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Let’s Dive Into State Licensure

Once you decide you want to travel nurse to the United States, the preliminary visa document and state license are the first big steps (and can be done concurrently)!

Before You Begin

The very first thing you should do is join the community of other Canadian to U.S. nurses. We have a Facebook group, Instagram, a Youtube, and this website for tons of resources and support.

The Canadian Travel Nurses (to the U.S.A.) Facebook Group

Our Instagram

Our Youtube

The key thing with getting your first state license is to start way in advance (and you can apply for a state license at the same time as you apply for a VisaScreen or Visa4Nurses to save time).

For an article all about the VisaScreen or Visa4Nurses

CLICK HERE

For help along the way, join our facebook group and head to the many STATE CHATS CLICK HERE

State Licensure

In order to work in ANY state, you will need to be licensed in that state. This is pretty much the same in Canada. If I am licensed in Ontario, I cannot just start applying for jobs in Alberta and expect them to hire me without an Alberta license. The United States functions in a similar fashion. Thus, you need to obtain a license in the state you want to work in before you can expect to get a travel nurse contract there.

Every state has different educational and licensing requirements and processing times. It can take anywhere from 4 weeks to 6+ months depending on the state!

Most state boards of nursing (BONs) will want things like your transcripts, verification of practice (from all jurisdictions previously licensed), and many other things like fingerprints, CES report, etc.

Generally, your documents will need to be sent directly from your university and provincial college of nursing to the state BON you are applying to.

Likewise, if your nursing education was done in a language other than English, you will need to take an English proficiency test (e.g. TOEFL) and you will need to have your documents translated. For the article on English Requirements, CLICK HERE

It is ESSENTIAL to know that for your first travel nursing contract, you can only apply to states that do NOT require a Social Security Number (SSN).*

*Relocation is slightly different. The facilities involved will sponsor and it changes the impact of not having a SSN.

Warning

I would caution not to rely too heavily on recruiters or agencies. Many recruiters aren’t aware of all the states that will take Canadians without an SSN. Likewise, if you have anything unique like you are missing some educational requirement, it isn’t unusual for a recruiter to basically say you’re out of luck rather than try and figure it out. Not many recruiters are super knowledgeable about every single state and how they treat Canadians.

Take-home-message: Some recruiters/agencies don’t know the difficult issues Canadians have when applying for a state license.

LIST OF FIRST-TIME CANADIAN FRIENDLY STATES

1. Colorado

2. Connecticut

3. Idaho

4. Illinois

5. New York

6. Massachusetts

7. Minnesota

8. Michigan

9. Montana

10. New Jersey

11. Oregon

12. Pennsylvania

13. Texas

14. Virginia

15. Washington

16. Washington DC

17. Wisconsin

+ the Northern Mariana Islands

If there are any other states that do not require an SSN, please let me know!

PLEASE NOTE: States like Alaska, Arizona, California, Hawaii, and Florida are NOT Canadian-first-time-friendly as a travel nurse as they require having an American SSN in order to apply.

Timelines

Every state has its own board of nursing (BON) that issues nursing licenses and regulates the profession in that state.

The time it takes to get a nursing license depends on the state, how quickly you submit all your documentation and numerous other factors...

Many states have specific requirements for nursing education and must review your documentation. This could take months with some states. Additionally, some states want background checks and fingerprints, possible jurisprudence testing (e.g. Texas), and might be going through an insanely high volume of applications which can ultimately result in taking months to issue a state license.

Other unique issues, such as if you were educated in Quebec or internationally might mean you have to take an English proficiency exam, have your nursing documents translated, and you may still need to write the NCLEX.

TIMELINES FOR STATE LICENSES

1. Colorado (4-12 weeks)

2. Connecticut (4-8 weeks)

3. Idaho (4-12 weeks)

4. Illinois (6-12 weeks)

5. New York (streamlined 6-12 weeks or 18-24+ weeks)

6. Massachusetts (6-12 weeks)

7. Minnesota (2-8 weeks)

8. Michigan (6-8 weeks)

9. Montana (4-8 weeks)

10. New Jersey (6-12 weeks)

11. Oregon (4-12 weeks)

12. Pennsylvania (4-8 weeks)

13. Texas (4-8 weeks)

14. Virginia (4-12 weeks)

15. Washington (4-8 weeks)

16. Washington D.C. (4-12 weeks)

17. Wisconsin (4-8 weeks)

It's important to note that these time frames are estimates ONLY and can vary. Also, some states have expedited processing options available for an additional fee.

For more up-to-date times, join out facebook HERE and head to the state chats!

Branches of Eucalyptus Leaves on a Marble Background

Pros & Cons

Every state has pros and cons to travel nursing or relocating there.

Important things to take into account include the following:

State tax rates (note: some states do not charge state income tax, but you will likely owe Canada)
Ease of attaining a state licenses (e.g. education requirements met)
State licensing times
Cost of living
Weather
High pay
You location
Other (e.g. Is is a compact state? Does it require an SSN? Are there state mandated patient ratios?)

For a more in-depth step-by-step guide to getting each state license, CLICK HERE for the Canuck to Yankee Guide State Licensing Section.

*Note: You will need to create a login username and password.

HOW-TO PICK A STATE

I will use myself as an example. Do the same thing with your unique situation and circumstances.

Personally, I picked Massachusetts and New York…

State Income Tax Rates

Going through the pros and cons, we’ll start with state tax rates. Both Massachusetts and New York have higher tax rates, but also seem to have higher pay to offset these higher taxes. As a result, I figure I would probably not owe much in taxes or anything to Canada since Massachusetts and New York are nearly on par with Canadian taxes.

Ease of Attaining a State License

Next, it was easier to get an MA license than a NY license. I initially started with NY and then realized it might take 6+ months to get a license (note, this was before the new streamlined option). As a result, I panic applied to MA and got that license within about 2-3 months. For both states, I met all the education and other requirements to apply and did not have any issues.

State Licensing Times

I think I covered that above. Had I known, I probably would have just applied to MA right away and skipped NY due to the longer licensing times for NY.

Cost of Living

Both MA and NY have high costs of living. My plan for this was to look for the highest pay and then to look at the commute and housing. I opted to take contracts just outside major cities so I actually ended up saving more money because my housing wasn’t costing a fortune. For example, a contract might pay $3,000/week in NYC but the cost of living is insanely high. Whereas, a contract in Albany, NY could pay $2,700/week and the housing is significantly cheaper so you end up saving more over the course of your contract.

Weather

I was going during winter and both NY and MA had about the same weather, but it didn’t bother me. I wasn’t looking for somewhere warm. I cared more about high pay than beautiful weather.

High Pay

Boston in the winter... doesn’t sound too appetizing, right? I agree, which is why the contracts paid really well. It is hard for undesirable locations to lure nurses, so they often have to provide better pay. And MA already tends to tax high, and pays high.

Your Location

I am based in Ottawa so it made way more sense to just drive down about 5-6 hours to Boston versus applying and taking a contract somewhere like Washington or Oregon which is way too far away to drive for me.

Is It a Compact State?

Both MA and NY are NOT compact states so there is a little less competition and the pay seemed much better to try and lure nurses. For those who don’t know, a compact or multistate license is one license that will let a nurse work in about 40+ states. But it means there isn’t much competition for those states who aren’t part of the compact scheme.

Does It Require An SSN?

Neither NY or MA required a SSN.

Now, look at your own situation and ask yourself these same questions. You might need to google some of the answers (e.g. what the state income tax is like) and you can find out what the pay is like in this article (HERE) for every state.

REMINDER

There are step-by-step instructions and explanations for most of the first-time Canadian friendly states in the Canuck to Yankee Guide HERE

However, it is nearly impossible to keep up-to-date with every state, so the best place to check is the state BON and the state chats in the facebook group HERE

Education Requirements

This is another warning.

Whichever state you choose, do look into the educational requirements they have before spending your money and applying to that state.

You can typically find the educational requirements on the state’s BON website, on their verification form (that they want you to submit to your university), or you can contact them (via phone or email) and ask.

Many Canadian nurses (especially from Ontario and Alberta) have had trouble with missing courses in pediatrics, mental health, maternity, etc.

For those in this position, I HIGHLY encourage you to write a scathing letter to your provincial college of nursing as they are the ones who ultimately accredit every nursing program in the province.

Here is a sample email to send to your provincial college of nursing

(just remove the ‘CNO’ and replace it with your provincial college of nursing’s abbreviated name)

The CNO is responsible for ensuring universities and colleges in Ontario are rendering a sufficient education to their students. However, as nurses wanting to go and work in the United States, we are frequently being told we are missing an course, lab or clinical hours. Now, I realize the CNO could turn around and say, “Well, we aren’t certifying nurses for the U.S., we are certifying them for Canada.” Certainly, that is one way to look at it; but there is also another angle that we see. As students in and from Ontario universities and colleges, we paid a lot of money to be given an education that would result in us becoming nurses. When going to the United States and being told we are missing core education theory, labs or clinicals, it highlights that we attended an insufficient nursing program and a program that is not even equivalent to an American nursing program. When told we do not qualify for a state license due to missing, for example, maternity, mental health, etc. it is alarming. How can a nursing program not have a clinical in maternity? Or mental health in this day and age? What other gaps and missing coursework should we have gotten? And most importantly, who is responsible for ensuring all of these nursing programs are adequately preparing us as nurses? Nevermind in the United States, but right here at home in Canada. Finding out we are missing essential components of any nursing program from a U.S. state board is often devastating and has already resulted in a lot of costs to a nurse, but what is most jarring is finding out we nurses paid out a lot of money, put in a lot of hours and trusted the universities, colleges and the CNO to deliver a holistic, comprehensive nursing program. Hearing from U.S. states that there are gaps in our education is a slap in the face for all the work we did and money we paid in our programs and yet we are being told these nursing programs are inadequate and have left us with gaps in our knowledge in areas like mental health, maternity, etc..

P.S. Similarly, as the CNO is mainly responsible to the public, this is a certainly an important patient safety issue. For example, what if a nurse ends up going into a maternity position after graduating but has never actually had a maternity clinical in their nursing program. This is gross negligence on the part of the nursing program and the CNO who certify and approve them in the province of Ontario.

Other Requirements

Criminal/Background Check & Fingerprints

One concern could be if you have any sort of prior conviction or criminal issue on your record.

They will be a look into your criminal history in Canada by the RCMP typically.

You can often order a fingerprint card and pay the related fees, then have your fingerprints taken at a local law enforcement agency. The state you are applying to should outline what they require for fingerprinting.

Testing

Some states like Texas have a jurisprudence test and many other states like New York require two short courses on things like human trafficking.

Affidavit

How some states decide to handle us Canadians coming without a Social Security Number is with an affidavit.

Basically, you fill out and mail in this form to the state BON and in the form you attest that you do not have an SSN and cannot get one currently; but as soon as you do get one, you pinky promise you will get it notarized (or just emailed or sent in depending on what the state BON wants) to the state BON.

State Q&A

What is the meaning behind ‘endorsement’ or ‘examination’?

Usually there is some definition or criteria for each state when they use these terms.

I think a lot of Canadian nurses get confused because they think, ‘I already have the NCLEX so I shouldn’t have to take it again, so it must be by endorsement then’.

This is not really how it often works.

Many state BONs want to know, do you already have the NCLEX and are licensed in another state? If so, apply by endorsement. However, they will then immediately ask, which state you are licensed in so they can look you up on Nursys or something.

Well... We aren’t licensed in another state if this is your first American state license. Then you’d apply by examination.

Typically, you will either need to get a hold of your NCLEX info or your provincial college of nursing in the province where you took the NCLEX will have a section they fill out on the verification form that they send in to the state BON. Most verification forms ask a bunch of info about the NCLEX.

Once the state BON has processed your document from your provincial college of nursing, they typically waive the NCLEX requirement now that they see you already took it and passed.

What is ‘NURSYS’

Check it out on google!

It is basically a ‘find a nurse’ type of online website but you can find a nurse in almost every state!

The link to NURSYS is HERE

Once licensed in a U.S. state, take a look and see if you are on the NURSYS website too.

Some state BONs will want you to forward your information from NURSYS onto them.

On the website, there is an option for ”Nurse Licensure Verification for Endorsement” where you can send your license information to a board of nursing when applying for licensure in a new state or U.S. territory.