NurseWeek: Return Engagement: For nurses who would like to re-enter clinical practice, you can go home again

Return engagement
For nurses who would like to re-enter clinical practice, you can go home again

By Connie Goldsmith, MPA, RN
July 24, 2000

Re-entry nurses have several options available if they want to resume clinical practice.

Photo: Photodisc


	You've read the article. Now tell us what you think. Related sites State Boards of Nursing American Nurses Association Re-entry planning Review "Assuring Competence," a National Council of State Boards of Nursing publication. When planning to return to clinical practice, concentrate continuing education hours on basic clinical topics. Select an update on medications rather than a course on hospice care. Call your state board of nursing to see if it can provide a list of refresher courses. Call community colleges and universities in your area to see what’s available. Contact major hospitals in your area to see what training they provide to re-entry nurses. Consider working in a subacute care or skilled nursing facility to update your clinical skills. Consider enrolling in a formal nursing program to upgrade a diploma or associate degree to a BSN, or a BSN to an MSN. ~Connie Goldsmith

The nursing shortage is a grim reality as the Department of Labor predicts nearly 800,000 more nurses will be needed by 2008. An aging workforce, falling enrollment in nursing programs, an increase in career choices for women (more than 90 percent of all RNs) – have been listed as contributing factors.

About 85 percent of nurses are working, but what about the rest? Some may want to return to clinical work; others may be working in nonclinical areas, but are thinking about returning to a hospital. What’s the best way to prepare? Returning nurses have several options available.

Getting started
"Nurses considering a return to clinical practice should research competency models that document necessary expertise," said Patricia Franklin, MSN, RN, senior staff specialist on workplace advocacy for the American Nurses Association.

"It’s the individual nurse’s responsibility to make sure skills to provide quality patient care are present. This enables the nurse to advocate for a proper orientation, and confident enough to request needed training. One model is the National Council of State Boards of Nursing."

Because of nursing shortages, some hospitals are willing to accept re-entry nurses.

"We’ve been offering a refresher course since 1996," said Margaret Loper, RN, director of recruitment and employment for Houston’s Memorial Hermann Healthcare System. "There are relatively few such programs in the state. We’ve had people commute 200 miles to attend. While the applicant is not directly hired into a position, if staff members think a particular nurse would be a good match for their unit, they’ll recruit the nurse during clinicals."

Other hospitals have yet to formalize the process, though.

"We don’t offer a refresher course, but we’ve been discussing the need for it," said Susan Flores, RN, recruitment manager for San Antonio’s Baptist Health System. "We’ve hired nurses that have been out of the hospital for several years, depending on the nurse’s previous experience and the skill mix and experience level of the unit. Re-entry nurses would attend nursing orientation and then be oriented to their unit by their preceptors. However, we generally recommend that nurses take a refresher course before applying for a position."

Back to school
Another route to clinical re-entry training is through community colleges, although this training doesn’t always award credit or continuing education hours.

"The board doesn’t approve refresher courses, but we know of five community college nursing programs offering them: Alvin, Houston, Austin, El Paso and Tarrant County community colleges," said Katherine Thomas, MN, RN, executive director of the Board of Nurse Examiners for Texas.

The board also suggests guidelines for the employment of returning nurses on its Web site.

Kirk White, MSN, RN, coordinator of health professions at Austin Community College in Texas, outlined the college’s re-entry nursing program.

"Our course lasts 12 weeks and totals 192 hours. It includes a 64-hour clinical preceptorship in local hospitals. Components of the course include nursing process and patient teaching, basic pharmacology and medication administration, documentation, CPR certification, and quality assurance and legal issues."

Pros and cons
Nurses have a lot to think about before deciding to return to clinical practice.

"On the pro side are a relatively high salary, good benefits and job security," said Sally Bergen, MBA, RN, a Sacramento, Calif., consultant who works with health care professionals on career issues. "Returning to clinical practice can enhance the self-confidence that comes with using nursing judgment and critical-thinking skills to the maximum."

However, the last few years have brought a lot of changes to clinical practice, especially in hospitals.

"Returning nurses may not want to work full time, or in areas of special need like night shifts, intensive care units or operating rooms," Bergen said. "Patient acuity is higher, and keeping up with advancing technology is a major challenge."

Returning nurses should be aware that they might not receive the shift they prefer or the unit they want – at first. Although it will take time and determination to re-enter clinical practice, hospitals definitely have a place for returning nurses.

"These nurses bring stability and a core of knowledge back to the nursing unit with them, a stability that is sometimes lacking," White said.