I don't live in the U.S.A. so don't know what your regulations are. However, I must say that after 10years out of nursing it would be dangerous NOT to have a refresher course. Things are continuously changing (especially medications). In the UK it would be compulsory to undertake a course and be tested as competent. Interested to hear the responses about this.
Depending on your area of practice and community connection you might be able to shadow a nurse in practice like in a local school, MD office, or clinic. You might could also audit a med-surg course at a community college. Clinical experience is the key and one of the things that most refresher courses provide is clinicals. Apply for internships with the new grads too. Also, you don't mention your level of nursing but, if you go back to school like LPN to RN, RN to BSN that will get you more clinicals too. Good luck to you.