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Never has there been a better time for returning to bedside clinical practice. As groups like Nurses for a Healthier Tomorrow have pointed out, the current nursing shortage is projected to continue for several years. As a result, the U.S. Department of Labor Bureau of Labor Statistics lists nursing as the top position for growth. (For more information, visit http://stats.bls.gov/oco/ocos083.htm.)

Maybe you left nursing to raise your children and now it’s time to return. Maybe your financial situation has changed because your spouse has been laid off. Maybe you left nursing for another career and now want to return. Maybe other nursing opportunities have led you away from the bedside and now you want to reenergize by taking care of patients. Or maybe you’re on your own again after a divorce. All of these were reasons given by the 14 nurses in the nursing refresher course I took.

As a nurse for more than 25 years, it was time for me to take care of patients again. Although I’ve enjoyed my recent years as vice president, patient care services and chief nursing officer at BryanLGH Medical Center East in Lincoln, Neb., I’d been moving further and further away from the bedside. So, to get up-to-date in bedside clinical practice, I enrolled in an RN/LPN refresher course at Southeast Community College in Lincoln. Thanks to that course and some additional continuing education offerings, I feel prepared to reenter the world of bedside practice.

Taking the refresher course was a worthwhile experience, and I learned as much from the other students as the instructor. Because I kept a journal during the course, I have some suggestions for getting yourself back to the bedside. After all, there has never been a better time.

Choose the right course

• If you have a choice, look for a program that combines classroom lectures, a skills lab, clinical time with a preceptor, and computer-simulated learning.
• Take a course that prepares you for licensure in your state. Some state boards only accept courses they have approved. You will probably need a temporary license during the course.
• Colleges or schools with nursing programs often will let you use the same computer simulations as their regular students. Be sure to take notes during the computer simulations. Given the frequency of computer use in most facilities, using the computer simulations will be good practice for you.
• Don’t be afraid of a class that combines RN and LPN students. It’s a great opportunity to learn roles and gain empathy.

Hit the books and the sites

• Subscribe to a few clinical nursing journals or check them out at the library.
• Visit your state board of nursing’s website because it has important information about relicensure. In addition, many websites, such as www.nurseweek.com, have topics about clinical issues and practice updates.
• Keep up with your class reading assignments before each class; that way, you will get more out of the content that is taught.

Attitude is everything

Being open-minded is a great way to learn new things. For example, be willing to work some night shifts and weekends in your clinical experience. Often, facilities have many students on day shifts and their preceptors are occupied with new employees of the facility, which may limit opportunities. Working nights and weekends helps the facility and conveys an attitude of willingness that may help you with future employment opportunities.

An added benefit is observing how the shifts integrate. For example, it is common practice for the daily medication administration record to be printed on the night shift and validated by the night shift nurses. You may not learn this if you only experience the day shift.

Other attitude adjustments you should make are —

• Practice humility. Don’t feel compelled to talk about your past experience; focus on learning about today. Avoid asking preceptors “why” they do certain things. These kinds of questions can make people defensive. Instead, ask “Is there anything else I should learn about this?” or, “Tell me more about how to address this.”
• Don’t just observe in the skills lab. Rather, be sure to practice skills in the lab with your instructor and other students. If you haven’t taken care of patients in awhile, you need the practice.
• Learn on breaks. When you’re in your clinical with a preceptor, join other team members from the unit for meals. You can learn much from the unit secretary, nursing assistants, and therapists.

Work with your preceptor

• Try to get a preceptor who works where you might choose to work. You should meet with the preceptor as soon as possible to complete the paperwork required by your course, as well as the preceptor’s agency.
• Use a checklist of the key skills you want to accomplish with your preceptor. Be sure to review the facility’s policies and procedures before performing skills. Many times you can print these from the facility’s computer.
• Ask for a packet of the most common charting forms so you can review them in advance. These often are already assembled in a new patient admission packet.
• Work your preceptor’s schedule. Initially, try to arrange a day off between shifts so you can look up information. Later, be sure to work a few days in a row if possible. And, work some full shifts so you get the whole picture. Attending change-of-shift reports will help you and your preceptor identify opportunities for practicing skills with other nurses and patients.
• Understand that your preceptor may teach you practices that are different from what your instructor teaches you. Make sure to focus on the principles, not just the task.
• Remember the saying that leads to mastery of skills: “Watch one. Do one. Teach one.”
• Read the facility’s communication bulletin boards. You will likely gain up-to-date clinical information and may even find a job posting you are interested in.
• Don’t accept a patient assignment. You need to be assigned to the preceptor and her or his patients.