Transitioning out of Home Care Nursing

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Specializes in Pediatric Home Health.

Hi, I currently work in Pediatric Home Care and have been trying for about a year now to get a position in the hospital. It has been extremely difficult and is starting to feel like an impossible mission. I have gotten to the end during the hiring process twice and was declined due to my company having a policy against giving references. Currently, I am a strong final candidate for a position on an oncology unit, but once again the references are an issue. I have 5 references (3 nurses and 2clients). My issue is is that most hospitals want a manager or supervisor as a reference. The hospital currently is bending the rules for me, but suggested I get charge nurses instead (we do not have those at my company). I am feeling extremely defeated. I have worked in home care my entire nursing career and want so badly to gain experience and progress in my skills. Has anyone ever been in a similar situation and how did you overcome it?

Specializes in CCRN, Geriatrics.

Can you elaborate on why your company is against giving out references ? I’ve never heard of it before. I would suggest asking your supervisor if he/she can give you a letter of recommendation.

Specializes in Pediatric Home Health.

They have a policy against it. The office I work out of is ran by managers and then an office director. All have said no, not because of my work but because of this policy the company has. The only reliable references I can get are from field nurses who have trained me and worked besides me and from parents of past clients. This is not enough for the hospitals I have applied (which I understand). The best my company will do is answer the phone and give my position and length I have been employed.

Specializes in Dialysis.

Many won't do this, and quite a few companies actually do have a policy against saying beyond yes, an employee works there. I currently am only allowed to say if a person works in my clinic, then give our HR phone number for any other questions, even hire dates, etc. Because of a perception of being sued (or other situation) if the prospective employer doesn't offer a job. It keeps any iffy situations to a minimum, even though it does cause issues with folks like the OP. I’ve been on both ends, so I see both sides

I would think prospective employers would have a workaround policy for such issues. No one should be rejected for this reason, since it is out of their control. FWIW I have always given the personal phone numbers of immediate clinical supervisors with their permission. So far it has worked.

4 hours ago, brownm27 said:

My issue is is that most hospitals want a manager or supervisor as a reference. The hospital currently is bending the rules for me, but suggested I get charge nurses instead (we do not have those at my company).

This whole issue is ridiculous on both sides. The way to avoid a successful lawsuit when serving as a reference is simply to not slander previous employees. Not too difficult.

This current hospital seems completely out of touch. Who asks a home care employee for "charge nurse" references?

I don't know what more you can do except provide them with either HR or director/manager information in order for one of those individuals to confirm your employment and reiterate that the company policy is that these individuals may not serve as a formal professional reference.

Lastly, you could ask your director/supervisor if they will serve as a personal reference and not a formal professional/supervisor reference. It would then just so happen that they know you through work and could speak to that. I've only ever had one person feel comfortable doing this, but it worked in that instance.

Also, when communicating with HR at new place, use persuasion. Feel free to say something like, "I'm really excited about this opportunity...and was so impressed [with x, y, z] during my interview [blah, blah, blah]...I would hate for this to be a deal-breaker because there is nothing I can do to change it. Their strict company policy is that their employees may not individually serve as a professional reference other than to confirm my employment." If their HR says dumb things like, "try to get references from your charge nurses" then just calmly explain: "In home care we don't have that kind of nursing structure...each RN is a case manager who reports directly to [xyz position] - and those are the people who are barred from serving as professional references...."

Sorry you are having a rough time with this. It's just so incredibly dumb.

Specializes in Critical Care; Cardiac; Professional Development.

If you are a recent grad (last couple of years), ask the hospital if a reference from a previous clinical instructor would suffice in lieu of a current supervisor. It is pretty common in all businesses for individuals interviewing for a job to not want to give their current employer a heads up that they are looking, so there has to be some way around this requirement.

Specializes in Pediatric Home Health.
17 hours ago, JKL33 said:

This whole issue is ridiculous on both sides. The way to avoid a successful lawsuit when serving as a reference is simply to not slander previous employees. Not too difficult.

This current hospital seems completely out of touch. Who asks a home care employee for "charge nurse" references?

I don't know what more you can do except provide them with either HR or director/manager information in order for one of those individuals to confirm your employment and reiterate that the company policy is that these individuals may not serve as a formal professional reference.

Lastly, you could ask your director/supervisor if they will serve as a personal reference and not a formal professional/supervisor reference. It would then just so happen that they know you through work and could speak to that. I've only ever had one person feel comfortable doing this, but it worked in that instance.

Also, when communicating with HR at new place, use persuasion. Feel free to say something like, "I'm really excited about this opportunity...and was so impressed [with x, y, z] during my interview [blah, blah, blah]...I would hate for this to be a deal-breaker because there is nothing I can do to change it. Their strict company policy is that their employees may not individually serve as a professional reference other than to confirm my employment." If their HR says dumb things like, "try to get references from your charge nurses" then just calmly explain: "In home care we don't have that kind of nursing structure...each RN is a case manager who reports directly to [xyz position] - and those are the people who are barred from serving as professional references...."

Sorry you are having a rough time with this. It's just so incredibly dumb.

Thank you so much for your helpful tips! I am going to use them after one last ditch effort to get around this. I have been reaching out to nurses who work at the hospital and friends of relatives who have family members who work on the backend to see if there is a way to bypass this issue. It is really unfortunate because the position I interviewed for is my dream position within my dream healthcare system. It is super discouraging though and starting to feel like I will be trapped in home care forever :(

Specializes in Vents, Telemetry, Home Care, Home infusion.

If reference issue impeding getting into "dream" hospital, see if your area has a LTAC -long term acute care hospital. LTAC have patients needing intensive care post 30 days hospitalization -vents, trach, open wounds, post septic. That specialty experience will help you land your "dream hospital" later.

Specializes in CCRN, Geriatrics.
On 8/6/2020 at 5:46 AM, Lovethenurse2b25 said:

Can you elaborate on why your company is against giving out references ? I’ve never heard of it before. I would suggest asking your supervisor if he/she can give you a letter of recommendation.

Thanks for clearing that up. Considering that the company has no legal obligation to act as a reference. I would take it as an experience to learn from. In the future upon hire ask about the policy for providing references to avoid any further hinderances. Also consider other areas of nursing like LTAC, Longterm care etc. at least for the time being.

On 8/6/2020 at 4:24 AM, brownm27 said:

Hi, I currently work in Pediatric Home Care and have been trying for about a year now to get a position in the hospital. It has been extremely difficult and is starting to feel like an impossible mission. I have gotten to the end during the hiring process twice and was declined due to my company having a policy against giving references. Currently, I am a strong final candidate for a position on an oncology unit, but once again the references are an issue. I have 5 references (3 nurses and 2clients). My issue is is that most hospitals want a manager or supervisor as a reference. The hospital currently is bending the rules for me, but suggested I get charge nurses instead (we do not have those at my company). I am feeling extremely defeated. I have worked in home care my entire nursing career and want so badly to gain experience and progress in my skills. Has anyone ever been in a similar situation and how did you overcome it?

This is my pet peeve. A hospital who, in all likelihood, has a policy against giving out references EXPECTS you to provide a reference from your current or former employer before they will hire you. This is AFTER you pass a background check, drug screen, multiple computer tests, a physical, multiple interviews, and education verified. What MORE could they possibly want? And STILL they won’t hire you until they hear some random stranger say you’re the best employee that ever graced Gods green earth. References are useless. If you were dishonest you could pay someone to pretend to be your former supervisor. Sorry you’re going through this.

Specializes in Pediatric Home Health.

Just wanted to thank everyone who has replied to this thread for their advice. I took it all and explained as best as I could to HR about the dynamics of home care. Happy to say that I was offered the position talked about above and start in October!

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