Quick answer: Registered nurses (RNs) in the United States earned a median salary of $97,550 a year ($46.90 an hour) in May 2025, according to the US Bureau of Labor Statistics (BLS). There are about 3.47 million RN jobs, and the BLS projects around 180,800 openings every year through 2035, with 6% growth. International nurses can work in the US by getting their education evaluated, passing the NCLEX-RN exam, obtaining a state nursing licence, and securing a visa, most commonly an employer-sponsored green card.
The US is the world’s largest and highest-paying market for nurses. Hospitals in many states have recruited internationally for decades, especially from the Philippines, India, Nigeria, Kenya, Jamaica and the Caribbean. The path is longer than in some countries, but the pay and career options, including advanced practice roles that can pay far more, make it one of the most valuable nursing destinations anywhere.
US Registered Nurse Careers at a Glance
| Median pay (May 2025) | $97,550 per year / $46.90 per hour |
| Number of jobs (2025) | 3,465,400 |
| Projected growth (2025–35) | 6% (faster than average) |
| Average annual openings | About 180,800 |
| Licensing exam | NCLEX-RN |
| Licence issued by | Each state’s Board of Nursing |
Pay by Work Setting
| Work setting | Median annual pay (May 2025) |
|---|---|
| Government | $110,780 |
| Hospitals (state, local and private) | $100,220 |
| Ambulatory healthcare services | $91,230 |
| Nursing and residential care facilities | $84,300 |
Pay also varies widely by state and city. Coastal states and large metropolitan areas usually pay more, but have higher living costs. Night shifts, weekends and specialty units such as ICU, operating room and emergency often add differentials.
The Path for International Nurses
1. Check your education
Your nursing education must be comparable to a US registered nurse program. Most state boards require a credentials evaluation from an approved organisation, which reviews your transcripts, clinical hours and licence.
2. Pass the NCLEX-RN
The NCLEX-RN is the national licensing exam used by every US state. It is a computer-adaptive test of clinical judgement and safe practice. It can be taken at Pearson VUE test centres in several countries outside the US, so you do not need to travel to America to sit it.
3. Get a state licence
You apply to a specific state’s Board of Nursing. Requirements vary by state, including background checks and, for some states, English proficiency. Many states belong to the Nurse Licensure Compact, which allows multistate practice once you hold a qualifying licence.
4. Meet immigration requirements
Most international nurses immigrate through an employer-sponsored green card, often in the EB-3 category for skilled workers. Foreign-educated nurses entering on an employment basis generally need a VisaScreen certificate, which verifies education, licence and English ability. Waiting times for green cards depend on your country of birth and can be long for some nationalities.
Ways to Increase Your Earnings
- Specialise: critical care, perioperative, emergency and oncology nurses are in high demand.
- Get certified: specialty certifications can bring pay increases.
- Advance your education: nurse practitioners, nurse anesthetists and nurse midwives earn substantially more than RNs.
- Consider travel nursing once you have US experience. Short-term contracts often pay a premium.
The Fine Print
- Read recruitment contracts carefully. Some agencies require a multi-year commitment with large penalties for leaving early.
- Never pay for a job offer. Legitimate employers and recruiters do not sell jobs or green cards.
- Allow plenty of time. Credential review, NCLEX, licensing and immigration together can take a long time, especially where green card backlogs apply.
- Check state rules. Each state sets its own licensing requirements and fees.
Is Nursing in the USA Worth It?
For qualified nurses, the US offers the highest nursing salaries in the world, strong demand, and a clear career ladder into advanced practice. The trade-offs are the long process, possible green card waits depending on nationality, the cost of exams and credential checks, and the need to adapt to US clinical practice. Nurses who prepare well for the NCLEX, choose a reputable employer, and understand their contract terms put themselves in the strongest position.
Frequently Asked Questions
How much do registered nurses earn in the US?
The median salary was $97,550 a year in May 2025, according to the BLS.
Can I take the NCLEX outside the US?
Yes. The NCLEX is offered at Pearson VUE centres in several countries.
Which visa do international nurses use?
Most use an employer-sponsored green card, often in the EB-3 skilled worker category.
Is the US nursing job market growing?
Yes. The BLS projects 6% growth from 2025 to 2035, with about 180,800 openings a year.
What is VisaScreen?
It is a certificate verifying a foreign-educated healthcare worker’s education, licence and English ability, generally required for employment-based immigration.
Official sources: US Bureau of Labor Statistics, Occupational Outlook Handbook: Registered Nurses, at bls.gov, and the National Council of State Boards of Nursing (NCSBN) at ncsbn.org. This site is not affiliated with any government agency or employer and never charges any fee for job information.