After months, or sometimes years, of licensing, credentialing, immigration paperwork, interviews, and planning, you have finally arrived in the United States to begin your new nursing career.
It is an exciting milestone, but those first few weeks can also feel overwhelming. You are not only starting a new job. You may also be adjusting to a new country, healthcare system, home, community, and way of life all at once.
Knowing what to prioritize can make the transition much easier. Here is a practical checklist for your first 30 days in the U.S. as an international nurse.
Before You Arrive: Keep Important Documents With You
Before you even board your flight, make sure your most important documents are organized and easily accessible. Do not pack essential immigration or employment documents in your checked luggage.
Depending on your individual situation, you may need access to documents such as:
- Passport
- Visa or immigration documentation
- VisaScreen Certificate, if applicable
- Nursing license information
- Employment offer or verification letter
- Educational and credential documents
- Housing information
- Employer and recruiter contact information
- Copies of important personal records
It is also a good idea to keep digital copies of important documents stored securely in case you need to access them quickly.
Days 1–3: Get Settled
Your first few days do not need to be spent completing every item on your to-do list.
Start with the essentials.
Make sure you know how you will get to work, where you can purchase groceries and household necessities, and how to contact your employer or recruiter if you need assistance.
If you are staying in temporary housing, familiarize yourself with the area and begin thinking about what you will need when transitioning into longer-term accommodations.
You may also need some time to recover from travel and adjust to a new time zone, climate, or environment. Give yourself an opportunity to get oriented before your first day of work.
Week 1: Apply for Your Social Security Number
A Social Security number, or SSN, is an important part of establishing yourself in the United States. It is commonly needed for employment, taxes, banking, credit, and many other financial and administrative processes.
Eligible international nurses should determine when and how they can apply for an SSN based on their immigration status.
Once you receive your Social Security card, keep it somewhere secure. You generally should not carry the physical card with you every day.
Set Up a U.S. Bank Account
Opening a U.S. bank account will make it easier to receive your paycheck through direct deposit, pay bills, and manage everyday expenses.
Requirements can vary between financial institutions, so check what documentation you will need before visiting a bank or credit union.
You may be asked to provide items such as identification, proof of address, immigration documentation, employment information, or your Social Security number.
Once your account is established, you can provide your employer with the appropriate information for direct deposit.
Get a U.S. Phone Number
Having a U.S. phone number can make everything from communicating with your employer to setting up accounts and scheduling appointments easier.
Compare mobile plans based on your expected usage and budget. If you are bringing a phone from another country, confirm that it is unlocked and compatible with your chosen U.S. carrier.
Remember to update your employer, recruiter, bank, and other important contacts once you have your new number.
Plan Your Transportation
Transportation can look very different depending on where you are relocating.
Some U.S. cities have extensive public transportation systems, while others are much easier to navigate with a car. Before starting work, make sure you know exactly how you will get to and from the hospital, including for early morning, overnight, weekend, or holiday shifts.
If you plan to drive, research your state’s requirements for obtaining a driver’s license and registering or insuring a vehicle.
Do not wait until the morning of your first shift to test your commute. Try the route ahead of time so you know how long it takes and where you need to park.
Prepare for Hospital Orientation
Your first days as a nurse in the U.S. will likely include hospital and unit-specific orientation.
You may complete employment paperwork, review hospital policies, learn the electronic medical record system, complete required education modules, receive your badge, tour the facility, and begin clinical orientation.
Even experienced nurses may find that certain processes are different from what they are accustomed to.
Ask questions when something is unfamiliar. Learning a new hospital’s procedures, documentation standards, communication style, and workflow takes time.
Starting a U.S. nursing position is an adjustment, not a test of how quickly you can know everything.
Understand Your Paycheck
Your first U.S. paycheck may look different from what you are used to.
Your hourly rate or salary is your gross pay, meaning your earnings before deductions. Your take-home pay will be lower after applicable taxes, insurance premiums, retirement contributions, and other deductions.
Depending on your position, you may also receive additional compensation for working nights, weekends, holidays, overtime, or other qualifying shifts.
When you receive your first pay statement, review it carefully. Make sure your hours and applicable differentials are reflected correctly, and ask your employer’s payroll or human resources department if you do not understand a deduction.
Learn About Your Employee Benefits
During onboarding, you may be given several benefit options and deadlines.
Depending on your employer, benefits may include:
- Medical insurance
- Dental and vision coverage
- Retirement plans
- Paid time off
- Life insurance
- Disability coverage
- Employee assistance programs
- Tuition or continuing education benefits
Pay close attention to enrollment deadlines. Some benefits may require you to make selections within a specific period after your employment begins.
Begin Establishing U.S. Credit
New arrivals to the United States may have little or no U.S. credit history, even if they had excellent credit in their home country.
Building credit takes time, so do not be discouraged if you initially have limited options.
Paying bills on time, keeping balances manageable, and using credit responsibly can help establish your credit history over time.
Good credit can eventually make it easier to rent an apartment, finance a vehicle, obtain certain credit cards, and qualify for other financial products.
Find Longer-Term Housing
If you arrived in temporary accommodations, you may spend part of your first month looking for a permanent home.
Consider more than just the monthly rent. Think about:
- Distance from the hospital
- Commute time
- Parking
- Neighborhood
- Utilities
- Laundry
- Public transportation
- Lease length
- Upfront deposits and fees
If possible, explore the neighborhood in person before signing a lease.
International nurses without an established U.S. credit history may also encounter different rental requirements, so ask the property manager what documentation they accept.
Take Care of the Everyday Details
There are many small tasks involved in establishing a new life that may not feel urgent during your first few days.
Over the course of your first month, you may need to work on things such as obtaining a state ID or driver’s license, arranging insurance, setting up utilities, learning where to shop, finding healthcare providers, and updating your address with appropriate organizations.
You do not need to accomplish everything during your first week. Prioritize the things necessary for your employment, housing, transportation, and finances first.
Give Yourself Time to Adjust
Relocating internationally is about more than paperwork.
You may be excited about your new career while simultaneously missing your family, friends, food, routines, and community back home. That is a lot of change to experience at once.
Look for ways to build a routine outside of work. Explore your new city, connect with coworkers, find community groups, continue hobbies you enjoyed at home, and stay connected with the people who matter to you.
Your new city may not feel like home immediately. Becoming comfortable in a new environment takes time.
Your First 30 Days Checklist
By the end of your first month, you may have completed or started working on many of the following:
✓ Settled into temporary or permanent housing
✓ Applied for or received your Social Security number, if applicable
✓ Opened a U.S. bank account
✓ Established a U.S. phone number
✓ Confirmed reliable transportation to work
✓ Completed employer and hospital orientation
✓ Started clinical or unit orientation
✓ Reviewed your first paycheck and deductions
✓ Enrolled in applicable employee benefits
✓ Begun establishing U.S. credit
✓ Researched driver’s license or state ID requirements
✓ Started establishing a routine in your new community
Remember that everyone’s timeline is different. Some steps may happen immediately, while others may take several weeks or longer.
Starting Your U.S. Nursing Journey With All Med Search
Moving to another country to continue your nursing career is a major accomplishment. The process does not end when you receive a job offer or board your flight. Starting your new life in the United States is another important part of the journey.
At All Med Search, we understand that international recruitment involves much more than matching a nurse with a hospital. Our team works with nurses throughout the recruitment process as they prepare for their next career opportunity in the United States.
Whether you are just beginning to explore U.S. nursing opportunities or preparing for your upcoming move, All Med Search is here to help you take the next step.
Ready to explore nursing opportunities in the United States? Connect with All Med Search to learn more about available positions and the recruitment process.