How do I get back to where I came from?

[rnshallind]

Hello everyone. I want to get back to acute care bedside nursing, which includes working in the Emergency Department. How do I do this?

First, let me tell you a little bit about myself and the frustrations and obstacles that I have faced in returning to the bedside.

I am an experienced RN, having got my license in February 2004. I have worked as a ER nurse, staff RN, Clinic RN, Case Manager, Charge RN, Wound Care RN, Staff Educator, Hospice RN, Corrections RN, Chronic Care Pediatric RN.

I have a associates degree. I last worked as a Hospital staff RN in 2008. I left that position because I didn't have enough confidence in myself or my abilities to be an effective RN. Now, with some experience, I am a confident and competent RN.

Once, when I was 5 years out of being in the ER, I had asked a ER staff educator at a teaching hospital, how do I get back in? Her response was to let me know that I had been out too long and that there was nothing I could do. I was surprised since I thought that teaching hospitals were there to teach. I was also saddened at the thought that the teaching hospitals ER patients are often being taken care of by new grads aka inexperienced nurses rather by experienced ones.

Another RN friend suggested that I apply and get a job at a smaller hospital. I tried. Problem with that approach is that you need to know someone personally. I didn't and still don't. Secondly, I have found from my experience anyway, that nurse recruiters to be less helpful and more of a hindrance in getting back into the hospital. Finally, have faced age discrimination since I am in my 50s. I went on a job interview and the interviewer let me know that the job that I was applying for was "fast paced" insinuating that I wouldn't be able to do the job because of my age. It certainly had nothing to do with my appearance since I am not overweight as this is sometimes can be a hidden barrier to getting a job in the medical profession.

I just don't know what to do. Please help?

[llg, PhD, RN]

Sadly, the opportunity for you to slip easily into an ED staff nurse position may have passed. That's a reality we all have to face as we age. That doesn't make it right, it's just true. Once you get away from the bedside for a few years (and you age), it is hard to go back. I am in my 60's and there is no way I would want to stress my aging body with a staff nurse position at this stage of life.

If you dead set on going back, you'll need to take steps to show that you can do it. Here are a few suggestions -- that might or might not work.

1. What is your current job? Does it involve direct patient care? If not, you may need to look for a job that is something in between what you do now and the job you ultimately want. If you are not now in a role that involves being on your feet all day, managing rapidly changing clinical situations, rotating shifts, etc. ... you need to find a job that will show that you can do those things. If you have a job that is primarily an "office job," you'll need to show that you can be on your feet and physically active all day before an ED will be likely to hire you.

2. Have you stayed current in your knowledge base about contemporary ED care? If not, take some courses, etc.

3. What is the job market for ADN's in your area? A lot of specialized units (like ED's and ICU's) prefer BSN's -- even if the hospital will hire ADN's in other departments. Perhaps if you got a job on another unit in the same hospital as your desired ER, you could demonstrate what a great RN you are -- then transfer into the ED.

4. Consider taking a EMT course and working in that field for a while to show that you "still have it."

In other words, look for some opportunity that is a step in the right direction -- even if it is not exactly what you want. Use that other opportunity to show your competence ... and as a stepping stone to your preferred job. That may give you the best chance of long term success. Don't expect to "get there" all in one step.

[Meriwhen, ASN, BSN, MSN, RN]

In addition to all that llg said, also consider per-diem jobs or working for an agency/registry. Agencies/registries may be more forgiving when it comes to age and/or having recent experience, though if your knowledge is too rusty, the learning curve may be steep at first.

You may not be able to land a gig right in the ED on the first try, but start by getting into any acute care specialty you're familiar with and begin refreshing your skills. The more flexible about what you are willing to do and when to do it, the more likely you are to be picked up.

Besides gaining experience, doing this can also help you establish your reputation, give you networking opportunities and if you are a facility per-diem, make you an internal candidate for transferring to where you want to be.