E-guide | U.S. 2017

CAREER PATHWAYSIN NURSING:
Using Your International Education in the U.S.

© 2017 World Education Services. All rights reserved.

TABLE OF CONTENTS
Introduction ....................................................................................................................................................... 1
Your Career Pathway in the United States ................................................................................................... 4
The Nursing Profession in the United States ............................................................................................ 6
Gaining Recognition for Your Foreign Education ...................................................................................... 9
Educational Pathways in Nursing .............................................................................................................. 11
Licensing and Certification Requirements in Nursing ............................................................................ 18
Transferable Skills and Using Them in Related or Alternative Careers ............................................... 20
SMART Goal Worksheet ................................................................................................................................. 25
Additional Resources in the Field of Nursing ............................................................................................ 26
Index of References ........................................................................................................................................ 28

Pathways in Nursing | © 2017 World Education Services. All rights reserved.

iINTRODUCTION
Immigrating to the United States is an opportunity to use your international training to either
advance in your field or pursue a new career that builds on your education and experience. Because
nursing involves obtaining a license—a process that can be costly and time-consuming—it isespecially important to consider your options.
This guide will help you explore career pathways related to the field of nursing, as well as alternative
careers that use your skills but may not require a license. You will find useful resources to guide you
as you plan for your future.

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The Pathways Guide at a Glance
If you have completed your education in nursing in another country and are now starting yourcareer in the United States, you will need to understand to what extent you meet the academic
requirements of your chosen career.
• The Gaining Recognition for Your Foreign Education section (page 9) will explain how todetermine the U.S. equivalency of your foreign degree to help you explore career pathways innursing and other fields.
• The Educational Pathways in Nursing section (page 11) provides examples of careers inhealthcare that may match your qualifications.
• If you want to continue your nursing career in the United States, you must obtain a license. See
the Licensing and Certification Requirements in Nursing section (page 18) of this guide.
• Not all internationally trained nurses decide to pursue a nursing license in the United States,
either because of the time and expense involved, or because they want to pursue a different
career. See the Transferable Skills and Using Them in Related or Alternative Careers
section (page 20).
Let’s get started!
Strategies for Success
Ask Lots of Questions
Although you may have a strong idea of what your career will be in the United States based on theprofessional experience you already have, establishing yourself in a new country is a chance toreach new goals and possibilities. Analyzing your career options in the U.S. can be challenging, but
by remaining flexible you can use the education and experience you already have to take steps to
succeed.

As you research your options, ask yourself:• What are my short-term and long-term employment goals?
• What options are available to me based on my skills and qualifications?
• What are the steps and requirements in terms of time, costs, and additional training
to pursue my goal?
• Who can I talk to about my options?

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Make a Plan
After you’ve explored some of the career options available to you in the United States, it is time tomake decisions and come up with a plan. In the U.S., developing your career path requires a lifelongcommitment to learning, networking, and taking risks.
A successful plan includes realistic steps and time frames for completion. Your plan should also makeit possible for you to work toward multiple goals at once and allow for some setbacks along theway. It will take patience to reach your goals and it is normal to change your mind or adapt to new
circumstances as you move forward.
.

Think about the steps it will take to reach your goal. A clear goal-oriented plan may looksomething like this:
GOAL: Improve my language skills.
STEPS TO GOAL:• Take an English language course that suits my needs.
• Meet with an English language conversation partner weekly.
• Learn terminology and professional language in my field.
• Read the newspaper every day.

You can use the SMART Goal Worksheet (page 25) to guide you as you outline your plan.

Take Initiative
Although your academic and professional credentials are very important in your professional
success, so are skills like your communication style, English language level, and ability to adapt to
U.S. workplace culture. Networking with healthcare professionals you know, meeting professionals
in the field, joining a professional association, attending conferences, and volunteering in a hospitalare great ways to expand your understanding of the field, improve your skills, and grow your networkin the U.S.
Finding meaningful work as an immigrant can take time and you may face challenging obstacles.
Although many factors are out of your control, try to remain flexible, be persistent, and take initiative.
As you explore this guide, you will find a number of helpful resources to support you.

GLOSSARY

Academic and professional credential: The degree, diploma, or license that you receive when you complete a
program, pass examinations, or meet a set of requirements.
Networking: Interacting with other people to exchange information and develop contacts, especially to further
one’s career.

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YOUR CAREER PATHWAY
IN THE UNITED STATES
Like many immigrants, you may initially struggle to gain entry into your professional field in the U.S.
Although you may have adequate knowledge or experience, the challenge often occurs in translating
your skills and qualifications in a way that local employers will value and understand. You may alsoneed further education and training, an understanding of your local labor market, and knowledge of
how to navigate your options to choose a career pathway.

Your career pathway is made up of the educational and professional decisions that will
open doors to new opportunities. Education and training are the building blocks of yourcareer—with the skills you acquire, you can earn promotions and take on additional
professional responsibilities.

To start thinking about your career options, you will need to understand the difference between
regulated and non-regulated professions.
Understanding Regulated Professions
Each state decides which professions it will regulate and what level of formal education or training
is required for entry into the field. In the United States, specific authorities or regulatory bodies are
responsible for recognizing professional credentials required for state licensing. Because the time andcost associated with licensing varies by state, contact the relevant regulatory body before deciding toproceed with licensing. In this guide, careers usually requiring licensure are clearly marked, but again,
this varies from state to state.
Understanding Non-Regulated Professions
Some occupations in the United States are either internally regulated by professional associations,or are entirely non-regulated. In occupations such as Certified Nursing Assistant (CNA)1, or Home
Health Aide, academic credentials may be enough to gain employment. But, although less strict
than regulated professions, certain standards of professional practice or designations might
still be preferred by employers and professional associations in non-regulated professions. You
can demonstrate that you meet these standards through a certification process linked to training
programs provided by employers or community colleges.

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Can I work as a nurse in the United States without a U.S. license?
The healthcare industry in the United States is highly regulated to protect public health andsafety. That means that most healthcare occupations in the U.S., including nursing, require
either a license or certification to practice.
The nursing license you may have from your home country is not valid in the U.S.
Internationally trained nurses need to meet the same requirements as U.S.-educatednurses.

In this guide, occupations that require a formal certification or licensure process are clearlymarked.
Many internationally trained professionals decide not to pursue employment in regulated
professions due to the challenges of relicensing. The healthcare field provides access to lessregulated employment opportunities in both clinical and non-clinical capacities, often with voluntary
certification.

If you decide against relicensing as a nurse in the United States, you can still work in thehealthcare field in a non-regulated occupation. Some related careers are discussed in
the Transferable Skills and Using Them in Related or Alternative Careers section(page 20) of this guide.

GLOSSARY

Career pathway: A series of “stackable credentials”—achievements that build on each other based on continuing
education, specialization, and certification to allow you to move up a career ladder.
Regulated professions: Professions that require a license or certification.
Designation: A title earned by an individual through a certification process.
Certification: A voluntary credentialing process by a non-governmental, private professional association.
Relicensing: Having to meet licensing requirements in the United States, even if you have a license from anothercountry.

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THE NURSING PROFESSION IN
THE UNITED STATES
Nursing is a regulated healthcare profession that focuses on providing care to individuals, families,
and communities. It is actually the largest healthcare profession in the United States!
Nurses have a vital role in multidisciplinary healthcare teams, with special areas of responsibility.
Depending on their level of training, nurses use technical, clinical, or managerial skills. They practicein different settings like homes, hospitals, schools, and doctors’ offices, and they can specialize incaring for particular kinds of patients, such as children, cancer patients, or the elderly.
Working as a Nurse in the United States
A nurse’s roles and responsibilities in the United States may be different than in other countries
where the profession refers to more general care. Internationally trained nurses need to meet thesame requirements as U.S.-educated nurses, so even if you have many years of experience, you mustobtain a new license in the U.S.
In the U.S., each state/territory regulates the practice of healthcare professionals and establishes its
own set of requirements and scope of practice concerning professional licensure.
Internationally Educated Nurses (IENs) or Foreign-Educated Nurses (FENs) can obtain licenses in the
U.S., although it can be a costly and time-consuming process.

For example, to register as a nurse in New York in 2017, you would have to pay an initialcredential verification fee of $550.00, an application fee of $143.00, course and certificate
fees of $70.00, and an exam fee of $500.00.
The costs associated with relicensing change over time and vary depending on yourstate, so check what the specifics are for your location.

GLOSSARY

Scope of practice: The procedures, actions, and processes that a healthcare practitioner is permitted to undertakein keeping with the terms of their professional license.

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It is recommended that IENs or FENs contact the Commission on Graduates of Foreign Nursing
Schools (CGFNS)2 for assistance in obtaining a license in the United States. The CGFNS will assist
you by evaluating:• Foreign education•

Some states may require you to complete a Foreign Educated Nurses (FEN)
refresher course that typically consists of 120 hours in the classroom and120 hours of clinical practice under the supervision of a licensed Registered
Nurse.

• Foreign licensure
Because nursing license requirements vary by state, consider these key points:• Each state in the U.S. is responsible for the licensure of nurses within that state. State-specificlicensure information can be found by visiting the National Council of State Boards ofNursing (NCSBN) website.3• All U.S. nursing boards require candidates to pass either:•

The National Council Licensure Examination for Registered Nurses(NCLEX-RN)•

The National Council Licensure Examination for Practical Nurses(NCLEX-PN)

Roles and Responsibilities
The main designation for a licensed nurse in the United States is as a Registered Nurse (RN).
In the U.S., nurses are responsible for:• Working with a variety of patients from pediatric to geriatric, or specializing in one area suchas neonatal intensive care, cardiac care, dermatology, or radiology.
• Observing and recording patient behavior and vital statistics.
• Consulting with physicians and other health care practitioners on treatment plans andoptions.
• Following treatment plans, operating medical equipment, and administrating medications.
• Supervising Licensed Practical Nurses (LPNs) and Certified Nurse Assistants (CNAs).

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Understanding Job Titles
The roles and responsibilities of Registered Nurses are highly dependent on areas of expertise andexperience. For example, when searching for employment as a Registered Nurse, you may see job
postings with the following titles:• Chief Nursing Officer• Nurse Anesthetist• Critical Care Nurse• Clinical Nurse Manager• Labor and Delivery Nurse• Patient Educator
Continuing education and training can open doors for additional certifications and practicing indifferent settings.
You can read more about academic and professional credentials in the Educational Pathways
in Nursing section (page 11) of this guide.

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GAINING RECOGNITION FOR
YOUR FOREIGN EDUCATIONYour education is the foundation of your career. Although there may be challenges to using yourforeign credentials in the United States, you do not have to “start over.” For an internationally trained
professional, exploring career pathways begins with an understanding of the value of the education
you received in your home country.
Obtaining a foreign credential evaluation is often the first step an immigrant takes to gain
access to educational and employment opportunities in the U.S. A credential evaluation helps you
gain recognition for your previous studies by considering your country’s education system, thestatus of the institution you attended, the content of the program, and any entry and graduation
requirements.

A credential evaluation compares theeducation you received in your country toa similar degree or diploma in the UnitedStates and provides a degree equivalency.
In the United States, employers, licensing boards, and universities use credential evaluations to judge
the quality and level of your academic achievements in comparison to U.S.-educated candidates:• Universities use the information to make admissions decisions and to award transfer credit oradvanced standing in a program.
• Employers and licensing boards refer to credential evaluations to assess whether or not you
meet their academic requirements.
Unlike many other countries, the U.S. does not have a national education ministry to evaluate
foreign degrees. As a result, some academic institutions and state licensing boards—and nearly all
employers—rely on agencies like World Education Services4 (WES) to examine official documents.
Others perform their own evaluations or use preferred agencies.
Before requesting a credential evaluation from any agency, contact the institution that needs
the evaluation to understand their requirements. These institutions are responsible for the
final recognition decision.
For nurses educated outside the United States, all U.S. State Boards of Nursing require credential
evaluation, certification, or verification as the first step in the application process. Specificrequirements differ by state. Check the Commission on Graduates of Foreign Nursing Schools(CGFNS)5 for a complete listing of the specific evaluation requirements by state.

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If you are exploring a new career, it may be helpful to have an idea of the U.S. equivalency of
your foreign credentials.
WES allows you to preview the U.S. equivalency of your highest completed degree by using
their free degree equivalency tool.6
Note: This preview does not replace a formal credential evaluation that may be needed for
official purposes.

Many regulated professions in the U.S. require you to have your foreign degree evaluation conductedby a professional association or preferred provider. If you are applying for a license or certification,
always remember to check with your state’s licensing board and/or educational institution toensure that a WES evaluation is recognized and accepted. If so, you can apply for a WES credential
evaluation.
Watch The WES Evaluation Process Explained7 video to learn more about credential
evaluation.

Advanced Standing and Transfer Credit
If you are applying to an academic program, you may be eligible for advanced standing or transfer
credit for previous education.
For internationally educated individuals, advanced standing and transfer credit is usually determinedat the time of application through a foreign credential evaluation.

GLOSSARY

Foreign credential evaluation: An expert analysis of a foreign degree or diploma.
Degree equivalency: The extent to which a degree or diploma earned abroad compares to a similar U.S. credential.
Advanced standing: This means you may be allowed to skip pre-requisites for admission into a course, or not
repeat a required course, reducing the time to complete a degree.
Transfer credit: This means that your previous education is counted toward the total number of credits required
for the degree.

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EDUCATIONAL PATHWAYS IN NURSING
Once you know the value of your foreign degree, you can use the information in this section to move
forward in your career.
Nursing is a growing and rewarding field that offers many exciting career options. In this section, youwill find some examples of nursing careers you may be qualified for, including their key roles andresponsibilities and where further education may be helpful. You will also find information on how tomeet the academic requirements for some popular nursing careers.
There are many ways to enter the nursing field. Some internationally trained nurses gain U.S.
experience in entry-level professions as they pursue licensing. Certified Nursing Assistants (CNA),
for example, only require the completion of a state-approved education program. Others begin byenrolling in degree programs to gain access to higher-level jobs.

HELPFUL TIPS
Research shows that immigrants
who add a U.S. degree or
certification to their foreign
education and training are more
likely to progress faster in theircareers.

ASSOCIATE
DEGREEA career pathway is a series of“stackable credentials”—achievementsthat build on each other based oncontinuing education, specialization,and certification to allow you to move
up a career ladder.

BACHELOR’S
DEGREEMASTER’S
DEGREEDOCTORATE
DEGREEASSOCIATE OF SCIENCE IN NURSING DEGREE (ASN)
ASSOCIATE DEGREE IN NURSING (ADN)
Registered Nurse (RN)8• Provide nursing care to patients and may offer health education and consultative services.
• Employed in hospitals, nursing homes, extended care facilities, rehabilitation centers,
doctors’ offices, clinics, community agencies, companies, and private homes, or selfemployed.

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Specializations include:• Public Health Nurse9• Pediatric Nurse10• Psychiatric Nurse11• Geriatric Nurse12
Completion of an accredited nursing program and state licensure is required.

GO FURTHER

Although RNs can find jobs with an Associate of Science in Nursing (ASN)
degree, a Bachelor of Science in Nursing (BSN) degree may increase yourchances of finding employment. There is a growing national movement torequire all nurses to hold a BSN.

BACHELOR OF SCIENCE IN NURSING DEGREE (BSN)
Registered Nurse (RN)8• Provide nursing care to patients and may offer health education and consultative services.
• Employed in hospitals, nursing homes, extended care facilities, rehabilitation centers,
doctors’ offices, clinics, community agencies, companies, and private homes, or selfemployed.
Specializations include:• Occupational Health Nurse13• Clinical Nurse Leader14• Nurse Advocate15
Completion of an accredited Nursing program and state licensure is required.

GO FURTHER

You can upgrade your education and skills to qualify for more jobs in thefield of nursing by earning a Master of Science in Nursing (MSN) degree. If
you have the equivalency of a BSN, you can also consider a Master of Public
Health (MPH) degree, a graduate degree that prepares you to work on a wide
range of public health initiatives without requiring a license.

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MASTER OF SCIENCE IN NURSING DEGREE (MSN)
Advanced Practice Registered Nurse (APRN): Nurse Anesthetist, Nurse Midwife, and Nurse
Practitioner (NP)16• Work as a licensed RN with post-graduate education in a specialized educational
background.
• Function as a primary care provider to the public.
• Responsibilities include diagnosing and treating patients with chronic illnesses andprescribing medications.
Licensure is required.

Nurse Educator17• Train the current and future generation of nurses in nursing schools, hospitals, public healthagencies, and other community settings.
• Responsible for ensuring the quality of nursing education by designing, implementing,evaluating, and reviewing academic and continuing education programs for nurses.
• The Certification for Nurse Educators (CNE) is granted by the National Commission for
Certifying Agencies (NCCA). You must already be an RN to pass this examination to become anurse educator.
Licensure is required.

Master of Public Health (MPH) Degree
In the U.S., any person with an accredited undergraduate degree may pursue
an MPH and it usually takes two years of full-time work to complete. Somestates recognize MPH holders as supportive clinical professionals (interactingwith patients) especially with regard to preventive medicine, healtheducation, and other functions in the clinical and hospital environments.

GO FURTHER

Upgrade your education and skills to qualify for more jobs in the field ofnursing by earning an advanced degree.

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DOCTOR OF NURSING PHILOSOPHY (Ph.D.)
DOCTOR OF NURSING PRACTICE (DNP)

With these advanced degrees, you can supervise nursing homes, head local
health outreach efforts, and assume oversight for hospital nursing practices.
In contrast to a nursing Ph.D., which primarily focuses on research andteaching, a DNP can advance your career on the clinical side.
Note: A Ph.D. degree is optional for some occupations but can make you
more competitive in the job market.
Nurse Researcher18• Conduct research on various aspects of healthcare and illness in order to improve the field ofnursing.
• Work is conducted in various settings, including schools, hospitals, laboratories, scientificorganizations, and private companies.
Licensure is required.

Nurse Executive19• Facilitate the design of patient care delivery, advance the discipline of nursing, build
relationships with staff and colleagues, and foster stewardship.
• Must have strong leadership and management skills, along with critical thinking, decisionmaking, and communication skills.
Licensure is required.

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Academic Requirements in Nursing
Consider these educational requirements for careers in the field of nursing, from entry-level toadvanced professions.

As the first step in the application process, all U.S. State Boards of Nursing
require nurses educated outside of the U.S. to have their credentials
evaluated. Requirements differ by state, and applicants must select either the
RN or LPN evaluation category when applying.

Requirements for

Nursing Aide
Requires no formal education and can be trained on-the-job in most states; however, mostemployers prefer hiring graduates of accredited post-secondary education programs.
Programs are accredited either through the Commission on Accreditation of Allied Health
Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES).

Requirements for

Certified Nursing Assistant (CNA)
Must earn a post-secondary certificate or award from a state certified CNA program and complete
supervised clinical work in addition to passing a state certification examination.
CNA programs are found in community colleges, vocational and technical schools, and in
hospitals and nursing homes. Some high schools also offer nursing aide programs.
In order to be admitted to CNA programs, you must have the equivalent of a high school
diploma.

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Requirements forLicensed Practical Nurse (LPN)
Must complete a state-approved training program in practical nursing or its foreign equivalentand obtain state licensure.
Note: Internationally trained RNs can get approval to take the NCLEX exam for LPNs, and somechoose that pathway as a more manageable first step.
Training programs are available from high schools, technical and vocational schools, community
and junior colleges, universities, and hospitals.
LPN programs usually take 12-18 months to complete.
Minimum education requirement for an LPN program is a high school diploma or its equivalent.

Apply to Nursing School as an Advanced Standing Student
Many U.S. nursing schools enable internationally trained nurses to receive
credit for previous education and gain advanced standing. For example,
an RN with the equivalent of an associate degree may want to obtain abachelor’s degree for better career prospects or professional advancement.
When researching schools, be sure to check with the admissions office to see
if this advanced standing can apply to you.

Search “State-approved RN Programs”20

Requirements for

Registered Nurse (RN)
Obtain an Associate Degree in Nursing (ADN) or Associate of Science in Nursing (ASN) degree(two to three years), nursing diploma (three years), or Bachelor of Science in Nursing (BSN)
degree (four years), or have a completed foreign equivalent.
Must apply for licensure through your state’s board of nursing upon completion of a stateapproved nursing program or an equivalent program abroad.
After receiving your RN license, consider taking a nursing refresher course to learn about the U.S.
healthcare system while gaining clinical experience.

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Case Study: Tsering

Tsering, an ethnic Tibetan, immigrated to the United States from India in 2009. In order tocontinue the work she had done as a nurse in her native country, Tsering enrolled in the
NCLEX-Licensed Practical Nurse (LPN) preparation course for English Language Learners
through the NYC Welcome Back Center (WBC) at LaGuardia Community College in New
York. The intensive eight-month training course integrated English language skills practicewith technical instruction, while also providing assistance filling out credential verification
applications. With this guidance, Tsering was able to obtain her New York State nursing
license, and, finally, pass the NCLEX-RN exam. She is now continuing the career she began
before immigrating and works as a full-time Registered Nurse (RN) in New York.

Requirements for

Advanced Practice Registered Nurse (APRN)
Must possess a state-issued RN license, have completed advanced training beyond anundergraduate level RN course (BSN), and hold a MSN. *varies by state
Graduate programs prepare registered nurses to become nurse practitioners, nurse midwives,
clinical nurse specialists, and certified registered nurses.
A growing number of nursing schools offer accelerated BSN and MSN programs for non-nursing
college graduates, as well as RN-to-Master of Science in Nursing (MSN) and BSN-to-Ph.D.
programs.

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LICENSING AND CERTIFICATIONREQUIREMENTS IN NURSINGThis section of the guide provides general information on licensing and helpful resources to guide
you as you move forward. Consult the National Council of State Boards of Nursing21 for up-todate information.
Licensure for Nurses
If you want to practice as a RN, LPN, or enroll in advanced nursing degree programs in the UnitedStates, you must either obtain a state-issued license or meet the prerequisites for admission.
• Licensing requirements for internationally trained nurses vary by state. Each state has a boardof nursing that regulates licenses. You can search the Nursing License Map22 for statespecific information on how to become a nurse, nurse salaries, nursing credentials, nurse
certification tests, and nursing compact agreements.
Discovernursing.com provides a step-by-step overview23 of the licensing
process of foreign-educated nurses. However, you should always consult
with your state’s board of nursing24 to learn about state-specificrequirements and steps.
• In most states, to be eligible for licensure, you must successfully pass the NCLEX examination.
•

Specific state boards of nursing require the CGFNS Certification Program in order totake the NCLEX.

• Licensing takes time. Make sure to plan sufficient time for this process.

The NCLEX is administered at test
centers throughout the United Statesand internationally. The examination
covers four areas: safe effective careenvironment, health promotion andmaintenance, psychosocial integrity,and physiological integrity. Candidates
must correctly answer a minimum of 75
multiple-choice questions.

HELPFUL TIPS
The state of California allows you
to apply for a six-month temporary
license that entitles you to work as
a nurse under supervision before
you pass the NCLEX exam.

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Interstate Licensing Agreements: Working in Other States

ND

MT

SD

ID

IA

NE
UT

AZ

ME

WI

NH
RI

CO

MO

AR

NM

KY

VA

TN

NC

MS

DE
MD
DC

SC

TX

NLC States

Source: ncsbn.org/NLC_Map.pdf

The Nurse Licensure Compact (NLC)25 is an interstate agreement that allows nurses to have one
multistate license, with the ability to practice in both their home state and other compact states. You
can obtain a compact (multistate) license as an Eligible Nurse if you:
• Legally reside in a NLC state.
• Hold an active RN or LPN/VN nursing license in good standing.
• Declare a NLC state as your primary state of residency.
Note: Advance Practice Registered Nurses (APRNs) are not included in this compact.

The information presented in this guide should not be considered exhaustive. It is always
important to consult state licensing boards and professional associations for the latest andmost authoritative guidance. See page 26 for a list of helpful resources.

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TRANSFERABLE SKILLS AND USING THEM
IN RELATED OR ALTERNATIVE CAREERS
Transferable Skills
Many immigrants find that they may not be qualified for the same job they had in their home country
because job titles and requirements in their field are different in the United States. Whether becauseof a lengthy licensing process or a need for immediate employment, they may pursue other options
that use their training and experience.

The key to finding alternative paths to a fulfilling career is to identify your skills(what you know how to do), knowledge (what you know), competencies (whatyou are good at), and aptitudes (what is easy for you to learn) that can be
useful in a related or alternative career. These transferable skills are essential
for career success and will enable you to adapt to changing circumstances,
especially when your education and experience are from another country.
As you identify your transferable skills, it can be helpful to think about the difference between hardskills and soft skills. Employers place great value on soft skills, such as your ability to communicate,lead others, organize projects, and work effectively on a team—skills you probably already use ona daily basis. You can also apply your more technical hard skills, such as computer skills, foreign
language fluency, and understanding specialized vocabulary, to a completely different career.

Are you including your transferable skills on your résumé?
Nursing professionals typically have the following skills and expertise that could beapplied to a different career:• Monitoring, assessing, and evaluating complex situations.
• Juggling multiple tasks at once.
• Keeping detailed records.
• Delegating responsibility and managing outcomes.
• Collaborating with other professionals on an interdisciplinary team.
• Managing crises.

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Related and Alternative Careers

Why Consider a Different Career?
Finding employment in a related or alternative job can:• Open doors to new career possibilities.
• Provide income while you work toward your license.
• Grow your professional network in the United States.
• Help you gain American work experience.

If you have spent many years committed to a profession, it is understandable to feel that yourcareer—just like your relationships, hobbies, and beliefs—is a key part of your identity. It is not
unusual to experience a sense of identity loss or failure at having to explore a new career path.26 In
the United States, however, going “back to school” to switch careers is quite common.
Some of the careers described in this section require additional education or training. It is possible
to find options that take only a few months, as well as more in-depth options that can take a year or
more.
Examples of Related Careers

Allied health careers27 support the fields of nursing, medicine, dentistry, and pharmacy
in the prevention, diagnosis, and treatment of patients. There are dozens of occupations
that you can explore in this category that include both technical and clinical roles. Some
examples are occupational therapist, nutritionist, medical sonographer, and laboratory
technician. Although a license or certification is usually required for these professions, thecost and length of training may be less than that needed to relicense as a nurse.

Some healthcare careers do not require you to be licensed or certified. These are ideal options forinternationally trained nurses who want to continue working in the field of healthcare, but do notwant to undergo the relicensing process, or who want to work while relicensing in the United States.

Healthcare Interpreter28• Help patients with limited English proficiency communicate with doctors, nurses, and othermedical staff.
• Requires a strong grasp of medical terminology in both languages, along with cultural
sensitivity.

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• Often self-employed.
• Minimum requirements vary by state and most states do not require certification.
• There are two national certifications for healthcare interpreters: The Certification
Commission for Healthcare Interpreters (CCHI)29 and the National Board of
Certification for Medical Interpreters (NBCMI).30

Homecare Assistant/Aide31• Assist people who are ill or disabled with activities of daily living.
• Administer medications and perform routine examinations.
• It is not necessary for a homecare assistant/aide who works in patients’ homes to havecertification. However, some employers prefer hiring certified candidates.
• A homecare aide who works for Medicare-certified home health agencies must have statecertification or pass a competency evaluation program that meets certain federal regulation
standards.
• The National Association for Home Care & Hospice32 (NAHC) certifies homecare
assistants/aides.

Medical Transcriptionist33• Record physicians’ and other healthcare workers’ recordings into written reports.
• Interpret medical terminology in preparing patients’ medical histories, discharge summaries,
and other documents.

Pharmacy Technician34• Help pharmacists dispense prescription medication to customers or healthcare professionals.
• Work in pharmacies, which can be located in grocery stores, drug stores, hospitals, andhealthcare facilities.
• A high school diploma is required to become a pharmacy technician. Training is provided
on the job, and many states require pharmacy technicians to pass an exam or a formal
education program.

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Case Study: Mohammed

When he came to the United States as a refugee from Iraq in 2015, Mohammed left behind a
successful career as a nurse in Baghdad, and assumed he would step into the sameprofession in the United States.
Once his family was settled, Mohammed hoped to quickly find work as a nurse, but therelicensing process was longer and more costly than he had anticipated. He needed
to support his family right away, and hoped to find work that would use his skills andprofessional experience.
With the help of a resettlement agency, he was able to enroll in a short medical
interpretation certification class offered by a local community college. As a medical
interpreter, he was able to use his experience in nursing and his understanding of medical
terminology to help Arabic-speaking patients communicate with their medical team. He iscurrently financially stable, making about $22 an hour, and looking forward to taking the
NCLEX examination later this year to obtain his U.S. nursing license.

Examples of Alternative Careers
Alternative careers are occupations outside of the field of healthcare in which you can use the skills
and knowledge you gained during your education and training as a nurse. Consider these types ofcareers if you are interested in exploring a different career path.

Technical Writer35• Prepare instruction manuals, how-to guides, journal articles, and other resources to clearlycommunicate complex information, such as medical information.
• Work in a variety of industries.
• A college degree is usually required, as well as experience or expertise in a specific subject.

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23

Medical Sales Representative36• Provide physicians and hospitals with information and customer service to purchase new
medical devices, products, and supplies.
• Requires the ability to make presentations and to manage a region or caseload of clients.
• Educational requirements vary and on-the-job training is usually provided.

Hospice Manager37• Provide administrative oversight for management of hospice facility and compliance with all
regulations.
• Train and coach interdisciplinary teams.
• Educational and experience requirements vary.

Health Insurance Claims Specialist38• Apply knowledge of medical terminology and diagnostic coding to process medical insurance
claims and resolve billing issues.
• A high school diploma is sufficient, but employers typically prefer to hire candidates withbachelor’s degrees.

Community Health Worker39• A trusted member of the community who serves as a liaison between community and social/health services.
• Responsibilities may include outreach, community education, informal counseling, social
support, and advocacy.
• Some employers require only a high school diploma, whereas others require a college degree.
This is not a licensed profession and on-the-job training is often provided.

GLOSSARY

Transferable skills: Skills developed in one situation or occupation that can be transferred to another context.
Professional network: Relationships and acquaintances that you stay in contact with based on professional rather
than personal connections.

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SMART GOAL WORKSHEETWhen?
Is it relevant to yourultimate vision?
Can it be done?
Who? What? Why?
Where? When?
What do you wantto achieve?

How much? How
often? How many?

SPECIFICGOAL

MEASURABLE

ACHIEVABLERELEVANTTIME-BASED

Now that you have reviewed this guide, the next step is to think about your career plan.
We recommend using Specific, Measurable, Achievable, Relevant, and Time-based (SMART) goals.
You can use this SMART goal template to help you identify your next steps.

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25

ADDITIONAL RESOURCES IN
THE FIELD OF NURSING
You can explore the following helpful resources for more information on education, employment,
licensing, and financial assistance to pursue a career in the nursing field.
Educational Resources• Nursing education programs40 includes guidelines prepared by the American Association ofColleges of Nursing (AACN). There is also information about different nursing programs basedon academic levels, bridge programs, and accelerated programs.
• The NYC Welcome Back Center41 at LaGuardia Community College (CUNY) offers a variety offree courses for international candidates. If you want to become licensed in New York State,
you can enroll in the NCLEX Preparation Course for Internationally Trained Nurses.42• The English for Health Care43 courses give a basic overview of medical terminology andhelp students who are Home Health Aides or non-clinical hospital employees in NY.
• The Acclimation of International Nurses into U.S. Nursing Practice44 course is designed
for internationally trained nurses who would like to practice in the U.S.
• The ESOL Bridge to Allied Health Careers course at LaGuardia Community College (CUNY) is
designed for immigrants who want to join the healthcare industry in NY.

Career/Employment Resources• Nurse.com45 includes a search engine for nursing jobs that addresses questions forprospective nurses in the U.S.
• National Student Nurses Association (NSNA)46 provides information for nurses on how towrite cover letters and résumés, as well as tips on how to get a job in nursing.47• NurseZone.com48 offers job interviewing tips for prospective nurses.
• Career Link49 lists employment opportunities in nursing education.
• New Careers in Nursing Career Central50 offers career tools, advice, and mentorship
opportunities.
• ExploreHealthCareers51 offers comprehensive information about a wide variety of healthcareers.
• Discover Nursing52 includes a step-by-step overview of 104 professions in the nursing field
as well as a nursing program search engine and a scholarship search function.
• Welcome Back Initiative53 helps foreign-trained health professionals re-enter their careers
in the United States. There are 10 Welcome Back Centers across the U.S.
• Resumeok.com54 provides résumés examples and templates for healthcare professionals,
including CNAs55 and medical nurses.56
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Licensing Resources• Resource Manual for International Nurses57 includes information on licensing, degree
evaluation, English proficiency, and immigration for nurses in the U.S.
• The Official Guide for Foreign-Educated Nurses58 is a guide book for foreign-educatednurses in the U.S.
• Commission on Graduates of Foreign Nursing Schools Certification59 offers information
about CGFNS certification that is required by many U.S. boards in order to take the NCLEX-RN
exam for licensing.
• Nurse Licensure Compact60 includes information about nursing licensure (RN &LPN) that is
valid in 24 states.
• Upwardly Global’s Professional Licensing Guides61 provide licensing information for
California, Illinois, Michigan, New Hampshire, and New York.
• National Council of State Nursing Boards62 provides links to all nurse aide state registries.

Financial Resources• The Office of the U.S. Department of Education provides resources for eligible non-U.S.
citizens.63

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INDEX OF REFERENCESThe Nursing Profession in the United States
1.

https://nursingassistantguides.com/what-is-a-certified-nursing-assistant-cna/

2. http://www.cgfns.org/
3.

https://www.ncsbn.org/index.htm

Gaining Recognition for Your Foreign Education
4.

http://www.wes.org/

5.

http://www.cgfns.org/support/resources/6.

https://applications.wes.org/degree-equivalency-tool/

7.

https://youtu.be/7lMmpBb1pn8

Educational Pathways in Nursing
8.

http://www.bls.gov/ooh/healthcare/registered-nurses.htm

9.

https://www.discovernursing.com/specialty/public-health-nurse#.Vz4NXvkrLcs

10. https://www.discovernursing.com/specialty/pediatric-nurse#.Vz4NjvkrLcs
11. https://www.discovernursing.com/specialty/psychiatric-nurse#.Vz4Np_krLcs
12. https://www.discovernursing.com/specialty/geriatric-nurse#.Vz4NufkrLcs
13. https://www.discovernursing.com/specialty/occupational-health-nurse
14. https://www.discovernursing.com/specialty/clinical-nurse-leader#.WXuW6YqQwUE
15. https://www.discovernursing.com/specialty/nurse-advocate
16. https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nursepractitioners.htm
17. https://www.discovernursing.com/specialty/nurse-educator#.WYDJcITyvcs
18. https://www.discovernursing.com/specialty/nurse-researcher#.WR8HVsm1sUF
19. https://www.discovernursing.com/specialty/nurse-executive#.WR8HZ8m1sUF
20. http://www.acenursing.us/accreditedprograms/programSearch.htm

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Licensing and Certification Requirements in Nursing
21. https://www.ncsbn.org/index.htm
22. https://nursinglicensemap.com
23. http://www.discovernursing.com/starting-out#.UvOiGj1dVKo
24. https://www.ncsbn.org/contact-bon.htm
25. https://www.ncsbn.org/enhanced-nlc-implementation.htm
Transferable Skills and Using Them in Related or Alternative Careers
26. http://cjcdonline.ca/wp-content/uploads/2014/11/Restoring-Hope-Responding-to-Career-Concerns-of-Immigrant-Clients1.pdf
27. https://explorehealthcareers.org/field/allied-health-professions/28. https://explorehealthcareers.org/career/allied-health-professions/health-care-interpreter/
29. http://www.healthcareinterpretercertification.org/
30. http://www.certifiedmedicalinterpreters.org/
31. https://www.bls.gov/ooh/healthcare/home-health-aides.htm
32. http://www.nahc.org/
33. https://www.bls.gov/ooh/healthcare/medical-transcriptionists.htm
34. https://www.bls.gov/ooh/healthcare/pharmacy-technicians.htm
35. https://www.bls.gov/ooh/media-and-communication/technical-writers.htm
36. https://www.verywell.com/medical-device-sales-jobs-1736209
37. http://www.topmastersinhealthcare.com/job-profiles/hospice-administrator/
38. http://education-portal.com/articles/Health_Claims_Specialist_Job_Description_and_
Requirements_for_Becoming_a_Health_Claims_Specialist.html
39. https://explorehealthcareers.org/career/allied-health-professions/community-health-worker/
Additional Resources in the Field of Nursing
40. http://www.aacn.nche.edu/Education/nurse_ed/nep_index.htm
41. http://www.laguardia.edu/nycwbc/
42. http://www.laguardia.edu/uploadedFiles/CE/Content/Career_Skills_and_Training/
Healthcare/NYC_Welcome_Back_Center/NCLEX-Preparation-Course.pdf

Pathways in Nursing | © 2017 World Education Services. All rights reserved.

2943. http://www.laguardia.edu/ciet/
44. http://learningext.com/nurses/p/acclimation_intl_nurses.aspx
45. http://www.lagcc.cuny.edu/ciet/work_description.html
46. http://www.nurse.com/jobs/browse/
47. http://www.nsna.org/
48. http://www.nsna.org/career-planning-guides.html
49. http://www.nursezone.com/Recent-Graduates/interviewing-tips.aspx
50. http://www.aacn.nche.edu/career-link
51. http://www.newcareersinnursing.org/scholars/career-central
52. http://explorehealthcareers.org/en/home
53. https://www.discovernursing.com/launch-your-nursing-career#.WSW09Ovyvcs
54. http://www.welcomebackinitiative.org/wb/index.html
55. http://www.resumeok.com/doctors-resume-samples/
56. http://www.resumeok.com/certified-nursing-assistant/
57. http://www.resumeok.com/medical-nurse-resume-example/
58. https://www.ncsbn.org/171.htm (free download)
59. http://www.springerpub.com/product/9780826110657
60. http://www.cgfns.org/
61. https://www.ncsbn.org/nlc.htm
62. http://www.upwardlyglobal.org/job-seekers/american-licensed-professions/licensed-professions-guides
63. http://www2.ed.gov/about/overview/focus/immigration-resources.html

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Our Expertise. Your Success.

wes.org
nyc@wes.org

WES Global Talent Bridge is a program dedicated to helping skilled
immigrants fully utilize their talents and education in the United States.
Global Talent Bridge joins with institutional partners and community
organizations to help skilled immigrants leverage their training, achieve theirprofessional goals, and contribute their talents to their full potential.
Global Talent Bridge provides technical assistance, staff training andspecialized resources to community organizations, adult education
programs, government agencies and academic institutions so they canbetter support, advise and integrate highly-qualified immigrants. It also
conducts research and policy advocacy efforts to advance opportunities forskilled immigrants at the local, state and national level.

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