Registered nurses are the backbone of U.S. hospitals, clinics and home-care teams. They assess patients, give medicines, coordinate treatment and educate families. For many Nigerians, nursing is a more reachable U.S. healthcare path than medicine, because you do not have to repeat a full residency if you already hold a recognized nursing qualification.
A licensed registered nurse in the United States commonly earns about $70,000 to $120,000 per year. The U.S. Bureau of Labor Statistics reported a median annual wage of $97,550 for registered nurses in May 2025. The lowest 10 percent earned less than $68,940, and the highest 10 percent earned more than $137,470. Travel nurses, intensive-care nurses and nurses in California or New York often earn more.
That median figure is for a licensed RN already working in the United States. It is not the salary of someone still waiting for NCLEX results, a VisaScreen certificate or a first state licence.
Table of Contents
- What Does a Registered Nurse Do?
- Registered Nurse Salaries in the USA
- Types of Nursing Jobs
- Where Nurses Work
- Working Hours and Conditions
- Educational Route
- Can Foreign-Trained Nurses Work in the USA?
- Step-by-step licensing path
- Visa options
- Areas with strong demand
- Factors that change pay
- Understanding a job offer
- Benefits
- Cost of the process
- Job outlook
- Recruitment scams
- Final thoughts
What Does a Registered Nurse Do?
Registered nurses provide and coordinate patient care. Their exact duties depend on the unit, but typical work includes:
- Taking vital signs and medical histories
- Performing physical assessments
- Administering medication and IV fluids
- Dressing wounds and assisting with procedures
- Monitoring patients after surgery
- Recording notes in electronic medical records
- Educating patients and families
- Coordinating with doctors, pharmacists and therapists
- Responding to emergencies and rapid-response calls
- Supervising licensed practical nurses and nursing assistants
- Following infection-control and privacy rules
Specialist nurses may also insert lines, manage ventilators, run dialysis, assist in theatre or provide mental-health care.
Patient-facing work is the core of most RN roles. The licence, not the job advert, is what allows you to do it.
Registered Nurse Salaries in the USA
Pay depends on state, specialty, shift, overtime, travel contracts and years of experience.
| Nursing role | Approximate annual income |
|---|---|
| New graduate RN | $65,000–$85,000 |
| Staff RN, medical-surgical | $75,000–$105,000 |
| Hospital staff RN (national median) | about $97,000–$100,000 |
| ICU / critical care RN | $90,000–$130,000 |
| Emergency department RN | $85,000–$125,000 |
| Operating room RN | $90,000–$130,000 |
| Labour and delivery RN | $85,000–$120,000 |
| Dialysis RN | $80,000–$115,000 |
| Psychiatric RN | $75,000–$110,000 |
| Home health RN | $75,000–$105,000 |
| Travel RN (contract, high-demand weeks) | $100,000–$160,000+ |
| Nurse manager | $100,000–$140,000 |
| Nurse practitioner (advanced practice) | $120,000–$160,000+ |
BLS industry medians for May 2025: government RNs about $110,780; hospital RNs about $100,220; ambulatory care about $91,230; nursing homes about $84,300.
California, Hawaii, Oregon, Massachusetts, Alaska, Washington and parts of New York sit at the top of the pay table. Southern and Midwestern states often pay less in dollars, but rent is also lower.
Types of Nursing Jobs
1. Medical-surgical nurse
The most common hospital role. These nurses care for adult patients after operations or with general medical conditions.
2. Intensive care / critical care nurse
ICU nurses look after unstable patients on monitors, drips and ventilators. Pay and stress are both higher.
3. Emergency nurse
ED nurses triage and treat people who arrive with injuries, chest pain, strokes, asthma attacks and trauma.
4. Operating room / peri-operative nurse
Theatre nurses prepare patients, assist the surgical team and recover patients after anaesthesia.
5. Labour and delivery / maternity nurse
These nurses support women in labour, assist births and care for newborns.
6. Paediatric nurse
Paediatric RNs treat infants and children in wards, clinics or paediatric ICUs.
7. Psychiatric / mental-health nurse
They work in hospitals, community clinics and residential facilities with patients who have mental illness or substance-use disorders.
8. Dialysis nurse
Dialysis nurses run haemodialysis or peritoneal dialysis for patients with kidney failure.
9. Home health and hospice nurse
They visit patients at home, which can mean more independence and more driving.
10. Travel nurse
Travel nurses take 8–13 week contracts where hospitals are short-staffed. Housing stipends can inflate the headline pay. The work is unstable compared with a permanent staff job.
Advanced practice (nurse practitioner, nurse anaesthetist, clinical nurse specialist) requires a master’s or doctorate and a separate licence. That is a later step, not the first U.S. job for most Nigerian RNs.
Where Nurses Work
- Public and private hospitals
- Teaching hospitals
- Outpatient clinics
- Urgent-care centres
- Nursing homes and rehabilitation facilities
- Home health agencies
- Dialysis centres
- Schools and universities
- Correctional facilities
- Veterans Affairs hospitals
- Telehealth companies
- Insurance and case-management offices
Hospitals remain the largest employer.
Working Hours and Conditions
Most hospital RNs work 12-hour shifts: 7 a.m.–7 p.m. or 7 p.m.–7 a.m. Three shifts a week is a full-time schedule, plus handover time.
Nurses may work:
- Nights
- Weekends
- Public holidays
- Overtime
- On-call rotas
The job involves lifting, long periods on your feet, infectious-disease exposure, documentation pressure and emotional load. Night and weekend differentials often add several dollars an hour.
Educational Route for U.S.-Trained Nurses
A typical U.S. path is:
- Complete an approved nursing programme (ADN or BSN)
- Graduate
- Pass the NCLEX-RN
- Obtain a state RN licence
- Start work
- Optionally complete a BSN if you started with an associate degree
- Optionally move into advanced practice later
A Bachelor of Science in Nursing (BSN) is preferred by many large hospital systems.
Can Foreign-Trained Nurses Work in the USA?
Yes, but a Nursing and Midwifery Council of Nigeria licence does not transfer automatically.
A Nigerian-trained nurse is treated as an internationally educated nurse. Before you can take a staff RN job you generally must:
- Prove your school and licence are genuine
- Meet English-language rules
- Pass the NCLEX-RN
- Obtain a state RN licence
- Obtain a VisaScreen certificate if you need an occupational visa
- Have a U.S. employer or visa path that actually lets you work
Some agencies sell “guaranteed U.S. nursing jobs.” The licence and exam still sit in front of the job.
Step 1: Confirm Your School and Licence
Your nursing school and qualification must be acceptable to the state board and to the credential reviewer (often CGFNS or a board-approved evaluator).
You will usually need:
- Nursing diploma or degree
- Official transcripts sent directly by the school
- NMCN licence verification
- Government-issued ID
- Passport bio-data page
Name mismatches on certificates delay files for months. Fix them before you pay exam fees.
Step 2: Credentials Evaluation (often CGFNS)
Most internationally educated nurses use CGFNS or a similar service for:
- Education comparability
- Licence verification
- CES professional report (required by many state boards)
Some states have their own list of approved evaluators. Check the state board of nursing you intend to apply to, not a recruiter’s flyer.
Step 3: English Language Test
Many boards and VisaScreen require an approved English exam unless you qualify for an exemption.
Common tests:
- IELTS Academic
- TOEFL iBT
- OET Nursing (accepted by some pathways)
Required scores change. Confirm the current cut-off for both the state board and VisaScreen.
Step 4: Apply for State Licensure and NCLEX Eligibility
Nursing is licensed by the state, not by one national card.
Popular first states for internationally educated nurses include New York, Texas, Illinois, North Carolina and Florida, but rules, wait times and English requirements differ.
After the board finds you eligible, you receive an Authorization to Test and book the NCLEX-RN.
NCLEX is a computer-adaptive exam of nursing knowledge and clinical judgement. A pass is mandatory. A fail means you wait and pay again.
Step 5: VisaScreen Certificate
If you need a work visa or green card in a healthcare occupation, you typically need a VisaScreen certificate from CGFNS International. It confirms:
- Education
- Licensure
- English
- NCLEX (or an accepted exam)
Employers and consulates look for this document. Start it early; verification from Nigerian schools and NMCN can be slow.
Step 6: Get a Job Offer and a Visa
A U.S. RN licence lets you be hired. It does not by itself give you the right to enter and work.
Common visa routes for nurses:
| Route | Who it fits | Reality check |
|---|---|---|
| EB-3 skilled worker green card | Many hospital-sponsored foreign nurses | Often the main long-term nurse path; PERM labour certification + immigrant visa or adjustment |
| H-1B | Some specialist or degree-required RN roles | RN is not always treated as a specialty occupation; lottery and extra fees apply; not the default nurse visa |
| TN | Not available to Nigerian citizens | Canada/Mexico only |
| F-1 then OPT | If you complete a U.S. nursing degree | Expensive; OPT is temporary |
| Family immigrant visa | If a close U.S. relative can petition | Separate from nursing credentials |
The classic agency model is: licence + NCLEX + VisaScreen + hospital sponsorship on an employment-based immigrant petition. Timelines are measured in many months, sometimes years, not weeks.
Always confirm current USCIS and State Department rules. 2025–2026 has seen extra fees, screening and country-specific restrictions that can affect interviews and entry even after a petition is approved.
Areas With Strong Demand
Nurses are needed almost everywhere, but recruitment of internationally educated nurses is strongest where hospitals cannot fill nights, ICUs and long-term care.
You may see more sponsorship talk in:
- Rural hospitals
- Midwestern systems
- Southern hospital networks
- Long-term care and rehab
- Dialysis chains
- Veterans Affairs facilities
- Inner-city safety-net hospitals
High-pay coastal cities also hire, but housing can erase the extra salary. A $115,000 job in San Francisco can feel tighter than a $90,000 job in Houston or Dallas.
Factors Affecting Nurse Salaries
Specialty. ICU, OR, ED and dialysis usually beat general medical-surgical.
Shift. Nights and weekends pay differentials.
Overtime and extra shifts. Many RNs raise income this way. It is tiring, not free money.
Union vs non-union. Some city hospitals have strong unions and step scales.
Travel vs staff. Travel pay looks higher; benefits and stability are weaker.
State. California and New York pay more. Texas and Georgia often offer better rent-to-pay ratios for new arrivals.
Experience. U.S. experience counts more than overseas years until employers trust your charting and protocols.
Understanding a U.S. Nursing Offer
Read the whole package, not the Instagram headline.
Ask:
- Is this base hourly wage or estimated total with extra shifts?
- How many hours are guaranteed?
- Night/weekend differential?
- Health insurance start date and employee share
- Relocation allowance
- Housing for the first weeks
- Who pays NCLEX, VisaScreen, attorney and filing fees
- Contract length and early-termination penalty
- Which state licence they expect
- Whether sponsorship is H-1B, EB-3 or “we will see”
Some contracts require you to repay recruitment costs if you leave early. Get that in writing and understand it before you resign in Nigeria.
Employment Benefits
A solid hospital package may include:
- Health, dental and vision insurance
- Retirement plan (401(k) with match)
- Paid time off
- Shift differentials
- Tuition support for a BSN or MSN
- Licence and certification reimbursement
- Malpractice / liability cover through the employer
- Relocation stipend
- Immigration legal support
Benefits can be worth $15,000–$25,000 a year on top of wages.
Cost of Moving as a Nigerian Nurse
Budget for the process itself, not only the plane ticket.
Typical costs include:
- CGFNS / credentials evaluation
- Licence verification from NMCN
- English test
- NCLEX registration and possible retakes
- State board application
- VisaScreen
- Medical exam and police certificates
- Visa filing fees (employer often pays some of these)
- Flights
- First month’s rent and deposit
- Winter clothes and exam travel if you sit NCLEX abroad
A realistic planning range for documents, exams and travel is often several thousand dollars before you earn the first U.S. paycheck. Agency packages that “pay everything” usually recover the cost through your contract.
Job Outlook
BLS projects registered nurse employment to grow about 6% from 2025 to 2035, faster than the average occupation, with tens of thousands of openings a year from growth and retirements.
Demand is real. A job is still not automatic. You must pass NCLEX, hold a state licence and have lawful work status.
Warning About Nursing Recruitment Scams
Walk away if someone:
- Guarantees a U.S. RN job before NCLEX
- Says your Nigerian licence is enough
- Asks you to pay for a job offer
- Operates only on WhatsApp
- Sends a contract from a Gmail address with no hospital letterhead
- Promises a green card in 60 days
- Wants your bank details or blank signed forms
- Offers fake NCLEX or IELTS results
State boards, NCLEX and USCIS do not sell shortcuts.
Final Thoughts
Registered nurses in the United States can earn around $97,550 a year at the median, and more in high-cost states, critical-care units and travel contracts. That pay is for a licensed RN, not for a candidate still collecting transcripts.
For Nigerian nurses the honest sequence is: verify credentials, pass English and NCLEX, secure a state licence, complete VisaScreen, then attach that licence to a real visa or green-card sponsorship. The shortage is genuine. The paperwork is still the job.
Check current rules on:
- Your target state board of nursing
- NCSBN / NCLEX
- CGFNS International
- USCIS
- travel.state.gov
