[ToddEMTP]

I am a proud New York City EMS Paramedic preparing to enter the Excelsior nursing program.

As a professional in an urban EMS system, I've worked side by side with registered nurses under austere conditions for many years. I consider nurses to be my peers, and I have enjoyed a good rapport and a sense of mutual respect in the context of our professional relationship. The vast majority of nurses I have worked with recognize that health professionals -- paramedics and others -- can and do maintain valuable clinical experience and skills.

However, there is always a small minority of divisive individuals in healthcare and academia who are blind elitists. These are the ones who summarily conclude that if you were not a codified student of a particular discipline, you know nothing. Frankly, I think there needs to be a more nuanced and respectful analysis on the part of those few who think that the clinical experience of other health care providers outside of their own scope of practice amounts to nothing.

Excelsior College attempts to address this problem by recognizing that paramedics like myself, as well as LPNs, PAs, MDs and others, tend to acquire clinical skills that are reasonably compatible with nursing. Excelsior provides a bridge for those providers to fill in any gaps and cross over into nursing in the same way that nurses have demanded a bridge to cross into the paramedic's domain (as PHRN) without having to go through the extensive paramedic training programs and EMS internship.

The two states that summarily reject Excelsior grads do so because they believe the program provides insufficient clinical training compared to traditional programs. This ignores the fact that all students are required to be licensed healthcare providers with clinical experience from the outset. The typical paramedic working in the field has patient care experience that, frankly, meets or exceeds that of most nursing students, and it is probably fair to say the same is true of many other experienced clinicians.

I would argue that the minority powers-that-be who do not see this logic have probably failed miserably in their responsibility to be discerning in their judgment. The fact that there are Excelsior nurses practicing in all fifty states in supervisory positions is proof that the paradigm works. The bureaucrats from the two states who have placed restrictions on latter-day graduates and marked them with an unfair stigma will hopefully retire soon and make way for leaders who can think outside of the box.

Paramedics, LPNs, PAs, and MDs who wish to bridge into nursing require respect. Excelsior grads are experienced clinicians that have consistently excelled in national-level clinical and didactic nursing examinations, and they deserve to be universally and unequivocally recognized as registered nurses!

[suzanne4]

Each state has their own licensing requirements and there are actually full programs that function in a normal school environment that do not meet the requirements of all states for licensure.

The exams that you take at Excelsior are not universally recognized, and there are actually 8 states that do not accept Excelsior training; more than you are actually aware of.

CA does things their way and they can accept the trainings that meet their requirements, same way that an LVN can do a 30 unit program there and get their RN license, but they are aware that it is not accepted for endorsement to any other state as it does not meet the educational requirements for the other states.

And physicians are trained completely different than nurses, same as you were trained in your program as a paramedic. And not all excel in the other field. We have seen many physicians come from other countries that had issues even with the NCLEX exam, as well as the responsibilities that go along with the RN license. All training is not the same all over the US, as well as all over the world.

The Excelsior program was approved in the past, and the states that no longer accept it did so for specific reasons. You are entering that program fully aware of its restrictions, that is something that is not going to be changed in the forceable future. If you wish to work in the role of the RN, you will need to do so in one of the other 42 states that accept your credentials.

Bes of luck to you.

[suzanne4]

And as I point this out to you, you are just starting the program now, you have not even done any of the clinicals nor have you taken one of their exams.

Things may not be as you think that they are.

I am entitled to my opinion as well as you are entitled to yours. And I do have many friends that went thru that program, including respiratory therapists, etc. But things change and you have to be able to adapt to them.

Not the other way around.

[ToddEMTP]

My research indicates that that there are exactly two states that do not accept Excelsior -- California and Maryland -- and thirteen other states who eventually accept Excelsior with additional clinical or work requirements. The vast majority of states accept Excelsior without any conditions, as they should. Would you please name the eight states that you have information on so that we can compare notes?

In answer to your point about physicians and paramedics being trained differently from nurses, you are correct. Why, then, do some nurses seek to bridge to a paramedic cert without going through the full paramedic program? The answer is that it makes no sense to marginalize the clinical experience of nurses and force them to start from scratch just because they're trained differently.

I have no intention of moving to any states that do not recognize Excelsior graduates, so this is not about me. However, when I see a glaring injustice like this, I am for the underdog. The argument that the almighty state nursing authorities do things their way and nothing can be done about it will only make me more vocal. When something is blindly unfair, people need to stand up and demand respect.

At the end of the day, there is simply no logical reason why Excelsior nurses should not be recognized in every single state and jurisdiction. All of the arguments are founded upon vague generalizations and casual assumptions that distintegrate when they are challenged.

[justme1972]

In my state, MD's or PA's would not be permitted to function in a nursing capacity.

My state requires that healthcare professionals perform to the level of your highest training.

That means that there is no way a PA or MD, functioning as an RN (and I can't imagine what scenerio in which that would occur...just for salary reasons) would be held accountable one step down...they would be held to the same standards as all other PA's and MD's.

[PsychNurseWannaBe]

Good luck in your studies!!

[Mollypita]

I am an Excelsior graduate who passed the NCLEX Feb. 4. I lived in Maryland at the time the MBON changed their policy, but since they gave us Md students until Dec. 31, 2007 to graduate, I actually benefited by getting my clinical exam scheduled faster so I could hurry up and graduate! A little ironic, I guess, but I made the deadline and passed NCLEX. Now I'm orienting with two BSN grads from a local college, and it's blatantly obvious that I know more than they do. Not that they won't be good nurses also, but it's clear that my 14 years as an LPN is relevant and helpful to my current position as an RN. So, I have to agree with Todd, but I guess I look at it philosophically. Many people are not comfortable with what they perceive as different or unconventional. Excelsior is both. But for those of us like myself who couldn't drop everything in their lives and go to school full time, it was also a huge blessing. (Except for the CPNE, but that's another conversation!!!) Excelsior helped me and others achieve our goal, and now it's up to us to prove through our job performances and knowledge that we are equally worthy of the RN title. I look forward to succeeding at that!!

[Harleyhead]

I remember a time when I took a practice CPME at the GA BON headquarters. So the GA BON would accept my money but would not reconize my degree to sit for the Ga nclex. But if you obtained your RN from an other state Ga would accept you new License. That was just klazy man.

[ToddEMTP]

Originally Posted by Harleyhead

I remember a time when I took a practice CPME at the GA BON headquarters. So the GA BON would accept my money but would not reconize my degree to sit for the Ga nclex. But if you obtained your RN from an other state Ga would accept you new License. That was just klazy man.

Yes, that's a perfect example of mindless red tape that serves no purpose. "You can't be a nurse in Georgia unless you get another state to license you first, then apply for immediate reciprocity." Georgia was one of those states that I found would ultimately accept Excelsior grads, but only after imposing senseless flaming hoops like this. Shame on them.

[mandasueRN]

Originally Posted by Harleyhead

I remember a time when I took a practice CPME at the GA BON headquarters. So the GA BON would accept my money but would not reconize my degree to sit for the Ga nclex. But if you obtained your RN from an other state Ga would accept you new License. That was just klazy man.

GA is still like that--the GNA runs the SPAC and does the CPNE at Metro Atlanta area hospitals but you still have to get your license by endorsement. I'm a proud 2006 graduate of Excelsior who works at a Level I trauma center. I passed the NCLEX the first time as do a good majority of Exclesior students--how many traditional programs can say that. I'm certified in ACLS, PALS and TNCC. I think I'm just as good of a nurse as any nurse from a traditional program. I brought years of pre-hospital experience to the table when I started the Excelsior program. When I started the program I was living in Alabama, where the BON will not license new Excelsior grads but I believe will eventually license after a year or so of experience (I'm not 100% sure though). The AL BON was very, very much against the Excelsior program and I know of a number of very qualified Paramedics who petitioned the board for an exception and were denied without a second glance. This of course is a controversial topic and I'm sure there will be quite a few interesting points of view given. I say anyone who can pass that darn CPNE will make a great nurse!