2.4 How Foreign Educated Nurses Can Practice in the US

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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.

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.

3. 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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