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How Foreign Educated Nurses Can Practice in the US

If you're an International Registered Nurse and you want to practice in the States, getting licensed is a detailed process, but you can make it happen.
  • Here’s what you’ll need to do:

  • 1 Meet the educational requirements.

    Make sure you’ve completed the following education and licensing requirements in your country:

    • You’ve graduated from an accredited Registered Nursing program
    • You’re licensed as a Registered Nurse (RN)
    • You’ve practiced as an RN for at least two years
    *To get licensed in the US, many states require you to complete a Foreign Educated Nurses (FEN) refresher course. The course consists of 120 hours in the classroom and 120 hours of clinical practice under the supervision of a licensed Registered Nurse.
  • 2 Pass an English language proficiency test.

    Depending on which country you’re from, you’ll likely be required to take one of the tests below:

    • You can take the Test of English as a Foreign Language (TOEFL), the Test of English for International Communication (TOEIC) or the International English Language Testing System (IELTS).
    *Most nursing recruiting agencies prefer that their foreign clients take either the IELTS or TOEFL.
    • Your test results need to be sent directly to the state board you’re applying to, by your test administration.
    • You may be exempt from taking one of the exams above, if you meet the three criteria below:
      • The country where you went to nursing school was the United Kingdom, Australia, New Zealand, Canada (except Quebec), or the Republic of Ireland.
      • The spoken language of your nursing school was English.
      • Your nursing school textbooks were written in English.
  • 3 Pass your National Council Licensing Examination – Registered Nurse (NCLEX – RN).

    You’ll need to register with Pearson VUE (Virtual University Enterprises) and schedule a date, and location, to take your NCLEX-RN exam.

  • 4 Find a nursing recruiting agency or US-based employer.

    A nursing recruiter can help you secure a position as an RN in the US.

    • Nursing recruiters can also serve as your “US-based employer” helping you secure an immigrant visa and finding you a job at one of the hospitals they partner with.
  • 5 Get an RN immigrant visa/green card.

    To get an RN immigrant visa, you’ll need the following documents:

    • Evidence of a US-based employer who will be the petitioner for your immigrant visa. An RN recruiter can be your petitioner.
    • A Visa Screen Certificate (VSC). This is issued by The International Commission on Healthcare Professionals (ICHP), a division of Commission on Graduates of Foreign Nursing Schools (CGFNS).
    Both of these documents must be sent directly to ICHP/CGFNS on your behalf by the issuing authority.
  • 6 Get an RN visa interview and medical examination.

    Here’s what happens after your visa immigrant petition is approved:

    • The United States Citizenship and Immigration Service (USCIS) sends your file to the National Visa Center (NVC) for processing.
    • The NVC will forward your file to the nearest US embassy where your visa will be issued.
    • You’ll also receive a package from the NVC with the appointment date for your visa interview, and what you need to bring to the embassy.
    • Then you need to have a medical exam. You’ll find a list of designated panel physicians you can contact, in your package from the NVC.
    • Processing your visa could take a few months to a year, or even years, depending on factors personal to your situation.
    • After you’ve gone through your visa interview and medical exam, you could receive your visa as soon as a few hours, or weeks, after.
  • 7 Accept your RN job offer and take an employment medical exam.

    Here’s what will happen when you’re getting ready to accept your position as an RN in the US:

    • Your employer/RN agency will have secured you an RN position with one of their client hospitals before your visa interview. You’ll need to have provided your résumé and RN specialty checklist.
    • You’ll also take a second medical exam, this time it’ll be given by your employing hospital. The requirements for the exam vary by hospital.
  • 8 Get an RN Resuscitation Certification.

    You’ll need to take an Advanced Cardiac Life Support (ACLS) course, a Basic Life Support (BLS) course, or a Pediatric Advanced Life Support Course (PALS).

    • The type of resuscitation certification you’ll need will depend on your area of practice, and hospital policies.
    • You can get these certificates before arriving in the US, but make sure the provider of these courses is American Heart Association (AHA) accredited.

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