How to work in the USA as a Canadian nurse

If you’re a Canadian nurse thinking about working in the United States, the good news is that it’s easier than for other international nurses, thanks to dedicated visa pathways, comparable nursing standards and the geographical proximity of both countries.

Canadian registered nurses (RNs) are in demand across the country, and hospitals are actively hiring international talent to fill ongoing workforce shortages. With the right licence, visa and support, you can take your nursing career further and build a rewarding life in the United States.

At Espirita, we help nurses from across the world navigate the journey of relocating to the USA. If you’re ready to explore opportunities in the United States, register today to learn about US roles.

Can Canadian nurses work in the US? 

Yes, you can work in the United States as a Canadian nurse. Canadian RNs are generally recognised across the country because nursing education standards in Canada are comparable with those in the United States. Espirita regularly works with hospitals in states such as Colorado, Kansas, New York, Alaska and Texas to place Canadian RNs in full-time, permanent roles.

Canadian registered nurses typically qualify for one of two immigration pathways: 

• TN visa 
• EB-3 immigrant visa 

Once you’ve obtained your state nursing licence and the correct visa, you can begin work as a full-time RN. 

Is the Canadian NCLEX-RN accepted in the United States? 

Yes, the NCLEX-RN exam in Canada is the same exam used in the United States. If you’ve passed the NCLEX in Canada, you can transfer your exam results to your chosen state board of nursing. There’s no need to retake the exam unless your circumstances are unusual. 

If you haven’t passed the NCLEX yet, you must take it before you can obtain RN licensure in the United States. 

At Espirita, we support you through the entire credentialing and licensing process. This includes your credentials evaluation and state licensure application, helping you gather the right documents, meet requirements and avoid unnecessary delays so you can transition smoothly into working in the United States.

How to work in the United States as a Canadian nurse

1. Complete a credential evaluation

Most state boards require an evaluation from TruMerit (formerly CGFNS) to verify your education and credentials. This report confirms that your Canadian nursing education meets US standards.

You’ll usually need:

• Transcripts from your nursing school
• Verification of your RN registration and good standing
• A full professional history from your regulatory body

TruMerit evaluation can take several weeks, so it’s best to start early.

2. Apply for licensure in a US state

Once your credential evaluation is in progress, you can apply for licensure in the state where you plan to work. Application steps vary, but generally include:

• Completing your licensing application
• Submitting fingerprints
• Completing a criminal background check
• Providing proof of NCLEX results
• Processing times vary by state and can take anywhere from a few weeks to several months.

We have in-depth guides for the registration process with nursing boards in Kansas, Texas, New York and Alaska. When relocating with Espirita, we’ll help you through the licensure process to avoid unnecessary delays.

3. Secure your visa

Canadian nurses usually apply for one of two visas:

TN visa

• For Canadian and Mexican citizens only
• Fast and straightforward
• Can be issued at a US port of entry
• Valid for up to three years and renewable

EB-3 immigrant visa

• Long-term sponsorship route
• Leads to permanent residency (green card)
• Allows family sponsorship for eligible dependents

Espirita supports nurses through both visa routes. We recommend the best option based on your circumstances, qualifications and long-term goals. Our team, alongside experienced immigration lawyers, guides you through the visa process from start to finish, providing personalised support to help you navigate requirements with confidence.

4. Find a role

With Espirita your job search begins as soon as your credentialing is underway. We help you fast-track the process, so you’re ready to move quickly once your licence and visa are approved.

We work with leading US hospitals that offer competitive salaries, strong benefits and supportive onboarding programmes. Relocation support, travel assistance and settling-in guidance are all part of your experience with Espirita.

5. Relocate to the USA

Once your licence and visa are approved, you’ll be ready to make the move to the United States. Espirita is here to ensure your transition is as smooth and stress-free as possible. From a warm meet and greet at the airport to pairing you with a dedicated buddy for cultural and pastoral support, you’ll feel supported from day one. We also provide helpful guidance to get you settled into your new surroundings, along with regular check-ins to make sure everything is going well as you adjust to life and work in the US.

Licensure pathways by state

Every state has its own licensing rules. There are a few states that offer a more streamlined process while others have additional requirements, such as verification of credentials and review of course transcripts.

Choosing a state with fewer registration requirements can reduce the time it takes to get your licence and ultimately move. If you’re set on a particular state or interested in a specific role in a state that has a longer licensure process, don’t let it put you off. With the support from Espirita’s credentialing and licensure experts, your licensure application is dealt with efficiently and competently.

States with streamlined processes for Canadian nurses

These states tend to have efficient application processes and are generally familiar with Canadian nursing education, helping reduce delays:

• Arizona
• Texas
• Washington
• New York
• Michigan

These are popular choices for Canadian nurses because they offer predictable processing and strong employment opportunities.

States requiring full TruMerit credential verification

In the states below, a full Credentials Evaluation Service (CES) report is commonly required to verify your education before licensure:

• Florida
• Minnesota
• Nevada
• Pennsylvania
• North Carolina

States with additional requirements

Some states take a more detailed approach to evaluating nursing education and may request additional documentation:

• California (case‑by‑case education review)
• Montana
• Oregon

Applicants may be asked for course descriptions, clinical hour breakdowns or additional verification.

Working in eNLC states

The eNLC (enhanced Nurse Licensure Compact) allows US nurses to work across multiple states with one licence.

Canadian nurses on non-immigrant visas aren’t usually eligible for compact licensure as eligibility depends on having a primary state of residence in an eNLC state and the legal right to live there permanently. You can still work in any eNLC state by applying for that state’s individual licence.

Which US states accept Canadian nursing qualifications?

Most US states accept Canadian nursing qualifications as Canadian RN education is widely recognised and aligned with US standards. However, some states have more thorough credentialing and evaluation processes than others, which can affect how quickly you’re able to obtain licensure.

For example, California is known for its detailed, case-by-case review of nursing education and may require additional coursework or clinical training before granting a licence.

As requirements can vary and change over time, it’s always important to check the latest guidance from your chosen state board of nursing.

How long the process takes

Overall timelines can vary depending on your chosen state and visa route. The TN visa is typically the fastest option, allowing you to begin working as soon as your licence is approved. The EB-3 visa takes longer but provides a permanent residency pathway which may be preferable for long-term plans.

Working with Espirita helps streamline the process, as key steps like job placement and preparation for relocation can begin while your credentialing and licensing are still in progress.

Here’s an overview of how long each step takes on average:

Step	Typical timeframe
TruMerit CES evaluation	4–12 weeks
State licence application	4–12 weeks
NCLEX scheduling and preparation (if needed)	Varies
VisaScreen (if needed)	3–6 months
TN visa	Same day at border
EB-3 visa	Several months or longer
Job placement	A few weeks

Costs you should expect as a Canadian nurse

In total, professional and licensing costs typically range from USD 1,600 to 2,100, depending on the state and your individual circumstances. When factoring in additional expenses such as travel, accommodation and settling in, the overall cost can be significantly higher.

When relocating with Espirita, we cover key costs for you, helping to reduce the financial burden. We go further than many other international nursing agencies, covering your travel to the USA, visa costs and licensure fees. Learn more about benefits and rewards for US relocation with Espirita.

Here’s an overview of costs associated with the documentation required for relocation:

Item	Cost
TruMerit CES evaluation	Licence renewal
VisaScreen	Around USD 740
State licence application	USD 100–375
Fingerprinting	USD 50–100
NCLEX (if required)	USD 200
Licence renewal	USD 50–200

If you’re interested to understand overall cost better, check out our article on the cost of moving to the USA as a nurse.

Common relocation mistakes and how to avoid them

Here are some issues that slow down the process for many nurses: 

• Choosing a state with long wait times when faster options exist 
• Waiting too long to order transcripts 
• Assuming you must retake the NCLEX 
• Accepting job offers without proper visa support 
• Underestimating differences in documentation and workflow 
• Not preparing for fingerprinting and background checks 

With Espirita’s guidance, you can avoid these common delays. Our team helps you choose the right state and stay on top of documentation requirements, navigating each step of the process with clarity.  

We also present you with roles that align with your experience, preferences and long-term goals, so you can move forward as efficiently and smoothly as possible. 

Professional differences to prepare for

 Working in a US hospital might feel different from what you’re used to. Some differences Canadian nurses have noted include:

• Larger and more complex record keeping systems
• Faster-paced environments with varying patient ratios
• Greater emphasis on documentation and metrics
• Shorter or more structured breaks
• Shorter orientation periods

Espirita prepares you with cultural training and practical expectations so you feel ready from day one.

Living in the United States as a Canadian nurse

Relocating to the United States offers Canadian nurses the opportunity to experience a new lifestyle while benefiting from strong earning potential and a wide range of living options.

While the two countries share many cultural similarities, there are some key differences in salary, job availability and cost of living to consider.

Salary and earning potential

One of the main benefits of working in the USA is higher earning potential. Nursing salaries are typically higher than in Canada, supported by strong demand and a competitive healthcare market. In some states, the absence of income tax can also increase your overall take-home pay.

Demand and job opportunities

The United States is experiencing a nationwide nursing shortage, creating strong demand for qualified nurses. This can lead to:

• A wide range of job opportunities across the best US states for Canadian nurses
• Greater flexibility in choosing your preferred location and specialty
• More opportunities for career progression and development 

 Cost of living and financial considerations 

While salaries are often higher, the cost of living can vary depending on where you choose to live. 

1. Some states offer a lower cost of living and more affordable housing  
2. Major cities may have higher expenses despite higher salaries  
3. State taxes and living costs can impact your overall take-home pay  

This means your overall financial position will depend on both your salary and your chosen location.

Quality of life

Both Canada and the United States offer a very good quality of life. While higher salaries are a relocation driver, many Canadian RNs are motivated to move by other factors too – living in a warmer climate, experiencing US culture or being in or close to metropolitan areas with iconic sights.

You can learn more about the differences between nursing in Canada and the United States in this guide.

Eligibility checklist

You’re ready to get started if you: 

• Hold a valid Canadian RN licence 

• Have passed the NCLEX or plan to take it 
• Completed your education in English or can prove proficiency 
• Hold a valid passport 
• Can complete a background check 
• Are ready to relocate for a full-time role 

Espirita can support you, even if you don’t meet all these criteria yet. Simply register your interest and our recruitment team will be in touch to discuss your application. 

Register for US opportunities

Frequently asked questions