Foreign Graduates: Becoming a Nurse in the United States

Nursing is a great profession, in high demand in many areas these days: you can work as a nurse in operating rooms, emergency departments, women's health and mental health institutions, provide care for children, adults, or elderly people, work in any areas where people need health care services – the list is endless. As a Nurse, you can apply your skills in many different fields of the medicine. Large number of nursing positions is available throughout the United States for qualified people of any background and culture. You can work standard or flexible shifts based on your family demands or other obligations, take advantage of ample continuing education opportunities, and work on improvement of your professional skills. And the job is rewarding: along with your satisfaction in helping people, you could earn a good money right from the start.

Other great opportunities for the licensed nurses are widely open and growing fast in the areas of independent enterprises and small businesses. You can open your own business in medical or medical related fields. Along with demands for positions, there is great and growing demand for type of services, which may be provided by small businesses established by nurses. The central theme of independent practice has many variations. Some practice in traditional settings, either as a sole proprietor or within a group practice; some deliver services directly to the healthcare consumer; and some own medically related businesses. Regardless of the particular form, the unifying idea is self-employment. As a nurse you have two choices to make more money. Work more hours or work fewer hours and make more money with your own medical staffing agency. Take advantage of the nursing shortage by starting your own medical staffing agency and becoming an independent nursing contractor. Some of the advantages of being an independent nurse: substantial increase in income, increased professional autonomy, more control over personal life.

Currently there are 126,000 unfilled nursing positions across the country, a number that is expected to reach 1.1 million by 2012. More new nursing jobs are expected to be created for registered nurses than for any other occupation, so the time is right to help make a difference and pursue a rewarding career in nursing.

So, you decided to become a nurse. Where to start?
Nurses qualified outside the US who would like to practice, as a registered nurse in the US must:
1. Usually (but not always) pass the CGFNS Qualifying Exam in order to be able to take the Licensure Examinations.
2. NCLEX-RN or NCLEX-PN (National Council Licensure Examination).  The NCLEX-RN or NCLEX-PN is required in order to be able to practice as a nurse in the United States.
3. You must also obtain a visa in order to work in the United States.
First, be advised that licensure requirements are different in every state. You need to know where you will be working before you arrive in order to be sure that you meet all of the criteria.
The Commission on Graduates of Foreign Nursing Schools (CGFNS)
CGNFS is an independent, not-for-profit and immigration-neutral organization committed to protecting the public by ensuring that foreign-educated healthcare professionals are eligible and qualified to meet licensure and other U.S. practice requirements.  CGFNS is not a government organization, nor does it recruit international professionals for employment in the U.S.
Nurses qualified outside the US who would like to practice as a registered nurse in the US must complete the Commission on Graduates of Foreign Nursing Schools (CGFNS) Nursing Certification Program. The Certification Program includes three parts:

1. A review of the applicant's credentials. Applicants must be a first-level, general nurse and must have graduated from a government-approved nursing program, which included at least two years general nursing training. Applicants must also be registered as a first-level general nurse ('registered' or 'professional' nurse) in your country. Nurses who specialized in one area without being educated and registered/licensed as a general nurse (e.g. midwife, pediatric nurse, psychiatric nurse) are not eligible.
2. A one-day qualifying exam. Nurses whose credentials meet the CGFNS requirements can register to take the CGFNS Qualifying Exam, which measures basic knowledge in nursing. The exam is offered in several countries. Registration and information is available online at www.cgfns.org.
3. Test of English as a Foreign Language (TOEFL).
Licensure for Nursing Graduates - NCLEX-RN or NCLEX-PN
All nurses must be licensed in the state where they wish to practice. Note that licensure requirements differ from state to state.  Therefore, be sure to contact the Board of Nursing in the state where you wish to practice in order to verify the respective and current requirements in that state.  Procedures for endorsing (transferring) licensure from state to state vary as well.  The website: http://www.allscrubs.com/boards.html has links to all the State Boards of Nursing.
Most US states require a CGFNS Certificate from foreign nursing graduates before they can take the US registered nurse licensing exam - the NCLEX-RN, http://www.ncsbn.org/. Foreign nursing graduates with CGFNS certification and nurses with US nursing qualifications need to contact the relevant state board of nursing, http://www.ncsbn.org/regulation/boardsofnursing_boards_of_nursing_board.asp  for information on registration for the NCLEX-RN exam. The NCLEX-RN exam is offered in the US only.

Visas
Those nurses who gain licensure for a particular state and have an offer of employment for a US health care organization are eligible to apply for a non-immigrant (H1-B) or an immigrant occupational visa. The CGFNS, through its International Commission on Healthcare Professionals (ICHP) division, is qualified to administer a Visa Screen program for nurses who plan to apply for an immigrant visa. Nurses should contact the US employer and CGFNS for more information.
So there are many reasons to become a nurse.  If you think it’s for you, just go ahead, and you will be able to overcome any obstacles stand in your way. Make a difference!
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Resources:

1. "Becoming a Nurse in the U.S." http://www.cgfns.org/sections/tools/apps/steps.shtml
2. For more detailed information on all the various CGFNS programs and requirements, visit their website at http://www.cgfns.org
3. Map of CGFNS test centers: http://www.cgfns.org/files/pdf/maps/CGFNS_World_MAP.pdf
4. TOEFL: http://www.ets.org/bin/getprogram.cgi?test=toefl
5. medical business exchange

Valentina Izvekov
Translator and Evaluator
 
Evaluation and Translation Services