bring in international nurses anytime they want since they are not subject to the H-1B visa cap.

Nurses from all countries can secure their H-1B visas in a couple of months.

  •  EB-3 Green Card (Permanent Work Visa): This work visa allows internationally educated nurses to be employed in the US as permanent US residents. Nurses can bring their spouses and children under 21 as dependents on their EB-3 permanent work visa. 

Currently, it is taking nurses from most countries 2+ years to secure a Green Card through an employer. It is taking nurses from India over a decade to secure a Green Card through an employer.

Step 7: Arrive in the US

Arrive in the US and apply for your Social Security Number and Permanent RN License. You Can Now Thrive and Prosper as a Registered Nurse in the USA!!

Achieve your American Dream with Global Nurse Force

Right now, your nursing education and experience can take you further in your career than you ever imagined possible. You already know that US hospitals are eager and willing to compete for the nursing skills you have worked long and hard to learn.

At Global Nurse Force, we understand the complexities of moving to the USA as an internationally educated nurse. Our goal is to support and empower international nurses like you every step of the way.

We can find you a nursing job at one of the leading hospitals in the US and guide you through the licensing, immigration and relocation process. 

With Global Nurse Force by your side, your path to a successful US nursing career is clear and attainable.

How to Work as a Registered Nurse in the USA
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