An Overview of Nursing in the US:

1. The Career Pathway Salary of Nurses in the US 
2. Working Conditions 
3. How to Apply as a Nurse in the US 
4. Documents to Comply in CGFNS 
5. FAQs

The United States has one of the world's most advanced healthcare systems, and it leads the globe in terms of patient choice for medical treatments, as well as medical science and technology innovation. You will be a part of a fantastic healthcare team in the United States as a Registered Nurse.

Our team at 1NURSE.com has compiled all of the necessary information for international nurses wishing to work and live in the US. Continue reading this article to find out more.

If you're a foreign nurse who wants to work in the US, you must have/be:

• Complete the academic requirements
• Hold a Nursing license in your country
• Take and pass an English language competence test 
• Pass the Registered Nurse National Council Licensing Examination (NCLEX-RN) 
• Complete Credential Evaluation 

Section A: The Career Pathway

Registered nurses are expected to grow at a rate of 9% from 2020 to 2030, which is roughly the same as the average for all occupations. Over the next decade, there will be an average of 194,500 vacancies for registered nurses.

There are a lot of different ways to get into the field of nursing. You can start as an LPN and work your way up to becoming a Registered Nurse, or you can get an ADN or BSN and then take the NCLEX right after graduation. 

CNA (Certified Nursing Assistant)
A certified nursing assistant (CNA) supports patients with activities of daily living and other healthcare needs. They practice under the direct supervision of a Registered Nurse or Licensed Practical Nurse. A Nursing Assistant, a Patient Care Assistant (PCA), or a Nurse's Aid is another name for a Certified Nursing Assistant.

A Licensed Vocational/Practical Nurse 
LVN or LPN is a nurse who has completed a short course of study and clinical hours. They are in charge of basic patient care, such as checking blood pressure and vital signs, as well as assisting patients with eating and dressing. Patients' care and comfort are dependent on both of these professions.

US Registered Nurse
In the United States, a registered nurse is referred to as a USRN. A nurse who has completed a nursing program satisfied the state's standards and passed the NCLEX-RN exam. RNs are paid more than CNAs because their curricula are longer and more comprehensive.

Section B: Salary of Nurses in the United States

The average registered nurse pay in the United States is $80,010, with the median (50th percentile) being $75,330. As of May 2020, California is the highest-paying state for nurses, with RN salaries averaging $120,560. (according to the U.S. Bureau of Labor and Statistics). Alabama's average is $60,230, which is $60,330 lower than California's.

The following were the median annual incomes for registered nurses in the major industries where they worked in May 2020:

SOURCE: Registered Nurses: Registered Nurses: Occupational Outlook Handbook:: U.S. Bureau Of Labor Statistics. (2021, September 8). Registered Nurses: Occupational Outlook Handbook:: U.S. Bureau of Labor Statistics. https://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-5.

Section C: Working Conditions

• Nurse-Patient Ratio: In medical-surgical units, the average is one nurse for every five patients. Although California is the only state with legislation in place, more states are recognizing the importance of safe nurse staffing levels for both patient care and the nursing profession's success.
• Hospital Equipment: The United States placed #1 in Science and Technology in the FREOPP World Index of Healthcare Innovation. In fact, in every dimension of the Index, the gap between the United States and second-place Denmark was by far the largest, boosting the overall position of the United States. The United States was first in terms of the number of new medications and medical equipment that were approved by the FDA, first in terms of Nobel Prizes in chemistry or medicine per capita, and second in terms of scientific influence as assessed by citations.
• Working Atmosphere: Although the majority of nurses work in hospitals, there are still nurses that work in home health and public health facilities. They travel to their patients' homes, schools, community centers, and other locations to care for their patients and families.
• Shifting: Nurses who work in hospitals and nursing homes frequently work in shifts to ensure that they are available 24 hours a day, seven days a week. They may work at night, on weekends, and even on special occasions and holidays. They may be on-call, which means they are on duty and need to be able to work quickly. Nurses who work in non-24-hour environments such as workplaces, schools, and other non-hospital settings are more likely to have regular business hours.
• Patient Safety: To improve the quality and safety of the care they offer, registered nurses participate in a variety of collaborative initiatives.

Section D: How to Apply as a Nurse in the United States

Even though there is a well-known shortage of registered nurses and healthcare professionals in the United States, existing immigration regulations in the United States might make it difficult for foreign-educated nurses to find work. Nurses who come to the United States must follow tight immigration procedures to guarantee that they are eligible and certified to perform their profession. The right permits and papers from the United States are critical for anyone who want to pursue this route. Department of Citizenship and Immigration Services.

Educational Requirements:
Students must complete an authorized nursing program to become registered nurses. Nursing diplomas, associate degrees, and bachelor's degrees are among the options available. In addition to their nursing training, students must attend general education classes as part of their bachelor's degree program. 

A bachelor's degree covers many of the same areas taught at the associate level, but a four-year program will provide a more in-depth set of skills and knowledge. As the nursing profession becomes more competitive, more businesses are asking new RNs to have a bachelor's degree before hiring them. 

Pass The NCLEX-RN Exam
Nurses who wish to practice their profession in the US must pass the NCLEX-RN Exam. 

Take and Pass an English-Language Proficiency Test
Either the TOEFL or the IELTS (International English Language Testing System) is acceptable, albeit the TOEFL is the more popular option. You'll need a TOEFL score of 83 or above, plus a 26 on the spoken section, or an IELTS score of 7.0 on the spoken section, plus an overall score of 6.5 on the TOEFL.

Credential Evaluation
The Commission on Graduates of Foreign Nursing Schools will require you to produce transcripts from the institutions where you received your high school diploma and nursing degree (CGFNS). This non-profit organization has been given government approval to certify non-U.S. citizens. citizens to work in a variety of healthcare roles.

The CGFNS will check to see if you've completed a general high school education as well as postsecondary nursing education in the following five areas: Adult medical and surgical, Neonatal, Pediatrics, and Psychiatric.

Visa Screen Certificate
To work in the United States, international healthcare workers must pass a visa screening process. ... A Visa Screen certificate is awarded to those who complete the Visa Screen application. The federal screening standards are met by this certificate.

Section E: US Immigration For Nurses

You must meet federal standards to legally relocate to the United States. Here are some of the most common visas available for foreign registered nurses.

EB3 Visa
For employment-based permanent residency in the United States, the EB-3 is one of several immigrant visa categories available to applicants. Skilled workers, professionals, and others are all eligible to use this program. Within this category, nurses are usually categorized as "skilled or professional workers."

Processing:

• To apply, a nurse must graduate from an accredited Registered Nursing (RN) program, be certified as an RN in your nation, and practice as an RN for at least two years, ideally more, to meet your country's education and licensing criteria. Working in a specialty field, such as critical care, emergency room, or labor and delivery, is beneficial.
• A candidate must pass an English language test, such as the TOEFL or the International English Language Testing System (IELTS), if possible (IELTS). 
• In the state where you wish to work, apply for a license. There is no national nursing license in the United States; each of the 50 states has its nursing license. Because you won't have a Social Security number until you arrive in the United States, you'll have a lot of trouble getting a state license. You should, however, receive a letter from the state licensing board confirming that you are eligible for a license even though you do not have a Social Security number. For immigration purposes, this will be adequate to obtain the visa. So, once you've arrived in the United States, you may receive your SS number and license.
• Pass the NCLEX-RN Exam for nurses.
• Find a company or a recruiter in the United States to work with. The I-140 petition is then filed by the employer or agency/employer. It takes three steps to apply for citizenship through an I-140 petition.
• Obtain a visa screen certificate. Your education, training, licensure, and English proficiency are all verified and certified as a result of this. You will need to re-certify if your VisaScreen expires before you immigrate because it is good for 5 years.

H1B Visa For Nurses
For nurses, the United States Citizenship and Immigration Service (USCIS) has given recommendations on H-1B visas. If the position is deemed to be a specialty occupation, the petition will only be granted if all of the other standards are met.

Nursing assistants must have at least a bachelor's degree to be eligible. As a result, in most cases, RN or LPN positions will not be eligible for an H-1B visa. There are some exceptions, however, because some states demand a bachelor's degree to obtain a nursing certificate. An H-1B visa is available if an applicant wants to work in a state that requires it.

Processing:
A nurse's application for an H-1B work visa must be filed with the proper US government agency. Services for Citizenship and Immigration (USCIS). The H-1B work visa application will be reviewed by a USCIS officer, who will either approve or deny it. An approval notification will be issued by USCIS if the nurse's H-1B application is approved, and this will be the nurse's formal H-1B status documents.

Section F: Examination

NCLEX-RN 
The goal of the National Council Licensure Examination (NCLEX-RN®) is to see if you're ready to start working as an entry-level nurse. It's a far cry from any nursing school exam you've ever taken. While the NCLEX-RN® is a knowledge-based exam, it also measures your ability to apply and analyze what you've learned in nursing school. You'll be judged on your ability to make nursing decisions based on your critical thinking abilities.

Section G: FAQs

What is the cost of a Visa Screen?

The cost of placing a VisaScreen® Renewal order six months following your certificate expiration for re-certification is the most significant difference. The cost of a basic VisaScreen® order is $590, while the cost of a renewal order is $300. The new expiration date on your certificate is another significant distinction.

Is it possible for a nurse from another country to work in the United States?

If you're a Registered Nurse in your native country, you're eligible to work in the United States. Contact the Commission on Graduates of Foreign Nursing Schools (CGFNS) to find out if you're eligible. You can take the NCLEX-RN and apply to the Board of Nursing in the state where you want to work.
Are You Ready to Work and Live in the US?

You're now one step closer to accomplishing your goals now that you've learned about the prerequisites and qualifications for becoming a nurse in the US. Just a quick reminder that your application may be delayed or changed as a result of the pandemic.