Licensing: Nursing – USA

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US Registered Nurses

You are eligible to work as an RN anywhere in the United States.

However, you have to be licensed in the state where you'd like to work. Individual states are responsible for issuing their own license to practice. Therefore, applicants are encouraged to contact the licensing body in the state in which they wish to work, in order to confirm the specific requirements for that state. Please see the information below.

The basic process to licensure is: completing a RN program, applying to the licensing body in the state in which one wants to work to obtain and complete an application package, and passing the national licensing examination, known as the NCLEX. Once you've passed the exam and pay your registration fee, you will be registered by the state to which you applied.

In general, however, if you currently hold a license to practice in one US state, endorsement is often possible. Please contact the appropriate state licensing body for more information. Also, there are states that participate in the Nurse Licensure Compact (NLC), which means that if you hold a license in a NLC state, you can work in another NLC state without having to obtain a license in that second state. For example, if you have a license in Texas, which is a NLC state, you could work in Wisconsin, which is another NLC state, on your Texas license.

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Registered Nurses from Canada or Mexico

Licensing summary: Individual states are responsible for issuing their own license to practice. You will have to apply to the licensing body in the state in which you would like to work. The process will involve a credentials assessment (you can find acceptable assessment agencies by contacting the licensing body) and writing the NCLEX. English competency examinations, such as the TOEFL, may be required (most Canadians are exempt).

In general, if one holds a license to practice in one US state, endorsement is often possible for other states. Please contact the appropriate licensing body for more information. Also, there are states that participate in the Nurse Licensure Compact (NLC), which means that if you hold a license in a NLC state, you can work in another NLC state without having to obtain a license in that second state. For example, if you have a license in Texas, which is a NLC state, you could work in Wisconsin, which is another NLC state, on your Texas license.

Visa information: Under NAFTA, RNs who are citizens of Canada or Mexico are eligible for TN visas to work in the United States. Under NAFTA, Canadians receive TN-1 visas and Mexicans receive TN-2 visas.

However, in July 2004, the US Department of Homeland Security instituted a VisaScreen program which must be completed before a registered nurse (and several other types of healthcare professionals, except physicians), who will be on an occupational visa, can work in the US.

The VisaScreen requirements override any previous state reciprocity rules for Canadian or Mexican RNs.

Contrary to what the name suggests, the VisaScreen has nothing to do with a security check. The VisaScreen program is offered by The International Commission on Healthcare Professions (ICHP), which is a division of CGFNS.

VisaScreen duplicates the CGFNS certification process for foreign RNs. It includes an educational review, licensure review, English language skills assessment (most Canadians are exempt), and predictive examination for nurses. Its purpose is to confirm the verification/evaluation of an RN's credentials to ensure that s/he meets the US government's minimum eligibility standards.

What exactly is required for the VisaScreen?

Canadians and Mexicans who graduated from a US nursing school must also complete the VisaScreen process.

Once the VisaScreen certificate is obtained, Canadians can apply for a TN-1 visa at Class A US Ports of Entry; Mexicans must apply for their TN-2 visa at a US Consulate.

Documents required:

1. Statement from the employer with a full description of the nature of the duties the beneficiary will be performing, the anticipated length of stay, and the pay arrangements.
2. Evidence that the person seeking the visa meets the education and/or other credentials for the activity.*
3. Evidence that licensure requirements have been satisfied.*
4. Recent résumé.
5. Evidence of Canadian (or Mexican) citizenship.

*Items 2 and 3 are parts of the requirements that are verified under the VisaScreen.

The VisaScreen certificate is valid for five years.

For more information, see the CGFNS website, or particularly:

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Registered Nurses from Outside North America

Non-North American nurses also must complete the licensing and VisaScreen process as described above for Canadians and Mexicans.

Additionally, however, you are required to have a US work visa before being allowed entry to the US and employment in the US, and usually sponsorship is required. Those who are not citizens of Canada or Mexico are not covered by NAFTA visa policies. Please contact the nearest US Embassy or Consulate to inquire about obtaining a US work visa.

You can also find more information about various types of immigrant and non-immigrant employment visas on the US Citizenship and Immigration Services website and on the State Department.

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