Are you a foreign-educated nurse or an international student enrolled in a nursing program in the United States? To answer the question the article title poses, let's consider a couple of possibilities.
First, you might be a trained nurse in your home country wanting to become eligible to practice nursing in an American state. Whether you want to enroll in a U.S. nursing degree program or not, we'll tell you how it works.
Second, you might be an international nursing student without previous nursing training who is enrolled in a U.S. nursing program and wondering if you are eligible to sit for the NCLEX exam through a state nursing board.
Keep reading to learn about the process for foreign nurses or nursing students/graduates to become licensed in the United States.
NCLEX Requirements for Nurses Educated in a Country Outside the United States
Becoming a licensed nurse in the United States requires "licensure by examination" for all candidates whether foreign-born or native to the United States.
The only exceptions may be those who qualify for "licensure by endorsement" in states that recognize nursing licenses from some countries, such as Canada or a U.S. territory.
Getting a nursing license in an American state is complex, so we recommend that you allow at least six to eight months for the process before you hope to begin working in the U.S.
How Licensing for Nurses Works in the United States
Each American state has its own nursing regulating body (NRB), usually called the state's board of nursing.
While each state uses the same licensure exam-known as the National Council Licensure Examination (NCLEX)-each state determines what is required for you to be eligible to take the test and also to receive your license.
So, first, you will need to determine in which state you want to take the test. If you have already relocated to an American state, you should start by researching that particular state's requirements.
However, be sure to remain open to taking the test in a different state since some states are more welcoming of international nurses than others.
Requirements for Foreign Nurses in Various U.S. States
To practice nursing in the U.S., international nurses must meet specific eligibility requirements:
- You must be a graduate of an accredited nursing program in your home country.
- You must hold a license to practice as a registered nurse (RN) in that country.
- You should possess at least two years of work experience as an RN.
Although foreign nurse candidates are not required to be U.S. citizens to take the NCLEX, some states require applicants to have a U.S. Social Security number to apply for licensure or sit for the NCLEX exam.
You may also need to do one or more of the following:
- possess a driver's license from that particular state
- show other proof of residency in that particular state
- get fingerprinted
- receive a background check
Many international nurses choose to apply in a state that does not require a social security number to take the NCLEX, such as Colorado, Idaho, Illinois, Minnesota, Montana, New York, Ohio, Texas, Washington, West Virginia, and some others.
Steps To Obtaining a Nursing License in a U.S. State
1. Evaluate Foreign Nursing Credentials
You will need to get your foreign nursing credentials evaluated by the Commission on Graduates of Foreign Nursing Schools (CGFNS). The CGFNS is a nonprofit organization that verifies credentials for nurses who want to live and work in various countries.
To obtain an official certificate and a Credentials Evaluation Service (CES) professional report, you'll need to submit your documents (translated into English). These should include your secondary school transcripts, diplomas, licenses, and any professional education.
Some states may require you to take the CGFNS qualifying exam before allowing you to take the NCLEX. Taking this exam is a good idea to prepare you for the NCLEX, and it also fulfills screening requirements by the federal government needed to receive an occupational visa.
2. Show English Language Proficiency
You will usually need to show that you're proficient in the English language by taking an English proficiency exam. CGFNS will help schedule that as well. If you've attended nursing school in an English-speaking country, this should not be necessary.
The Test of English as a Foreign Language (TOEFL) is most common, though some institutions will also accept the International English Language Testing System (IELTS).
3. Obtain a Visa
If you do not already have one, you'll need to obtain a visa. The United States government's Department of Homeland Security requires a screening program to obtain an RN immigrant visa or H-1B visa. The CGFNS is able to handle these screening requirements with you.
4. Determine the Necessary Licensing Requirements
Next, it's time to check in with your state board of nursing to find out their licensure requirements. Do you need to be fingerprinted? What is the application process?
First, you must apply and pay application fees. Your state's board of nursing must approve your application, usually through a background check, fingerprinting, etc. Be sure that the name on your application matches the one on your passport exactly.
Once approved, the state will issue you an Authorization To Test (ATT), which allows you to register for the NCLEX exam.
You'll register for the NCLEX on the National Council of State Boards of Nursing (NCSBN) website. Be sure to download a copy of the NCLEX test plan, too, so you'll have a better understanding of what to expect on the exam.
5. Prepare for the NCLEX Exam
The next step is to prepare for taking the NCLEX exam. Just because you may have worked as a nurse in another country does not guarantee that you can pass this test.
For example, the first-time pass rate on the NCLEX in 2021 for U.S.-educated nurses was 82.48% and only 46.48% for foreign-educated nurses.
It's essential to learn about the NCLEX exam, have a study plan, and work on as many practice questions as possible.
6. Your goal for the final step is to pass the NCLEX exam and meet your chosen state's licensure requirements!
Pearson VUE testing centers administer the NCLEX exam throughout the United States. If you're still living abroad, you can take the exam in a number of countries such as Australia, Canada, Hong Kong, India, Japan, Mexico, the Philippines, Puerto Rico, Taiwan, and the U.K.
The exam consists of 75 to 145 questions that you answer on a computer. You will have up to five hours to complete it.
After testing, you should expect to wait several weeks to get the official results from your state board of nursing. However, your state board of nursing may be able to provide unofficial results for a small fee after two days. Check the state's Board of Nursing website.
The United States Needs Nurses, So Follow the Above Process to Become Licensed as an RN
The need for nurses in the United States is very high at the moment, so your chances of finding a good job as a foreign-born (and perhaps foreign-educated) nurse are very high after you've become licensed in an American state.
