Nursing Jobs In USA For Foreigners With VISA Sponsorship

The American Dream is not just a cliché—for international nurses, it is a tangible, highly lucrative career path. As we move through 2025, the United States is facing a critical shortage of healthcare professionals, with projected gaps of over 200,000 to 450,000 registered nurses. For you, this crisis presents an unprecedented opportunity.

If you are a qualified nurse in the Philippines, India, Nigeria, Kenya, the UK, or anywhere else in the world, this guide is your roadmap. We will move beyond the basics and dive deep into the exact steps, visa pathways, hidden costs, and recruiters you need to know to secure a nursing job in the USA with visa sponsorship.

Part 1: The Visa Landscape – Your Ticket to America

Before you apply for a single job, you must understand the legal vehicle that will get you there. In 2025, there are two primary pathways, but one is the “Gold Standard.”

1. The EB-3 Visa (The “Green Card” Route)

This is the most common and desirable visa for nurses.

What it is: A permanent residency visa.
The Benefit: You arrive in the US with a Green Card. You are a permanent resident from Day 1. Your spouse and unmarried children under 21 can come with you and also receive Green Cards.
The “Schedule A” Advantage: Nursing is considered a “Schedule A” shortage occupation. This means your employer does not have to prove that there are no US workers available (skipping the long Labor Certification process), significantly speeding up the timeline.
Processing Time: Currently 12–24 months (depending on your country of birth and “Visa Retrogression” status).

2. The H-1B Visa (The “Specialty” Route)

The Catch: Historically, standard RN jobs did not qualify for H-1B because they didn’t strictly require a bachelor’s degree (Associate degrees were accepted).
The Exception: Specialist roles (Nurse Practitioners, Nurse Anesthetists) or management roles that strictly require a BSN or higher may qualify.
Pros/Cons: Faster processing than EB-3, but it is a temporary non-immigrant visa (valid for 3 years, renewable to 6). It is riskier for standard RNs.

3. The TN Visa (NAFTA/USMCA)

Exclusivity: Only for citizens of Canada and Mexico.
Speed: fast approval, sometimes directly at the border.
Status: Non-immigrant status (temporary), though renewable indefinitely.

Expert Tip: Focus your energy on the EB-3 Visa. It offers the most security and stability for you and your family.

Part 2: The “Golden Ticket” – Passing the NCLEX-RN

You cannot work as a nurse in the USA without passing the NCLEX-RN (National Council Licensure Examination). There is no way around this. Your home country’s license allows you to sit for the exam, but it does not let you practice in the US.

Can I take the NCLEX outside the USA?

Yes. Pearson VUE (the testing administrator) has international test centers in:

Asia: Philippines (Manila), India (several cities), Hong Kong, Taiwan, Japan.
Europe: UK (London), Turkey.
Americas: Brazil, Mexico, Canada.
Africa: South Africa (Johannesburg).

Strategic Licensing: The “Easy” States

You must apply to a specific US State Board of Nursing (BON) to get permission to test. However, you do not have to live in the state where you initially get licensed.

Top States for International Nurses in 2025:

New York:
- Why: Does not require a Social Security Number (SSN) to apply. Does not require an English test (IELTS/TOEFL) before taking the NCLEX (though you need it for the visa later).
- Verdict: The #1 choice for foreign nurses to get their “foot in the door.”
Texas:
- Why: Fast processing, but requires an English test and a background check.
- Verdict: Great if you want to work in Texas immediately.
Montana:
- Why: Fast, efficient, and SSN is not required for the initial application.
Florida:
- Why: High demand, but stricter requirements on credential evaluation.

Part 3: The Step-by-Step Roadmap (Timeline: 12-24 Months)

Do not skip steps. The order matters to avoid wasted money.

Step 1: Credential Evaluation (Months 1-3)

US Boards of Nursing need to know your foreign education is equivalent to a US degree.

The Authority: CGFNS International is the gold standard.
The Service: Order a “Credentials Evaluation Service (CES) Professional Report.”
Cost: Approx. $450+.

Step 2: English Proficiency (Months 2-4)

Most states and visa rules require this.

IELTS Academic: Aim for Overall 6.5 (Speaking 7.0 is the “magic number” for VisaScreen).
TOEFL iBT: Minimum 83-84 total, with specific speaking score of 26.
OET (Occupational English Test): Increasing popularity because it tests medical English, not generic literature.

Step 3: Apply to State Board & Register for NCLEX (Months 3-6)

Apply to the NY or Montana Board of Nursing.
Receive your ATT (Authorization to Test).
Register with Pearson VUE.

Step 4: Pass the NCLEX (Month 6)

Cost: $200 (Exam fee) + $150 (International scheduling fee).
Format: Computer Adaptive Test (CAT). It shuts off between 85 and 150 questions.

Step 5: Obtain VisaScreen Certificate (Month 7)

This is a federal requirement for the visa, issued by CGFNS. It verifies your education, license, and English scores all in one document. You cannot get a Green Card without it.

Step 6: Secure a Job Offer (Month 8)

You need a petitioner (employer). You have two choices: Direct Hire or Staffing Agency. (See Part 4).

Step 7: The Visa Process (Months 9-20+)

Employer files I-140 Petition (Premium processing available for extra fee).
Case goes to NVC (National Visa Center).
Wait for Priority Date: Check the “Visa Bulletin” monthly to see if your date is “Current.”
Embassy Interview: You will undergo a medical exam and an interview at the US embassy in your country.

Step 8: Arrival & Deployment

Fly to the USA, receive your Green Card stamp, and begin orientation.

Part 4: Agency vs. Direct Hire – The Ultimate List

This is the biggest decision you will make.

Option A: Staffing/Recruitment Agencies

Agencies act as your employer. They sponsor your visa, pay for your flights/licensing, and then “lease” you to a hospital for 2–3 years.

Pros: They handle all the paperwork. They usually pay for the immigration costs ($5,000+ value). They offer a “soft landing” (meet you at the airport, help with housing).
Cons: You are bound by a contract (2-3 years). If you quit early, you face a “breach fee” ($10k-$30k). Your hourly pay might be slightly lower than a direct-hire nurse.

Top Reputable Agencies (2025):

Avant Healthcare Professionals: Excellent training program (clinical and cultural transition).
O’Grady Peyton International (AMN Healthcare): One of the largest, with placements all over the US.
Interstaff: Known for transparency and good support.
Shearwater Health: Massive presence, particularly in the Philippines.
PassportUSA (Health Carousel): Strong track record.
MedPro International: Offers a “MedProU” training academy.
Conexus MedStaff: Focuses on long-term growth.

Option B: Direct Hire

You apply directly to a US hospital. They sponsor you.

Pros: You are an employee of the hospital immediately. You get full benefits and the same pay as American nurses. No “middleman” taking a cut.
Cons: You must navigate more of the relocation logistics yourself. Harder to find hospitals willing to sponsor if you are still abroad.

Hospitals Known to Sponsor Direct Hires:

Cleveland Clinic (Ohio): World-renowned, has a specific “Global Patient Services” and international recruitment arm.
Mayo Clinic (Minnesota/Florida/Arizona): consistently ranked #1 hospital in the world.
Adventist HealthCare: Has an “International Nurse Program.”
HCA Healthcare: The largest health system in the US. They often hire directly for their 180+ hospitals.
Johns Hopkins Medicine (Maryland): Highly prestigious.

Part 5: The Financial Breakdown (2025 Estimates)

How much money do you need to save before you get sponsored? Even if an agency reimburses you, you need upfront cash.

Item	Estimated Cost (USD)	Notes
CGFNS Credential Evaluation	$450 – $600	Required for state board & visa.
English Exam (IELTS/OET)	$200 – $450	Varies by country and test type.
State Board Application	$100 – $200	Varies by state (e.g., NY vs TX).
NCLEX Registration	$200	Paid to Pearson VUE.
International Test Fee	$150	If testing outside the USA.
VisaScreen Certificate	$700	Valid for 5 years.
Medical Exam (Embassy)	$300 – $500	Paid to panel physician.
Visa Fee (DS-260)	$345	Usually paid by employer, but verify.
Total Estimated Upfront	$2,500 – $3,500	Plan to have $4,000 liquid cash.

Salary Expectation: The average RN salary in the US is $89,000/year (Bureau of Labor Statistics). In high-cost states like California, it can exceed $120,000. In lower-cost states like Texas, it might be $75,000 (but you pay no state income tax).

Part 6: Critical FAQ for 2025

1. What is “Visa Retrogression”?

Sometimes, more people apply for Green Cards than the annual limit allows. When this happens, the State Department sets a “cutoff date.” If your priority date is after the cutoff, you must wait.

Current Status: Check the US State Department Visa Bulletin.
Strategy: Even if there is a backlog, start the process now. You cannot get in line until you file.

2. Can I bring my family?

Yes. Under the EB-3 visa, your spouse and children (unmarried, under 21) are “derivative beneficiaries.” They get Green Cards too. Your spouse can work anywhere in the US.

3. I have a Diploma in Nursing, not a BSN. Can I apply?

Yes, but it is harder. Most “Magnet” hospitals and top agencies prefer a Bachelor of Science in Nursing (BSN). If you have a Diploma, consider doing an RN-to-BSN bridge program online to increase your chances.

4. Is there an age limit?

Legally, no. The US does not have an age limit for the visa. As long as you can pass the medical exam and are fit to work, you can be hired. Many nurses in their 40s and 50s migrate successfully.

5. What if I fail the NCLEX?

You can retake it! There is a 45-day waiting period between attempts.

Part 7: Acing the Interview – It’s More Than Just Clinical Skills

When a US Nurse Manager interviews you via Zoom, they already know you are smart (you passed the NCLEX). They are testing for two things: Safety and Cultural Fit.

The “STAR” Method

US interviewers love “behavioral” questions. Never answer with a simple “Yes” or “No.” Use the STAR method:

Situation: Describe the context.
Task: What was your responsibility?
Action: What specifically did you do?
Result: What was the positive outcome?

Part 8: The First 90 Days – Agency vs. Direct Hire Experience

Your first three months in the USA will be the hardest of your life. This is where the difference between an Agency and a Direct Hire becomes real.

The Agency Experience (The “Soft Landing”)

If you sign with top-tier agencies like Avant Healthcare Professionals, MedPro International, or O’Grady Peyton, your arrival is highly structured.

Clinical Transition Programs:
- Avant: You will likely spend 3-5 weeks at their corporate HQ in Florida for their “Clinical Transitions Program” (CTP) before you ever touch a patient. You practice on high-fidelity manikins to learn US-specific protocols.
- MedPro: Uses “MedProU,” a proprietary training academy that mimics US hospital settings.
- Shearwater Health: Often provides 1 month of free housing and furniture to let you settle in.
Cultural Onboarding: They teach you how to buy a car, how to use a US credit card, and how to drive on the right side of the road.

The Direct Hire Experience (The “Sink or Swim”)

Orientation: You go straight to the hospital. You will have a standard hospital orientation (1-2 weeks) and then be paired with a preceptor on the floor.
The Reality: You are expected to be “plug and play.” If you don’t know how to use the specific EMR (Epic, Cerner, Meditech), you must learn fast. You are responsible for finding your own apartment, signing your own lease, and buying your own car immediately.

Warning: If you are a Direct Hire, you must have at least $5,000 – $7,000 in savings to cover your first month’s rent, deposit, and a down payment on a car. The hospital sign-on bonus usually isn’t paid until after 90 days.

Part 9: The “Hidden Costs” Checklist

Many nurses budget for the exam but forget the relocation costs. Here is the reality of what you will spend in your first month in the USA (2025 prices).

Expense	Estimated Cost (USD)	Notes
Apartment Deposit	$1,500 – $3,000	Usually 1 month’s rent upfront.
First Month’s Rent	$1,500 – $2,500	Varies wildly by state (CA/NY vs. TX/GA).
Car Down Payment	$2,000 – $5,000	Essential in 90% of US cities.
Car Insurance	$150 – $300/mo	High for you because you have no US driving history.
Furniture	$2,000+	Most US apartments are unfurnished.
Utility Setup	$200 – $500	Deposits for electricity, internet, water.
License Endorsement	$150 – $400	Moving your license to the specific state you work in.
VisaScreen Renewal	$400+	Only if your process took >5 years.
Total “Safe Landing” Fund	$8,000 – $12,000	Do not come empty-handed.

Part 10: The Retrogression Reality (2025/2026)

As of late 2025, Retrogression is real.

What it means: Even if you pass your NCLEX today, you might not fly until 2027.
The Data: For nurses from “Rest of World” (excluding India/China), the wait time is hovering around 18-24 months. For Philippines/India, it can be longer.
The Strategy: Do not wait for the dates to become “Current” to apply. You must be “Documentarily Qualified” (DQ) at the NVC (National Visa Center) to even get in line.
While You Wait:
1. Gain Experience: US hospitals want current bedside experience. Do not quit your job.
2. Specialty Matters: ICU, ER, and OR nurses are prioritized over Med-Surg nurses by many recruiters.
3. Save Money: Use the delay to build your “Safe Landing” fund.

Conclusion: Your Next Move

The path to working as a nurse in the USA is not easy, but it is formulaic. It does not require luck; it requires following the steps: Credentials -> English -> NCLEX -> Sponsor -> Visa.

Do not let the paperwork scare you. Thousands of nurses make this journey every year, transforming their financial future and their families’ lives. The US healthcare system is waiting for your skills.

Are you ready to start?

This Week: Download the CGFNS handbook and review the requirements for the “CES Professional Report.”
Next Month: Schedule your IELTS or OET exam.
Commit: Buy an NCLEX review course (like UWorld, Archer, or Saunders) and start studying immediately.

The future is yours to write. Good luck!