Saturday, October 27, 2007

Becoming a nurse in the US

This post was initially intended as an answer to a question posted by one of my visitors, but I've decided to make it an entirely new blog entry so that others may also read it.

I often encounter a lot of people who get confused about the entire US nursing application process. Although there are many resources on the Internet that provide information on this, I guess many still get lost and don't know where to look. Others, perhaps, look for a crystal ball that can provide answers in a jiffy without making them sweat even just a little when searching. Still, questions need to be answered, regardless if you belong to the first or the second, so I hope this satisfies those who are looking for information.

Most of what I'll explain here was already discussed in previous posts, particularly in the NCLEX series of articles. Part 1 of the series is at the end of this link.

To be able to work as a nurse in the US, you must have the following:
1. US Nurse license
2. US Visa that allows you to live & work there
3. Employer, of course

Nurse licensure
To get a nurse license in the US, you must apply for licensure and pass the NCLEX-RN. Each of the fifty US states have DIFFERENT requirements. To learn about these requirements, just go to each State BON's Web site and download an application packet. You must meet all the requirements before you are ELIGIBLE to register for the NCLEX-RN. Please note that I used the word "register". If you are given an "Eligibility" by the state BON, you still can't take the NCLEX. Not just yet. Once you get the eligibility, you must register with Pearson-Vue, who will then confirm to the state BON that you are eligible to take the NCLEX-RN. Once Pearson-Vue makes the confirmation, it will issue what is called, the Authorization To Test or the ATT. After that, you can proceed to make an appointment for your exam.

Note that choosing a US State for your nursing licensure and taking the NCLEX exam are two different things. This is where most of the confusion arises. Each state will have its own requirements and US state BONS have varying processing times for licensure applications. Some states will probably issue an eligibility in as little as 2-3 months, while others may take 6 or more months. This depends on many factors--such as how fast you complete all your requirements, how many other applications are being processed, or how many people are working for the processing agency. Certain states process applications fairly quickly; Vermont, for example, has a reputation for fast processing. In California, applications are processed from as fast as 3 months to more than 6 months.

When deciding which state to apply for nursing licensure, make a decision based on where you really want to work, and not just how fast your papers will move. Although you can apply for ENDORSEMENT, this takes another set of requirements and another set of fees and you'll end up paying more than if you apply directly to the state where you want to live and work.

As I've said, choosing a State and taking the NCLEX are two separate events. When you have already chosen a US State and have been given an eligibility, you can choose whereever you want to take the NCLEX-RN test. When you register with Pearson-Vue, you can choose to sit for the exam either in the US, provided you already have a US visa to travel to the US, or you can take the exam in U.S. territories such as Guam or Saipan, or you can go to Hong Kong or other Asian countries where the NCLEX-RN is administered. You may also elect to stay here in the Philippines, where you can already sit for the NCLEX-RN. Click here to see where Pearson-Vue in Manila is located.

Before issuing a nursing license, most US state BONs require that you already have a US Social Security number. However, you CAN'T get a SSN unless you are an immigrant in the US, or a legal resident, either through student visas, working visas, or others. So, even if you pass the NCLEX-RN, you won't be issued a nursing license unless you have been petitioned for the US by an employer. And, so, the next step begins.

Getting a US visa
There are different types of visa issued by the US government that allows you to visit, stay, or work in their country. Nurses, being classified in the shortage occupations category or Schedule A, immediately get an immigrant visa, unlike other professions that can be petitioned through employment-based visas or working visas. To be eligible for sponsorship, you must have a legal US employer who will sponsor your visa petition. You must also submit certain documents; among these documents is the VISASCREEN Certificate, for which you must submit an application to CGFNS. CGFNS will only issue you a Visascreen if you have (A) either passed the NCLEX-RN OR have the CGFNS Certificate (through the CGFNS exam) AND (B) a passing score for an accredited English exam, such TOEFL or IELTS.

Retrogression
The U.S. government allocates only a certain number of visa numbers every year, meaning only a number of visa applicants can be given a visa for a given year. Because of the huge number of foreign nurse applications to the US, there is a backlog of applicants who are still waiting for their visas to be issued. This backlog goes back a few years. For nurses, if I recall correctly, the backlog stretches as far back as 2002 (for confirmation). So, this means that current applicants can't be issued a visa yet. Nobody knows when visas will be available again. There are ongoing efforts to resolve this, but nothing is definite at this time. We, at the Filipino Nursing Herald, try to keep up with the latest news on retrogression, so check back regularly for updates.

Getting an employer
After passing the NCLEX, getting an employer should be your next goal. Although there is still retrogression, there are a number of employers who continue their recruitment drives, knowing that visas will be available again, hopefully, soon.

When choosing an employer, scrutinize contracts and agreements carefully if you have been given an offer. Consult with relatives, friends, and ask questions in public chatrooms so that you can gather as much information that you need to make a decision.

It is my hope that some questions about the US nursing application process has been answered. If you want to contribute other information that I may not have touched on, please feel free to send you comments.

For a more detailed article on the applying for the NCLEX, read the NCLEX Series here in the Filipino Nursing Herald.

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10 comments:

Philippine said...

Well done! Great article. Really help me alot understand the step by step process in applying for nclex.

Anonymous said...

hi geoff, this is a nice post. although im already familiar with these things, it is delightful that some people have the kindness to write such simple and well-written posts. keep it up, good job!

Anonymous said...

Galing talaga ng blogspot na ito, dami ko questions na nasagot mo Sir Geoff. Salamat.

Lalaine said...

great article... can i post this on my blog but i will mention your blogs as my credit... ^^

Geoff said...

Lalaine,
Yes, please repost the article on your blog. I do hope that you provide a link back to the Filipino Nursing Herald blog as well. Thank you!

Anonymous said...

Ure doing a great job geof..Your articles are good. I constantly check your site. Keep it up.

Anonymous said...

hi geoff, pagnkapasa k b ng nclex life time ba ung validity nun? kc i heard dpat mapasa mo din daw ung ielts within 6mos after mo pumasa ng nclex para matagal ung validity? tama ba un? nclex california ako
thnx so much!...

Geoff said...

NCLEX scores are for life, unless, I think, if you took it for more than ten years ago and you haven't practiced nursing since then. I'm not sure about that, but yes, I know NCLEX scores are for life.

The CA BON will give you a few years to submit your SSN before your registration expires, but you can register again and still use your old NCLEX scores.

Take your IELTS when you're ready to take it. Don't rush. Prepare. English exams are fairly easy if you prepare for it.

Anonymous said...

I'm in the international nurse recruiting business and just wanted to comment on your article. Some USA Boards of Nursing will accept the CGFNS as a basis of sponsorship but an international nurse will still have to pass the NCLEX. My point is this: if you have to pass the NCLEX anyway, why take CGFNS? It's just an intermediate and unncecessary step that costs the nurse money. My recommendation to Filipino, and all international nurses, is do not bother with the CGFNS, save your money and go straight to the NCLEX!

stf said...

hi geoff!! just wanna say GOD BLESS YOU ALWAYS!!

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