How to Work in the US as a Foreign-Educated Nurse

Posted on October 7, 2022 By Mathew Berg

There’s a widespread agreement that the United States is in need of registered nurses and other healthcare professionals. Unfortunately, the complex immigration policies often make it hard for foreign-trained nurses to find work in the US. Many nurses struggle to evaluate reports for regulatory authorities, employers, and educational institutions. The authentication and verification of academic and professional credentials is another primary concern. Finally, international nurses must also prepare for relevant exams. While all this may sound overwhelming, the good news is that you can secure the visas and documentation required to make your American dream come true with the right resources and understanding of the procedure.

Requirements for Foreign Nurses to Work in USA - 5 step guide

Are you ready to become a foreign-educated nurse in the US? Here is a general outline that will help you streamline the process.

1- Education Requirements

The first step is to ensure you meet the education requirements to work in the US. You must have graduated from a Registered Nurse (RN) education program that meets international standards. Work experience is also essential. So, ensure you have a minimum of two years of experience to add to your resume.

Furthermore, most states mandate that nurses with international education take a refresher course designed explicitly for Foreign-Educated Nurses (FEN). The program requires a total of 240 hours, including 120 hours of classroom instruction and another 120 hours of clinical experience under the direction of an RN.

Some foreign-educated nurses must also pass an English proficiency test, such as IELTS, TOEFL, and TOEIC. This varies based on the national origin, and the findings are transmitted directly to the state nursing board.

2- The NCLEX-RN Exam

After confirming that you fulfill the academic and language criteria, it is time to submit an application for the NCLEX in the state where you wish to work.

NCLEX examinations are now conducted in multiple countries, including Mexico, the Philippines, Puerto Rico, Australia, Hong Kong, India, Japan, Canada, England, and more.  

You  will be required to have your academic records evaluated to guarantee the State Boards of Nursing that you are qualified to take the NCLEX. Make sure you opt for the best credential evaluation services to ensure quick results. The organization will carefully review your nursing school credentials and educational background in your native country. 

3- Credential Evaluation

You must also have the reputed organisation evaluate your documents. State Boards of Nursing engages to guarantee that candidates satisfy the minimum standards and are qualified to take the NCLEX.

The organization will carefully review your nursing school credentials and educational background in your native country. While this firm is the most popular and well-known, it is also the most expensive, and different states demand varying degrees of certification.

4- Immigration Process

The next step is to acquire a work visa. There are various possibilities. However, keep in mind that sponsorship from a hiring agency is required. In most cases, working with an independent recruiter is more manageable than working directly with a hospital.

Many agencies are well-versed in assisting nurses in working in the United States and having processes in place to ensure all information and documentation accuracy.

You must fulfill all government requirements to get a Green card or an H-1B visa. The petitioner for your visa must be a U.S.-based employer. The US law mandates that nurses pass a screening procedure before obtaining an occupational visa.

ERES is authorized to authenticate credentials for occupational visas for nine foreign healthcare professions, including registered nurses. There are different types of work visas you can consider.

  • H-1B Visa for Temporary Work: Nurses who possess a four-year degree and perform a specialized nursing function are eligible for an H-1B temporary work visa. You can later apply for a green card.  
  • Permanent Visa: You can also apply for a green card, sometimes a permanent work visa. This application must be submitted before traveling to the United States, and the visa must be received before lawful immigration.
  • TN Visa: Mexican and Canadian nurses can work in the United States with a special TN visa provided they have a job offer, a license to practice in their home country, and pass the NCLEX and state licensing criteria for nursing.

5- Get Started!

Practicing nursing in the USA for foreigners requires you to pass a state board test. But that’s not it. You will also require your CES nursing report from a NACES member.  The CES nursing report is an all-encompassing analysis of nursing qualifications earned in other countries at various educational levels.  

Remember that you are not obligated to engage with a nursing recruiter to get a position as a registered nurse. However, you may opt to do so. These recruiters can also serve as your U.S.-based employer to obtain an immigrant visa.


Now that you know how to work as a foreign-educated nurse in the US, you are all set to build a successful RN career in the US. Good luck!

Credential Evaluations on June 24, 2024 by Jessica Thorne

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