RN Refresher Course

This course meets the states of Washington and Alaska requirements for re-entry into practice for nurses who have allowed their license to lapse or become inactive for longer than 3 years and/or are required by the state board of nursing. This course is also for nurses who have an active license and want to return to a clinical position, and who would like a review of nursing theory and the opportunity to practice and refresh their nursing skills.

Course Overview

  • Washington State University requires students and personnel to be vaccinated against COVID-19. The only exemptions being considered at this time are medical and require proper documentation. Acceptance of those exemptions is at the discretion of individual clinical sites, not WSU.
  • Self-directed online review of medical/surgical nursing theory & pharmacology.
  • 2-day live session for Skills Review Immersion on the Spokane campus.
  • Up to 160 hours of clinical experience with a facility in your area.
  • Total cost for all 3 sections is $3,600.
  • Eligible for 240 continuing competency hours for license renewal.
  • To start the registration process, please complete the online application. You will be contacted by the professional development office.


Program Coordinator

Course Description

The RN Refresher Course provides you with a self-directed review of medical-surgical nursing theory and pharmacology in a three-part series. The theory portion of the course can be started at any time throughout the year. A two-day Skills Review Immersion will be conducted at the WSU College of Nursing in Spokane and promotes application of principles as participants practice nursing skills in a simulated learning environment. Upon successful completion of those two sections, a nurse-precepted clinical experience is completed in a health care facility. The clinical setting is determined by your past work experience, your goals related to nursing practice, and the availability of a preceptor in the clinical agency and geographic location.

Course completion meets Washington requirements for reactivation of a lapsed or inactive nursing license. The course has also been helpful to people who have maintained a nursing license and want to return to nursing without recent nursing experience. Other states, including Idaho and Oregon, have approved the course offered by WSU and refer nurses to our program. If you are unsure if your state will accept the course for re-entry into nursing practice, contact your state nursing commission.

Philosophy statement

The RN Refresher Course aligns its philosophy and purpose with the WSU College of Nursing. Information on the college’s mission, vision, values, goals and program outcomes, and student expectations and responsibilities, can be found in the Undergraduate Student Handbook and the Strategic Plan, both located at nursing.wsu.ed. The Office of Professional Development provides support and training for nurses who are returning to nursing or making a change in their practice area, so that each nurse can enhance the health and quality of life for themselves and those they serve.


To be eligible for this program, the learner:

  • Must be able to show documentation of valid COVID-19 vaccination prior to enrollment into the program. Medical exemptions with documentation will be considered, but acceptance of those exemptions is at the discretion of the clinical site, not WSU.
  • Must have taken NCLEX and passed.
  • Have an Active, Inactive, Retired, or Expired US RN License and/or those with orders/disciplinary requirements from the state that mandate a refresher course.
  • Held a US license or for those that were educated outside of the US have approval from the Washington Department of Health to enroll in the program
  • An applicant with a suspended license will not be eligible.
  • The applicant has been out of practice for less than 15 years.
  • An online application needs to be completed to initiate a telephone/Zoom interview. The application does not commit the learner to enroll in the program.

Once the Professional Development office at the College of Nursing receives your application, we will conduct a telephone interview with you to ensure that the timing and logistics of the course meet your specific needs. The interview includes a discussion of how best to accomplish the self-directed theory section, scheduling a time to attend the Skills Review, and gathering information about education and experience that will facilitate setting up the clinical experience. We have many affiliation agreements already in place with clinical agencies throughout Washington. However, if you want to fulfill the clinical experience in a site without a WSU affiliation agreement in place, we will work to obtain an agreement – please note this may take upwards of 6 months. Note: students are not guaranteed placement in high-demand agencies and specialty units.

Clinical Experience Prerequisites

In some cases, proof of meeting the following clinical prerequisites may be requested by the clinical agency.

  • Professional license, Limited Education Authorization (LEA), or permit to practice nursing depending on the requirement of the state in which you live. The forms to obtain an LEA in Washington are found on the Department of Health website (PDF).
  • An LEA is required for all RN Refresher students without an active license and is valid for nine months from the time it is issued, and can take up to six weeks to receive.
  • Basic Life Support, Healthcare Provider Course, completed in your home community and approved by the American Heart Association.
  • Immunizations as required by the clinical site and outlined in the affiliation agreement.
  • Payment to WSU of approximately $15 liability insurance coverage. Information will be provided to participants to complete payment and initiation of WSU Liability insurance. Must be on file before setting up a clinical placement.
  • Pay for a state and national background check through CastleBranch.com at the cost of $80.75. Information will be provided to participants at the time of enrollment and results must be available prior to setting up a clinical experience for course participants.

Course Map / Requirements

Each of the three components of the course (theory, skills review and clinical) must be successfully completed to meet the requirements for reactivation of a lapsed/inactive RN license, or to satisfy disciplinary requirements. The entire course must be completed within one year from the time the theory component begins. However, nurses who are satisfying disciplinary requirements will observe the completion date stipulated in their disciplinary orders. Upon successful completion of all three sections a final certificate will be presented to the learner. In addition, the Nursing Care Quality Assurance Commission or the WA Board of Nursing will be notified of your successful completion of the requirements.


Completion of the theory section is not dependent upon college schedules; an individual may begin theory at any time throughout the year. You choose a pace for completion of the requirements that best suits your schedule, keeping the one year limit in mind. The course places emphasis on medical-surgical nursing concepts, pharmacology, and the nursing process, managed care, evidence-based practice, critical pathways, principles of health assessment, and clinical application.

The course materials are accessed through a learning management system called Blackboard. Materials include:

  • Course syllabus
  • Textbook reading assignments
  • Learning activities
  • Self-evaluation quizzes and answers
  • Assignments
  • Unit exams, based on medical-surgical and pharmacology content, are administered and graded electronically via Blackboard
  • Final examination
  • Folders containing:
    • Skills Review Immersion Information
    • Clinical Information
    • Virtual Simulation Information
    • Dropboxes for online submission of documents and assignments

Skills Review Immersion

This component takes place at the WSU College of Nursing in Spokane, 103 E. Spokane Falls Blvd. The Skills Review Section is a two-day immersive experience. Dates available for the review will be discussed during the initial phone interview and updated on the website. Information on these sessions, including registration, will be provided in the handbook once the learner registers for the Theory section.  This requirement may be met at any time the nurse is enrolled in the theory portion of the course, during the Skills Review session, students are provided practice time to learn and regain basic assessment and nursing skills.  At the conclusion of the session, each student will be individually validated on the designated skills, assessment techniques, and math skills used in medication preparation/administration. The skills review session must be completed before beginning the clinical experience.

Clinical Experience

This component takes place after the successful completion of the theory and skills review sessions. The course clinical coordinator will assist in arranging a clinical experience with a healthcare facility in your area. The clinical site may be either an acute care facility, long-term care facility, or non-traditional setting where a registered nurse is available to serve as the preceptor, and the clinical objectives may be met. High Demand facilities and specialty units placement cannot be guaranteed. The Office of Professional Development will provide every effort to place our learners in sites as available. Flexibility in the learner’s choices will help to ensure timely placement. As of Sept 1, 2020, the 160 clinical hour requirement can be fulfilled with at least 80 hours of qualified direct patient contact hours and up to 80 hours of virtual simulation. Please refer to the Clinical Experience Prerequisites section above for more detailed information. All clinical placements are at the discretion of the Director of Professional Development and the clinical agency. The agency can terminate a clinical experience for patient-safety concerns. 

Please note: clinical sites are not required to grant requests for participation in the clinical rotation. Students with Nursing Commission orders must refer to those orders concerning limitations on clinical placements. Early planning will avoid delays.


Course Fees

Theory self study$1,600Paid with registration
Skills Review Immersion$1,000$100.00 non-refundable deposit made before Skills Review.
$700 balance paid 10 days prior to class attendance
Clinical experience$1,000$100.00 non-refundable deposit made before clinical placement process. $700.00 Due before the first day of clinical experience.
Liability insurance company payment to WSU (adjusted each Sept.) $15
CastleBranch.com background check$80.75
Clinical Placements Northwest (if required) $75-$100
BooksSee list for Med/Surg and Pharmacology books

Personal Fees

  • Personal fees prior to clinical experience will vary depending on the specific requirement for uniforms, shoes and equipment.
  • Basic Life Support, Healthcare Provider Course – American Heart Association
  • Immunizations (specified by affiliation agreement with the agency)
  • Textbooks will cost $200 to $300, depending on whether you buy the optional titles. If you buy used textbooks, be sure to get the correct edition of the book.
  • Books
REQUIREDBrunner and Suddarth's Textbook of Medical Surgical Nursing, 2017
14th Edition, Lippincott
One volume edition ISBN: 978-1496347992,
Two volume edition ISBN: 978-1496355157
Note: it's a matter of preference which edition you buy, the one-volume edition is large and difficult to handle; the two-volume edition may be available for purchase at the same price.
$170 new text - E-text availableYou may purchase the book on the Lippincott website. Or you may buy this book from other retailers. Make sure you purchase the correct edition.
Pharmacology and the Nursing Process, 2017
9th edition, Mosby
ISBN-10 : 0323529496
ISBN-13 : 978-0323529495
$110 new text. E-text available.
OPTIONALMath for Meds: Dosages and Solutions, Curren, Witt.
11th Edition
ISBN-13: 978-1111540913
ISBN-10: 1111540918
$86 new text. E-text available.
Mosby's 2020 Nursing Drug Reference, Skidmore-Roth, 33rd ed.ISBN-13: 978-0323661362
ISBN-10: 032366136X
$45 new text. E-text available.

Accommodations and grievance procedure

Reasonable accommodations are available for students who have a documented disability. Please notify the instructor during the first week of class of any accommodations needed for the course. Late notification may cause the requested accommodations to be unavailable. If you have a disability and need accommodations to fully participate in this class, all accommodations must be approved through the WSU Spokane Student Affairs Office: Jane Summers at jane.summers@wsu.edu or (509) 358-7537. See Student Affairs website.

Student grievances may be addressed by following the same procedures listed in the Undergraduate Student Handbook (PDF), found on the College of Nursing website.