Home Again
A re-entry RN appeals for support of inactive nurses trying to get back into their scrubs

By Janis DeFoe, RN
April 14, 2003

With all of the articles being written and concerns expressed about the nursing shortage and the increasing crisis looming, I believe many are missing out on an untapped resource.

I graduated from nursing school in 1967. At 21, I was fulfilling my longtime desire of becoming a nurse. Working in a small 150-bed hospital gave me a variety of experiences, as we often covered and filled in where needed. They trained me in obstetrics, mostly labor and delivery, and I loved it.

For three years, I worked full time. In addition to labor and delivery, our duties included overseeing postpartum patients, as well as the newborn nursery. After the birth of my first child, I went back and worked three to four days a week; 3½ years later, I gave birth to my second daughter, and my husband and I made the choice for me to become a "stay-at-home" mother. It was difficult financially for us, as well as careerwise for me, but I never regretted our decision.

"Once a nurse, always a nurse" holds true. I "nursed" my girls, their friends, my friends and family, and occasionally did related volunteer work. I subscribed to nursing magazines and read them with interest. I continued to take continuing education classes. I looked forward to the day I would know it was time to resume my career.

Once my girls were in high school, I took a refresher course at our junior college. The semester course was taught by a young woman who had a master's degree in nursing, but had never pursued clinical application after her schooling. It did refresh my knowledge, but had no practicum.

I sent in my application to several agencies of choice and one hospital, but no one was interested in allowing anyone who had been out of nursing for 18 years to even track with them. Disillusioned, I filled my time with alternative activities and volunteer work.

Three years later, I again took a refresher course, through a private corporation, with guest lecturers included for every system. A practicum was included in the fee, but the timing was poor for me because my husband took a sabbatical and we were out of state for three months.

When I returned, the instructor said I was "on my own to find someone to track with." When I was unable to find someone, I again became disillusioned and filled my time with other pursuits. The nurse in me would not give up, though. I had been an excellent nurse before, and I knew I could be again.

Two years later, I took a course in perioperative nursing. Perhaps a specialty would make me more valuable, and I had always loved surgery. I loved the course and did well in it. I felt I was on my way back into nursing.

I made an appointment to interview at our hospital and brought an updated résumé. Filling out the application was easy, but when I came to the skills assessment form, my positive attitude took a major drop. How could I or anyone else who had been out of nursing this long check "Proficient" in any skill?

This was also at the time when major health care reforms were being talked about politically, and many health care agencies were "running scared."

The director of nursing told me that they were not only not hiring, they also were laying off nurses to prepare for the forthcoming changes. I offered to track in surgery for free as long as it took for them to feel confident in my skills. I would even pick up my own malpractice insurance.

I was "gently" informed that there was no chance of employment for me there and likely nowhere else. More discouragement.

Several years went by and the expected changes in health care did not come, and the nursing shortage was worsening. I was approached by a relative who worked for a home health agency, who stated that they were in dire need of more nurses.

"Had I ever considered going back into nursing?" Needless to say, she got an earful. She encouraged me to just chat with their nurse manager. I was feeling pretty unmarketable by now. I called anyway and found she was understanding and even encouraging.

I had taken many CE courses through the years and a fairly recent one was on home health care, which enabled me to ask informed questions of her. We parted with her pushing me to at least update my license and then to get back in touch with her.

I took a course in pediatric emergency care nursing through correspondence and once again had an active license. The application process with the local branch of a national home care agency was somewhat intimidating after all these years. I did pass the general and pediatric exams, though.

I followed expected protocol and got the TB test, other vaccines and took the CPR course. In short, I jumped through all the required hoops. My interview with the nurse manager went well, too. She was encouraging and felt that I could easily pick up my skills again. She assured me that I would not be "turned loose" feeling unprepared or inadequate.

I was beginning to get excited about being able to nurse and work closely with patients again. I had one more interview to go, with the nursing administrator and area coordinator.

I was left pretty deflated again.

This woman can only be described as condescending. She questioned my even thinking I could possibly get back into nursing after all these years. She obviously felt I had nothing of value to offer. This time, I went away angry.

I knew my limitations, but I also knew I could become the good nurse I once was. I knew I could learn and relearn the needed skills. I knew that this time, I would be bringing a lifetime of experience, maturity and other wisdom that one can achieve only by simply living life. If they did not want to give me a shot at it, it was their loss. I had done all that they had asked. The next move was theirs.

Imagine my surprise when, about a month later, they called to offer me a position. It seems the nurse manager and records manager had gone to bat for me. They did some research and called the corporate offices when they uncovered a preceptor course that was already part of the corporation, but one that had rarely been implemented. They were told they needed a nurse who was willing to become my preceptor and they had found one on their staff. Was I interested?

I have worked for this agency as a home health nurse for more than a year. I am even doing some case managing. I love my job.

I am so grateful to those people and the nurse who came alongside of me and encouraged and taught. My preceptor continues to be a source of inspiration for me, as well as a great resource. I have learned so much and learn more every day that I work.

Never once did they make me feel less valuable than the more experienced nurses. Never once was I asked to accept the care of a patient or do a procedure that I did not feel confident in doing. They patiently come alongside me with each skill and they train and retrain as I labor over all the documentation.

Renewing my chosen profession at age 56 has energized me. I still love nursing and, particularly, the one-on-one patient care and teaching found in home care. I was even approached to allow nursing students from our state university to track with me on my calls. I love having them come with me. We learn so much from one another.

The frosting on the cake came the day our nurse manager introduced me to our area manager. "She is the nurse we implemented the preceptor course for," she said. "I wish I had 10 more of her."

Our office in Santa Rosa recently received the first award for 100 percent patient satisfaction, based on a survey sent to our clients. And I had been a part of this.

I am the first to admit that I still have much to learn. Every day I work, every patient I care for, every staff conference and community contact generates opportunities for me to advance my skills.

I am left wondering how many "good" nurses are out there? Perhaps they, too, have been intimidated and discouraged from attempts to re-enter nursing. I know this is not the perfect answer to the nursing shortage. Much more must be done to recruit and train younger men and women.

I believe there may be many more nurses like me, with a heart of compassion and a love for nursing, who once again could be an asset and stopgap measure until we can pass the torch.

Janis DeFoe, RN, is a home health care nurse/case manager for Gentiva Health Services in Santa Rosa, Calif. She has worked as a labor and delivery nurse, including a stint as shift supervisor of the postpartum and newborn nursery, and did some med/surg rotations. After her failed re-entry experiences, she worked as an administrative assistant, took real estate training, ran an Internet-based business, and was a wedding planner. None of these occupations filled the void that nursing had left.

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