Tuesday, August 21, 2007

US Nursing Career Part 1: NCLEX Application

Every year, thousands of Filipino nurses aspire to migrate and become a licensed nurse in the US. Here's a practical guide intended to help Pinoy nurses achieve this dream. Because the application process requires several steps and there are ongoing issues related to foreign nurse employment in the US, we've broken down this feature article into a series. This is Part 1 of the Filipino Nursing Herald's Guide to Becoming a US RN.

What is the NCLEX-RN
To be able to practice as a nurse in the US and its territories, you must be registered in the US state you wish to work in. Each state has a nursing board that regulates the registration process. A major requirement for registration is that applicants must pass an examination that "measures the competencies needed to perform safely and effectively as a newly licensed, entry-level registered nurse".

The National Council of State Boards of Nursing (NCSBN) develops this examination, which is called the Nursing Council Licensure Examination (NCLEX). There are two types: the NCLEX for Practical Nurses (NCLEX-PN) and the NCLEX for Registered Nurses (NCLEX-RN).

Choose a State
Before you can apply for the NCLEX-RN, you must FIRST meet the requirements set by the nursing board in your chosen state, which assumes that you already have a US state in mind to where you wish to migrate.

The first step towards a US nursing career is deciding to which of the 50 US states you want to apply. This decision may be based on a number of factors, such as, family (Your family is already based in a particular state), support system (You have a relative or a close friend living there), work environment (You like the weather, attractions, etc.), cost of living (Different states have different wage standards and cost of living rates) or work opportunities (You already have a potential employer), among others.

Once you've already chosen a state, the next step is to find out its requirements for nursing registration. The requirements usually vary, but some common requirements are: submission of an application form, fingerprinting and security background checks; and of course, a passing score in the NCLEX-RN.

If you've picked a state, go the Web site of your chosen states' nursing board. You can simply go to Google and search (example: "California nursing board") or you can get a list of contact information in the NCSBN Web site.

Some nurse applicants choose not to apply initially in their desired state, instead they apply in a different state which has fewer requirements or perhaps process applications faster, and then endorse later on to their desired state. Personally, I think this is often unnecessary and presents some issues later on. First of all, you'll be spending more than what is really needed because, in effect, you will be applying to more than one state and endorsement also requires fees to be paid. If you endorse to another state, you will still be required to satisfy all their requirements, for example, if they require a credentials evaluation, you will still have to comply with this even though it was not asked for in the first state where you applied for registration.

To illustrate further, a number of nurses choose to register initially with New Mexico or Vermont but their real desired state is California. While applying in either New Mexico and Vermont may cut the processing time, it does not guarantee that you will be able to work in the US much faster. You will still need to meet California's requirements to be able to endorse your license and this presents additional problems, which we'll discuss later on.

CGFNS Certification Program
Some state nursing boards require applicants to secure a Certification from the Commission on Graduates of Foreign Nursing Schools (CGFNS). The Certification Program (CGFNS CP) is a three-step process.

The first step is a credentials evaluation, where you will be required to submit information on your professional and secondary education, as well as license registration in your home country. Typically, transcript of records and license information are sent directly by your school or regulatory agency. In the Philippines, for example, you must request your TOR--using a form that is included in the application packet that you can download from either your nursing board or CGFN--from your school and the school will have to mail your records to CGFNS or your nursing board directly. You must also request the needed license information from the PRC who will send the documents directly to your US registration body.

The second step is the CGFNS Qualifying Exam, which is a test of nursing knowledge.

The third step is submission of a passing score in an English proficiency exam. Applicants usually take either the IELTS or the TOEFL iBT. (More on these later.)

The CGFNS Certificate program costs about $418 and some states require applicants to secure this first before they can be allowed to sit for the NCLEX-RN.

US nursing boards DO NOT require applicants to hold a nursing license in their home countries. However, to be able to qualify for the CGFNS CP, you must hold a valid license in your home country. So, a local license is only needed if you are applying in a US state that still requires the CGFNS CP.

About 23 US States have already removed the CGFNS CP from their list of requirements. Click here for a list of states that no longer require the CGFNS CP.

Credentials evaluation
Often, state nursing boards will require a credentials evaluation in lieu of the CGFNS CP. You can request a Credentials Evaluation report from either the CGFNS or another company authorized by the state BON. I would advice those applying for a Credentials Evaluation to request it from CGFNS because all state boards usually recognize the CGFNS. Other providers of the service may only be recognized in a particular state, so that when you endorse to another state, you will have to file another Credentials Evaluation request with a company recognized by the state.

The CGFNS offers two types of evaluation reports: the Full Education Course-by-Course Report and the Healthcare Profession and Science Report. The latter is usually accepted by state BONs but if you wish to go to graduate school in the US later on, you should get the full course report. Again, follow the procedure mentioned earlier for requesting and sending your school records and professional license information.

Download Application Forms
Once you've found a state and researched the requirements set by the state board of nursing, download the application packet. This packet contains information about the NCLEX, application procedure, requirements, fees, and the application forms.

When filling out the forms, make sure the information you submit is accurate. Double-check names, numbers and dates. Occassionally, applications are delayed because of inaccurate dates of graduation or entry in the school. Be sure to ask your registrar the exact dates and be consistent.

When you download the application packet, request a fingerprint card as well. For information of processing fingerprint cards in the Philippines, please check out this guide.

NEXT: Payment procedures, waiting times, and related issues

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gib said...

i'm currently reviewing for the nclex exam. i've heard from one of our reviewer about the manner of scoring and passing the nclex exam. i would like to ask about the real scoring of the test. our reviewer told us that there is a new system of scoring in the new nclex exam. he told us that you must get a minimum number of cluster required?! he further explained that in order to have a cluster you must have a 5 consecutive correct questions in order to have 1 cluster. is there truth about it? is the format of nclex exam new that aside from multiple choice questions there are other type test formats in the test?

Geoff said...

Thanks for the question, gib. Unfortunately I'm in no position to answer your question about the NCLEX's scoring system.

If you search the Pearson Vue or NCSBN Web sites, they only say that the NCLEX uses a Computer Adaptive test, which simply means that the computer uses your answers to select succeeding questions. I can only speculate as to how exactly it implements this, so I really can't give you a definitive answer myself.

If something comes up in the future, I'll let everyone know.

poie said...

Hello. Nursing Herald blog spot is such a very helpful site. I just would like to request also, if you can discuss reciprocity espeically in california, illinois, new mexico and new jersey.

Is there reciprocity to Illinois or New Jersey if i apply NCLEX in California or New Mexico?

I must admit, processing in Illinois is very costly and it takes a lot of time.

Thanks so mych for you time.

Geoff said...

Hi Poie,
Thank you for your kind words. I do plan to write about the endorsement process. The term reciprocity is actually no longer used and is no longer accepted. Reciprocity and the new endorsement process are different from each other. I'll research more information about this and post them soon.

Anonymous said...

Thank you for creating this blog. Maybe you will be able to help me with my question about NCLEX Exam ( I've taken mine so many years ago and TOEFL/TSE did not exist at that time. Now I don't know anything about what tests are required before taking NCLEX exam). Can my sister take the NCLEX exam (california) without passing the TOEFL/TSE tests yet? I know california does not require CGFNS but she is a CGFNS holder.

Wish you luck with your new found career. Thanks once again.

Anonymous said...

Hi. I am so glad to find your website. Can my sister take the NCLEX Exam (california) without taking the TOEFL and TSE tests yet? She passed her CGFNS few years back but I know that California does not require it. Are there any pre-requisite tests she needs to pass before taking the NCLEX exam?
Best wishes to your new found career. Thanks.

Geoff said...

Yes, the eligibility to take the NCLEX-RN for CA does not require an English test. However, your sister will need a passing score in either IELTS or TOEFL iBT for the visascreen application.


auric said...

hi. i just wanna ask. im applying online @cali's site for licensing. they require me to have SSN (Social Security Number) how can i have one? please help. im so confused pa in how to apply the NCLEX-RN examination.

please help me. thanks

Geoff said...

You can only get a SSN if you become a legal resident in the US. the California BON will not issue a license unless you have an SSN, however you can still apply for a license and sit for the NCLEX even without the SSN. Once you pass your NCLEX, you have a few years to secure an SSN. you can renew your registration if the grace period lapses.

japorms said...

Hi Geoff, where did you apply for visascreen?

Geoff said...

You apply for a visascreen with CGFNS. To qualify for a visacreen certificate, you must have a passing NCLEX score OR the CGFNS Certificate (Exam) AND a passing English exam score (either IELTS or TOEFL iBT).

You can find more details in the CGFNS Web site (cgfns.org)

japorms said...

Thank you

Anonymous said...

hi, i just want to ask... if online application for licensure exam in california is only for those who reside there?

Anonymous said...

i tooked my nclex rn CA exam i stopped at 75 items no select all that apply, i encountered 6-7 medication more on priotization... they said if u had 4-5 SATA you have a big chance to pass... is it true? if u have no select all u wil fail? any one who had same experienced

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