Nurses leave and come back — after raising children, after illness, after a career elsewhere, after burnout. The route back has three parts that have to be dealt with in order: the licence, the competence, and the employer.
The licence
Start with the board of nursing in the state where you intend to work, because the rules are set there and vary widely.
If the licence is current, nothing is required legally. Continuing education requirements will have continued to apply and may be in arrears.
If it lapsed, the board has a reinstatement process. Typically that means an application, fees, a background check, and evidence of continuing education. Where the lapse is long, many boards additionally require a board-approved refresher programme or a defined number of supervised practice hours — and some set a threshold, commonly around five years without practice, above which the refresher becomes compulsory.
If it expired long ago or was never renewed after a move, you may be applying afresh rather than reinstating.
Do not rely on general accounts of this, including this one. Boards publish their own reinstatement requirements, and they are specific. See state boards of nursing and nurse practice acts and boards of nursing.
If you are also moving states, the compact and endorsement questions arrive at the same time. See nurse licensure compact and licensure by endorsement.
Refresher programmes
A nurse refresher programme is a structured re-entry course, usually offered by a college, a hospital, or an online provider with a clinical component arranged locally. Typical contents:
- Theory: pharmacology, current practice standards, documentation, patient safety, and the parts of practice that have changed.
- Skills laboratory work.
- A supervised clinical placement, commonly 80 to 200 hours.
Two things to check before paying. Whether the board of nursing recognizes that specific programme, if you need it for reinstatement. And whether the programme arranges the clinical placement or expects you to find it, because finding one independently is genuinely difficult. See clinical placements.
Even where a refresher is not required, it is often the fastest route to being employable, because it produces a recent clinical reference.
What has changed while you were away
Returning nurses consistently report the same list. Electronic documentation has replaced paper and is now the largest single time cost of a shift. Acuity is higher on every unit, because care that used to occupy a higher-level bed is delivered a floor down. Medication administration is barcoded and scanned. Infection prevention practice is tighter. Rapid response teams exist. And the pace is faster than it was.
None of that is unlearnable, and it is what the refresher is for.
Getting hired
Be specific about the gap. One line in the resume — the reason and the dates — closes the question. Unexplained gaps invite the worst assumption. See nursing resumes.
Say what you have done to prepare. Reactivated licence, completed refresher, current life support certifications, recent continuing education.
Target settings that hire returners. Long-term care, home health, clinics, dialysis, and school nursing hire re-entering nurses more readily than intensive care does, and several of them train their own. See long-term and post-acute care nursing and school nursing.
Ask for a proper orientation and take the longest one offered. Being treated as an experienced hire and given a fortnight is the most common way a return fails.
Consider per diem to restart. Shift-by-shift work rebuilds skills and confidence without committing to a full rota, and employers use it as a low-risk way to take a chance on someone. See per diem nursing.
The employer's side of this
Returning nurses are an underused source in a market where the typical hospital carries 43 unfilled posts and takes 78 days to fill one. They are licensed, experienced, frequently want part-time hours, and are competing against nobody. The barrier is usually an applicant tracking system that screens on recency. See where nurse candidates come from.
Related
- Nursing careers
- Leaving the bedside
- State boards of nursing
- Licensure by endorsement
- Per diem nursing
Sources
- Nursys — National Council of State Boards of Nursing, the national licensure and disciplinary database, for verifying licence status. Accessed September 9, 2026.
- National Health Care Retention and RN Staffing Report — NSI Nursing Solutions, 2026 edition, for vacancy and time to fill. Accessed September 9, 2026.