A Comprehensive Guide to Nursing Registration in the USA

1. Scope of Nursing in the USA

The USA offers a dynamic landscape with vast opportunities for nurses from around the world. Nurses can specialize in various fields and pursue advanced roles as Nurse Practitioners, Nurse Anesthetists, Nurse Midwives, and more. With competitive salaries, opportunities for leadership and educational roles, and the chance to serve in a diverse healthcare system, nursing in the USA is a rewarding career choice. The increasing demand for nurses, driven by an aging population, expanded healthcare access, and a nursing shortage, makes it easier to find a position in this thriving field. Additionally, nurses can enjoy the rich cultural diversity and beautiful landscapes of the USA, all while practicing in one of the world’s top healthcare systems.

You can also find information about nursing registration for other countries given below:

Disclaimer: The information provided in this guide is for general informational purposes and serves as a guideline for application of a Registered Nurse. It is not intended to replace professional consultancy or to represent any medical council or regulatory body. Always consult the official websites for the most up-to-date information and specific guidelines related to your individual case.

2. Steps to Apply for Nursing Registration in the USA

The five major steps have been illustrated in the following section.

Step 1: Check Eligibility Criteria

Educational Requirement

In order to apply for nursing registration in the USA, you must have a graduated nursing recognized degree equivalent to the US standards.

Professional Requirement

You should have a nursing license in your home country to practice; however, two year clinical work experience is optional in some states but preferred mostly. Also, you are supposed to complete a Foreign Educated Nurses (FEN) Course with 120 credit hours and 120 clinical practice hours under supervision of a registered nurse.

Step 2: Pass English Language Test

 English Language Test

If you are a non-native speaker of English, you need to demonstrate your communication skills and proficiency in English, as it is not your native tongue. The Commission on Graduates of Foreign Nursing Schools (CGFNS) and the Health Resources and Services Administration (HRSA) in the USA accept a variety of English language proficiency tests with varying scores, as listed in the table below:

English Language Tests & Scores Accepted by HRSA  and CGFNS

*The accepted test scores or their validities may slightly differ with time, so always check updates from official sources.

For OET Nursing preparation, including resources, guidelines, and mock tests, please read the following articles:

OET Online Course for Nurses

OET Mock Tests for Nurses

OET Writing Correction

OET Reading Tests for Nurses

OET Speaking Sample Roleplays for Nurses

OET Listening Sample Tests for Nurses

For PTE test preparation, authentic practice resources, and evaluation, you can read the following articles:

Step 3: Apply For Credentials Evaluation

CGFNS or any other state specific credentialing organization will evaluate your educational and professional documents to ensure that they are up to the US standards. For the evaluation, visit CGFNS , register yourself by submitting your application, and upload all the relevant required documents to verify your credentials.

Step 4: Pass the Licensure Exam

Once you complete the verification step, you should apply for the National Council Licensure Examination for Registered Nurses (NCLEX) exam. You can find the testing center’s location here  where you can book, pay a fee (approx 200$), and take the NCLEX exam. You will get your results within six weeks after the exam. If you do not pass, you will receive a Candidate Performance Report (CPR) which will act as a guide for re-taking the NCLEX exam.

Step 5: Find a Nursing Job

You will need to find a registered nursing position in the USA which you can do with the help of a recruiter or independently. You can also get recruited with the help of a US based employer or agency. You can search for nursing jobs on various nursing job boards and portals online.

Step 6: Get a Visa

Employment visas for Nurses are the following:

TN visa is specifically for Canadian and Mexican nurses who have an offer letter from a US employer, license to practice nursing, passed NCLEX and state license exams.

H-1B Visa or temporary work visa but you can apply for green card laters. It is very limited in number and only available for nurses who have completed a four year nursing degree with specialization as cardiology nurses, critical care nurses, and emergency room nurses.

EB-3 Visa is a green card or permanent residence visa which is available for two year degree education in nursing from accredited institutions with a license to practice. You can serve in the US with this visa for up to ten years, and you can also take your spouse or children under the age of 21 with you. The good thing is that you do not need any job offer letter for this visa.

3. FAQs

What type of nurse is most in demand?

Nurses are in high demand across the USA, especially those with specialized skills. In-demand nursing roles include Registered Nurses (RNs), Psychiatric Nurses, ICU Nurses, Emergency Room (ER) Nurses, and Labor and Delivery Nurses. Other sought-after positions are Oncology Nurses, Nurse Practitioners (NPs), Pediatric Nurses, Home Health Nurses, and Surgical Nurses. These specialties reflect the growing need for both general and highly skilled nursing care in various healthcare settings.

Can I bring my family to the U.S. as a nurse?

Yes, you can bring your family to the US with H1B or EB3 visas. Please read the visas section above.

Is NCLEX hard to pass?

You can expect some challenges in passing NCLEX as it is adaptive in nature(more difficult questions when you answer correctly. However, difficulty in the NCLEX exam greatly depends on your understanding and preparation. It mainly tests your knowledge on patient care, pharmacology,  safety, medical-surgical nursing, etc.

How to register for NCLEX in the USA?

First, determine your eligibility for the exam, you will receive authorization to test if the State Board approves your application. Then, you will register with Pearson Vue to schedule your exam after paying the fee.

Can I work as a nurse in the USA without NCLEX?

As a general rule, this is mandatory for most of the nurses; however, a few exceptions are for CNA (Certified Nursing Assistant), Nurse in progres with provisional license, or Nurse Practitioner with other licenses or certifications.

What is a passing score on the NCLEX?

Since the NCLEX is a computer-adaptive test (CAT), there is no fixed passing score or number of questions. The test is designed to assess the minimal competency required to practice as a nurse. For the NCLEX-RN (Registered Nurse), the passing standard is set at 0.00 logits, while for the NCLEX-PN (Practical Nurse), it is -0.18 logits. These passing standards are accepted until March 31, 2026. The adaptive nature of the exam means that the difficulty of questions adjusts based on your responses, aiming to accurately assess your competence.

When can I retake the NCLEX exam if I fail?

You must wait for 45 days from the last test date before scheduling for the next attempt for the NCLEX exam. You are allowed to take the exam 8 times in a year. Remember to check the specific state conditions for specific rules.

Do nurses get a green card in the USA?

Yes, a lot of foreign nurses work in the US and obtain green card.

If you need any more information about registration for nursing in the USA, feel free to contact us!