Can't find job with restricted license

[Nurse Beth, MSN]

This must be very frustrating for you, I'm sorry.

I would pull out all the stops in your case. The more contacts you make, the greater your chances will be. Apply widely, submit applications daily, attend job fairs, and make cold calls. Your full-time job now is searching for a job.

• Reach out to the dialysis hiring manager to understand the reasons for your rejection and explore if there's any possibility of being reconsidered for a position. You have nothing to lose. 
• Activate your network. Let everyone know that you are looking for a job. Ask for favors and reach out to those who owe you favors. You just never know who might be sympathetic towards someone in your situation.
• Look for positions in smaller facilities in more rural settings. They may be more flexible and willing to meet your requirements. Some rural acute care facilities have attached long-term care units.

Hospital or Facility-Based Roles with Direct Supervision

Some hospitals or larger healthcare facilities might have roles specifically designed for nurses with restricted licenses. These roles can provide the required supervision while allowing you to continue practicing and gaining experience. Some options could include:

Supervised shift work. Some facilities, especially larger ones, may offer roles for nurses with restrictions where you're assigned to shifts with direct supervision from more experienced or charge nurses. These positions exist in Med-Surg, Psychiatric Nursing, or Long-Term Care departments.

Nursing Homes, Assisted Living, or Rehab Centers

While some settings hire nurses for autonomous roles, others involve direct supervision, especially for nurses with restrictions.

• Assistant Director of Nursing (ADON) with supervision. While an Assistant DON usually operates with more autonomy, some smaller or rural facilities may have opportunities where the ADON works directly under the DON (Director of Nursing), allowing for supervised practice. These positions would be more structured for someone like you who needs direct oversight.
• Nurse Manager. Some nursing homes or assisted living facilities might be open to hiring you in a supervisory capacity, but with a direct supervisor overseeing your work. This could also apply to roles like Charge Nurse, where the DON or another senior nurse provides direct oversight.

Hospice or Home Health with Supervision

While home health generally requires more independence, there are settings where you can still work in these areas but with direct oversight:

• Hospice nurse with preceptorship. Some hospice care organizations have programs that hire nurses with a restricted license but provide close supervision initially. You might be paired with a senior nurse to review patient care plans, charting, and any clinical interventions while ensuring you're following established protocols.
• Home health under supervision. Some home health agencies might be willing to offer you a position where you can work under direct supervision for the first period of time, either through regular check-ins with a supervisor or by having a senior nurse accompany you on home visits.

Psychiatric Nursing with Supervision

Since you have significant psychiatric nursing experience, you might want to try psychiatric or mental health facilities that have a supervision structure in place:

• Psychiatric nurse with senior nurse supervision. Some psychiatric hospitals or mental health clinics may be open to hiring you with direct supervision from a more experienced nurse. These facilities often have senior staff who oversee the care of newer nurses, making them potentially more willing to take on someone with a restricted license.

Agency or Contract Work with Supervision

Talk to an agency or two. Some have experience placing nurses like yourself and can offer insight. They may know of positions in various healthcare settings, such as hospitals, nursing homes, or clinics.

Clinical Instructor or Mentor Role

Though this is not a clinical patient care position, if you're passionate about teaching and have the right temperament, you could explore becoming a clinical instructor or mentor for nursing students. You'd work under the supervision of a higher-level clinical coordinator or educator while guiding nursing students through the practical aspects of their training. These positions could allow you to work in a supervisory capacity with students while still meeting the direct supervision requirement.

If you're struggling to find a job that accommodates direct supervision, legal or nursing advocacy groups specializing in licensing issues might assist you in locating employers who are more understanding of the restrictions. Organizations like the Texas Nurses Association or Texas Peer Assistance Program for Nurses (TPAPN)

may be able to provide connections to employers willing to hire nurses with restrictions. The Nurses in Recovery forum may be helpful.

I understand that finding a job with direct supervision while also having years of experience feels like a major challenge. However, you can still find opportunities with persistence, networking, and possibly leveraging specific settings or roles designed for nurses with restricted licenses. Don't hesitate to reach out to staffing agencies, peer support groups, or even mentors who may have insight into employers willing to accommodate your licensing restrictions.

Best wishes,

Nurse Beth

[bbrown74, BSN]

Are you in the diversion program? Or they just won't let you work certain areas? If you are in the diversion program, I see that rural facilities tend to be more accepting of that then bigger facilities.