How Proactive Should I Be?

Last month I accepted a position in an ICU. I have been a nurse for a few years and am really excited about this. I had an interview July 20th. The interview went great. I really connected with the manager and then with the staff in the peer interview. After the peer interview the manager spoke with the staff and I was offered the job on the spot. I verbally accepted to the nursing manager but had to wait for the official offer from HR, of course. We discussed a start date of September 17th due to a pre-planned vacation for September 3rd-14th. She also gave me her personal cell phone number for if I had any questions or concerns.

July 26th, HR recruiter calls me to make a verbal contingent job offer. I, of course, accept. We discuss potential pay(they have to verify previous employment before making a written final offer) benefits, schedule, start date, etc. We also discuss my vacation and the reason for the later start. The recruiter goes on vacation the following week and I follow up the week after to see how everything was going. She informed me that we were in a waiting period as they could not do anything before 30 days prior to start date(August 17th). I thought they were pulling employment and everything the week prior and would be expecting to do employee health requirements and drug screening and sitting down to get the written offer.

I sat on my hands until Friday, August 10th when I received two emails. The first requesting references. I had 24 hours to enter names and send the requests. I had them entered before the evening. All my references had completed their surveys before Monday morning. The email requested four references but I provided seven. I used my current manager, one previous charge nurse, three subordinates from my current position as a charge nurse, and two coworkers from a previous job. The second email i received that day was hospital policies. Also, I was told that a certain HR rep would be contacting me to set up the HR appointment which I assume is drug screening and pre-employment physical.

Monday was less than 30 days out. I know that sometimes things slip through the cracks and things are forgotten, so I made a call to the HR rep who was to be contacting me about the appointment. I left a message stating my name, the position I accepted, anticipated start date, contact information, and a basic reminder that I was going on vacation and had discussed that with the recruiter and just wanted to bring it up in case it slipped through the cracks.

Yesterday, I had not received a call back, so I sent the recruiter a reminder email also. I just stated that I attempted to contact the HR rep and was unable to do so. I reminded her that I had the upcoming vacation and that I was just remaining proactive in trying to get everything completed in time to start on the 17th. I was more so just hoping she could help push things along at this time.

Today I have yet to receive anything.No call or return email. I know HR can get busy and my main thing is I don't want to be a nuisance and ruin this chance. However, next week is the last week I am here until orientation and I have nothing set yet. I am getting nervous that I may fall through the cracks and not be able to start when I return or I lose out on the opportunity all together.

I am not sure what my next steps should be and when to take them.

So advice is needed. Do I attempt to call the recruiter or HR rep again? If so when?

If I still do not hear back by the end of the week, Do I call the manager and see if she can help? Should I just sit and wait? Thanks for any advice.