Nursing is one of the noblest professions in the world, as well as one of the most in-demand today. As a nurse, it is your responsibility to care for patients, assist doctors, perform certain medical procedures, and many more.

There are many reasons why nurses might want to work in the US. One is the pay: in some states, nurses can earn north of $120,000 a year. Another is the fact that nurses in the US have access to the latest medical tools. Many nurses want to work in the US simply because they prefer life there to that in their home country, and nursing is a good way to gain residential rights.

Becoming a registered nurse in the US, though, can be a complicated process if you’re not sure how to start. This article outlines the basic steps to becoming a nurse in the United States and will hopefully serve as a useful guide.

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Steps to Becoming a Nurse in the US

1. Study Nursing and Gain Work Experience

The simplest pathway to a nursing job in the US is to study there, but not everyone has that luxury. Therefore, this guide will focus on the requirements of foreign-educated nurses.

The first step to becoming a nurse in the US is to study at an accredited nursing program in your home country. This doesn’t necessarily have to be a bachelor’s degree: two-year associate programs are also accepted. Accredited programs are usually named Associate Degree in Nursing or Bachelor’s Degree in Nursing, but you’ll have to conduct further research on the school to make sure.

You’ll then need to register as a nurse in your home country. This does not automatically qualify you to be a nurse in the US but is a requirement. Afterward, you’ll need to work as a nurse for at least two years in your home country. This requirement exists because US employers want to see that you have some experience before hiring you.

In some states, you’ll need to take additional refresher courses specifically designed for foreigners once you’ve arrived.

2. Take an English Proficiency Test

Nurses are in constant communication with doctors and patients. Often, getting the right message across can be the difference between life and death. Thus, it’s crucial to speak English with a reasonable degree of proficiency if you want to practice nursing in the US.

You’re required to take either the TOEFL or the IELTS. Minimum scores vary by test and state. If you can understand this article, you probably speak English well enough to pass. However, if you want to make sure, you can sign up for either a general English language course or a test-specific course in your home country.

Note that this only applies if your nursing education was not completed in English. If you’ve studied in the UK, Ireland, Canada, Australia, New Zealand, or if your degree was taught in English, you’ll be exempted from having to take an additional test.

3. Evaluate Your Credentials

To become a nurse in the US, you’ll need to have your qualifications professionally evaluated and converted to the American system. This is both to ensure a minimum standard of nursing in the country and to prevent underqualified nurses from being exploited.

Many nurses use the Commission on Graduates of Foreign Nursing Schools (CGFNS) for evaluation. Besides converting your high school and college degrees, the company also offers options to take the CGFNS exam, which in some states is a requirement, and to have them help you obtain a work visa.

Besides the CGFNS, other credential evaluation companies include the World Education Service (WES) and the International Credentials Assessment Service (ICAS). However, the CGFNS is the most straightforward option for nurses because it works directly with state nursing boards in the US.

4. Take the NCLEX-RN Exam

Just like being a lawyer or an accountant, being a practicing nurse requires you to pass a standardized test. The next step to becoming a nurse in the US is to take the National Council Licensure Examination. NCLEX covers topics like creating a safe care environment, understanding patients’ health needs, providing emotional support to patients, and ensuring that patients are physically comfortable.

The exam is conducted electronically, but you’ll need to go to a licensed testing location. These are located all over the world. The test is pass-or-fail, and the types of questions are modified by a complex algorithm to fit candidates’ aptitude. The test ends once there is a 95% chance that you’ll either pass or fail.

As mentioned, some states require foreigners to take the CGFNS exam as a prerequisite to the NCLEX-RN. It’s best to check the specific requirements of the state you want to work in.

5. Find a Job

If you’ve reached this stage, you can pat yourself on the back for having completed the previous steps. Now comes the most important part to be an official nurse in the US: getting a job.

While it’s possible to apply for individual positions, many foreign nurses choose to go through a recruitment agency. These are specialized companies that send your credentials to hospitals they think you’ll be a good fit with. By working with an agency, you can also get a visa before you start work with a hospital as they are allowed to sponsor you. Drawbacks include the fees and the fact that you won’t have as much control over where you end up working.

It’s also possible to find a job on your own. Your best bet is through online boards like and RN Wanted. The most efficient way to look for a job is to filter for listings that are specific to your area of expertise and apply to these.

Once you’ve secured a job, getting a work visa becomes much more straightforward. Your employer can sponsor you for an H1-B visa, an H1-C visa, or a permanent work visa/green card. If you’re from Mexico or Canada, you may also be eligible for a TN visa.


I hope that this article on Stepts to Become a Nurse in the United States was helpful. To know more information on how you can study in the United States, visit the US Scholarships Page.