The United States has long been a lucrative career destination for Nepali nurses due to its ever-growing demand for qualified healthcare professionals. The country also promises better pay, training, and opportunities.
But earning a spot as a registered nurse in the U.S. is not as simple as packing your bags. It requires completing a multi-step process filled with documentation, credential verifications, English proficiency tests, and passing the all-important NCLEX-RN exam before you can even think about moving.
This article walks you through the entire journey, step by step, so you know exactly what lies ahead and how to prepare for it.
Step 1: Research Your Target State’s Board of Nursing
The United States does not have a centralized licensing authority for nurses. Each of the 50 states and U.S. territories has its own Board of Nursing (BON), and their requirements vary.
Your journey will begin after you decide which state you want to work in and research its licensing rules.
New York is considered one of the friendlier states for foreign-educated nurses because it does not require the CGFNS Qualifying Exam.
Texas and Illinois, on the other hand, require a full Credentials Evaluation Service (CES) report from CGFNS before you can proceed to the NCLEX-RN.
California is one of the strictest states and often denies applications from international nurses if there are gaps in clinical training, particularly in areas like psychiatric nursing, obstetrics, or pediatrics.
Do not assume that because your relatives live in a particular state, that is automatically the best option for you. Check each BON’s website thoroughly, compare requirements, and then make a decision.
Step 2: Verify Your Nepali Credentials
The U.S. licensing process requires complete verification of your nursing education and license from Nepal.
PCL Nursing (Proficiency Certificate Level) program, once the standard in Nepal, is often not recognized as equivalent to a nursing degree in the U.S. In most states, PCL graduates must upgrade to a Bachelor of Nursing (BN) or BSc Nursing before applying.
BSc Nursing (four years) or BN (two years after PCL) qualifications stand a better chance of being accepted.
Documents you will need include:
- Official transcripts from your nursing school sent directly from the school to the evaluation agency
- License verification from the Nepal Nursing Council, also sent directly
- Secondary school completion certificates (your SLC/SEE and +2 transcripts).
No U.S. Board of Nursing will accept documents submitted by you personally. All documents must come directly from the issuing authority.
Step 3: Complete CGFNS Evaluation
The Commission on Graduates of Foreign Nursing Schools (CGFNS) is responsible for verifying the educational and professional credentials of internationally educated nurses. For most Nepali nurses, this step requires obtaining a Credentials Evaluation Service (CES) report. Here are some of its details:
- Cost: Between $365 and $445, depending on the type of report required
- Processing time: 3–6 months, the timeline can be longer if your nursing school or the Nepal Nursing Council delays in sending documents
- What they check: Your coursework, clinical hours, and license are compared against U.S. standards. Gaps in curriculum (e.g., insufficient hours in mental health or maternity) can trigger additional requirements.
Some states also require the CGFNS Qualifying Exam, a separate test that evaluates nursing knowledge. However, this exam is not universally required.
Step 4: Apply to Your Chosen State Nursing Board
Once the CGFNS evaluation is complete, the next step is submitting your application to the Board of Nursing in your chosen state.
You will have to pay an application fee of around $150–$300, depending on the state. A fingerprinting and background check costing $50–$100 will also be required, some states require you to complete it in the U.S., while others allow it internationally.
Your application will not be approved until your CGFNS evaluation is received and verified. Some Boards may also impose additional conditions, such as requiring you to take specific coursework to make up for deficiencies in your Nepali education.
Step 5: Meet English Language Requirements
For Nepali nurses, proving English proficiency is almost always mandatory. Even if your nursing program was taught in English, that does not exempt you. Boards and employers want proof through standardized exams. The two most commonly accepted tests are:
- IELTS Academic: An overall score of 6.5 to 7.0, with no individual section lower than 6.0 or 6.5.
- TOEFL iBT: A total score of 83–90, though requirements may vary by state
Seats for these exams in Kathmandu are limited, and rescheduling is not easy. So, do not wait until the last minute.
Step 6: Pass the NCLEX-RN Exam
The NCLEX-RN is the single biggest hurdle in your journey. This is a computer-adaptive test that assesses whether you are safe to practice as an entry-level nurse in the U.S.
It consists of between 85 and 150 questions under the new Next Generation NCLEX system with a time limit of 5 hours.
It costs $200, plus additional international testing fees if you take the exam outside the U.S. (India and Hong Kong are common centers for Nepali nurses).
As per the NCSBN, only 47–52% of internationally educated nurses pass the NCLEX on their first attempt, compared to 80–85% for U.S.-educated nurses.
Step 7: Secure Your Visa and Employer Sponsorship
Passing the NCLEX does not automatically make you eligible to work in the U.S. You also need a visa and an employer willing to sponsor you.
H-1B visas are rarely available for nurses. The most common path is the EB-3 employment-based Green Card, where a hospital or recruitment agency in the U.S. sponsors you.
The timeline for the visa varies, but you must expect 12–24 months on average for visa processing, sometimes longer depending on backlogs.
Many U.S. hospitals offer relocation support, cultural orientation, and even financial assistance with exam and licensing fees.
Preparing for NCLEX with Feuer Nursing Review
If you are serious about becoming a U.S. RN, preparing with the right tools is non-negotiable. Feuer Nursing Review is a reputable name among Nepali nursing graduates aiming to establish their career in the U.S. Since 1971, we have specialized in helping foreign-educated nurses close the gap. Our programs focus on:
- Breaking down NCLEX concepts into clear, digestible lessons.
- Building the critical thinking skills that the exam demands.
- Providing structured study plans that help you stay on track.
- Offering review options that fit different learning styles, from live lectures to online modules.
Thousands of international nurses, including many from Nepal, have reached their American dream with the help of Feuer Nursing Review.
Book your free consultation with Feuer Nursing Review today!
