For Canadian Nurses Travelling to the USA
Select Medical Connections is Canada's leading nursing and healthcare professional recruitment firm. Since 2000, we have been connecting Canadian nurses and healthcare professionals to their dream jobs in the USA, whether permanent or temporary, and answering their questions surrounding working conditions, licensing, the NCLEX, work visas, etc.
View a current listing of permanent and travel nursing jobs available in the USA.
Where do we go from here?
A move to the USA or abroad is a big decision, and we encourage you to inform yourself as much as possible. We will be glad to answer any of your questions and support you throughout the process. To begin your journey, read more about Select's application, placement services and recruitment processes, and about working and living in the USA:
Working Conditions
Process for Exams, Licenses, Work Visas
USA Relocation Resources
We look forward to working with you and assisting you in your move. Contact us with any questions you have, and to begin the application process.
Working Conditions in the USA
Contracts: If you are seeking a permanent position as a nurse or healthcare professional, your contract will be with the specific hospital that has offered you a position. Typically, these contracts are for one year, and can be extended indefinitely. Select will help negotiate your contract, but we need to know what your expectations are for positions, wages, benefits and schedules before you talk with the hospital. We will let you know if your expectations are in line with that hospital's current guidelines.
If you are seeking a traveling nurse position, your contract will be with the travel company. Wages and benefits vary based on location and type of contract. Typical assignments last 13 or 26 weeks.
Shifts: The positions available with most hospitals are either evening or night shifts. The length of time before a day shift becomes available varies from hospital to hospital, and department to department. Shifts are either 8, 10 or 12 hours, depending on the department.
Relocation Bonus: Some hospitals offer relocation bonuses and some do not. Bonuses are paid once you arrive in the USA, typically with your first paycheque. Most bonuses are paid based upon the receipts the hospital receives, and can cover everything from flights and hotels to moving companies and mileage. Each hospital has a different program, which will be explained to you by your Select Recruiter when reviewing your offer of employment.
Sign on Bonus: Some hospitals offer sign on bonuses and some do not. Typically the bonus is paid over a period of time, usually 1 or 2 years. Many hospitals are using their sign on bonus as a retention bonus or bonus to their nurses willing to work the night shifts, or for nurses with specialty backgrounds. Each hospital's program will be different, depending on its particular needs. Your Select Recruiter will be able to give you the details when he/she is presenting the job opportunity to you.
Salary: Salaries in the USA are based on the cost of living of a particular city and suburb within that city. The lower the cost of living, the lower the wage is likely to be. If you are offered a high wage, the cost of living is probably equally as high. For example, a starting salary for a new grad nurse in San Francisco can be $35 US per hour. At the same time, a one-bedroom apartment will cost you approximately $2000 US per month. The same position in a rural community could be $17 US per hour with rental accommodation costing approximately $500 US per month. In addition to your base hourly wage, you will be paid extra differentials for evening, night and weekend shifts. You can also receive extra differentials for having a BSN and other certification.
Benefits: Most hospitals have excellent health benefit packages. These include health insurance for you and your family, dental insurance, disability and liability insurances. Generally, their benefits work like the Canadian extended benefits package: you pay a deductible, and then the employer pays 80% of everything after that. We ask that you enquire about the benefits package during your interviews with the hospitals, as each hospital offers a different package. Many offer a "cafeteria" type plan, which allows you to pick and choose benefits which are most appropriate to your particular healthcare and financial needs.
Vacation and Sick Time: Standard vacation time is two weeks for most USA hospitals. Many have programs where you are able to combine your sick time, holiday time and vacation time into a PAID TIME OFF program. Ask your Select Recruiter for details surrounding your particular employment offer.
Continuing Education & Tuition Reimbursement: Most USA hospitals have tuition reimbursement programs, which allow you to continue your university education to enhance your nursing skills. In addition, there are extensive paid continuing education programs offered within the hospitals which allow nurses to complete such courses as their ACLS, TNCC, IV certification, specialty training, etc.
Houses, Assets, Investments: If you have any assets or investments in Canada, you should speak with an accountant who is well versed in international accounting rules.
Taxes: Taxes are much lower in the USA than Canada, so you will see more of your take home wage (most Canadians experience a 20 to 30% gain in their take home pay). There are now tax treaties between the USA and Canada to ensure you do not have to pay taxes in both countries. Please contact your accountant or Revenue Canada about living and working abroad and your tax status in Canada. Visit www.cra-arc.gc.ca to learn more.
CPP: You cannot contribute to the Canada Pension Plan (CPP) while you are in the USA, but what you have contributed will be held for you and you can resume contributions when you return to Canada. If you decide to remain in the USA indefinitely, you can apply for CPP from the US when you reach 65 years of age.
Personal Belongings: Taking your personal belongings to the USA is relatively easy. All items need to be itemized and the boxes labeled. You present the itemized list at the border, or provide it to the moving company who will transport your goods. USA Customs wants to ensure you will not be selling any goods while in the USA, but importing your personal belongings is not a problem.
Cars: You will need a car, no matter where you go in the USA, especially if you are a travelling nurse. Most USA cities do not have an extensive transit system. If you are planning on taking your car from Canada, ask your Select Recruiter to provide information regarding emission and safety standard compliance letters. If you have a leased car, you may have difficulties taking it out of the country. Ask your leasing company and inquire about switching to financing.
Housing: Rental housing prices vary across the USA. One can rent a 1-bedroom apartment in a rural community for as low as $350 US a month. In major cities, that same apartment can rent for upwards of $2000 US a month. Your Select Recruiter will assist you in finding the appropriate type of housing, based on your specific requirements.
Credit: In order to establish credit in the USA, you should bring a copy of your credit history in Canada. This is typically available through your local bank, or by application to Equifax (www.equifax.ca, a national credit information company). Equifax will issue a free copy of your credit report to you, upon receipt of your application and two pieces of identification. USA credit agencies do not look outside of their own country. You will need to provide your credit history when applying for any type of loan or credit card, or even to rent an apartment.
Finances: You should have the equivalent of 3 month's salary saved in order to facilitate your transition to the USA.
Process for Working in the USA
FREE NCLEX, LICENSE AND VISA SCREEN ASSISTANCE!
Contact Us today to learn more!
Licensing: To work as a Registered Nurse in the USA, you must be licensed in the state in which you plan to practice. Initial licensure in a state is awarded by receiving a passing grade on the National Council License Examination for Registered Nurses (NCLEX-RN®). Once a nurse passes the NCLEX, and is licensed in a state, he/she may apply to other states through a process known as endorsement.
While there are a few states which still accept the Canadian license via reciprocity, new work visa legislation requires a passing grade on either the NCLEX or CGFNS exam. There are several courses and programs available to help you prepare for the NCLEX or CGFNS exam. Please contact us for free information and a list of current resources. Our Select Recruiters are happy to share up-to-date feedback and tips on preparing for these exams.
About the NCLEX: The NCLEX is designed to make sure that each nurse has the knowledge to practice safely at a minimum of an entry-level Registered Nurse. Many nursing schools in other countries have examinations that are knowledge-based, testing nurses on the facts they have learned. The NCLEX, however, is an application-based examination. The NCLEX examination, administered via Computerized Adaptive Testing (CAT), uses standard multiple-choice questions. With CAT, each candidate's test is unique: It is assembled interactively as the individual is tested. As the candidate answers each question, the computer calculates a competence estimate based on all earlier answers. CAT provides greater measurement efficiency, because it administers only those questions which will offer the best measurement of the candidate's competence. For more information on writing the NCLEX, visit the National Council of State Boards Web site at www.ncsbn.org. The great news is that you can now write the NCLEX in Canada!
Work Visas & the TN (Treaty NAFTA) Work Permit: To enter the USA as a Registered Nurse, provisions under the North America Free Trade Agreement (NAFTA) allow you to enter with a letter of employment from a US hospital or employer. To be eligible, you must be a Canadian Citizen, and show proof of employment, a license to practice as a RN in the USA, and proof of your nursing education. You will receive a TN work visa (Treaty NAFTA), which is in effect for up to one year, and allows multiple entries into the USA. Your spouse and minor aged children can enter the USA as your dependents and receive a visa, but they will not be allowed to work. Children under 21 can enter as your dependents and attend school or university. There are many other professions under NAFTA where your spouse may be eligible for hjs/her own work visa, so please ask your Select Recruiter for details. If you are bringing your spouse with you, you must be legally married.
If you are a Landed Immigrant in Canada and wish to work in the USA, please contact us to learn more about this process. Many of our client hospitals are happy to sponsor you.
New Immigration Regulations: The USA Bureau of Citizenship and Immigration Services of the Department of Homeland Security issued a final ruling on July 25, 2003 entitled "Certificates for Certain Healthcare Workers". Foreign healthcare workers, such a Canadian nurse seeking temporary admission to the USA, will now be obliged to observe the new certification requirements. The requirements apply to the Treaty National (TN) visa, available to Canadian nationals under the North American Free Trade Agreement (NAFTA).
Certification will now require foreign healthcare workers to submit a Visa Screen certificate. Visa Screen certificates can be acquired from the Commission on Graduates of Foreign Nursing Schools (CGFNS), or an equivalent independent credentialing organization approved by the Attorney General, in consultation with the Secretary of the Department of Health and Human Services.
The Visa Screen certificate is comprised of four parts:
- an educational review,
- a licensure review,
- an English language proficiency assessment (graduates from an educational institution in Canada, except Quebec, are exempted) and,
- a CGFNS certificate or a passing score in the National Council Licensure Examination for Registered Nurses (NCLEX-RN).
For more information, guidance and applications for licensure, NCLEX, Visa Screen and the TN work visa, please contact us. Select Medical Connections offers a FREE licensing and documentation service to all candidates we place. Speak with one of our Select Recruiters to learn more.
USA Relocation Resources
City Information
Moving Companies
Airline Reservations
Travel Insurance
US Nursing Associations
Credit Reports
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