Nursing is one of the most respected and in-demand professions in the United States. With an aging population and a growing healthcare industry, the need for qualified nurses continues to rise. If you’re an international nurse or a student dreaming of practicing in America, this article will walk you through how to become a registered nurse in the USA: visa types, requirements, and job roles in clear and easy-to-understand language.
Whether you’re just starting your nursing education or already working in another country, this comprehensive guide will help you understand what it takes to become a nurse in the United States.
Why Choose to Work as a Registered Nurse in the USA?
The USA offers a strong healthcare system, excellent work benefits, and competitive salaries for nurses. Here are some reasons why people choose to become registered nurses (RNs) in America:
- High demand for nurses nationwide
- Good pay and job security
- Opportunity to live and work in the USA
- Pathway to permanent residency (green card)
- Diverse workplace with advanced technology
Job Role of a Registered Nurse in the USA
Registered nurses provide essential care to patients in various healthcare settings. They assess patients, administer medications, assist in surgeries, educate families, and more.
Core Responsibilities:
- Monitoring patient health
- Administering treatments and medications
- Assisting doctors in procedures
- Recording patient histories
- Educating patients and families about care plans
- Collaborating with medical teams
Work Settings:
- Hospitals
- Clinics
- Nursing homes
- Home healthcare
- Schools
- Government agencies
Types of Registered Nurses
| Type of RN | Description |
|---|---|
| Medical-Surgical Nurse | Works with post-op and general patients |
| Pediatric Nurse | Specializes in child care |
| Critical Care Nurse | Works in ICUs and emergency departments |
| Geriatric Nurse | Focuses on elderly patients |
| Oncology Nurse | Cares for cancer patients |
| Psychiatric Nurse | Supports mental health treatment |
| Travel Nurse | Temporary assignments across the country |
Step-by-Step Guide: How to Become a Registered Nurse in the USA
Step 1: Get a Nursing Degree
To become an RN in the USA, you need a nursing diploma or degree from an accredited program. The level of education you need depends on the state and employer, but typically includes:
- Associate Degree in Nursing (ADN) – 2 years
- Bachelor of Science in Nursing (BSN) – 4 years (preferred for international nurses)
If you’re an international student or professional, ensure that your degree is equivalent to a U.S. nursing degree through a credential evaluation (discussed below).
Step 2: Credential Evaluation
Before applying for a license, foreign-educated nurses must have their credentials evaluated to meet U.S. standards.
Credentialing organizations include:
- CGFNS (Commission on Graduates of Foreign Nursing Schools)
- Josef Silny & Associates
- Educational Records Evaluation Service (ERES)
You will need to:
- Submit transcripts and course syllabi
- Show proof of nursing licensure in your home country
- Provide English translations if needed
Step 3: English Language Proficiency Test
If your nursing education was not in English, you must pass one of the following:
| Test | Minimum Score Required |
|---|---|
| IELTS | 6.5 overall, with 7.0 in speaking |
| TOEFL iBT | 83 total score |
This test proves your ability to communicate with patients and colleagues effectively.
Step 4: Take the NCLEX-RN Exam
The NCLEX-RN (National Council Licensure Examination) is a standardized test required for all registered nurses in the U.S.
Steps to take the NCLEX-RN:
- Apply to a state board of nursing (e.g., California Board of Nursing)
- Receive your Authorization to Test (ATT)
- Schedule and take the NCLEX-RN at an approved testing center
Format: Multiple-choice, computerized adaptive test
Cost: Around $200 USD
Step 5: Obtain State Licensure
Each U.S. state has its own board of nursing. After passing the NCLEX-RN, you can apply for licensure in the state where you plan to work.
Tip: Some states like Texas, New York, and California are more popular for international nurses due to higher demand.
Step 6: Get a Job Offer
You’ll need a job offer from a U.S.-based employer before applying for most visas. Many hospitals and healthcare recruiters actively hire foreign-trained nurses.
Places to apply:
- Indeed
- Glassdoor
- Nurse.com
- Staffing agencies (e.g., O’Grady Peyton, Avant Healthcare)
Visa Types for Registered Nurses in the USA
To work legally in the U.S. as a nurse, you must have an appropriate visa. Here are the main options:
1. H-1B Visa (Temporary Work Visa)
- For highly skilled professionals (requires a BSN degree minimum)
- Employer must sponsor the nurse
- Valid for 3 years, extendable to 6 years
- Limited number of visas issued each year
2. EB-3 Visa (Employment-Based Green Card)
- Best long-term option for nurses
- Permanent residency pathway (green card)
- No need for labor certification (nursing is a Schedule A occupation)
- Employer must file Form I-140 (Immigrant Petition)
Requirements:
- Valid NCLEX-RN result
- U.S. state license
- Approved visa screen certificate from CGFNS
3. TN Visa (For Canadian and Mexican Citizens)
- Part of the USMCA agreement
- Fast processing for Canadian/Mexican nurses
- Requires a job offer and proof of qualifications
4. J-1 Visa (Exchange Visitor Visa)
- Short-term training visa
- Not a direct pathway to permanent work
- Used for internships or practical experience
Required Documents Checklist
| Document | Purpose |
|---|---|
| Valid Passport | Travel identification |
| Nursing Degree/Diploma Certificate | Proof of education |
| License from Home Country | Demonstrates professional practice |
| English Proficiency Test Result | Verifies language ability |
| Credential Evaluation Report (CGFNS) | Ensures degree meets U.S. standards |
| NCLEX-RN Pass Letter | Required for licensing and employment |
| Job Offer Letter | Needed for visa application |
| VisaScreen Certificate | Required by U.S. immigration authorities |
Salary Expectations for Registered Nurses in the USA
| Experience Level | Annual Salary (USD) |
|---|---|
| Entry-Level RN | $55,000 – $65,000 |
| Mid-Level RN (3–5 years) | $70,000 – $85,000 |
| Senior RN (10+ years) | $90,000 – $110,000 |
| Nurse Manager/Leader | $100,000 – $130,000 |
Salaries vary based on location, employer, specialty, and shift type.
Top States Hiring International Nurses
| State | Reasons to Choose |
|---|---|
| California | High salaries, diverse population, strong demand |
| Texas | Lower cost of living, many job openings |
| Florida | Aging population, large hospital systems |
| New York | Large immigrant community, competitive healthcare market |
| Illinois | Growing demand in urban and rural areas |
Common Challenges for International Nurses
| Challenge | Solution |
|---|---|
| Complex paperwork and delays | Work with a reputable recruitment agency |
| Passing the NCLEX-RN | Use online prep courses and study guides |
| English language requirements | Practice through immersion and tutoring |
| Cultural adjustment | Attend orientation and cultural training sessions |
Summary: How to Become a Registered Nurse in the USA
Step-by-Step Recap:
- Complete your nursing degree
- Evaluate your credentials through CGFNS
- Pass the English language test
- Apply and pass the NCLEX-RN exam
- Get licensed in a U.S. state
- Receive a job offer
- Apply for the correct work visa (EB-3, H-1B, or TN)
- Move to the USA and begin your career
Conclusion
Now that you know how to become a registered nurse in the USA: visa types, requirements, and job roles, you can start planning your journey with confidence. Nursing is a noble and high-demand profession in the United States, offering rewarding pay, long-term career growth, and the chance to make a meaningful difference in people’s lives.
By following the right steps and staying patient through the process, your dream of becoming a registered nurse in America can absolutely come true.