Reference check questions for registered nurses

A nurse’s references are the closest you will get to watching them work a shift. A license tells you a nurse may practice. The people who worked beside them can tell you how they practice: how they escalate a patient who is getting worse, how complete their charting is and what the oncoming nurse knows after their handoff.

Anchor every question in something the reference saw. A charge nurse who worked forty shifts with the candidate can answer "tell me about a time" questions that a reference who met them twice cannot, so start by confirming how much of the candidate’s practice each reference observed.

Who to ask

• A charge nurse or unit manager from a recent position, who saw the nurse across many shifts.
• A preceptor or clinical instructor for a new graduate, who saw how quickly safe habits formed.
• A provider or pharmacist who worked with the nurse often, for how they raise concerns and questions about orders.
• For a charge or leadership role, a nurse they supervised or precepted.

Questions to ask, by competency

Choose the competencies that matter most for the position and two or three questions from each. Ask every reference the same set, and when an answer is a rating, ask for the example behind it.

Patient safety

Much of what goes wrong on a unit is caught, or missed, by the nurse at the bedside.

1. Tell me about a time the candidate noticed a patient deteriorating before others did. What did they do, and how quickly?
2. How does the candidate handle medication administration when they are interrupted or short on time?
3. Have you seen them question an order they believed was unsafe? How did they raise it, and with whom?

Clinical judgment

Protocols cover the common case. Judgment covers the patient in front of the nurse when the case is not common.

1. How does the candidate prioritize when several patients need them at once? Can you describe a shift where that happened?
2. When the candidate is unsure about an assessment or a procedure, what do they do?
3. Compared with other nurses at the same level of experience, how would you rate their clinical judgment, and what is that rating based on? (rating)

Documentation and handoffs

The next nurse and the next provider work from what this nurse charted and said at the end of the shift.

1. How complete and timely is the candidate’s charting? Has any of it needed correcting after the shift ended?
2. Describe one of the candidate’s shift handoffs. What would the oncoming nurse know after it?
3. How does the candidate document a late entry, an incident or a conversation with a provider?

Teamwork and communication

A unit runs on how nurses work with nursing assistants, providers, families and each other.

1. How does the candidate work with nursing assistants and other support staff on a busy shift?
2. Tell me about a time the candidate dealt with a distressed or angry family member. What did they say and do?
3. How do they respond when a colleague asks for help with a patient who is not theirs?

Close the reference

End every reference the same way: ask whether they would hire or work with the candidate again and why, what support would help the candidate do their best work, and whether there is anything else you should know. The general question bank explains why the first of these matters most.

Checks a reference does not replace

• Authority to practice where care is provided. Before assigning nursing duties, verify an active RN license covering each work state or an applicable active Nurse Licensure Compact privilege. For telehealth, check the state where the patient is located. A single-state license from elsewhere is not enough. Check status, restrictions and public discipline with the relevant board of nursing and Nursys QuickConfirm, whose authorization-to-practice map covers participating boards. Confirm both the home-state multistate license and the destination-state privilege when using the compact.
• The federal exclusion list. The HHS Office of Inspector General says anyone who hires a person on its List of Excluded Individuals/Entities may face civil monetary penalties, and that health care employers should check the list for new hires and current employees.
• Certifications the role requires, such as life support or specialty certifications, with the organization that issued them.

Warning signs to follow up

• A reference who worked alongside the candidate but cannot describe a single patient situation they handled.
• Hesitation, or a change of subject, when you ask about medication safety or charting.
• Every reference is a peer on the same shift, and nobody who supervised or precepted the candidate is offered.
• Dates, units or job titles that do not match the candidate’s application.

One warning sign is a reason to ask another question, not a verdict. Reference check red flags covers how to check a concern fairly.

Questions to leave out

Ask only about the work. Before an offer, the EEOC’s guidance says an employer may not ask a third party, such as a former employer, any question it could not ask the candidate directly. Leave out health, medical leave, age, family plans and other protected characteristics. What to leave out has the full list.

This article is general information, not legal advice. Confirm the requirements that apply to your organization, and in your state, with your counsel or HR policy office.