It's a Monday evening at Holy Redeemer Hospital in Huntingdon Valley, PA. Fifteen RN students--many who have not practiced for years, including one who's been absent from the profession for 25 years--begin their clinical experience in the nurse refresher course sponsored by Bucks County Community College (BCCC), Newtown, PA.

Testing the Waters
The nurses enrolled in the class come to test the waters. Is it safe to go in? Or will they be eaten alive by the sharks? After all, they've read about managed care, health care delivery and the constant changes in nursing. They've heard the admonition from some friends--"You can't go home again."

Maybe this course will help them decide--it's like wading into the surf before the plunge. They question: Is it possible to reenter the profession with minimal stress, at a time when clinical knowledge becomes obsolete quickly? Can they really learn new skill sets governed by medicine's technological revolution?

Learning to Swim Again
Sensitive to the needs and insecurities of these nurses, the BCCC course maintains a 1:7 instructor to student ratio. A nurse preceptor at the hospital works with them at all times during their clinical experience.

"We nurture the returning nurses to make them feel comfortable. To decrease stress, no tests are given in the course," reported Barbara Capozzoli, RN, continuing education project coordinator of Nursing and Allied Health and administrator of the refresher program.

In operation for more than 10 years, the BCCC program, is offered during the fall and spring semesters and if there is a need in the summer semester.

The 80-hour class meets twice a week and is divided into 48 hours of classroom instruction and 32 hours of clinical experience. In spite of the individualized instruction, BCCC strives to keep the tuition, now $525, affordable and competitive, according to Capozzoli.

Need to Become Cross-Trained
John Bellitta, RN, Paoli (PA) Memorial Hospital, Jefferson Health System, enrolled this semester in the BCCC refresher course. While the psychiatric nurse has been practicing since he graduated in 1995, he wanted to ensure that his drug knowledge and medical-surgical clinical skills remain current.

"On our unit, we care for many patients with chronic medical problems and patients transferred from ICU who have overdosed and who require monitoring and medical care. I wanted to become cross-trained, Bellitta explained.

"On the first night of our clinical experience, I followed a nurse and got some good experience with IV's. By the end of the evening, I was much more comfortable with these skills," commented the psychiatric nurse.

Confidence Builder
Carol Seese-Roberts, BSN, RN, Bensalem, PA, a veteran nurse of 20 years, worked as an agency nurse and in home care before she took a four-year hiatus. Even though she hadn't been away too long, she thought it would be best to take the BCCC course. "I wanted to take it slowly. I felt nervous about returning to practice. Taking this course has been great. The instructors have helped me to restore my confidence."

Upon completion of the course, many of the nurses, armed with a certificate and a letter of recommendation, return to practice, according to Capozzolo. A future goal of the program is to invite former students back to share their re-entry experiences in a support group.

Re-Entry in New Jersey
For New Jersey nurses considering returning to practice, Rutgers University College of Nursing, Center for Professional Development, offers a 140-hour course with 70 hours each of theory and clinical instruction. Held at the New Brunswick campus and JFK Medical Center, the student/faculty ratio is 1 to 8-10 and tuition is $995.

Buyer's Market
As a nurse educator and as a consultant to ADVANCE for Nurses I have received calls from many nurses asking me where they could take a refresher course. I have advised them that there aren't many options available to them. I would tell them that these programs are expensive to run and there really wasn't a need.

In other words, the supply and demand factor prevailed. I told them they might have to wait until the next nurse shortage surfaced.

Well, we're moving into that era right now.

Pam Hain, BSN, RN, Norristown, PA, a student in the BCCC program, is finding that re-entry may be an easier transition than she thought. Hain who graduated from nursing school in 1980 has worked as a case manager for an insurance company for the last eight years. When she decided that she wanted to practice on a per diem basis, she signed up for the BCCC course.

To her pleasant surprise, she has already been interviewed for a position at a prestigious teaching hospital in Philadelphia.

Mark Baiada, president, Bayada Nurses, Moorestown, NJ, confirms my projection. He believes that many employers will again offer refresher courses as the demand for nurses increases.

Gayle Pearson, DRPh, RN, director, Center for Professional Development, Rutgers College of Nursing, reported that she's had calls from employers suggesting that community health be added to the refresher course she directs.

Before long it will be a buyer's market. If you're interested in jumping into the pool, Bayada suggests that you check out advertisements in ADVANCE and your local newspaper.

Kay Bensing has been a continuing education specialist and is a consultant to ADVANCE.