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General     Course of action     Eligibility     CGFNS exam     NCLEX-RN exam     Visas

In order to work as a qualified nurse in the USA, you must have a license to practise there as a nurse AND a visa that permits you to work.
Salaries and conditions in the USA vary from state to state and in general there are no national agreements. The cost of living in different states varies too and this should be considered carefully, especially regarding accomodation and transport. A car may be essential in certain areas as many hospitals tend to be on the outer fringes of cities. Health insurance is normally included in the employment package, but check carefully if this is the case and the type of cover offered. Your holiday entitlement in the USA can vary, and is usually quite limited, somewhere between 2 to 4 weeks a year is the norm.
Their are two main requirements to gaining employment as a nurse in the USA.
As follows:-

Course of action
The two main requirements are --
1. Sitting your CGFNS exam (The Commission on Graduates of Foreign Nursing Schools)
in this country. (See Below)
2. Sit the NCLEX-RN exam in a chosen state of the USA. (See Below)
Joining a recruitment agency which sponsors nurses to fly to the USA to sit this exam is a good way of gaining this qualification.

In the USA there is only one category of first-level of nurse, this being the Registered Nurse (RN). An RN is the equivalent to the UK RGN qualification. Only a RGN is eligible to apply for nurse registration in the USA.
Each state in the USA has its own board of nursing, and its own regulations for foreign-trained nurses. Do not assume that the requirements in one state will be the same as another.
For starters nearly all states require that you have passed the CGFNS exam before you can apply for the
NCLEX-RN "state board" exam. At present only New York and Florida are the exception to this rule. But each board will advise you whether the CGFNS exam is a requirement.

CGFNS exam
The CGFNS Certification Program is designed only for first-level, general nurses educated and licensed outside of the United States who wish to assess their chances of passing the U.S. registered nurse licensing exam, the NCLEX-RN, and attaining licensure as registered nurses within the United States.
The exam is now held three times a year in London and all applications are processed at CGFNS headquarters in the USA.
The exam program is comprised of a Credentials Review, a one-day Qualifying Exam of Nursing Knowledge, and an English language proficiency exam. Upon successful completion of all three elements of the Program, the applicant is issued a CGFNS Certificate.
You must provide evidence of having covered theory and clinical education in medicine, surgery, paediatrics, obstetrics and psychiatry in your nurse education and also have three of more GCSEs. If some of these areas have not been covered during your nurse education, it may be required to gain this education before sitting the exam. Check with the CGFNS or the board of nursing in the state where you intend to practise whether the experience you have been offered is likley to meet their requirements.
For application forms, status of your application and further advice and information visit the CGFNS website @

The NCLEX-RN exam is the most important qualification to get if you want to work in the USA. You will not be able to practise as a nurse without first getting this qualification.
You can now take this exam in the UK via Pearson Vue. You can find details on the NECLEX section of the Pearson Vue website
At present the majority of recruitment as a nurse in the USA is done through an agency, as the number of available posts for UK nurses is limited. (See Useful Links for such agencies).
With this being the case, if you pass the NCLEX-RN exam the agency (or prospective employer) may then apply for a visa to enable you to return to the USA to work. Note: Only a US employer can apply for an employment visa on your behalf.

NCLEX-RN examinations are completely computerised and you can arrange to sit them all year round. You can arrange to take the exam at a test centre in one state but have the results sent to another state so that your license can be issued in that state. But check with the individual state boards about application deadlines.
For further NCLEX-RN exam information, state nursing boards, and application procedures visit the National Council of State Boards of Nursing website @

Visas/work permits
Your prospective employer will have to prove that they have made every effort to recruit persons who already have the right to live and work in the USA, before the USA authorities will allow them to recruit foreign nurses. Unless you are a US citizen by birth or by marriage you must have the correct visa to enter the USA. If you enter the country on a visitor's visa you will not be allowed to work. If you work on a visitors visa, it is illegal and you run the risk of deportation for this offence.
Nurses who do not require a visa to enter and work in the USA must still comply with the requirements of US nurse licensure.

For further information on gaining an Employment Visa and other useful immigration info check
the US State Department website @

Also check National Immigration Services @

Have YOU got any Extra Info or Useful Links?
Please send to Brutish Nursing Webmaster

This information compiled by Brutish Nursing using various resources including articles from The RCN and The UKCC

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