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As nursing faces a backlog of care and a short-staffing crisis, professionals who left but yearn to return are being welcomed back with open arms
In the 20 years she spent outside of nursing, a lot changed for Alison Leatherbarrow. After five years working as a mental health nurse, she decided on a sharp career change – retraining as an engineer and eventually getting a job at Transport for London (TfL), where she stayed for 15 years. She also started a family.
Nursing Standard. 38, 8, 19-22. doi: 10.7748/ns.38.8.19.s11
Published: 02 August 2023
But despite the good pay and conditions in her TfL job, she came to realise something was missing. ‘They were good times,’ she says. ‘I met my husband there, and in 2015 we adopted our two children. When I went back after that to work part-time, I felt different. It didn’t seem to align with my values anymore.
‘The job at TfL was well paid and the conditions were good so I was terrified to let it go. But we decided as a family to move.
‘It came to me that what I cared about was people and making a difference, so in late 2021, I started looking for return-to-practice courses and came across the course at City, University of London. I got in touch with the course leader and it all happened quickly from there.’
At a time when the news is full of stories about nurses leaving the profession, Ms Leatherbarrow is part of a cohort that is bucking the trend and deciding to return.
They are very much needed. According to the most up-to-date official NHS vacancy statistics, published in March, the vacancy rate for registered nursing staff in England was 10.8% as of 31 December 2022, with 43,619 vacancies overall.
This was an increase on the figure for the same point the previous year, when the vacancy rate was 10.2%, with 39,721 vacancies.
» Try to get as much exposure as possible to different services while on clinical placements so you can use the flexibility of nursing to choose which area you want to work in
» Think carefully how you will juggle studying and working at the same time when doing the return-to-practice (RTP) course
» Try not to worry about returning to study The RTP courses are designed to be helpful and are well structured
» Don’t worry about how long you have been away You can return to nursing regardless of how long you have been away
» There will be support available You will have regular contact with an RTP lead who will guide you through the process at the university, while the trust will offer practical/pastoral support and IT help
Source: Collated from the nurses interviewed for this article
In this context, persuading experienced nurses who left the profession to come back is a worthwhile pursuit – and a way of tapping into years of experience, says Royal Devon University Healthcare NHS Foundation Trust return-to-practice lead (east) Emma Chandler.
‘The thing about returners is that they have that previous experience,’ she says.
‘Because of the culture of some of the ward settings at the moment, with retirements happening, some areas have a junior staff base. Having returners brings some experience to the ward and junior, newly qualified staff can call on or lean on that.
‘Returners’ experience is an advantage, and their knowledge of the profession and professional values, attitudes and behaviour. They also tend to be more mature adults so they have life experience under their belt, which helps with resilience.’
The RCN is also keen to encourage nurses back into practice. A spokesperson says: ‘We always seek to support our staff when they come back.
‘Our nurses can come from a varied background and from all walks of life, which we welcome as it adds to the valuable experience and skills they bring to our caring profession. All the additional life experience they have gained in other areas of work helps them care even more effectively for their patients.’
Ms Leatherbarrow was a mental health nurse between 1996 and 2001 and her decision to leave was tied to health issues. She explains: ‘In my teenage years I had anxiety and depression. It worsened during my nursing course because I wasn’t being treated for it.
‘When I was only 21 and I found myself in charge of a ward, I felt anxious and unsupported, so I ended up having some time off and I became depressed.’
But after two decades out of the profession, her circumstances had changed and she felt better equipped to return.
She now works as a clinical nurse specialist in community mental health.
‘I was out of nursing for 20 years, and I had not had a great deal of experience in the first place, but when I spoke to the course leader and community mental health matron who eventually employed me, they said that wasn’t a barrier,’ she says. ‘It all came back to me.’
Most nurses returning to the profession after a break will have to complete a return-to-practice course.
These are provided by universities but are paid for by Health Education England, NHS Education for Scotland, Health Education and Improvement Wales, and the Department of Health in Northern Ireland.
These bodies pay tuition fees and provide students with financial incentives to return, as well as additional financial support in some areas.
How to locate the course for you
The courses combine classroom or online study and placement-based learning. They can take between three and 12 months to complete, depending on how long the person has been out of practice.
The courses are usually generic rather than field-specific. They will offer a refresher in the clinical skills and knowledge nurses need and aim to help individuals build confidence in their practice.
University of Plymouth programme lead for return to practice and lecturer in adult nursing Adele Kane says:
‘I have a brilliant teaching team and we are passionate about our students, and for us it’s a quick reward.
We put people back on the Nursing and Midwifery Council (NMC) register twice a year,’ she says.
‘Our course operates virtually, so it’s called “blended learning” because of the practice experience that the students have to undertake.’
Ms Kane concedes that nurses can feel daunted coming back, but adds: ‘What tends to happen is a third of the way through the course, they start to feel confident in their practice.’
The NMC can offer more information about returning to the register, and the NHS offers a course finder tool to help you locate a suitable course near you.
Family responsibilities led Fiona Douglas to leave nursing in 2015 after just two years as a nurse, working first in orthopaedics and then in an acute medical unit in Belfast.
‘My family needed me at home,’ she says.
‘I have three children. My two sons had particular health needs and my marriage broke down so it was caring responsibilities that I left for.
‘Initially I intended to just take a year out but after that it extended and I never got back in time for revalidation. My registration had lapsed.’
Once her children were a little older, Ms Douglas decided to go back into nursing and she completed her return-to-practice course at Ulster University in February. ‘I want to go into community nursing, but there is a waiting list,’ she says.
‘I am in the process of applying. I also applied for a hospital services post in my trust area and I was offered a post. Recruitment is centralised in Northern Ireland and I am waiting to hear where my post will be.’
Changes that she has noticed in the NHS since she was there first time around include new drugs, treatments, increased use of technology, more nurse specialists and greater involvement of the multidisciplinary team.
Nevertheless, some things remain unchanged, she says. ‘The basics that I learned back when I qualified are similar and there still appear to be shifts where there are staff shortages.
‘I wanted to be a nurse again and to help people. Whenever I have been in the job and when doing clinical placements, I can give a good service and that’s where I want to be.
‘When I went back on the placements, I felt like I had never left nursing.’
Beverley Anderson returned to nursing in 2021 after a decade of running her own chiropody business, and she couldn’t be happier.
After qualifying in 1991, she worked as a children’s nurse and then as a health visitor.
Ms Anderson left nursing in 2011. ‘From a health visiting point of view, it was a long time to have been doing that and the role had changed to more child protection and less prevention so I left and initially I did girl Friday jobs anywhere I could,’ she says.
‘My friend had just opened a chiropody clinic. I then looked into becoming a chiropodist myself and I did a diploma. In 2013, I qualified as a foot health practitioner.
‘I grew my business over the next ten years in Devon and it was lovely.
‘The downside of working for yourself is that you never stop. And it’s not just the face-to-face work, it is also all the background stuff you have to deal with.
‘One of my clients is the CEO of a hospice and he said to me: “Do you really want to be doing this for the rest of your life?”
‘He asked, “Why wait to go back to nursing?” It encouraged me to start looking at return-to-practice courses.’
Ms Anderson is now a community specialist nurse for a hospice charity. ‘Being in the right place is important,’ she says. ‘I have the team here and I feel the support. It’s still busy but I was born to be a nurse and I love it. It feels right to me.’
Employers are keen to draw on the pool of experience and knowledge that returning nurses can bring to the workplace.
Royal Devon University Healthcare NHS Foundation Trust clinical learning facilitator and return to practice lead Emma Chandler, pictured right, says: ‘Persuading former nurses to return is a good source of untapped talent to draw on. They have a lot to offer.’
She acknowledges that some nurses may be nervous at first. ‘If they have been out for more than five years, then a lot has changed, especially with technology. If that returner isn’t tech savvy, then it takes them that little bit longer to get confidence with it.
‘However, we still need to have those basic, fundamental skills from nurses – those interpersonal communication skills, good bedside manner, the same levels of patience and resilience.
‘Those core skills never leave us and that is one thing that return-to-practice nurses all have in common.’
Although there is support when doing a return-to-practice course, there are challenges, especially if you have been away from the profession for a significant period of time.
Ms Anderson says: ‘It was a challenge returning to nursing after ten years away, especially as I was changing from children to adults.
‘But the underpinning of nursing when you are assessing, planning and communicating was all the same.’ Ms Leatherbarrow agrees.
‘On a personal level, I don’t get paid as much as I did with TfL, so I have had to give up some salary,’ she says.
‘But I feel I am making so much more of a difference now than in my last job. I am older now and more experienced and I don’t suffer with anxiety.
‘The drugs have moved on. There are more effective treatments now, but far fewer resources and the community team are under-staffed and reliant on agency.’
For Ms Douglas, challenges include the lack of a nursing bursary in Northern Ireland and building up her confidence.
‘A challenge for me has been my confidence and coming back as someone who has been out of the profession for a while, wondering if I would be supported or thrown into the deep end,’ she says. ‘Thankfully it was a positive experience.’
