Step by step procedure to get license to work as RN in CA,USA

Silverdragon102, BSN · Dec 7, 2008

hi all,
i am new member here and i would like to get some information about getting rn license in ca,usa. before that i must say that there are lots of forums on internet about nursing but i found this one very useful.thanks all in advance.
i am a registered nurse from pune,india. i have completed my diploma in nursing in 2002. then i worked for 6 years in hospitals in india, mainly in the icu(intensive care unit) departments. now i am persuading bachelor's degree in india which is 2 year course and i have already completed one year of it. i would be finishing this course by nov 2009. i would like to work as rn in ca, usa. my husband works there and i already have got h4 visa.
from going through the forum posts i came to know that rules,requirements of different boards keep changing and different cases have different answers so i decided to compile complete list of my q here and post to get most up to date information about the question involved.
the main objective is to minimize time i waste after finishing my bsc course in nov 2009 but before i start job in ca, usa as rn.
1: what all exams do i need to appear for ?
i know ca does not require cgfns. also my nursing diploma was not with english medium but my current bsc nursing course (2 year course after diploma) is completely in english. but i guess nurses from india need to give english lagnuage exams. so i think nclex + ielts are the only exams i need to give. correct me if i am wrong. also is toefl/tse exam accepted instead of ielts ? if yes which one is easier and quick one to finish ? yes as long as you meet state requirements then nclex is all you need for california
2: what are all the steps involved in passing nclex exam ?
from some of the posts i got the idea that , i need to get my education certification verified from cse even though i will not appear of cgfns ? if yes what is the procedure for this ? and how much time it would take normally ? can this process be started from india even though i plan to appear for nclex in usa and not in india. also i would like to go through any process only after i get my bachelor's degree but it is going to take time i would like to start the verification process as early as possible. so in that case can i start with my diploma certificates now and later on get bachelor related certificates verfied? will this speed up anything ? the process can be started outside the us and once you get eligibility you can sit the exam anywhere
3: how long before i sign up for the tests do i need to get the verification done ? if i read correctly so far , nclex exam can be given throught the year. so how much waiting period is there for exam registration normally. or is it like i can even register today and appear for exam tomorrow ?
if this depends upon where i would appear it would be ca, usa. takes on average 4-6 months to get eligibility and then you register with pearsonvue and they will send your att and then you can arrange to sit it with them
4: what are all the visa types that nurses from india can have to work here as rn , legally. i have h4 but i know i can not work here with that. can you list all of them. and is it posssible for my h4 to get converted
to any of them ? i know this question better be asked to immigration attorney but what your experiences suggest ? not possible to change status and get a visa that will allow you to work
5: how easy is it to get the job once you are in us and cleared all the exams and in some cases got the required visa.( i know most of the times employer only will be sponsering visa.) how much time normally it takes to find the job considering i will have 3 + 2 years of nursing education and 6 years of work experience. i would like to get the answers to these queestions mostly in contexts related to me. like nurses from india or from other non english speaking counries, for jobs in ca, usa etc. i understand answer varies case by case but still what past experinences suggest with respect to this ? without a work visa you will find it hard plus california is suffering from high unemployment and we are seeing nurses being affected
6: what does this retrogression thing mean ? how does it affect my chances of getting job in ca, usa with valid visa.preferably green card. from some pointers i could collect that this is case when no. of applicants are more than visas available. but somewhere i also read that nursing profession has been included in some 'special' category in usa where they quickly get visa. will somebody please provide details about this issue. mainly in the context of indian nurses. what is current status ? when nurses are going to start getting valid visas next time ? is it only done once in year ? or the process is going on throught the year ? processing is done all the time but coming from india current processing times are 2001
7: in each of the valid visas to work as rn in ca, usa, how much time the processing normally takes to get them after nclex exam has been cleared ? can one start job before its done and if one is already in usa ? with no work visa you can not start working
8: how to prepare for nclex-rn exam if you have studied nursing from india. from forum posts i found saunders/kaplan/suzane books widely used. is there anything else i should be considering. also from what i read saunders is good for contents while kaplan/suzane is good for q & a. is this correct. mainly syllabus for indian nursign and us nursing is bit different so i do not know which books among these three really fills gap between indian nursing and us nursing education ? how much time indian nurse normally has to prepare before she passes the exam ? i read somewhere for international nurse passing rate is around 50 %. is there any corresponding figure for indian nurses ? check the nclex forum under the student section
9: does the material for exam change drastically each year ? reason i am asking these question is , is it ok to buy old books for nclex rn preparation ? or one should always get new one ? always get up to date resources
10: i have mainly worked in icu(intensive care unit )in india but is it possible to get jobs in other departments once you come to usa. or all the experience that i hold (6 years) will be void in that case ?
thanks and eagerly waiting for answers to above questions.
nurse
(yeah thats what i am and am proud to be !!)

how long has your husband been in the us and has his employer at all filed for gc? if not then the likelihood of being able to stay at the end of his h1b is slim as all categories for gc for india are retrogressed back several years more than other countries. retrogression is affecting many many nurses from all over the world and makes no difference where you are or that you are in the us as all done on place of birth. we also do not recommend ca for initial licensure as they will not issue a license without a ssn and that you will not get until in the us with a valid work visa. basically you will not be able to work in the us at the moment and seriously doubt things will change for a long while. although this is not the news you would like to see i strongly suggest a good read in the forum as much has been written

tellmemore · Dec 7, 2008

Thanks for quick reply.

Few more related questions :

1: What is ATT ? So after i get eligibility certificate how much time before i can actually appear for exam (assuming i take every next step on the very next day) ? Just trying to estimate minimum time here.

2: You did not talk anything about IELTS/TOEFL difference. My original Q no: 2. Any comments about it?

3: Also Q : 2 needs more explanation. I know that with diploma in Nursing from India you can sit for the NCLEX exam. So that alone is ok for eligibility. But i would always like to add my bachelor status in the processing to increase my chances of job. So is it ok to get eligibilty certificate on diploma basis and later on add bachelor qualification. As this would save me 4 months of time as i am yet to finish my bachelor which will only happen in Nov 2009. Also is there any time limit as to after you get eligibilty certificate , in certain amount of time you need to appear for exam ?

4: Can you tell more about possible visas for nurses which allow me to work leggaly in US ? By status i might also mean change of status of My husband's visa ? In that cases what option do we have ? Is green card only visa under which nurses can work in USA if she is from India ? Is H1 visa available for Nurses from India to work in USA ? Does retrogression applies to h1 visa also ? or for all types of visa for that matter or only for green card processing.

5: If not CA , which other part of USA you would like to sugegst which makes getting license easier ? Is boston, NJ, New york easier ? My husband would also shift to other place with me if required so just making sure he would also get the job if we plan to move to state other than CA where he currrently works on h1.

6: With respect to retrogression , processing time is 2001 . Do you mean they are processing application only from that year ? and My application would be put in the Queue and will come for processing only after 5-6 years ? What are other visa's part time work etc that i can get till that time ? Also do they not process a single application from this year ? is there any special category ?

7: Will you explain answer to orignial Q # 9 in more detail ? Just saying latets is best does not really help much. Does the content really change ?

8: My husband just came there in Nov 2008. And No gc processing yet. He is in software industry and currently on H1 for 3 years . thats all. So what do we need to do if we both want to work in US for longer period than 3 years of his h1 ? Will he be able to get GC and in that case can i get GC too so i can work ? How easy it would be for him to get GC mainly considering he is from software industry (There proeffesion seems to be in more demand)

Thanks for your quick reply and i really _admire_ that. But i am taking some effort to clearly explain the questions and if get equally explainotory answers i would be more delighted.

-Nurse

Silverdragon102, BSN · Dec 8, 2008

thanks for quick reply.
few more related questions :
1: what is att ? so after i get eligibility certificate how much time before i can actually appear for exam (assuming i take every next step on the very next day) ? just trying to estimate minimum time here. att is your authorisation to sit nclex. without it pearsonvue will not let you sit the exam. it is issued by pearsonvue once they get confirmation from bon that you have eligibility to sit the exam. do not register with pearsonvue until you receive eligibility
2: you did not talk anything about ielts/toefl difference. my original q no: 2. any comments about it? i know suzanne says ielts is better to take and is required as you will need a visa screen certificate to be able to work in the us once a visa is available for you
3: also q : 2 needs more explanation. i know that with diploma in nursing from india you can sit for the nclex exam. so that alone is ok for eligibility. but i would always like to add my bachelor status in the processing to increase my chances of job. so is it ok to get eligibilty certificate on diploma basis and later on add bachelor qualification. as this would save me 4 months of time as i am yet to finish my bachelor which will only happen in nov 2009. also is there any time limit as to after you get eligibilty certificate , in certain amount of time you need to appear for exam ? as you haven't finished your bachelor you can not include it and the bon will make their assessment on your current transcripts, they alone will decide if you meet their requirements and be able to sit nclex
4: can you tell more about possible visas for nurses which allow me to work leggaly in us ? by status i might also mean change of status of my husband's visa ? in that cases what option do we have ? is green card only visa under which nurses can work in usa if she is from india ? is h1 visa available for nurses from india to work in usa ? does retrogression applies to h1 visa also ? or for all types of visa for that matter or only for green card processing. there is very few hospitals that use h1b and for that you need to be a specialist and also a bsn which you do not have. only one really for nurses are the gc and as i mentioned you are affected by retrogression and looking at a processing time of 2001 at the moment so a long wait.
5: if not ca , which other part of usa you would like to sugegst which makes getting license easier ? is boston, nj, new york easier ? my husband would also shift to other place with me if required so just making sure he would also get the job if we plan to move to state other than ca where he currrently works on h1. there is now way at the moment you can work so doesn't matter which state you apply to
6: with respect to retrogression , processing time is 2001 . do you mean they are processing application only from that year ? and my application would be put in the queue and will come for processing only after 5-6 years ? what are other visa's part time work etc that i can get till that time ? also do they not process a single application from this year ? is there any special category ? yes they are only processing visas submitted before 2001 so yes you are looking at 8 years for processing and before you are being processed as it stands. there are no special categories for nurses and haven't been since i think it was feb 07
7: will you explain answer to orignial q # 9 in more detail ? just saying latets is best does not really help much. does the content really change ? content does change so when looking at books as a resource then you need to get the latest editions as they will be more up to date on the type of questions being asked
8: my husband just came there in nov 2008. and no gc processing yet. he is in software industry and currently on h1 for 3 years . thats all. so what do we need to do if we both want to work in us for longer period than 3 years of his h1 ? will he be able to get gc and in that case can i get gc too so i can work ? how easy it would be for him to get gc mainly considering he is from software industry (there proeffesion seems to be in more demand) if he has only just started working in the us then you are going to have problems, employer may not be willing to file for gc due to the retrogression and if his employer does file for gc it only means i140 gets filed and this will not give permission to stay in the us and work whilst waiting. impossibel to get 485 which gives permission to work whilst application or gc is being processed unless he gets a extension and retrogression is still in progress then you will have to leave the us once his h1b expires
thanks for your quick reply and i really _admire_ that. but i am taking some effort to clearly explain the questions and if get equally explainotory answers i would be more delighted.
-nurse

really with retrogression you are going to struggle to be able to work in the us. there are no short cuts especially as the demand for india is very high for us visas

suzanne4, RN · Dec 8, 2008

H1-B visas are valid for three years, they may be renewed one time so that would make a total of 6 years from when it started. I would recommend that you take a look at the Visa Bulletin to get some idea with the retrogression. You will see that India is back to 2001/2002; both for those with a Bachelor's degree as well as those with the Master's degree.

Getting licensed here is not the issue, but the fact that there are no visas currently available. The US has already been under the retrogression for two years, and we do not expect anything to open for processing of those that wish to adjust their status which is what you would be doing. That is called AOS. The US government is currently accepting the I-140 and nothing more than that. You would have to be able to submit the I-485 and that is not possible right now. The H-4 visa does not permit you to work, or even volunteer to work in a job that one would normally receive payment for.

Also getting petitioned for the green card in CA is quite hard right now, the state is actually ranked #3 in the country in terms of lay-offs so there are more Americans that are picking up extra work as well at this time. And then add in lay-offs and hiring freezes in effect; if a facility has one or the other, then they cannot even offer a job to anyone and this will affect you directly as well.

CA also does not issue a license without a SSN#, chances of getting one in the next three years is going to be slim at best.

The IELTS is always the better choice for most especially for the speaking section as you are testing with a human directly in front of you and not a machine.

Best of luck to you. Just wanted you to be aware of what is actually happening out there right now before you begin anything.

tellmemore · Dec 8, 2008

Hey thanks both of you for your helpful replies. Most of the questions are answered now. Though i have few new ones :).

1: The retrogression information that you are talking about is from current visa bulletin updates rht? Which might actually change if OBAMA government decides to change the policy related to these visas rht ? I am just trying to understand whole situation. Coz unless that government does something about these visa quoatas , i do not think i have any chance of getting visa approval in next 5-6 years. And frankly i was not planning to work there after around 6 years from now. So until some policy change happens, i think i am completely out of luck here.

2: I did not completely understand your comments about my husband's GC processing. For example lets say his GC proocessing starts next year, now this means only I140 rht ? But he would still have H1 and can work on that rht ? And assuming he gets one extention he can work for 3 more years . So he can work upto 5 more years after GC processing started. In this case its likely that his 485 would come even considering retroregression.(no gurantee but still a possibilty). Now i assume if he gets GC i will also get GC . If this is wrong let me know what Visa i will be having ? What is EAD ? Is it same as 485 ? So can i also start working once he files I140 and he gets it approved ? Is that also considered as my I140 approval ? Or only after 485 i can actaully work ?

3: Why such big issue of retroregression. News papers and agencies in India do lot of marketing saying Indian nurse have very good opportunities in US and all that stuff. So does not US healthcare really need foreighn nurses ? Are all those report false and only marketting stunt ? I am asking these coz i have lots of friends signed up with aganecies under assumption that once they pass NCLEX they can immediately start working in US which seem to be distant dream after whatever useful information/truth you have told me under this posting.

And if reports are true and US healthcare industry really needs those foreighn nurses, Why government is not doing anything for their visa issues ? Is this completely governemnt's fault in this case ? Or there are certain things i am not taking into consideration here ?

4: I understand that on H4 i can take education in US. Is that correct ? If yes does my visa becomes F1 or remains H4 in that case. And am i allowed to do 20 hrs on campus job in this case which is normally allowed for F1 ? Are such things allowed in MSN course in nursing ?

5: You also mentioned some hospitals do sponsor H1 for nurses. So can i opt for this way ? Or this has been banned now ? If i take MSN course in USA after coming there on H4 , will that be helpful in anyway to improve my chances of being able to work in USA ? Can i work on OPT for one year in that case ? Or being on H4 does not allow me to opt for OPT ? Or MSN is not going to change anything here as all visa concerns remain same.

6: Can i chose to do different job related to nursing like nursing instructor and opt for any other visa if there is such an option ? is yes can you provide some details about what kind of jobs and what kind of visas ?

6: Also from your experiences in this field and newly ellected government's policies what are your personal opinions about visa issues being resolved for nurses in near future and chances of me working in USA ? I know nobody can be definite here as everything is uncertain and we are talking about future about which even President OBAMA can also be not sure as of today but i am just asking for personal opinions of the people who are closely following all the news in this field .

Thanks for helpful information. I do not know if you are realizing what a great work you are doing by clearing all the doubts from nurses' minds. Keep it up. I have never seen a better nursing forum. God bless you.

suzanne4, RN · Dec 8, 2008

Please take the time to do some reading on this site, all of your questions have been answered over and over again. Not sure if you understand about the green card, the number of visas has not increased in years from countries, and it goes by country of birth. The fact remains that there are many more in the process from your country for the green card, and that is why it is retrogressed more than any other country as well. So do not expect changes for a good many reasons. First, Obama is actually offering a tax credit for each and every American that is offered a job over the next two years. CA also has the 3rd highest rate of unemployment in the country. An employer has to prove that they are unable to hire an American for the job before it can even be offered. And that is going to be quite hard to do.

You have not worked in the US, so how are you going to be familiar with how things are done here first of all? As well as the fact that our programs actually require a Master's degree to teach and not just the BSN.

It does matter what agencies are advertising in your country, the fact remains that there are no visas available. And your husband's employer can do nothing more than submit the I-140, that will not have any affect on you and will not permit you to work here.

The retrogression is a big thing since it has been in effect for more than two years, it is not something recent that just popped up. CA hospitals are mostly unionized, so this puts the H1-B visa out of reach for you as a start. They do not permit any temporary work visas, only the green card or a treaty visa; and there are no treaty visas available for those from India.

If you take the time to read what I posted above, you will see that going for the MSN here is not going to help you in any way with getting a job when you are done as there are many from your country that have already earned the Master's degree in the US, and if you look at the Bulletin again, you will see that the EB-2 for those from your country has essentially the same dates as those with the Bachelor's degree.

Many hospitals in CA are already having hiring freezes or lay-offs, so it is impossible for them to even offer a job to someone from another country. They cannot do it as they have to prove that they are unable to hire an American for the job and that is going to be almost impossible for them to do.

One cannot even apply for any of the temporary work visas, if they were available before they actually had all documentation in place, and this includes passing the NCLEX exam passing the English exams as well as having a Visa Screen Certificate in hand. Figuring four to six months to get approval from CA, then several more weeks to receive results by snail mail, then the approximate time of about four months for the VSC before you can do anything. So you are looking at next fall at the earliest, and suspect that it will even be harder by then to find a job in CA.

The other issue is that there are already so many ahead of you that already have completed petitions and are just waiting for a visa number to open for them so even if things were to be adjusted and the bill that was being discussed previously passed to increase the number to 20,000 additional visas per year for six years, it will not affect you. You also need to keep in mind that about 17 months ago, there was a slight problem and the US government was forced to accept petitions for the I-485 when there were no visas available and there were 800,000 submitted. You do the math, there are only a total of 140,000 green cards per year under the EB-3 category and this is what you would be under. You also need to actually have the BSN before you can apply for any of the temporary work visas in the first place.

140,000 into 800,000 is more than 5 years right from the start and that does not take into account all of those that are going thru Consular Processing and are out of the country. Their green cards come from the same 140,000 per year and there is a restriction of just under 10,000 per year for those from your country.

It is up to you to make an educated decision on this, but also be aware that CA will not be issuing a license to you without a SSN# and the passing letter that they will send is only valid for three years and then the file is destroyed.

I also have deleted the post that you made to me in the Questions for Suzanne thread as Anna has already gone over in detail for you each and every one of your questions. There is no reason for me to repeat it here.

And again, please do read the Primer at the top of this forum for much information that you need to be aware of. We are telling you how things are actually happening in my country right now, what an agency does in yours is purely up to them, but shameful none the less since no one is going to be getting a visa for many years if they are not already well into the process. If you take the time to do some reading you will find quite a few that actually began the process back in 2005 and they are still waiting. This was also before the big surge in applications/petitions to work here in the US.

suzanne4, RN · Dec 8, 2008

Step by step process is also given in the thread called the Primer at the top of this forum. It addresses most of your questions, the others have been answered in other threads here.

And thanks for the lovely note, it is appreciated.

tellmemore · Dec 9, 2008

Hey thanks a lot Suzanne. You seem to got little bit irritated with so many repeated questions. I can understand but i would also like to tell that i did use quick search methods before asking questions. I only repeated some of the questions because

1: I wanted to know if there is any update to answers

2: Wanted answers exactly in my context.

Anyways most of the questions are answered and i am much more aware of situation here.Thanks a lot. Only thing i do not understand is never ever you straightforwardly answer my question of reports being false about many nursing jobs available in USA as its usually marketed.

Getting H1 as nursing instructor question was asked considering MSN only. Meaning if i opt MSN and then try to get H1. As i know for sure H1 are processed each year independently of previous year. If instructors are allowed to have H1 visas i might still work in USA with that.

-Nurse

richo_006 · Dec 9, 2008

It's nice to hear your aspirations in life. As what had been said, its hard to find jobs right now in the states esp. california, its better not to assume alot of things. It's best to process your visa now so that you're just counting the years until you're approved to come here. Good luck to you

SuesquatchRN, BSN, RN · Dec 9, 2008

Only thing i do not understand is never ever you straightforwardly answer my question of reports being false about many nursing jobs available in USA as its usually marketed.

Nurses are losing their jobs. Last month, 500,000 Americans lost their jobs. My facility is not hiring anyone, including nurses, and is considering allowing all positions to remain unfilled if someone quits.

Yes, the reports are false.

Even if the reports were not false there is at least a five year wait for a visa.

Ginger's Mom, MSN, RN · Dec 9, 2008

Hey thanks a lot Suzanne. You seem to got little bit irritated with so many repeated questions. I can understand but i would also like to tell that i did use quick search methods before asking questions. I only repeated some of the questions because
1: I wanted to know if there is any update to answers
2: Wanted answers exactly in my context.
Anyways most of the questions are answered and i am much more aware of situation here.Thanks a lot. Only thing i do not understand is never ever you straightforwardly answer my question of reports being false about many nursing jobs available in USA as its usually marketed.
Getting H1 as nursing instructor question was asked considering MSN only. Meaning if i opt MSN and then try to get H1. As i know for sure H1 are processed each year independently of previous year. If instructors are allowed to have H1 visas i might still work in USA with that.
-Nurse

We certainly need more instructors, you need to graduate from an approved nursing program to gain employment in most colleges. NLN or CCNE approved MSN programs. Trouble is many programs are having funding issues, check the board here you will see many a nurse turned away due to funding issues.