NSW nurses who take a five-year break are being slugged $10,000 to re-enter the profession when the equivalent course is offered free interstate.A publicly funded method of returning NSW nurses to the workforce was made off limits to those with a five-year absence in July after the switch to a national medical registration system.The private College of Nursing is now the only accredited provider of re-entry courses in NSW.The shift has caused concern that experienced nurses will be priced out of returning to the profession after time off to rear children. At least 26 Australian-trained NSW nurses have been refused registration and referred to the college’s $10,000 course since July 1.Albion Park mother of four Heather Blair has accepted a clerical job while she decides whether to act on her referral letter, issued in December by the Nursing and Midwifery Board of Australia with a shelf life of 12 months.She is considering whether to take out a loan to cover the course fee or quit nursing for good.‘‘I have no idea if nursing is something I’ll ever go back to,’’ Mrs Blair said.‘‘I hope I do ... it’s just a huge amount of money. We have a mortgage, we’ve got two kids that have started apprenticeships this year and two cars to run.‘‘We’d have to really sit down and consider the long-term options.’’Mrs Blair worked as a registered nurse at St George Private Hospital between 2001 and 2006 and doesn’t question her need for retraining, only its cost.It is unclear whether NSW nurses can attend free or low-cost courses interstate.A spokeswoman for ACT Health told the Mercury interstate candidates for its equivalent course were decided according to ‘‘individual circumstances’’ but that it was designed as a recruitment and retention tool for nurses who would bolster the ACT workforce. An operator within the Victorian health system indicated the same.Until July 1, NSW nurses who were not working could continue to pay their annual registration fee and have the option of applying for a job at any time.The shift to national registration ushered in a ‘‘recency of practice’’ requirement, where nurses had to have worked for at least three months in the past five years to retain registration. Tracey Osmond, chief executive of The College of Nursing, said the requirement was already in place elsewhere, but in NSW had ‘‘caught a lot of people off guard’’.Mrs Osmond said indemnity insurance for the course’s clinical component, lasting up to six weeks, and the cost of two days’ worth of one-on-one attention contributed to the college’s course fee. She agreed it could be a deterrent - ‘‘particularly for someone who might have taken time out of the workplace to raise a family’’. NSW Nurses Association general secretary Brett Holmes said the union was working with the Australian Nursing Federation to pursue more affordable options.‘‘A $10,000 cost for a course is clearly a disincentive,’’ he said. A spokeswoman for NSW Health said more providers were likely to emerge in NSW with time. ‘‘Consideration is being given as to how the public system will support the re-entry of nurses required to undertake a formal program recognising the cost of the only program currently available.’’Between 2002 and 2008, more than 1800 nurses were re-employed through NSW’s publicly funded Nursing Re-Connect program. The return-to-work scheme remains available for nurses with absences shorter than five years.A 2007 Labour Force Survey showed there were 9480 qualified nurses under the age of 60 not working in the profession.NSW Nurses' Association local delegate Gordon Blair has seen firsthand the dismay caused by new return-to-work rules in the nursing profession.His wife, Heather, is one of at least 26 nurses referred to a $10,000 re-entry course since the introduction of a requirement for nurses to work three months within the past five years or lose their registration.Mr Blair believes the course cost discriminates against mothers wanting to return to the nursing workforce after an extended maternity break."They return to work, and they've been hit with this exorbitant fee without any warning," the delegate said."Just 12 months ago this concept was unheard of."If there was any warning that there was going to be a $10,000 fee, you would have had a great spike in people re-entering the workforce through the previous system."The shift occurred less than a year after the Federal Government scrapped its Bringing the Nurses Back into the Workforce Program, which provided up to $6000 in incentive payments.And it comes as the nurses union votes on a wages and conditions outcome that will require 1400 additional nurses in the public health system by mid-2013."In order to meet this [demand] they're going to need more nurses to come back to work," Mr Blair said.In NSW the number of public sector nurses fell from 43,687 in August 2009 to 43,124 in August 2010. There were unfilled vacancies for 1269 nurses.