Nursing in the USA for Nepali Nurses — 2026 Complete Guide

Requirements overview

Step-by-step: how to work as a nurse in United States

1. 1

   Why USA is the #1 destination for Nepali nurses

   Over 29,000 Nepali nurses were working in the USA as of 2024, and 6,000+ more arrived in FY2023–24 alone — the highest single-year figure ever recorded. American hospitals face a structural nursing shortage of 400,000+ positions that domestic graduates cannot fill. The EB-3 visa creates a direct path to a US green card for qualified foreign nurses. Unlike temporary work visas, the EB-3 grants permanent residency on arrival — allowing Nepali nurses to build a long-term life in the USA from day one. Salaries are the highest of any nursing destination: USD 93,600/year median, or USD 7,800/month. In high-cost states like California and New York, experienced nurses earn USD 120,000–140,000. Even after US living costs, monthly savings of NPR 35,000–55,000 are realistic.

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2. 2

   CGFNS credential evaluation — the first step

   CGFNS (Commission on Graduates of Foreign Nursing Schools) is the independent body that evaluates your Nepal nursing credentials for US state boards. Almost all state boards require a CGFNS Certificate or CVS (Credentials Verification Service) before issuing an ATT (Authorization to Test) for NCLEX. To apply: submit your Nepal Nursing Council (NNC) certificate, nursing diploma or BN transcript, and proof of English. CGFNS will contact your Nepal institution to verify documents. Processing takes 3–6 months. Fee: USD 350–500 depending on the evaluation type. Start CGFNS before you begin NCLEX preparation — the processes run in parallel, and you cannot sit the NCLEX without an ATT from a US state board.

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3. 3

   NCLEX-RN — the licensing exam for US nursing

   The NCLEX-RN (National Council Licensure Examination for Registered Nurses) is the single exam required for nursing licensure in all 50 US states and territories. It tests clinical judgement using a computer-adaptive format (Next Generation NCLEX, or NGN, since 2023). There are no Pearson VUE NCLEX centres in Nepal. Nepali nurses travel to Delhi NCR (Pearson VUE, Noida), Mumbai, Bangalore, or Hyderabad. Allow USD 150–200 for travel and 3–4 nights accommodation. Exam fee: USD 200. Preparation takes 3–4 months. UWorld (USD 349/3 months) and Kaplan NCLEX (USD 449) are the two most-used platforms among Nepali nurses. UWorld's question bank of 2,000+ NGN-format items is widely considered the gold standard. Pass rates for internationally educated nurses are 60–65% on the first attempt — thorough preparation is essential.

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4. 4

   VisaScreen and the EB-3 visa process

   VisaScreen (issued by CGFNS) is a separate certificate required by USCIS for all healthcare workers on immigrant visas including the EB-3. It verifies your licence, nursing education, and English proficiency. Fee: USD 400. Processing: 3–4 months. The EB-3 visa process: (1) Your US hospital employer files an I-140 immigrant petition on your behalf. (2) Once approved, your priority date becomes current based on the Visa Bulletin (currently 1–3 years for Nepal-born nurses). (3) You attend a US embassy interview in Kathmandu for the immigrant visa. (4) On arriving in the USA, your green card is mailed within 2–3 months. Most Nepali nurses are sponsored by US healthcare staffing agencies — AMN Healthcare, Aya Healthcare, TaleMed, and Medplex are the largest working with Nepali candidates. They handle I-140, consular processing, and initial housing. Contracts are typically 2–3 years.

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5. 5

   Cost breakdown for Nepali nurses going to the USA

   CGFNS Certificate/CVS: USD 350–500 (NPR 45,000–65,000). NCLEX exam fee: USD 200 (NPR 26,000). NCLEX prep (UWorld or Kaplan): USD 350–450 (NPR 45,000–58,000). NCLEX travel + accommodation (India): USD 200–300 (NPR 26,000–39,000). VisaScreen: USD 400 (NPR 52,000). State board application: USD 50–200 (NPR 6,500–26,000). Total upfront cost before visa: approximately USD 1,500–2,200 (NPR 1.9–2.9 lakh). This is recoverable in 3–4 weeks of US nursing salary. Most US staffing agency contracts include a signing bonus of USD 2,000–5,000 and cover travel to the USA, initial accommodation for 30–60 days, and medical insurance from day one. Some agencies also reimburse NCLEX prep costs.

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6. 6

   What to expect after arriving in the USA

   Your employer will assign you to a unit (ICU, medical-surgical, emergency, telemetry) based on your Nepal experience. Expect an orientation period of 4–12 weeks with a preceptor. US nursing practice emphasises documentation, scope-of-practice adherence, and communication — Nepali nurses with strong NCLEX preparation adapt well. Living in the USA as a Nepali nurse: a shared 2-bedroom apartment costs USD 800–1,200/month (your share). Groceries and transport are USD 400–600/month. With a USD 93,600/year salary, monthly take-home after taxes (25–30% effective rate) is USD 5,400–5,800. Savings potential: NPR 40,000–55,000/month. After 5 years on the green card you can apply for US citizenship. Many Nepali nurses in the USA sponsor their siblings and parents through family preference categories.

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Frequently asked questions