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To practice nursing in America one must satisfy a list of specific and precise qualifications and requirements. Minimum educational qualifications required for a nurse is that of a first-level and a general-nurse as defined by the International Council of Nurses and have the license, if applicable, to practice as a nurse in your country. This means that you have graduated from a government approved and accredited, general nursing program of at least two years in length; and received theory and clinical education in each of the following; nursing care of the adult including medical and surgical nursing, maternal and infant nursing, nursing care of children, and psychiatric/mental health nursing. You should also have at least two years of verifiable nursing experience in a hospital setting. Beyond this, you are required to successfully complete a series of exams to validate your clinical knowledge, and English proficiency, necessary to function as nurse in the United States. NCLEX-RN: You have to have a nursing license in the state that you wish to practice nursing. The license is also known as Registered Nurse, RN, license and is issued by the State Nursing Board. In the US, each of the (50) state governments and the government of the District of Columbia set the standards and administer the nursing licenses through State Boards of Licensing. The licensure requirements varies from state to state. However, once you have a license in one state, it is possible to obtain an endorsement for another state by satisfying the application requirements of that state. You need to take NCLEX-RN examination in only one state, and a passing score is accepted all across the state Nursing Boards. The RN licensing is a two-step process. First, you have to apply for an RN licensure in the State you wish to practice nursing. Upon satisfactory completion of the application process and have met all the state requirements, the state issues an authorization to take the test (ATT), National Council on Licensure Examination for RNs, also known as NCLEX-RN exam. The second step is registering for the exam. The Pearson VUE Professional Centers in US and in select cities internationally administer the NCLEX-RN computerized exam for RNs. Pearson VUE registration is available on-line from the link: www.pearsonvue.com/nclex. Upon satisfactory completion of the registration process, Pearson VUE issues an ATT, Authorization To Test. With ATT on hand, you make appointment to take the exam at one of the Pearson VUE Professional Centers. Pearson VUE forwards the test results to the state Nursing Board. State issues the Registered Nurse, RN, license to those candidates with the passing score on the NCLEX-RN exam. The candidates who have not achieved a passing score will have to re-apply and wait approximately 90 days to take the exam again. As mentioned earlier, the state nursing boards determine the requirements and credentials for their licensing. Individual state licensing requirements, applications and instructions are obtainable from the state Nursing Boards whose addresses and web sites are given at the bottom of this page. NCLEX-RN COMPACT STATES: The National Council of State Boards of Nursing, NCSBN, and the following State Nursing Boards have formed a mutual recognition of each others nurse's licensure known as "Compact States". The allows a a nurse to have one license in their State of residency and be able to practice nursing in all of the Compact States. At present, the Nurse License Compact States are: Arizona, Arkansas, Delaware, Idaho, Iowa, Maine, Maryland, Mississippi, Nebraska, New Mexico, North Carolina, North Dakota, South Dakota, Tennessee, Texas, Utah, Virginia and Wisconsin. Pending legislative process, state of New Jersey, New Hampshire, and South Carolina are in the process of joining the Compact States. NCLEX-RN, AN EXAM OVERVIEW: NCLEX-RN is a Computerized Adaptive Testing (CAT), multiple choice exam, maximum of six (6) hours in length, administered at Pearson VUE Professional Centers in the US, and at selected cities around the world. Being an adaptive test, the length of the exam is determined by the performance on the examination. If the exam answers can conclusively determine the nursing knowledge of the candidate, either good or poor, then the exam may be terminated in as early as after answering the first 75 questions during the first hour of testing. In other words, your testing could be over in just one hour depending on how good or bad you do on the test. The test results are forwarded to the state Board for notification to the candidates. The state Board, simultaneously issues licenses to qualified candidates. NCLEX-RN, CGFNS REQUIREMENT: 43 out of 50 States in the US require a CGFNS certificate from foreign-trained nurses before they are allowed to take the NCLEX-RN. States of California, Florida, Georgia, Hawaii, Maryland, Michigan, and South Carolina do not require CGFNS as a condition to take the NCLEX-RN exam. However, a state that requires CGFNS may not allow an endorsement from one of these states until a CGFNS Certificate is provided. NCLEX-RN, EXAMINATION CENTERS: The NCLEX-RN examination is administered in the United States, American Samoa, The District of Columbia, Guam, The Northern Mariana Islands, Puerto Rico, and the Virgin Islands. The examination is also administered internationally in Australia, Canada, England, Germany, Hong Kong-China, India, Japan, Mexico, South Korea, and Taiwan. In addition to the state application fee, the fee for taking the NCLEX-RN examination in the US is US$200.00 The international centers require an additional US$150.00 plus a value added tax where applicable. The most advantageous course of action is to go to the US on an Immigrant Visa (Green Card). Immigrant Visa requirements are specific and CGFNS Certificate or passing score on NCLEX-RN is one of them. Normally, nurses are not eligible for the H1-b visa processing. CGFNS: The CGFNS, Commission on Graduates of Foreign Nursing Schools, is an independent, private, non-profit organization established to evaluate and certify graduates of nursing schools located outside of the United States who are interested in practicing as registered nurses in the United States. Please note, CGFNS is strictly a private organization and has nothing to do with the US Homeland Security, US Immigration, US State Department or United States Government. Passing the CGFNS qualifying exam reasonably assures success in the NCLEX-RN exam as the CGFNS exam format is the same as that of the NCLEX-RN. Therefore, CGFNS exam is also called a predictor exam to the NCLEX-RN. CGFNS CERTIFICATE: The CGFNS Certification is a THREE parts program. 1. Credential Review: CGFNS first conducts a credential review of the nurse's education, registration, and the licensure. Based on your education and registration, CGFNS certifies that you are a first-level, general-nurse as defined by the International Council of Nurses. Once you pass the credential evaluation, you become eligible to take the CGFNS exam. 2. CGFNS Qualifying Exam: This is a one day qualifying exam of nursing knowledge. The exam consists of 260 questions in the multiple-choice format. Part I of the exam takes 2 HOURS and 30 MINUTES, which includes 150 questions. After a lunch break, the exam continues with Part II of the exam consisting of 121 questions and completed in 2 HOURS and 1 MINUTE. The exam measures the applicants' knowledge in the traditional clinical areas of nursing practice, nursing care of adult, nursing care of children, maternal/infant nursing, psychiatric mental health nursing, and community health nursing. CGFNS Qualifying Exam is administered in 44 countries worldwide in March, July, September and November. The CGFNS Examination Schedule - 2006:
The application for CGFNS may be obtained by writing, calling, faxing, or by downloading from the CGFNS web site. The application may be filed online. CGFNS The fee for the CGFNS qualifying exam is as follows and are payable only in US dollars.
3. One of the following three English Proficiency Exams has to be successfully completed to satisfy the requirement for the CGFNS CERTIFICATE. English Language Proficiency Certificate - TOEFL & TOEFL iBT: The Test of English as a Foreign Language, TOEFL, meets the English language proficiency requirement of the CGFNS Certification Program. Educational Testing Service administers the TOEFL worldwide. The exam measures listening comprehension, structure and written expression, and reading comprehension. TOEFL may be taken prior to or concurrent to the CGFNS Qualifying Exam. The passing score of 540 on paper and pencil version of TOEFL or a score of 207 or higher on the computer version of TOEFL is required for the CGFNS Certification. TOEFL scores are valid only for two years. The CGFNS now also accepts the internet version of the TOEFL exam, TOEFL iBT scores towards the Certification as well as the VisaScreen Certificate. A passing score of a total 83 and speaking 26 on TOEFL iBT are required for Registered Nurses. TOEFL iBT is an internet based exam measuring all four skills of reading, writing, listening, and speaking. The scoring scale contains only one total score on a scale of 0-120 and the four skills scores each on a scale of 0-30. For information and application for TOEFL, please contact: TOEFL Fee for TOEFL testing is US$ 140.00. For information about TOEFL, TSE in India, please contact: Institute of Psychological and Educational Measurement (IPEM) 119/25-A Mahatma Gandhi Marg, Allahabad 211011, U.P., India Telephone: (532) 242-7050 Fax: (532) 242-7041 Email: director@ipem.org Web Site: www.ipem.org
Even though TWE is not required for CGFNS Certificate, you should take TWE as part of the TOEFL exam. TWE is required for the Visa Screen and if taken at the time of TOEFL, there are no additional application procedures or fees; TWE is taken by simply checking the column for TWE on the TOEFL application. A passing score of 4 is required on TWE for Visa Screen. English Language Proficiency Certificate - TOEIC: CGFNS accepts test scores from English exam Test of English for International Communication (TOEIC0 for the CGFNS Certification program. However, to satisfy the VisaScreen requirement, you still need to take TWE and TSE exams.
A passing score of 725 on TOEIC is required for the CGFNS Certification.
The TOEIC test is available for US$65.00 per test to individual test takers through the Open Test Program. For country specific rates, please contact the representative in the respective country.
For information and application for TOEIC, please contact:
TOEIC - The Educational Testing Service [ETS] 664 Rosedale Road, MS 10-P Princeton, New Jersey 08541-2218. USA Telephone: (609) 734-1540 Email: toeic@ets.org Web site: http://www.toeic.com
For information about TOEIC in India, please contact: Institute of Psychological and Educational Measurement (IPEM) 119/25-A Mahatma Gandhi Marg, Allahabad 211011, U.P., India Telephone: (532) 242-7050 Fax: (532) 242-7041 Email: director@ipem.org Web Site: www.ipem.org English Language Proficiency Certificate - IELTS: CGFNS accepts test scores from English exam from the International English Language Testing System (IELTS). You need passing scores on the academic module exam administered by the British Council, Cambridge ESOL Examinations, or IDP Education Australia.
A passing score of 6.5 on the IELTS Academic Module ONLY and a Spoken Band of 7.0 are required for the CGFNS Certification and the VisaScreen Certificate.
For information and application for IELTS, please contact:
IELTS Administrator Cambridge Examinations and IELTS International 100 East Corson Street, Suite 200 Pasadena, California 91103. USA Telephone: (626) 564-2954 Email: ielts@ceii.org Web Site: http://www.ielts.org
The fee for the IELTS exam is approximately US$150.00 and please check the country site for specific information on fees, test dates and registration.
Information on IELTS in India can be obtained from the British Council link, http://www.britishcouncil.org/india/ On-line registration may be accessed thru, http://examinations.britishcouncil.org/asp/sysacc/examrelogin.asp
English Language Proficiency Certificate - SUMMARY: The foreign nurse applying for the CGFNS Certification Program will have the option to take any one of the three exams.
TOEFL or TOEFL iBT (Administered by the ETS, Educational Testing Service), TOEIC (Administered by the ETS, Educational Testing Service) or IELTS (Administered by the British Council, Cambridge ESOL, or IDP Australia) English Language Proficiency REQUIREMENT - VISA SCREEN: Foreign nurses applying for VISASCREEN program will have the option to take the following combination of English proficiency exams.
TOEFL, TWE and TSE, or TOEFL iBT TOEIC, TWE, TSE, or IELTS
Please note, those applicants taking TOEIC exam will still have to take TWE and TSE offered by the ETS.
The minimum passing scores for these exams are as follows: TOEFL: 540 (or 207 Computerized), TWE: 4.0, TSE: 50, or TOEFL iBT Total 83 and speaking 26. TOEIC: 725, TWE: 4.0, TSE: 50 IELTS (Academic Module Only): 6.5, IELTS Spoken Band: 7.0
NOTE: English proficiency exams scores are valid for up to two years from the date of administration. Additionally, all exam scores must be forwarded to CGFNS/ICHP by the administering organization. CGFNS will not accept a score report submitted by the applicant or by third parties.
TSE-P - TEST OF SPOKEN ENGLISH TSE is not a part of the CGFNS certification; however, if you took TOEFL as your English proficiency test, then you need the TSE scores for the VISA SCREEN. Without VisaScreen, one cannot file an Immigrant Visa petition in the occupational visa category. TSE-P is administered twelve times a year usually on a Saturday. If you took IELTS or TOEFL iBT, then you do not have to take the TSE.
A passing score of 50 is required in the TSE exam.
Fee for TSE is US$ 125.00.
For information and application, please contact: TOEFL/TSE SERVICES Indian Nationals must obtain the applications and registrations from: Institute of Psychological and Educational Measurement (IPEM) 119/25-A Mahatma Gandhi Marg, Allahabad 211011, U.P., India Telephone: (532) 242-7050 Fax: (532) 242-7041 Email: director@ipem.org Web Site: www.ipem.org Take the TSE simultaneous to the TOEFL/TWE Exam. VISA SCREEN: US Immigration laws require that foreign nurses submit a VisaScreen Certificate with their Immigrant Visa petition. A division of CGFNS issues the VisaScreen Certificate. The purpose of the VisaScreen is to assure the Immigration authorities that the candidate’s eligibility has been evaluated and meets all the criteria for migrating to the United States as a nurse. CGFNS Certificate or NCLEX-RN certificate of license, and passing scores on English exams are required for the VisaScreen. Please note, this is only an eligibility verification certificate and is not a guaranty of a visa. CGFNS or the VisaScreen operations are not in any way connected to the US Government or the USCIS.
The fee for the visa screen is US$325.00
The application for Visa Screen may be obtained by writing, calling, faxing, or by downloading from the CGFNS web site. CGFNS US IMMIGRANT VISA PROCESS: With the CGFNS Certificate, VisaScreen and copies of educational and personal credentials, an employer in the US can file for an Immigrant Visa petition for the nurse and for eligible family members, spouse and unmarried children under 21 years of age. Please note, H1 visas are usually not available for nurses.
As an employer, Advanced Health Alliance, Inc., will sponsor eligible nurses and their eligible dependants for the US Immigrant Visa or also known as the Green Card, or Permanent Visa. AHA requires a three year employment contract as condition of employment and the sponsoring. Please note, there are substantial penalties and consequences for breach of contract and early terminations as the employer has substantial monetary investment in the process.
Even though, the EB3 nurse visa category is one of the fastest for approvals, due to huge backlogs at the USCIS Offices, it may take up to six months or so for the initial employer approval. Under the current conditions, this is considered fast. The approved application is then forwarded to the United States State Department National Visa Center Offices in Portsmouth, New Hampshire for consular processing. The National Visa Center, NVC, will ask the nurse and the family to file a formal visa application and they do the remaining processing until ready for the local consulate interview. NVC will provide a list of documents required for the visa processing and the personal interview. A medical examination is part of the visa processing and the Consulate or NVC will provide a list of approved Doctors for the medical examination. Once a personal interview is scheduled, the consulate will notify the nurse in writing the place, date, and the time for the personal interview for the nurse and the eligible dependants. Upon satisfactory completion of the visa processing, the consulate will issue the Immigrant Visa for the nurse and the eligible dependants. The processing formalities may differ or vary in countries or consulates.
Employment based visa for nurses is one of the most straight forward and fastest visa processing, and yet, there are no guaranties that a visa will be issued as the consulate offices have total jurisdiction and control on issuing a visa. Therefore, candidates are cautioned to exercise prudence in making decisions on quitting present employment, disposition of properties, and making travel arrangements prior to receiving a visa.
Despite all the claims and rumors, please note, nobody has any undue preferences, inside information or can influence or expedite the issuance of a visa. It simply is going to take its normal processing and time. Nothing can be accomplished by calling or following-up the consulate or immigration authorities in the US. If anything, an inquiry or follow-up on the status of a visa can only delay the processing. STATE OF MICHIGAN RN LICENSE PROCESS: It is recommended that you apply for a state nursing license immediately after obtaining the visa. The application may be downloaded from the State of Michigan website http://www.michigan.gov/healthlicense. Under the heading "Licensing for Health Care Professionals", click on the link NURSING. Under Nurse Licensing Forms and Applications, access RN Application Packet. The instructions and application will be displayed in the PDF format. Print the form and complete it as instructed. Mail the completed application together with the required application fee to the State of Michigan Board of Nursing in Lansing, Michigan. It is recommended that a US address be provided on the licensing application and eligible candidates may use Advanced Health Alliance address as their address in the US.
State of Michigan requires CGFNS Certificate from foreign trained nurses for the RN licensing. In about ten days to two weeks of the mailing of the State application, just to allow adequate time for the mail, request CGFNS by email, to send and verify the CGFNS Certificate for the purpose of State RN licensing. In the email communication, provide your CGFNS ID, your date of birth, and the name as it exactly appears on the CGFNS Certificate. Sure to include in the email that you are requesting this information for the purpose of RN license in the state of Michigan. The status of the email request can be monitored on-line.
If the application is complete and satisfactory, upon receipt of CGFNS verification, the state will issue an authorization to take the NCLEX-RN examination.
Once the state Nursing Board approves a candidate eligible for the NCLEX-RN exam, register for the examination on-line with http://www.pearsonvue.com/nclex . Again, eligible candidates may use Advanced Health Alliance address for Pearson VUE registration. Upon satisfactory completion of the registration application, Pearson VUE will mail the ATT, the Authorization To Test. In approximately, within sixty days of the ATT, you have to take the exam at one of the Pearson VUE Professional Centers. For international centers, please follow the instruction on the NCLEX-RN bulletin. You may download the NCLEX-RN bulletin in the pdf format from: http://www.ncsbn.org/pdfs/2006_Candidate_Bulletin.pdf
Pearson VUE administers the exam six days a week and can be scheduled to take the exam anywhere in the US or overseas regardless of the licensing state. Upon passing the exam, the state issues a license in fairly short time. This is your authority that you are now eligible to practice as a nurse in the UNITED STATES.
THE LATEST NEWS AND INFORMATION MAY BE OBTAINED BY ACCESSING THE BLOG http://advancedhealthalliance.blogspot.com FREQUENTLY ASKED QUESTIONS: WHAT IS THE SALARY
RANGE FOR A REGISTERED NURSE? Yes, there is a nursing shortage in the US. This has not changed the attitude or the expectations for foreign trained nurses. They are expected to perform just like a US trained nurse with added pressure created by constant and rapid technological advances. It takes time and efforts for a foreign nurse to get used to a new country and a new system. Little extra effort and a positive attitude will help you get to a normal routines quickly. Once you are familiar with the culture, people, communication, and the environment and have a drivers license and own transportation, it is possible to move around and find extra work to make lot more money. There are plenty of opportunities for the right candidates with good clinical skills, communication skills, and flexibility. WOULD EMPLOYERS PROVIDE ACCOMMODATION AND TRANSPORTATION FOR THE NURSES IN THE US? Unlike in some European and Middle-Eastern Countries, it is not customary for US employers to provide accommodation and transportation to their employees. There are plenty of convenient accommodations available to fit any budget. The large cities such as New York and Chicago have excellent and convenient public transportations such as buses, taxies, trains and sub-ways. Most of the Americans learn driving in high schools and owning a car is a basic necessity especially in smaller cities. The wages paid to nurses are adequate to cover all these expenses. Please also note the employers do not pay transportation for annual furloughs.
WHAT IS THE ASSURANCE THAT THE NURSE WILL HAVE A JOB UPON ARRIVAL IN THE US? Advanced Health Alliance is an employer and not an agent or broker. Only an employer can apply for a visa. The employer will provide the Nurse with an employment letter and employment agreement detailing the employment offer, conditions, benefits and salary. This is your guarantee that you will have a job once you arrive in the United States. Without this guarantee, US Embassy/Consulate will not issue a visa to the nurse. The employment offer is the only reason for the issuance of a visa. Conversely, the nurse is contractually obligated to work for the sponsoring employer for the duration of the contract which is usually three years from the start of employment in the US. A breach of contract carries severe penalties. An employer or the sponsoring agency has substantial time and money invested in the process and it is only reasonable to expect strict enforcement of the employment contract. WOULD AN EMPLOYER HELP
A NURSE WITH TESTING FEES AND COACHING? CAN YOU START THE VISA
PROCESSING AND THEN PROVIDE ADDITIONAL DOCUMENTS AS THEY ARE OBTAINED? WOULD THERE BE ANY
ASSISTANCE UPON ARRIVAL IN THE US? ARE NURSES REQUIRED TO
SIGN AN EMPLOYMENT CONTRACT? HOW MUCH DOES IT COST
TO FILE FOR A VISA?
INTERNATIONAL NCLEX-RN TEST CENTERS: LONDON: SEOUL: HONG KONG Pearson VUE-London Pearson VUE-Seoul Pearson VUE-Hong Kong (Holborn) 6th Floor, Kolon Bldg. Unit 503, 5/F 190 High Holborn 45 Mukyo-Dong Grand Millennium Plaza London, WC1V 7BH Chung-Gu, Seoul, 181 Queen’s Rd Central GBR KOREA 100-772 HONG KONG 0207 404 0652 82-2-755-7801 85-2-2167-8568
Starting April 1, 2006, international test centers would be expanded to include Pearson Professional Centers in Sydney, Australia; Toronto, Montreal, and Vancouver, Canada; Frankfurt, Germany; Mumbai, New Delhi, Hyderabad, Bangalore, and Chennai, India; Chiyoda-ku, and Yokohoma, Japan; Mexico City, Mexico; and Taipei, Taiwan.
Administration of the NCLEX-RN examination abroad does not contradict or circumvent any current process or requirement. All international candidates are required to apply to the board of nursing in the state or territory where they wish to be licensed before registering for the NCLEX-RN examination. HOW CAN I TRUST YOUR
SERVICES? WHAT IS THE COST OF
YOUR SERVICES? It is a good idea for you to talk to your friends, classmates, or acquaintances who are nurses in the US to learn and to compare their experiences and get a realistic picture of what to expect as a nurse in the US. Talk about the job, people, language, culture, ethnic communities, religion, food, housing, transportation, education, cost of living, family, and children, just to name a few of the topics for conversation. No doubt, this is a wonderful opportunity, or may be even the best opportunity in the world; but certainly requires hard work, a positive attitude, and some sacrifices. Remember, anything that is of value has a price tag, and in the end, it is all worth it! We wish you ALL the best in your search.
Boards of Nursing - Contact Information and Web sites:
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