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What can an experienced RN working in pediatric home care do to get a position in a hospital with a union?


Dear Donna,

I left my 30-year career in a hospital to work pediatrics home care. I love it, but you do not get paid for sick time, time off or any other benefits. Every employee earns the same hourly wage, and I’ve never had an increase in pay, not even a cost of living increase.

My dilemma is trying to get a job at a hospital. I have two local hospitals in my area; both have unions. I have applied repeatedly. I was told by a nurse friend they will never hire me because of the union and because they would have to pay me on the years-of-experience scale. What can I do?


Dear Donna replies:

Dear Desperate,

“Believe half of what you see and none of what you hear” is an old expression that applies to your description of gaining employment at a hospital. The hospital job market has changed dramatically in the last four to five years, and most hospitals across the country, whether union or non-union, are hiring nurses only with very recent (within the past six months) hospital experience. This is because jobs are shifting out of the hospital into alternate inpatient settings, such as the home, the community and so on. There are fewer hospital jobs and more nurses vying for them.

I seriously doubt your recent experience has anything to do with the hospitals being union facilities or your years of experience. It most probably is due to the fact you have not been recently working in a hospital. This is all very different from the way things used to be, which is when any nurse could get hired in a hospital at any time. Many nurses are not aware of these changes and/or are having trouble accepting and acknowledging them and that they have to change the way they go about seeking an RN position.

There is no reason to panic. The jobs are out there, just in different settings and roles. Many homecare agencies do offer the same benefits or similar benefits you would get in a hospital, so shop around for one in your area that does. Most alternate inpatient facilities, such as sub-acute, long-term acute care and inpatient rehabilitation offer good benefits too.

Many of these facilities are caring for patients with very high levels of acuity. There also are specialties/opportunities such as hospice, outpatient hemodialysis and cancer care centers where you can seek employment. Hospitals are not your only option.

To get up to speed with trends in healthcare delivery and the changing role of the nurse, read “Nursing —A new paradigm” ( And even though you’re not a new nurse, the article, New nurse, new job strategies ( gives you more info about the current job market and what you have to do to be marketable and competitive.

Since networking is a great way to stay abreast of trends, learn of opportunities and make connections to get hired, you should attend and become active in local meetings of nursing associations, even as a guest if you don’t belong to any. Try both the American Nurses Association ( and the American Association of Ambulatory Care Nurses ( You also should attend nursing career fairs as non-traditional employers often exhibit there.

The times and the nursing market are changing. Every nurse, both new and experienced, has to look in new directions for employment to find and get hired.

Best wishes,

By | 2014-06-26T00:00:00-04:00 June 26th, 2014|Categories: Blogs, Nursing Careers and Jobs|0 Comments

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