Return to NP Practice

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I'm a R.N. and former N.P. who let both my licenses lapse in order to be a stay-at-home-Mom when my kids were young. (I was unable to find a NP position that was less than a 0.75 FTE, which wasn't an option for our family.) Prior to letting my licenses lapse, I had worked as an R.N. in extended roles for 11 years, and as a N.P. for the final 6 years.

I regained my R.N. license 2 years ago, and am currently in good standing with my licensing body. Now I am interested in reinstating my N.P. license, which I originally received in 2007. (I practiced as a N.P. until 2012.) In my jurisdiction, there is no current "pathway" to return to N.P. practice after a lapse in license. Inasmuch, my registering body has recommended that I seek out N.P.s who are currently practicing to get some suggestions from them as to the best route for me to return to practice. I have been advised to draft up my own "pathway" to return to competent practice. Once I have developed a pathway, I will be presenting my case in front of a committee who will then determine if my pathway is viable or not.

I realize the route back to N.P. practice will likely be a challenging one and am not at all expecting to "get away" with doing nothing. That said, I have always worked advanced practice, first in extended scope in rural hospitals, outpost nursing, or extended-scope emergency nursing, and then as a formal N.P., and I feel that some consideration should at least be given based on my former education and experience.

So, for those of you who are practicing NPs, what would you recommend someone in my situation do in terms of returning to competent practice? I believe I should update my pharmacology as there are many new drugs since I last practiced as a NP. I feel pretty confident in my understanding of pathophysiology as the human body really hasn't changed while I wasn't practicing. I'm going to suggest that I do both adult and a pediatric practicums, as I am hoping to return to Family NP Practice. (That was my previous designation.) What else would you recommend? I'm from Canada, and while I know there are differences between Canadian and American NP programs, I welcome any perspective as I want to ensure that I've considered as many factors as possible.

Thank you!!!

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Specializes in ICU, LTACH, Internal Medicine.

1). Start to get CME (or whatever it is named in Canada) like crazy. Choose reputable sources and the courses which correspond with what you see as your future area of occupation.

2). If such things exist in Canada, do refresher courses in patho, pharm and therapeutics/management. Preferably with clinicals. Try your former school - they might be easier to speak with, although the end result will likely be expensive.

3). Volunteer, volunteer, volunteer. I do not know if it is an option in Canada, in States you can find a formal "RN" position in a private practice office for a small money and go with an NP on home rounds, doing his/her notes, helping in SNFs, etc. Sign up for every health fair and such event you can reach. Go to summer camps as RN.

4). Find a practicing NP with license in good standing in the area of your interest and try to become an apprentice of a sort. Like a preceptorship. You might have to pay for it (in States there are services catering to just that kind of situations, and they charge $$$$) and do the dog's job writing 30+ notes in a day, doing billing, calls, all other paperwork, etc.

5). Network, network, network. Join professional society, go to conferences.

6). Document all the above as if your life depends on it.

Just my 2 cents. I am sorry you find yourself in this situation.

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Specializes in retired LTC.

To Katie - a compliment for your in-depth, comprehensive suggestion list.

To OP - good luck with your endeavor.

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I agree with KatieMI. North Carolina's board of nursing has a NP refresh course packet that you might be able to model your proposal after: https://www.ncbon.com/vdownloads/continuing-competence/refresher-course.pdf If that doesn't work consider doing a post masters in Adult-Gero and certify/license that way.

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Katie;

Thank you for your response!! A lot of what you suggested is what I was already thinking. NPs aren't as common in Canada as they are in the U.S. yet. They really only came to be in the last 15 years or so.

This is my tentative plan for returning to practice:
1. Update both my pathophysiology and pharmacology courses.
2. Locate a N.P. preceptor to do a certain number of clinical practice hours in each area: adults and pediatrics. I'm trying to determine how many preceptor hours I would need. The original certification program, for those who are new to both RN and NP practice, requires around 150 hours of preceptored practice per specialty area. I was thinking I would propose 75-100 hours for each area (adult and pediatric) for me since I am neither a new RN, nor a new NP.
3. Take the "controlled drugs and substances" course, which is now a requirement for NPs in my jurisdiction.

Does this plan seem reasonable?

Unfortunately, in my jurisdiction, volunteer hours don't count towards "learning" or refreshing one's license. I can volunteer as a RN since I am already a licensed RN, but I can't volunteer to work with a NP as I'm not currently licensed in that capacity.

Additionally, we don't have nursing CME courses in Canada like you do in the U.S. I really think this is a lacking in the maintenance of our professional licenses.

At any rate, I would love some feedback regarding my proposed return to practice plan. Is there anything I'm missing?

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3 hours ago, egg122 NP said:

I agree with KatieMI. North Carolina's board of nursing has a NP refresh course packet that you might be able to model your proposal after: https://www.ncbon.com/vdownloads/continuing-competence/refresher-course.pdf If that doesn't work consider doing a post masters in Adult-Gero and certify/license that way.

A NP Refresher course is exactly the kind of thing I have been looking for! Thank you so much for your help!

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Specializes in ICU, LTACH, Internal Medicine.

Godsgirl73,

The fact that they want you to write down your own "plan" can mean only one thing: in clear English, they just got no idea in the world what to do with you.

Therefore, your job gets to be quite simple: impress them BIG DEAL. Your past experience clearly counts for nothing (otherwise, they would know at least in general what to require from you). So, your powers lie right now and here.

Propose the same number of hours you did in school in every area. Volunteer as an RN - hours won't count, but your earnest efforts hopefully will. If you get a chance to join some kind of professional society, do it. If you can visit a conference, do it too. If you can snatch a course in addition to what you proposed, include it.

Here in States even smaller hospitals regularly hold meetings where specialists duscuss various clinical questions. NPs, even when not officially invited, are allowed to participate. If there is something similar in a hospital near you, go there and make friends. A letter or two written by NPs or MDs would be a good supplement for your "package".

The more filled and creative your package would look, the better. Show your efforts and willingness to work your tail off for that license, and, hopefully, they will believe you.

If it seems simpler thing to do and possible at all, consider post-masters certificate.

P.S. I am surprised regarding number of hours required. In my school, it was something close to 200 hours for at least 3 areas out of four, and most students did twice more without making too much noise about it. I am considering post-masters in acute care, and most schools wants anywhere from 500 hours and up from students who already employed as NPs in acute.

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Katie;
That's exactly it! They have no idea what to do with me! When I got my RN license reinstated after my license lapsed, I told my licensing body directly, both verbally and in writing so that it was on record, that my plan was to return to NP practice. After my "hearing" with my licensing body, when my RN license had been reinstated, my Case Manager told me that there isn't actually a route for NPs to return to practice in my province. I was the first NP to formally request a return to practice. She also told me I had to work for at least one year and have my RN license in good standing in order to even open a discussion about returning to NP Practice. I've done my part. My RN license is in good standing. My licensing body is no further ahead now than they were 2 years ago.
I have contacted 3 former NP colleagues who are still practicing, and 2 NP Instructors from my original MN-NP program to seek their counsel. I'm fully prepared to work for this, and I'm now acutely aware that I am trail-blazing for other NPs who may go through this. It's exciting, but a little bit daunting, too.

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Specializes in NICU.

Wow, lots of hoops. This is a good reminder to those thinking about quitting to not let your NP license expire unless you are absolutely done. My state requires just 250 hours of practice per 2 years- easy enough to volunteer just a little if you don’t want to work.

It sounds like you have a long uphill battle but are eager- best of luck to you. Let us know how things turn out.

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Specializes in ICU, LTACH, Internal Medicine.

Godsgirl 73, you will do a lot of favor if you continue to update this message as things go on, and if you make another one in the World/Canada part of this forum, with noting a province (no other details)

Really, one day someone may send tons of positive vibes your way. You're the first one and making a precedent. We hope you will succeed and show the way to another nurse facing the same hoops to jump through. This is what this forum exists for, after all.

Good luck and many blessings to you!

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I think practicums , a recent pharmacology course and retaking the boards is reasonable.

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I thought I would update you all on the progress made in the last week.
Earlier this week, I messaged a former MN classmate who is a current NP, as well as two former colleagues, whom I had previously preceptored as NP students. I told each of them about my situation and asked if they would be willing to give me some input on a return to NP practice. All three have agreed to meet with me before Christmas!

One of my former classmates, S, is now teaching MN level courses at the university where we received our MN-NP designations. He has kindly offered to take the lead in developing a return to practice pathway. I accepted his offer and will be meeting with him December 18th. We have very similar career interests so his input will be incredibly valuable.

Both of my former students have responded to my emails as well and have agreed to meet with me. They have indicated that if I require preceptorships (which I will!), they would be willing to take me on in that capacity. They are each Family/All Ages NPs, which was my former designation, and the one I am hoping to have again at some point.

I'm greatly encouraged by the happenings of this week. I was not expecting anything to happen before Christmas. The timing of all these meetings makes last minute gift shopping difficult - LOL - but I can live with that.

I will update this thread as things develop in the hopes of encouraging others who may find themselves in this position. For the most part, I don't regret giving up my NP designation to raise my kids. It was right and necessary for my family at that time. The road back to NP practice is still unknown, but doors appear to be opening so I'm going to walk through them.

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