Controversial Proposals Phase II

[VickyRN]

http://www.ncbon.com/forms/SummaryOfChanges.pdf

http://www.ncbon.com/forms/Draft2.pdf

This is our last chance to provide feedback. You can respond until Feb 15, 2005.

Note the definition of the pn, adn, and bsn. ("ADN/Diploma in Registered Nursing- The Associate Degree/Diploma graduate is prepared to function as a provider of care, a manager of care, and a member within the discipline of nursing. The ADN/Diploma graduate provide care to individuals with common, well defined needs with predictable outcomes in structured settings under the direction of a BSN or more experienced RN.") :angryfire Changes that have been made are that we now have until 2010 to complete the initial education requirements. All faculty must have a master's degree and a concentration in Nursing is preferred, by 2015. The student faculty ratio is back.

As these proposals now stand, many ADN and LPN nursing programs across the state will still close down, due to unfunded mandates (NLN accreditation is very costly and no monies have been guaranteed by the State Legislature to fund such an endeavor), and unrealistic educational requirements for faculty (we can hardly find BSN faculty, much less Masters, especially for adjunct faculty in the clinical setting).

This is an intense battle and your voice is desperately needed. There is a small but powerful subset of radically pro-BSN forces on our board which would like nothing better than to see these programs permanently close. This would be disastrous for health care across the state.

Here is the link for feedback:

http://www.ncbon.com/forms/DraftEducationRulesFeedbackForm.pdf

This draft needs to be copied to your hard drive, filled out electronically, and then sent back by email attachment to the designated party on the form. Any feedback forms sent to the NCBON via snail mail are generally not read and discarded.

Keep those forms, cards, letters, and emails coming in! We are making headway and we will win this battle!

[barefootlady, ADN, RN]

Once again a BON has decided that the BSN is the only path to practice as an RN. I agree with Marla, I sat for the same boards and passed with flying colors, I have taken many a new BSN and taught her/him the basic floor nursing practices, only to be told, "we are more geared to the paper end of patient care," so pass the toilet paper and get cracking. Sorry, but as a person who has only 3 elective classes to complete before going to the RN

classes for my BSN, I am tired of hearing my nursing skills are not up to PAR with a BSN. Let's get on the floor and get to work and see who knows and does what, that is the real question. ADN's don't vote because we are always working, always asked to do more than our share, always asked to fill in for a BSN who did not learn something in school or orientation, and always last to hear thanks for the job you do

Sorry to rant, but this one is a sore spot for me.

[VickyRN, MSN, DNP, RN]

Is there an association for ADNs nationally/statewide???

Thank you so much for your interest, Kelly. Yes there is a wonderful organization for associate degree nurses called the National Organization of Associate Degree Nurses (N-OADN for short). Here is the link for the N-OADN webside:

http://www.noadn.org/

[skanded]

I am a recent (12-16-04) ADN grad. I will email my comments and I am forwarding the PDF to all my fellow classmates, in hopes that they will do the same.

[VickyRN, MSN, DNP, RN]

I am a recent (12-16-04) ADN grad. I will email my comments and I am forwarding the PDF to all my fellow classmates, in hopes that they will do the same.

Thank you! Your support on behalf of nursing in NC is much appreciated :)

[CrunchRN, ADN, RN]

So, if I screw up it is the BSN who will be held responsible? LOL!

[pebbles1977]

Ok guys, as a BSN reading the replies of what's going on here, I just have to say that it seems SO wrong! Unfortunately, I need a bit of help figuring out the basics of the BON docs (busy cooking, taking care of the home, etc). Can I get some sections to look at in the docs to make sure I can make an accurate feedback to the bon? I'd really appreciate it!

[ragingmomster, BSN, MSN, RN]

Wow, I can see lots of continuing conversation here.

As an LPN who just completed my BSN, I can see both sides of the issue I think. And as a nurse who just accepted a job in Greenville, I hope you'll allow me to add my $.02.

Many BSN grads who hit the floor are in need of dire assistance in learning the basics because the program they attended focused on papers and theories. Mine included.

But if we want the profession to advance as a PROFESSION we have to look at other professions and their educational tracks. When a law student attends lectures the professor has to have a Master's degree or at least be an advanced Master's student teaching basic levels.

When you look at a medical school, you see the same thing. Other kinds of programs from Veterinarians to CPA's all work on the same principle.

ADN's are VERY IMPORTANT, and I would not advocate closing any program that turned out competent nurses. But the requirements for professors and teachers to have advanced degrees make sense, and would keep NC on par with many other states and would improve the ability of programs to become accredited or maintain accreditation.

The changes that the NCBORN is trying to make sound very sweeping and high-handed. Perhaps advocating for grandfathering would be a step in the right direction.

NO ADN, or diploma grad should have to work "under" a BSN nurse, a license is a license is a license, all require autonomy.

Nursing needs more PROFESSIONALS who will refuse to work without being respected by the professions they are surrounded by. Not just as individual nurses who have gained the respect of their fellow co-workers, but as a group as a whole.

We have come a long way from the early days of nursing, let's keep pushing forward and not get stuck where we are.

Looks more like $.04 to me, sorry for being so long-winded.

[Maggie in NC]

Before you consider advocating for grandfathering, consider other areas of North Carolina that are very rural and not close to a university-like where I live. We are LUCKY to have a community college. The closest university is 2 hours away. The average income in the county is $23,000. An ADN program is the LIFELINE for this area. Sure, we all want to go on and get a BSN but, we have to be able to live and feed our families before we can drive two hours one way for 2 years to finish a BSN program.

North Carolina has one of the LOWEST mean incomes in the south. There are pockets of North Carolina that are rural beyond your imagination. I have lived in major cities, small towns, and now in one of the more rural areas of North Carolina. We are lucky to attract GOOD doctors here. A top notch surgeon from Emory, Duke, or UNC doesn't come to Murphy as their first choice-they retire here. My point is, there are some top notch ADN nurses here and our program cranks out 100% pass rates on the NCLEX-why should we be grandfathered? Our program is working. Why should we HAVE TO HAVE BSN's to work? I am not saying it's not a good thing, I am thinking of the MINIMUM STANDARD for GOOD health care.

I live closer to Atlanta than any major city in North Carolina. Unfortunately, there are no agreements for in-state tuition with GA or TN here and living on the poverty level while trying to go to school as a transitional student makes it extremely difficult to take a step toward a BSN. Most students in the program at my school are over 25, have children, and are looking for a way out of poverty. NONE of them are stupid, NONE of them lack ambition, NONE of them lack the will to go forward, however, the best jobs here are in factories, Walmart, or the hospital and we all know how those jobs pay. Please look across the state when considering your position.

[ragingmomster, BSN, MSN, RN]

"My point is, there are some top notch ADN nurses here and our program cranks out 100% pass rates on the NCLEX-why should we be grandfathered? Our program is working. Why should we HAVE TO HAVE BSN's to work? I am not saying it's not a good thing, I am thinking of the MINIMUM STANDARD for GOOD health care."

"NONE of them are stupid, NONE of them lack ambition, NONE of them lack the will to go forward, however, the best jobs here are in factories, Walmart, or the hospital and we all know how those jobs pay. Please look across the state when considering your position."

Thanks for continuing this fantastic thread.

Please note, I never, and no-one else here that I have read, called anyone stupid, or lacking in ambition.

Also, when I mentioned grandfathering, I was speaking of ADN professors being grandfathered within their teaching position so that we do not lose nursing educators. Sorry if that was not clear.

Any institution that offers a nursing education program should have the ability to offer continuing education to their faculty or a connection with other schools so that our educators can continue their education. Educators with degrees on par with the graduates of the program in which they teach are not seen in other professions.

[RNPATL, DNP, RN]

This thread has had some really great debates and I have certainly appreicated the perspectives that have been given here. However, as is true with anything good .... this thread has a clear ability to go to the trash quickly. It is a highly passionate topic and one that has been debated for a long time.

Here is my recommendation .... let's stick with the topic that VickyRN originally started .... there is certainly enough to discuss as we see NCBON making some really bad decisions ..... ones that have the ability to impact nurses and colleges alike. Thanks for your kindness.

[VickyRN, MSN, DNP, RN]

ok guys, as a bsn reading the replies of what's going on here, i just have to say that it seems so wrong! unfortunately, i need a bit of help figuring out the basics of the bon docs (busy cooking, taking care of the home, etc). can i get some sections to look at in the docs to make sure i can make an accurate feedback to the bon? i'd really appreciate it!

thank you so much for your interest and support! here is the official response from the north carolina association of community college presidents:

to: ms. linda blain

north carolina board of nursing

from: dr. gordon burns, president

north carolina association of community college presidents

re: concerns with draft education rules

the north carolina association of community college presidents represents all of the presidents of north carolina's 58 community colleges. at our association's meeting on january 28, the presidents of north carolina unanimously approved the responses on the attached feedback form concerning the draft education rules.

our community colleges, as is the board of nursing, are committed to the highest standards and quality of nursing education. we thank you for the opportunity to respond as we work together to serve the people of this great state in both rural and urban, low-wealth and prospering, and declining and growing communities in need of adequate access to healthcare.

gordon burns

president

wilkes community college

[phone]

north carolina board of nursing

draft education rules feedback form

section .0300 - approval of nursing programs

directions: your feedback is important. please place any comments about the rules under the corresponding section on the form below and send by email to linda blain, education secretary ([email protected]). you may expand the space under each section to accommodate your comments. comments will be accepted until february 25, 2005.

this response is from the north carolina association of community college presidents representing all 58 community college presidents in north carolina. this document was approved unanimously by vote of the membership on january 28, 2005.

21 ncac 36.0120 definitions

the ncaccp has a concern with page 3, lines 5 - 18, which describe "program type." within the definitions of "bsn" and "adn/diploma in registered nursing" the language identifies "adn/diploma" as a rn and does not recognize "bsn" as a rn. if the intent is to create a new status of bsn, which is a higher level than rn, then the language should clarify this point. if a "bsn" is a rn, then the draft language implies that registered nurses come in more than one level with differing scopes of practice.

21 ncac 36 .0302 establishment of a nursing program - initial approval

21 ncac 36 .0303 existing nursing program

the ncaccp has a concern with page 7, lines 38 - 40: "(a) all nursing programs under the authority of the board shall obtain program accreditation by a board approved nursing accreditation body by december 31, 2015. thereafter, the program must maintain national accreditation to continue board approval."

the ncaccp suggests that national accreditation be voluntary for both associate degree nursing programs and practical nursing programs. there does not appear to be a correlation between national accreditation, the costs associated with accreditation, and the successful passing rates of accredited programs. the ncaccp believes community colleges and the state board of nursing should work together to provide quality programs preparing students to graduate and successfully pass the nclex. national accreditation does not necessarily accomplish this goal. it appears all bsn programs in north carolina are nationally accredited, while only a few community college programs are nationally accredited. the 2003 average passage rate for north carolina's bsn programs was 87% while the average passage rate for community college adn programs was 91%. neither nclex passing rates nor employer satisfaction surveys in north carolina support the idea that national accreditation of nursing programs adds value to the program, the graduates, or the licensed nurse in the workplace. the ncaccp suggests that our limited resources would be better spent addressing retention of students than pursuing national accreditation.

21 ncac 36 .0309 process for closure of a program

21 ncac 36 .0317 administration

the ncaccp has a concern with page 11, lines 34 - 39, which describe qualifications for program directors.

the ncaccp suggests that the director of a practical nurse program have a baccalaureate degree in nursing and a minimum of two calendar year's prior full-time employment or the equivalent in clinical nursing practice as a registered nurse.

the ncaccp suggests that the director of an associate degree nursing program have a minimum of a bsn and a master's degree in nursing, or a master's degree and at least 18 graduate semester hours in nursing.

21 ncac 36 .0318 faculty

the ncaccp has a concern with page 13, lines 11 - 19, which describe proposed changes in faculty qualifications.

the ncaccp is concerned that the rural areas of north carolina have a small number of master's prepared faculty members and have difficulty recruiting master's prepared nurses. this rule change will impact negatively on the very areas of north carolina having the greatest need for nursing programs to meet community needs. it is very difficult to find part-time faculty members with a bsn and nearly impossible to find part-time faculty with a master's degree.

the ncaccp suggests that the existing faculty qualifications in title 21 north carolina administrative code, chapter 36, section .0318 continue to be the minimum faculty qualifications and that none of the proposed changes be enacted.

21 ncac 36 .0321 curriculum

the ncaccp has a concern with page 17, lines 14 - 19, which describe clinical hours within a set time frame.

the ncaccp is concerned that this rule may place a burden on clinical facilities that serve as resources for numerous nursing programs, especially if clinical facility staff is utilized as preceptors.

the ncaccp suggests that the timing of the hours not be mandated and that the scheduling of clinical experiences be flexible to accommodate facility and program needs.

the ncaccp has a concern with page 18, lines 33 - 35, which describe average student retention rates.

the ncaccp suggests that the board delete this rule related to retention. community college students do not fit the traditional 18 to 21 year-old college student model. our students have many adult and family responsibilities that influence their ability to successfully complete a nursing program. a nursing program cannot control many of these variables, especially issues of a personal and financial nature. this rule might penalize programs in poor and underserved areas where nursing shortages are greatest.

21 ncac 36 .0322 facilities

21 ncac 36 .0323 records and reports

21 ncac 36.0324

thank you for sharing your comments.

[RNPATL, DNP, RN]

Joy - thank you for sharing these with us. I know for me, these changes have already begun to impact the hiring standards of the community colleges here locally. I know these are draft rules, but community colleges are so nervous that these rules will be enacted that they are actually acting on these drafts in their hiring standards. I am speaking about adjunct faculty positions for nurses with a BSN.

I do hope the BON listens to these suggestions and acts accordingly. Hopefully they will not turn a blind eye as these changes will be painful for our State.