By Ezrah 
Finding a nursing role in the U.S. involves a structured, multi-step process that varies depending on whether you’re trained in the U.S. or are, instead, internationally trained.
Despite this, the drawcard is strong: nursing employment opportunities are growing faster on average than for all other occupations, with a median annual salary of approximately $93,600.
For many new graduates and career changers, understanding how to get a nursing job can feel daunting, as it’s challenging to know where to begin. Researching educational pathways, learning how to meet licensure requirements, and gaining clinical experience can help budding nurses position themselves effectively in a competitive U.S healthcare job market.
The following steps chart how to secure that dream U.S. nursing role.
Step 1: Educational Pathways and Credentials
To practice as a registered nurse, nursing students who are trained in the U.S. must graduate from a nationally-accredited program, with either an Associate Degree in Nursing (2 years), a Diploma program (hospital-based, 1-3 years), or a Bachelor of Science in Nursing (4 years).
Another option for U.S. students who have already completed a degree from a different discipline is to undertake advanced nursing programs. This option supports students to get their Bachelor’s or Master’s of Science in Nursing faster.
To do the same, international nurses will need to submit their nursing degree, transcripts, and license to the Commission on Graduates of Foreign Nursing Schools (CGFNS) to ensure that their education is comparable to U.S. standards. If English is a second language, an English test is required. Once recognised by the CGFNS, a VisaScreen certificate will be issued, which is mandatory for foreign healthcare workers applying for a visa.
If starting a new career, consider online nursing study options, such as those offered by schools like Baylor University Online, which offer both undergraduate and graduate nursing degrees (with the umbrella university available either in-person, hybrid, or online).
Step 2: Pass the NCLEX-RN Exam
The National Council Licensure Examination (NCLEX-RN) is mandatory for licensure in all 50 states. Once you’ve chosen the state that you want to work in, you’ll need to apply for an authorization test (ATT), an email notification system that allows the candidate to schedule their exam.
The exam format is a Computer Adaptive Test, which tailors questions according to how well you’ve answered them. This can take up to 5 hours and covers up to 150 questions. The test automatically stops once it is 95% confident that the candidate is above or below the passing standard. Core content areas include a safe and effective care environment, health promotion and maintenance, and psychological integrity. Pearson VUE conducts this exam, in-person, throughout test centers worldwide.
Step 3: Apply for State Licensure
Passing the NCLEX-RN test only gives a nurse the right to be licensed; you must still apply to the specific state Board of Nursing.
There are several license types you can apply for. A licensure by examination is for new graduates and foreign nurses. A licensure by endorsement is for anyone who already holds an active license in one U.S. state and wants to practice in another. If you’re a U.S. resident looking to practice in multiple states with a single license, obtaining a compact licensure is highly recommended. A criminal background check is required for all applicants.
Step 4: Gain Clinical Experience
Hospitals and other institutions value pre-graduation clinical experience. You can access non-hospital nursing experience in outpatient clinics, home health care, schools, insurance companies, and detoxification/rehabilitation centers.
While many of these institutions prefer experience, some are open to new graduates, particularly in high-need areas of home health, detox/rehab centers, assisted living, and schools. Look for opportunities as a volunteer, extern (current student focused on observation and basic tasks), intern (usually a more senior student or recent graduate with longer-term training), or nursing assistant.
When compiling your resume, keep it concise with around 2 pages. Use keywords from the position description and list clinical hours and any nursing certificates, such as Basic Life Support.
Step 5: Interview Preparation
Common U.S. nursing interview questions focus on clinical competence, behavioral scenarios (the STAR method), patient advocacy, and core values. Key topics include handling difficult patients or coworkers, managing stress, prioritizing tasks, and teamwork.
Be prepared to discuss your interest in patient care, technology skills, and alignment with the hospital or center’s mission statement. In the interview, highlight your commitment to evidence-based practice and patient safety protocols.
Step 6: Finding a Job
International nurses often work with agencies to find positions that offer green card sponsorship or other visas. For both local and international nurses, specialized nursing job boards, such as NurseRecruiter, Nurse.com, Nursa, Aya Healthcare, Clipboard Health, and Vivian Health, are popular. Indeed and LinkedIn are also top choices for health care job listings.