Start here: A Primer For All That Wish To Work In The US

[suzanne4, RN]

Please read this first before posting any questions on the forum, especially if you are new to allnurses. I am going to try and answer the most common questions right here; please check it for any updates.

We have managed to turn this into the best International Bulletin Board and lets continue to keep it going.

Please post any questions that deal with US immigration or working in the US, directly in this forum, not the country specific forums. It will make it easier for all to see, unless it is strictly related to the one country. And make my job easier.

Thanks in advance.

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NCLEX-RN exam is required of all nurses, no matter where they trained to work in the US. It is a national exam, and the results are accepted in all fifty states, and never has to be taken again.

You must apply to a state for "License by Examination" and have your file approved before you will be permitted to sit for the exam. It requires an ATT (Authorization to Test) to have in your hand to take to the testing center. You will get this after you have been accepted by the state, and have paid the fee for the exam to Pearson-Vue. It is $200US if taken in the US, and $350US if taken out of the US.

There are a few states that require a local license, most do not. US Immigration does not require a local license in your home country.

CGFNS does require a local license to sit for the CGFNS exam.

The only thing that is needed for the GREEN CARD is a Visa Screen Certificate. This can be gotten by passing either the CGFNS exam or the NCLEX-RN exam, and the series of English exams, if you are not exempt from them. Requirement is based on where you did your initial nursing training, not where you have worked. Even if you are now in the US working on your MSN; but trained in another country for the BSN, you will still need to take the English exams.

Permanent residency, or green card, is what you will be getting. There are no temporary work visas being issued to nurses, and there have not been any for over two years. H1-B visas do not exist for nurses. If someone tells you otherwise, they are incorrect. Please list permanent residency on any application that asks for the type of visa, and include a copy of your passport with it.

All of the green cards for nurses are employer-based, which means that you must have an employer to start the process for you. You cannot apply to immigration for the green card on your own.

Once you have found an employer to do the petitioning for you, you will be given forms to complete. The one that you keep hearing about is the I-140, and this is what will need initial approval before you can go any further. Next, the visa bill will need to be paid, either by the employer, or you. DS-230 forms will come next, and will need to completed and returned. Your dependents must be listed here, or they will not be on your green card, and will need to go thru a separate process later on. And that can take about two years, so please make sure that everyone is on there.

If you have a baby, they can be added. But for others, there will be a wait involved. Once the DS-230 is received and verified, you will hear that your file is complete. Next step will the final step and that is the medical exam and the US Embassy interview. DS-230 is referred to as Packet 3, and the medical/interview is Packet 4. Length of time will be dependent on where you have to go to interview. the UK is currently about six weeks or so, Manila is on average about four to five months.

Anything that requires a notary, must be done at the US Embassy where you are. It does not need to be done in your home country, if you are not currently working there. If you are in the US, then a local notary is acceptable. There are some that have gotten by with local notaries in their home country, but many times they are not accepted and it is better to do things right the first time.

Reciprocity vs. Endorsement

The NCLEX exam has reciprocity, and is accepted in all fifty states. Once you pass it, you never have to take it again. Each state issues its own license, and you need to meet their requirements for it. Some have language requirements and some have additional courses required. Please check directly with the state that are seeking a license in.

Employment Contracts

These are binding legal documents and should be treated as such. If you were buying a home, you would not just sign it. Do the same with this. If it is not in the contract and written, it does not exist. Do not sign a letter of intent or employment, if you intend to look elsewhere and may break that contract. It makes it harder for others to get petitioned. Please be aware of this.

What to look for in a contract: Remember that you will be coming over to the US on a green card, all of you are college educated and with at least four year degrees. Do not sell yourself short.

You can request a specific state, or even city. If the agency doesn't have that one, then look other places. You can also do a direct hire with a hospital.

Make sure that length of orientation is included, this is extremely important. You should not be expected to be on your own in just a couple of days. Doesn't matter how much experience that you have in your country, things will be different in the US.

Never, ever sign a contract or letter of intent, etc., that has any blanks in it. It must be 100% complete; or your contract can be sold, and you are essentially sold to another company. Just like the slave contracts. And if you sign it, there is nothing that anyone can do to get you out of it. If something does not feel right to you about it, then do not sign it.

Canadian and Mexican RNs:

You are covered under the NAFTA Free Trade Agreement and can be issued a TN Visa right at the border. You just need to present a Visa Screen Certificate and a job offer form an employer. This visa needs to be renewed every year. You can also go thru the same process as other foreign nurses to obtain the green card, if you wish. You mut actually hold a passport from that country, and not just have permanent residency there to qualify for this type of visa.

LPN/LVN:

This training is not accepted by US immigration for a green card. Statute states that the nurse must be a first level nurse in their country, and have RN after their name. There are no temporary work permits available for nurses.

The only way around the above is if you are married to a green card holder or an American, but you cannot get the green card on your own. It would have to be spousal only.

CGFNS:

Credentials Verification for NY is called the CVS. NY requires this, even if you are endorsing to there.

Regular Credentials Eval is called the CES.

Visa Screen Certificate is needed by all that are applying for a green card in their name.

Their website is https://www.cgfns.org/

Most states are now requiring the CES, and not the CGFNS exam. And this can be for endorsement as well. Please check the specifics with the state that you are applying to. Check out the initial licensure, as well as endorsement requirements.

English exams:

You have choice of either the TOEFL series, which includes TOEFL, TWE, and TSE. This is offered thru ETS, Educational Testing Services, and their website is https://www.ets.org/toefl; or the IELTS, in the academic branch with the speaking section. This is available thru the British Council.

Consular Processing vs. Adjustment of Status (AOS)

Consular processing means that you follow the routine process and have all of your immigration details processed while you are still out of the US, and complete your interview at the US Embassy before you travel to the US.

AOS is done once you have been in the US for a period of 90 days, continuously. You are not permitted to leave during the processing time for any reason. It is actually in violation of US Immigration law to come to the US for the sole purpose of finding a job and staying however, it is done all of the time. But there are some things that you need to be aware of. You must make sure that you have about five months of funds available to you to live on while waiting. It is the 90 days before a petition can be submitted, plus about another 60 days before you are will receive the EAD, which permits you to work. Then you need to allow about one week for your SSN# to arrive after you apply for it. It is illegal to accept any type of work during this time, and if you are caught, you face deportation and not being permitted to return to the US for a period of at least ten years. EAD stands for Employment Authorization Document.

And if you are going to come to the US with the idea that you are going to stay, make sure that you already have approval to sit for the NCLEX exam before you arrive here. Do not come with the idea that you will start everything once you are here. You are not going to be able to get things done in most cases, and will have to leave. You never want to apply for an extension after those 180 days are up, unless you have a very good reason. It must be done well in advance, not just a few days before it expires.

Foreign nursing students in the US

You can attend school on any of the visas that permit you to be in the US legally. The tourist visa will not allow you to carry a full load of classes.

CPT is available for you during school to get experience working in a hospital. The OPT is available for up to one year when you graduate, but you must apply for it before you actually finish your classes, or it will not be available to you. There are restrictions for both.

The only visa that you can apply for when you graduate is the green card, or permanent residency. H1 visas are not available to nurses, and have not been for over two years.

[NRSKarenRN, BSN, RN]

State Boards of Nursing

[NRSKarenRN, BSN, RN]

Reliable information websites to assist in immigration/working in us

There's are a lot of inaccurate information out there. Do not depend on just hearsay and rumors. You need to check all the information given top you. 

Trusted Resources

For all state BON (and their respective requirements) and everything about NCLEX:

https://www.NCSBN.org/

For CES, CVS, CGFNSs certifications and esp. visa screen certification (everybody needs this). Read the whole website.

https://www.cgfns.org/

For official news releases from USCIS pertinent to schedule a nurses:

https://www.uscis.gov/

Instructions for registration with Pearson-Vue:

https://www.NCLEX.com/

https://www.NCSBN.org/

Hospital websites for diff. states:

https://www.hospitalsafetygrade.org/all-hospitals

With all these reliable websites, there are no reasons that nurses would get lacking or inaccurate information. We just have to do our own research and do what is best for ourselves and most importantly let's network and help each other out. if we know any info. (Bad or good) please share it. It has to be as much as possible accurate or if you received info but not sure if it's accurate or not, please. share it and ask about it in forums like this so that those who have gone thru the process or are more experienced or an authority could give their inputs and suggestions.

Lastly, to those posting on allnurses.com please be responsible, respectful and sensitive in your posts. These posts are monitored by not just RNs but everyone related in this industry (including prospective employers). We are all educated professionals here. many may have differing opinions but we must always maintain respect with each other. We are the captains of our own ship and no one is forcing anyone to do something we don't want to.