Toying with the idea of changing your job is easy. The hard part?  Selecting a new job. And choosing a new career opportunity in another country is a highly complex decision, with challenges on many levels. It deserves your time and energy to research and weigh options because it will have lasting consequences—the choice you make between direct hire or contract placement will affect your US experience and shape your nursing career. 

Generally, having options is a good thing, but we all know it can make decision-making more difficult. You may struggle with which option to choose, and the process can be overwhelming, stressful, and frustrating. These are actually good signs, as they demonstrate your understanding of the magnitude of the task before you and your respect for the effort required to get it right. The truth is that you’re not alone—we all struggle with making decisions when the stakes are high. The key is to reclaim your balance by translating fear into power and funneling it into an action plan. So, let’s do just that, and see where it takes us.

Ask Yourself Effective Questions

With all decisions in life, it helps to be very clear on what you want and why you want it.  Start with the basics: What do you want from your US experience? What is personal and professional fulfillment to you? Then, as you answer these questions, prioritize your answers and values, and use them as a guide.

Every question is worth exploring. However, it’s essential to focus on what is most meaningful to you. For inspiration, here are some examples to get you started.


  • Why do you want to move to the US? 
  • What do you want from your experience? 
  • Do you want to live in an urban or rural location? 
  • Do you want high-cost or low-cost living? 
  • What kind of climate do you prefer? 
  • What do you like to do in your spare time? 
  • Do you want a guaranteed location or the possibility of moving between states? 
  • Are there other things that are important to you? 


  • What are your career goals? 
  • Do you want a permanent staff position or a temporary job assignment? 
  • Do you want to get on a career path as soon as possible?
  • Is the healthcare facility’s culture influential? 
  • In a compensation package, what benefits are important to you? 
  • What is your vision of career advancement? 
  • Do you want professional development opportunities and continuing education? 
  • What other career aspirations do you have? 

As you read these questions, you’ll think of some of your own. Write them down. Be curious. The more you play with this, the clearer your preferences will become.  

When you’re satisfied with your list, put it down for at least two days before reviewing it again. Tweak it if you like. How does it resonate with you now? If in doubt, leave it for another few days, or a week, or several weeks. This process is a marathon, not a sprint, and taking as much time as you need will help you be more comfortable with your decision.

As you review your answers, identify the negotiables and the non-negotiables. Then speak to as many recruiters as possible and gather information. Finally, make comparisons based on your preferences and basics, such as compensation packages, out-of-pocket costs, including health insurance coverage, career development opportunities, and job locations. These comparisons will empower your decision-making. 

Keep Your Priorities in Mind

Prepare for job interviews with your priorities in mind. Draft a list of questions to help assess whether the opportunity is a good fit for you personally and professionally. And don’t be afraid to ask your interviewers any questions that will help with your decision-making.  

After the interview, ask yourself more questions. For example, if it’s a direct-hire position, can you see yourself at this facility, working with this manager, living in this city or town? Do you see career advancement opportunities with this employer? And if it’s a contract assignment, can you see yourself with this agency, working with this recruiter? Are you open to the agency’s placement process? In general, does the opportunity feel like a good fit for you, and are you agreeable to the terms and conditions of employment? And is there anything else you need to consider to ensure that the opportunity aligns with your values?

The Power Lies with You

Decision-making is a process. It takes time to gather information, analyze it, and apply it to your situation. You want to translate your goals into the closest reality possible. And although this process involves work, time spent in exploration is never wasted! It’s your right to dissect everything about each opportunity, so don’t be afraid to do just that.  

There has never been a better time to pursue your career passions and find the nursing job you want. So, take time to identify your goals to help determine which opportunity best suits your needs and will most likely bring fulfillment. Then, once you’ve done the work and applied your insight, go inward to find the answer. It lies within you—trust your gut! And when you’re ready to take the next step, I’m sure you’ll be welcomed by whichever agency you select to be your professional partner.

Related topic: 3 Differences to Consider When Planning your US Nursing Career