My Nursing Career

Healthcare organizations in the U.S. are experiencing a shortage in the nursing workforce. Since nurses are essential to the delivery of health care, it is not surprising that foreign-educated nurses are coming to the U.S. to fill gaps in nursing services. Those who want to become a nurse in the U.S. must be willing to invest time and patience in the intensive process.

Basic Information

There are two major processes you have to undergo: the licensing process and the education qualification process.

1. For licensing, each state has different requirements for you to obtain a license to work. It is thus essential to determine in what state you will be working so that you satisfy all requirements for licensure. The primary licensing requirement is for you to successfully complete the Nursing Comprehensive Licensure Examinations for Registered Nurses (NCLEX-RN).
2. For education qualification licensing, you will have to undergo a certification process administered by the Commission on Graduates of Foreign Nursing Schools (CGFNS). Essentially, CGFNS is designed to assess your likelihood of passing the NCLEX-RN licensure examination and becoming licensed as a registered nurse in the U.S.

This involves: the Certification Program; VisaScreen; and the Credentials Evaluation Service. The Certification Program and the Credentials Evaluation are required by the State Boards of Nursing, while the Immigration and Naturalization Service (INS) needs the VisaScreen certificates.

Certification Program (CP)

The CP consists of three parts: review of credentials; a Qualifying Exam on nursing knowledge, and the TOEFL.

• Credentials Review: This step examines your foundation in theory and practice in five fields of nursing: medicine, surgery, obstetrics, pediatrics, and psychiatry, to see if these are comparable to U.S. standards.
• Language Tests: The Test of English as a Foreign Language (TOEFL) measures your English language proficiency. TOEFL and the CGFNS Qualifying Exam should be taken within 2 years of each other to remain valid. The tests include Test of Written English and Test of Spoken English.
• CGFNS Qualifying Exam: To be eligible for the exam, you must possess a valid nurse’s license from your country and comply with specified hours of instruction and clinical practice in the five fields of nursing practice mentioned above.

Only 11 states allow you to take NCLEX-RN without completing the CGFNS Qualifying Exam first. For the 39 other states and the District of Columbia, you must pass CGFNS before taking NCLEX-RN.

The CGFNS Qualifying Exam is given only 3 times a year in over 40 locations worldwide. The CGFNS Website publishes this information.
Fees for the CP (includes the CGFNS Qualifying Exam fee) are $418 for first application; $308 for re-application. There are smaller fees for other transactions.

VisaScreen Certificate

The International Commission on Healthcare Professions (ICHP), a unit of CGFNS, administers VisaScreen. This certificate is a requirement for processing of your occupational/residency visa. The requirements for processing the VisaScreen Certificate are:

• Completed application form
• Validation of past and present licenses, to come from licensing authorities. Forms are supplied in the packet, but you handle sending them to the licensing authorities in your country after filling out the forms.
• Successful completion of the TOEFL
• Successful completion of CGFNS Qualifying Exam or NCLEX-RN examination
• Copy of high school diploma or equivalent
• Payment of application fee. The initial certification process requires $448 and there are other fees for renewals, replacements, and other transactions.

Credentials Evaluation Service (CES)

Conducted by CGFNS, this evaluation process is more exhaustive than the credential review performed in the CP. The CES examines the content of your entire nursing education and professional program to confirm its comparability with the U.S. program of study. The CES report goes to the State Board of Nursing, employers or other entities that may require it.

Different recipients may require different credentials. Check to make sure you submit exactly what is required. Note that academic records and license validations will be sent by issuing bodies.

Get the CES application (or download it) from CGFNS. Complete the form and send it to CGFNS, along with all required documents and full payment on fees (only in US dollars). Send all documents only by regular postal mail.

Request your school and licensing authorities to send to CGFNS your academic transcripts and license validations.

The CES fee for a full education report is $378 (for study purposes); for the healthcare profession and science report, the fee is $328 (for work purposes). There are other smaller fees, but the most relevant is the CGFNS Language Report for Boards of Nursing, equal to $75 each.

The education qualification process may take about one year to complete. If you can hurdle this process successfully, you may find a rewarding career that gives access to more advanced technology, better working conditions, and higher pay in the United States.

For a nurse, one of the most important examinations they will ever undertake is the National Council Licensure Examination, or NCLEX, which is a nursing examination developed by the National Council of State Boards of Nursing (NCSBN) in the United States.

NSCSBN has developed two examinations that are used to test the qualifications of entry-level nursing candidates. The NCLEX-RN exam is a test for registered nursing candidates, while the NCLEX-PN exam is for licensed practical/vocational nursing candidates.

Passing these exams are a requirement for anyone attending nursing school. The NCLEX exam is designed to test the knowledge, sills and abilities that are essential for safe and effective nursing at the entry-level.

NCLEX-RN Exam
For the NCLEX-RN exam, the exam is split into four categories: Safe Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity and Physiological Integrity. Most of the questions are multiple choice, however broader questions have been added in recent years. For example, some questions will require the candidate to identify and select a particular area of a drawn body part pertaining to the question, or answer a mathematical question, often relating to medication dosages.

NCLEX-PN Exam
The NCLEX-PN exam also uses computerized-adaptive testing, with questions that measure the higher levels of cognition. The exam is split into the same categories as the NCLEX-RN exam: Safe Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity and Physiological Integrity. However, some of the aspects of the categories and the questions asked are different.

Tips To Pass the NCLEX Exam
Passing the NCLEX exam does not need to be a stressful part of nursing school, but simply another chapter in an exciting career, yet to begin. By following a few simple steps to ensure you are properly prepared for the test and ready for a rewarding career in nursing.

Make A Study Plan
This is a process that should start several months in advance, and you are going to need to calculate your total study time and arrange when you want to study. You should break the weeks into sections so you can spend a certain week studying for a certain topic. As well, you need to organize your notes into headings, sub-headings and more so that the material is structured in a way that will allow you to learn the important information in an easy manner. If your papers are just a jumble of notes, it will be very difficult for your mind to put the information together in a logical manner.

Use Study Tools
It is important that as you study, you test your ability to practice nursing judgment, rather than focusing on facts. As well, you can apply critical thinking.
Another excellent way to aid in your studying is to become a part of a study group. A group can prepare questions to ask and share within in the group. This will aid in the process of studying and develop your “on-the-spot” answering capability. That being said, do not stay with a study group that is not helping you in your process of studying the nursing material.

Anxiety and Stress
When you are preparing for a big exam like the NCLEX exam in nursing school, you are going to deal with anxiety and stress. Stress, in turn, can cause you problems when you are trying to learn the material and make it difficult for you to retain the information.

When this happens, give yourself some positive reinforcement and remind yourself of the tough tests you had in the past, which you passed with no problem, despite being worried about them.
You can practice relaxation techniques that will calm you down and allow you to assess the questions and studying with a calm mind. All you have to do when you get anxious is to breath in slowly, count to ten and exhale.

As well, try doing some exercising in the weeks leading up to the exam and under no circumstances should you spend your last few days cramming to learn everything you can.

Before The Test
On the day of the test, make sure you get up nice and early after a good night’s sleep, have a healthy breakfast and ensure you are relaxed before proceeding for the exam. Make a list of everything you need the night before, including your identification, to ensure you are not racing the morning of the test to get everything together.

And Most Importantly….
Relax. It is so very important that you go into the test with a clear head, knowing that no matter what happens, it is not the end of the world.

Go in their with confidence, knowing you have studying the materials, and keep a positive frame of mind throughout the examination.

Do not get discouraged and do not let stress dominate your mind.

Breath, Relax and Pass.

Passing your NCLEX exam is a very important milestone on your way to becoming a nurse, however it can be a bit difficult if you don’t take the time to prepare yourself for the exam through proper studying.

Create A Study Plan
It is very important that you take the time to put together a study plan that will give you several months to prepare for the exam. Study a different topic each week and break all of the material into reasonable sections. You should organize all your notes so that it is easier for you to understand and learn the material that is needed.

Use The Study Tools
You have a wide variety of tools at your disposal to study for the NCLEX exam, but if you don’t use them you are going to cause a great deal of heartache when you go to take the test. There are many review books available through your school that will help divide the material into a way that is easy to study.

The internet can also be an excellent way to study for an exam. Try and learn everything you can that may appear on the test. The internet is the greatest information tool in human history, use it to your advantage.

Start A Study Group
One of the best ways to study for the NCLEX exam is to take part, or start, a study group. Study groups are an excellent way to prepare for the exam. Try and get group together that will have between three and five people, which meets on a weekly basis in a certain area. In the group, share questions and answers and have mock tests that will allow you to think on your feet and get prepared for the exam.

Beating Stress
Stress is going to be a problem no matter what you do to get rid of it. If you are going to be taking a big test like the NCLEX exam, you will have stress. However, there are ways to beat it if you have to. First of all, try and talk positively to yourself. This will raise your confidence as you tell yourself over and over that you will pass the test. As well, try and think of times you have made it through tough situations and how you faired in that.

Be Healthy
Another way to keep yourself in a good frame of mind is to exercise on a regular basis. This will keep your body, and your mind, fit. If you are fit, you are going to have an easier time learning and you will find you do not suffer from stress as much. Exercise is a great way to reduce tension, which gives you more mental and physical energy during stressful periods.

Eat Right
A body in good shape is a body that will do well in difficult situations, situations like tests. Maintain a good diet of fruits and vegetables to keep your body healthy.

During your study sessions, it can be difficult not to snack uncontrollably, however you have to break yourself from this habit because refined sugar only makes you more tire.

Make the Appointment Earlier than Later
You are able to schedule your test up to 30 days ahead of time by registering with the State Board of Nursing, which will provide the Authorization to Test. This will allow you to make the appointment, scheduling the date and the time. Try and schedule a time or day that will work best for you, allowing you to be at your most alert and best.

The Importance of A Good Breakfast
A healthy breakfast before your exam is incredibly important. It will allow you to be alert and ready for the exam. Skipping breakfast, even in favor of studying, will only result in you being sluggish and not at your mental sharpest.

Have Everything Ready
The night before your test, ensure that you have everything put together that you will need for the test. This includes items like your identification and any other legal documentation that you may need for the test. As well, don’t forget your lucky charms, possibly the most important part of your test paraphernalia.

Understand CAT
When we say understand CAT, we are not talking about things that go ‘meow’. CAT, or Computer Adaptive Testing, is a means to test a person’s knowledge base on a specific subject.

The test will begin with a question of moderate difficulty, if you answer correctly it will give you a more complicated question, if you answer incorrectly, it will give you an easier question. This will continue throughout the test to measure your aptitude. If your knowledge level is high enough in all areas, then you pass the test. If it is low, then you rate as low.