The United States has one of the strongest and most consistent demands for registered nurses of any country in the world. For internationally educated nurses, the path to working in the US is well-defined — but it requires completing several certification steps and meeting immigration requirements before you can begin practising. This guide covers everything you need to know to apply as a registered nurse in the US as an immigrant in 2026.
CGFNS Certification: The Starting Point for Immigrant Nurses
All internationally educated nurses must first go through the Commission on Graduates of Foreign Nursing Schools (CGFNS) — the body that evaluates whether international nursing qualifications meet US standards for practice. CGFNS certification is a mandatory prerequisite before most states will consider a licence application from a foreign-trained nurse.
CGFNS requires internationally educated nurses to:
- Submit official transcripts from your nursing school
- Pass the NCLEX-RN — the National Council Licensure Examination for Registered Nurses, which is the standard US nursing competency exam
- Complete the VisaScreen programme — CGFNS’s evaluation of international nurses’ credentials to determine eligibility for US employment visas
Additional State-Level Requirements
Beyond CGFNS, individual US states may impose their own additional requirements for internationally educated nurses. These can include:
- Passing the state-specific nursing licensure requirements for your target state
- Completing a formal English language proficiency test — such as IELTS, TOEFL, or the OET (Occupational English Test)
- Securing valid work authorisation before beginning employment
Requirements vary significantly by state, so it is important to check the specific conditions of the State Board of Nursing in any state where you intend to work.
Salary Expectations for Registered Nurses in the US
Registered Nurses in the United States are among the most well-compensated healthcare professionals. The median annual salary is approximately $75,330, though compensation varies significantly by:
- Location: States such as California, Hawaii, and New York consistently offer the highest RN salaries
- Specialisation: Nurses in high-acuity settings such as Intensive Care Units (ICUs), emergency departments, and operating theatres typically earn more than those in general medical-surgical wards
- Experience level: Seniority and specialist certifications command higher pay
Visa Options for Immigrant Nurses
Work authorisation is a separate process from nursing licensure. Common visa pathways for internationally educated nurses in the US include:
- EB-3 immigrant visa (employment-based green card): Many US healthcare employers sponsor internationally educated nurses directly for permanent residency through the EB-3 category, which covers skilled and professional workers
- H-1B visa: Less commonly used for nurses, as it requires a specialty occupation classification
- TN visa: Available to Canadian and Mexican nationals under USMCA for RN positions
Consulting a licensed US immigration attorney is strongly recommended to identify the most appropriate visa pathway for your individual situation.
Job Search Strategies for Immigrant Nurses
Finding employment as an internationally educated nurse can take longer than for US-trained counterparts, but a focused approach significantly improves your chances:
- Network with other internationally educated nurses — connecting with nurses who have already successfully navigated the US licensure process can provide practical guidance and employer referrals
- Attend healthcare job fairs — many large hospital systems actively recruit internationally at nursing career events
- Work with nursing staffing agencies — several agencies specialise in placing internationally educated nurses and may assist with visa sponsorship
- Use online job boards — platforms such as Indeed, LinkedIn, and health-specific boards like Health eCareers and NursingJobs.org list RN positions nationwide
- Volunteer or observe in healthcare settings where possible to build local professional connections
Tips for a Stronger Application
- Be prepared to demonstrate cultural competency and adaptability — US employers value nurses who can work effectively across diverse patient populations
- Highlight transferable strengths, including multilingual ability, experience in resource-limited settings, or exposure to a wide range of clinical conditions
- Be patient and persistent — the US licensure process for internationally educated nurses is thorough and takes time. Beginning the CGFNS and NCLEX-RN process well in advance of your intended move is essential
Conclusion
Working as a registered nurse in the United States offers internationally educated nurses strong salaries, diverse career opportunities, and a clear pathway to permanent residency in many cases. The key is starting the CGFNS and NCLEX-RN process early, understanding your state’s specific licensure requirements, and engaging the right immigration legal support to navigate visa options. With the right preparation, the path from internationally trained nurse to US-licensed RN is structured and achievable.