After finishing graduate school and working for a few years as a Family Nurse Practitioner, I took some time off to raise my family. 10 years to be exact. Although this is not an uncommon thing for women to do, I found re-entering the healthcare workforce to be far more challenging than I thought. Here is a snapshot of my journey, and some advice to help those of you who may be in a similar situation.
Step 1: Re-certification
As a registered nurse, I was able to keep my license current by simply completing the required continuing education and paying the renewal fee. Not so easy with my NP certification. One of the requirements to renew the NP certification is a minimum number of practice hours. Since I was a full-time stay-at-home mom, I had to re-take the exam. Being a busy mom of six, I needed to make a plan and time for studying. After studying for four months, I was ready to take the test.
Step 2: Job Hunting
After passing my certification exam (Yeah!), I was ready to start job hunting. Since I did not have a specialty area, I was able to focus on location. I applied for jobs in family practice, pediatrics, urgent care, acute care/hospitalist, long-term care, rehab, and specialty care both in the clinic and in the hospital. The majority of my day was spent searching the internet for job postings, completing applications on hospital websites and job sites, downloading my resume and cover letters, and emailing recruiters for three weeks! I probably applied for 100 different positions. I was contacted by about 10 recruiters for an initial telephone screening, asking things like what was I looking for, why did I chose their hospital/clinic, what relevant experience did I have, and salary expectations. The recruiters would take my resume and the screening information to their respective managers or doctors to see if they wanted to pursue the hiring process further with me. The result of all of this? 3 interview offers. Only three interviews: 3 out of 100. 3% return. Not good.
I couldn’t understand it. Why weren’t more employers looking to hiring me? I was re-entering the healthcare workforce – it’s not like I was a new grad. I had relevant job experience in both a specialty clinic and primary care, as well as experience teaching nursing students. However, I did not yet realize that new grads were actually set up better than me.
Step 3: Interviews
In addition to re-entering the healthcare workforce, I was also relocating to a new state. As a result, my first set of interviews were via telephone or video call. These conversations with physicians and office managers were a great opportunity to learn more about the position. Be sure to come prepared with questions you want to know about to make sure the job is a good fit. Do not bring up the topic of salary on the first call, but be ready to answer if they bring it up. Do your research. Talk to other NPs you know well. You can also look online at a few websites to get an idea of the average for the state, local area, and specialty area.
Interview #1: Red Flags
My first job offer was from a small clinic, for an onsite visit, but no offer to pay for my flight. The offer was lower than average and the benefits were minimal. In negotiations, I asked for a higher salary but the only change was that the end of the year productivity bonus became a signing bonus. I felt pressured by the manager to sign a contract for a year before even visiting the clinic. Talk about a red flag! Ultimately, I graciously thanked him for the offer (because it still is an offer), explained that I did not think it would work for my family, and moved on.
Interviews #2 and 3
My second two interviews were much different. These positions were for clinics that were part of a larger hospital system. They made arrangements and covered expenses for my flight, hotel, and rental car. My itinerary included a full day of touring the clinics, meeting staff, lunch in the office, and dinner with the providers. This gave me a great opportunity to ask more questions related to the job, but also inquire about the area. I got to meet my co-workers and their families at dinner and get to know everyone even more. Although the job offer was not even extended at this point, I knew that not only the job but the people I would work with were great. My advice – trust your gut. If something doesn’t feel right, then it probably isn’t right. No one should feel pressure to sign a contract for a job before even visiting the clinic and meeting co-workers.
I spent the second day of my visit with realtors that the recruiters set up for tours of the city, visits to the schools, and for some house hunting. On one of the visits, the realtor let me in on a secret. He said, “Don’t tell them I told you, but they just texted me and are prepared to make you an offer. They are really big on personality and wanted to get my opinion of you outside of the interview. I gave them a thumbs up.” After I returned home, my husband and I joked that it was the like the movie ‘The Firm’ – you never know who is working from the inside. So, during this process, be yourself and let your personality shine through. Get to know them and let them get to know you.
Step 4: Negotiation
After you receive a job offer, it is time to negotiate terms of your employment. I am by no means an expert, but advise that you read some articles about negotiating. Be ready, because most employers expect you to negotiate.
Step 5: Getting Credentials
This is where I realized the disadvantage of taking 10 years off. One of the main requirements for getting credentials and privileges within your organization is to have three references, including at least one physician, who can speak to your clinical competency within the last 12 months. I couldn’t fill that requirement, so obviously credentialing committee was willing to make an exception. (And the physician I would be working with was part of the credentialing committee, so I was really lucky). But not every organization may be willing to make that exception. Also, every physician may not be willing to enter into a working agreement with an NP (required by my state).
But even with this exception, I still had challenges to face. Two of the physicians I had worked with had died, two had retired, and another had moved. Yikes! What was I going to do?! Through the HR department and social media, I was able to track down two physicians to be references. Overall, it was a great chance to catch up with old colleagues.
My journey into re-entering the healthcare workforce as an NP took a lot longer than I thought it would. In hindsight, I wish I had worked a little throughout those years to keep to remain current in practice. It would have made getting a job and getting credentialed much easier. I feel very blessed to have this job opportunity and to be working with my collaborating physician. And I hope others can learn from my experience and return to work with more ease.