Excelsior and Clinical Issues

CSLee3, ASN, BSN, LVN, EMT-P · Jul 20, 2006

Yes, it is frustrating depending on what state you are in. In Texas, LVN's (Same as LPN) have 840 clinical hours minimum and 558 hours classroom time minimum. So our state, at least as of yet, doesn't have a problem with Excelsior, BECAUSE, CPNE grads are either LVN/LPN or Paramedics, therefore have clinical time and experience. I, too, don't under stand why a few states don't allow Excelsior. Some of them allow you to test and get licensed in another neighboring state then obtain a license by virtue of endorsement. So it all is pretty silly!

Does anyone have a current list of states that are "hatin" on Excelsior?

ERDUDE

anticoagulationurse · Jul 20, 2006

Excelsior publishes a State Board booklet/guide that lists special requirements of each state that has special requirements of EC grads. I wouldn't call it the real scoop on "hatin'" because I doubt EC would admit to that, but it's a start of indicating problems...

The endorsement thing - yeah - weird. According to WA I can get my RN license no problem in any other state, work there for a certain # of hours and THEN WA will endorse my license as if by that point it will not have mattered from what school I graduated. That is what I plan to do, so I am not complaining as the back door opens, but it sure doesn't make sense to me!

barbiedee · Jul 21, 2006

At least you can get a license after chalking up some clinical hours. My EC ADN will NEVER be recognized where I live. So all my money and effort is for naught if I want to stay here. (and yes, I did check with the provincal RN association first. Long story. If you really want to know the particulars PM me!) So smile....it could be worse. And, no, I haven't decided whether to move to the US or not. I'm still trying to figure out what my options are. And thinking of possible solutions so it can be accepted here. Oh well, too late to turn back now. I'll be the most over educated LPN in BC.

Laurie888 · Jul 21, 2006

I'm in the eastern panhandle of WV so I have a variety of states I can work in, but Maryland is where I've been working. Now Maryland is having a problem in allowing Excelsior students to test for RN licensure. Appealing that on Tuesday. If I move a couple miles down the road to Virginia and switch my license there, I can work in Maryland with no Maryland license. Once I work 500 hours (at my pace that's about 7-8 months at substandard pay) in WV I'm also good to transfer but ONLY because I know for sure that Excelsior grads were being approved as of the date I graduated (but I dilly dallied about a month before sending in my app).

But this is what takes the cake. My own boss in Maryland is hesitant to hire me as an RN (I'm not an LPN) because it's been so many years since my clinical experience in college (8 years), which I kinda understand and at least she's not saying no never and I did start an internship to kinda 'show my stuff' but didn't really have time to finish it because my mother is terminal and it's unpaid time. That's not the cake taker. The cake taker is that another hospital in rural WV hired me, no problem! THEN 3 weeks into my orientation, after my preceptor was pretty much letting me handle the whole (small) module by myself, they call me in and start asking questions about my education and pretty much suspend me pending a decision. Of course I'm not interested in going back there no matter what they decide, fortunately I never quit my other job (keeping my foot in the door pending my appeal to Maryland BON).

I know most people don't have this much trouble getting a job after graduating but me, let's just say this is not fun! I don't mind nursing home work but I really wanted to get my year or two of acute care done so I could do some traveling when my boychild comes of age and leaves home in a few years.

deej · Jul 22, 2006

That's absurd. You were hired, you were on the floor, you had obviously satisfied your preceptor that you were a competent nurse...and only THEN someone raised a nonexistent "issue" with your education? I hope you have a union.

That's why it's so important for EC grads to fight the disinformation and ignorance that opponents of nontraditional education try to spread.

firepilot17 · Jul 24, 2006

Hello. First post, and I have to add my 2 cents worth. I'll be taking excelsior nursing concepts I soon, and I'm a paramedic. I work in an ED part time and let me just say that the new grads that I've worked with from a traditional 4 year nursing program, well, let me just say I'm not impressed. I've answered more questions and showed them how to do more things than I can count. They are timid and very unsure of themselves. I had to explain to the patient what was happening and what to expect. Maybe it was just the one's I worked with, but wow, I figured if the hospital will hire them, we from excelsior will have no problem. There's alot to say about experience.

anticoagulationurse · Jul 24, 2006

well, that is really a bummer there's so many issues out there with ec grads and the state boards. someone on a different thread once made great points about the nclex being a national, standardized exam and presented a great idea to actually make an rn (or lpn) license national. he suggested a national nursing license. i wonder if physicians have the same issue (not that there's an online md program! yikes) with different states and their different requirements.

i guess if the issue is curriculum, well the different schools of nursing in each state have different standards from one another yet their grads have no problem moving on, simply because the education was obtained in that state. how silly, redundant and absurd! it is totally counter productive to the nursing shortage and mandatory overtime crises in some areas.

if the issue really is about clinicals then how can sbon look past the clinicals in work experience (some of you have lots of years and lots of variance of skills in nursing), let alone previously earned and related nursing education. sorry, they seem to make a really big deal about the difference between lpn and rn, but in real life where the lpns are doing the same job for less pay than the rns i don't see a lot of difference. besides education that is, and once that education is earned - really earned, you cannot ride the wave in excelsior programs like some students who squeak by in traditional schools - what should it matter from whence...

Ginger's Mom, MSN, RN · Jul 25, 2006

I have never practiced as a LPN but have worked with many great ones. Read your nurse practice act, as a LPN you never should have been allowed to practice independently. There should have been a MD or RN license you are working under.

A a LPN you should have never worked independently or been in charge of a floor. There are many CNA who give better care than a LPN but that does not make them a LPN

cardiacRN2006, ADN, RN · Jul 25, 2006

Hello. First post, and I have to add my 2 cents worth. I'll be taking excelsior nursing concepts I soon, and I'm a paramedic. I work in an ED part time and let me just say that the new grads that I've worked with from a traditional 4 year nursing program, well, let me just say I'm not impressed. I've answered more questions and showed them how to do more things than I can count. They are timid and very unsure of themselves. I had to explain to the patient what was happening and what to expect. Maybe it was just the one's I worked with, but wow, I figured if the hospital will hire them, we from excelsior will have no problem. There's alot to say about experience.

This may be a little OT, but bear with me. As a PCT I could tell nurses how to do lots and lots of things. That was because I had been there for almost 8 years, and they were new there. I might have even thought that I was smarter than a few of them. The second I stepped out on the floor I found out I was wrong. Now, if you are a new grad (and working someplace new) and still telling the other nurses how to do things and you are still a shining star, then that's something else.

But you're right about experience-it's huge when it comes to success in nursing school or being a nurse.

anticoagulationurse · Jul 26, 2006

I totally get it and have read the NPA, etc. Real life is a different story from the state NPA. I guess, probably because of the nursing shortage, LPNs are being used in a lot of floor nursing functions and some even in charge nurse functions. So that's what I mean my same job less pay. Maybe we shouldn't, but what's an LPN to do?

RN34TX · Aug 12, 2006

Excelsior publishes a State Board booklet/guide that lists special requirements of each state that has special requirements of EC grads. I wouldn't call it the real scoop on "hatin'" because I doubt EC would admit to that, but it's a start of indicating problems...
The endorsement thing - yeah - weird. According to WA I can get my RN license no problem in any other state, work there for a certain # of hours and THEN WA will endorse my license as if by that point it will not have mattered from what school I graduated. That is what I plan to do, so I am not complaining as the back door opens, but it sure doesn't make sense to me!

To address the many comments here about how a particular state won't allow initial licensure of EC grads, but will do so if endorsing after a certain number of clinical or employment hours, here is how it does make sense from the point of view of an experienced RN endorsing into another state:

The whole idea behind licensure restrictions with regard to educational/clinical requirements is based on the questioning of whether the applicant in question is going to be a safe and competent practitioner in a particular state. The state BON is in a position of deciding this when receiving licensure applications.

For example, an RN in another state who graduated from EC 10 or 20 years ago after being an LPN for years and has practiced full time continuously as a staff RN in an acute clinical setting with no problems or issues being reported is most likely not going to pose any problems as an RN in their new state.

On the other end of the spectrum, the state may have received an application from a nursing assistant who completed 50% of their traditional RN program, so they gained entrance into EC as a result and passed the CPNE and/or NCLEX. They have not yet worked in any type of licensed capacity and are now trying to endorse or gain initial licensure into Washington.

Those are two completely different applicants with different risk factors involved in granting them licensure in Washington.