Nurses quit working for a number of reasons - having children, spouses getting transferred, dealing with family crises. When their circumstances change, however, many want to re-enter the work force but know they need to bring their skills and licensure up to date. Refresher programs at Georgia hospitals, colleges and nonprofit agencies are helping them do that.

Looking for any measure that would help attract and retain the nursing staff she needed to run three hospitals, Emory Healthcare Chief Nursing Officer Alice Vautier, RN, Ed.D, noticed that the state nursing board listed several nurses who had licenses but were not working.

Recognizing an untapped source of talent, "we worked with the board to create a refresher course for nurses," said Marti Wilson, MSN, RN, manager of nursing special projects at Emory Healthcare.

Emory's program hires qualified nurses who have been out of hospital nursing for more than four years and pays them to attend an eight-week training course, where they gradually work in units of their choice with a preceptor, until they are comfortable working alone.

"It's intimidating going back into nursing today, because the technology has totally changed and you need computer skills," Wilson said. "Also, hospitals now get only the sickest-of-thesick patients. Nurses have fewer patients, but the work is more intense."

Laura Austin, RN, who had never earned a Georgia nursing license because her husband was transferred so often, said that Emory's program allowed her to help pay for her daughters' college educations while doing what she loves: nursing.

"Emory's program had a terrific curriculum that covered all the bases - not only orientation to the hospital but to nursing, medicine, pharmacology and today's technology. It gave me a great re-entry back into feeling competent as a nurse," said Austin, who works on a general surgery floor at Emory University Hospital.

Mary Duffie, BSN, RN, CFN,COMC, returned to bedside nursing after 26 years in home health care management and consulting.

"The way I used to nurse, it would be me and an aide taking care of 32 patients. Now I average about five patients, but with the new drugs and technology, it's totally different," said Duffie, who works in an orthopedic-neurological unit at Crawford Long Hospital in Atlanta.

"Coming back was a whole new world and a real eye-opener, but I'm so glad I did it. It felt good to be learning to have my skills back," Duffie said. The re-entry program gave Stacey London, RN, an opportunity to switch specialties.

"I had been a psychiatric nurse for nine years, but thenmy mom died of cancer, and I made a life-changing decision to work in oncology," London said.

"I hadn't used my medical skills in years. I kept asking myself how to make it happen. Who would hire me without skills and experience? This program perfectly fit my needs."

London asked to be put on the bone-marrow transplant floor because she wanted the challenge of learning an oncology specialty. Now she's also a preceptor.

Hiring people first and then retraining them has been critical to the success of Emory's program.

"We ask them what they want to do and place them accordingly, so that they feel a part of the team from the start," Wilson said. "We've gotten some great employees."

About 100 nurses have gone through the program. Kennesaw State University's WellStar College of Health and Human Services has offered a nurse re-entry program since 1996 and an interactive online version since 2000.

"We began the program as a community service to help nurses moving to Georgia from out of state. There was a surplus of nurses at that time, and we felt like we should help newcomers get into the market," said Vanice Roberts, DSN, associate dean of the WellStar College of Health and Human Services.

"Of course, in light of the nursing shortage, the program has become a whole lot more than that now."

Refresher courses
Kennesaw State University offers a refresher course four times a year - on campus in May and December and online in March and September.

"We're seeing large classes of about 20 online and almost 40 on campus," Roberts said.

The on-campus theory course is taught in eight days (48 hours total) in the classroom, nursing simulation lab and computer lab.

"One of the advantages of taking the course here is the abundance of educational resources," Roberts said. "Our students are very motivated, and if they know that they have a weakness in some area, they can use our computer lab full of resources or spend extra time in the lab working with the virtual venapuncture simulator or other technology."

Students spend 20 to 30 hours a week for eight weeks to complete the online theory course. Both programs offer an overview of changes and trends in health care and concepts basic to the care of patients, as well as nursing content related to specific medical/surgical areas. After students pass the theory course, KSU places nurses with preceptors in hospitals to complete the 160 hours of clinical experience required by the Georgia Board of Nursing.

"We work collaboratively with Grady Memorial Hospital, which pays tuition for clinical work and hires the nurses afterward. Sometimes Northside [Hospital] or WellStar does that as well, but we work with many hospitals. Our goal is to place students in hospitals that want to hire them and where they'll be most successful," Roberts said.

Tuition is $1,250 for the on-campus course and $1,500 for the online version. Students who pay their own tuition may be able to write it off their taxes and could earn new-employee signing bonuses. Pat Amrine, RN, had been out of nursing for 28 years and was the owner of 14 clothing stores when both of her parents became ill.

"Caring for them, I remembered what it was like to be a nurse. The feelings I had then, I was having again. Dad died in hospice, but not before he knew I was going back into nursing. He was real encouraging," Amrine said.

Amrine took a job with St. Joseph's Hospital in Atlanta in the nephrology and pulmonary unit, where she has worked for two years. Partnership that works Foothills Area Health Education Center, a nonprofit regional health education center in Gainesville, recently partnered with Northeast Georgia Medical Center and Health System to offer a re-entry program for registered nurses in the 31 counties it serves.

"Our students often have anxiety about re-entering nursing because of all the changes in technology, in medicine and in the health care environment," said Sheila Griffin, PT, MLIS, with Foothills.

"Our coordinator helps them apply for their temporary license and get started. Once they've gone through the theory and 160 hours of clinical training, they've regained their courage."

The program is designed to be flexible, allowing nurses to enroll in 40 hours of self-study at any time. Once they pass the tests for all modules, the Foothills program coordinator places them with preceptors at Northeast Georgia Health System for 160 hours of supervised clinical training. Nurses who complete both parts of the program and regain their license can apply to work anywhere. The cost for the program is $700.

"The hospitals that have employed our re-entry nurses have been very pleased with them. They bring life experiences to the workplace, are motivated and make good nurses," Griffin said.