How Can the California BRN Improve the Licensure Process?

[vickymarie]

Hi everyone!

So, I'm a new grad from a BSN program, and a large majority of my graduating cohort (as well as many others from other programs, from what I've read) have been feeling a great deal of frustration with the delays in receiving our ATT's and the BRN's limited capacity to process applications that it definitely knows it's going to be getting.

Some friends and I got into a discussion today and were trying to see if anything could even be done. It seems like the system itself is what's lacking, and that the applicants AND the employees are both frazzled in trying to deal with it. It seems to me like the BRN could do with some QI of their own.

So... I guess I just wanted to see if I could spark up a discussion about what, if anything, we could advocate for as nurses and future nurses far as improvements to the process?

I don't know if it's allowed here to post, but I started a Change.org petition this afternoon containing some of the ideas that came up today. (The link is: http://www.change.org/petitions/denise-d-brown-reform-licensure-application-processing-by-the-board-of-registered-nursing, but I worry it might not be allowed because it has the name of the Director of the Department of Consumer Affairs in the URL)

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In the State of California, 10,814 students completed a prelicensure nursing program in the 2011-2012 school year, compared to fewer than 6,000 in the 2002-2003 school year. Projected new student enrollment is only expected to increase in coming years (1). In order to begin practice as nurses, all of these graduates must submit applications to the California Board of Registered Nursing.

Implementation of the new BreEZe system and "circumstances beyond the control of the Board of Registered Nursing have resulted in inordinate delays in processing new applications, in some cases forcing potential nurses to wait 8-10 weeks after their satisfactory completion of requirements and graduation from nursing school to receive their Authorization to Test (ATT), which in turn allows them to register for the National Council Licensure Examination for Registered Nurses (NCLEX).

The delays in the process of passing this examination cause unjust hardship on applicants, who are depending upon reception of their licensure to be hired or retained in nursing positions. The delays in the process result in time, income, and career opportunities lost.

Moreover, visits in person to the Board of Registered Nursing in Sacramento often reveal that phone inquiries by applicants often yield false or incorrect information being given over the call. Often, phone calls yield no information at all, and many applicants are forced to travel in person from all regions of California in order to receive any helpful information on the status of their applications.

While we recognize that this delay reflects limitations of the new system and of the ability of the available personnel in the Board of Registered Nursing's employ, it is evident that these delays are resulting in undue burden and anxiety among applicants, and that the burden on employees of the Board of Registered Nursing have seen a tremendous increase in their workload which limits their ability to perform their job in a timely fashion.

As such, we petition Governor Edmund "Jerry" Brown, the Department of Consumer Affairs, and the Board of Registered Nursing to implement any or all of the following interventions in processing applications for licensure by the Board of Registered Nursing:

+ MAINTAIN a pool of qualified temporary personnel to aid application evaluators to address the current backlog;

+ HIRE and TRAIN both evaluators and front counter personnel to address increased demand for service and deliver timely, correct information;

+ UTILIZE aforementioned personnel in periods during which high volumes of applications are active (i.e. June and December, when many students complete nursing programs and graduate);

+ OPTIMIZE work flow and protocol to prioritize in state licensure applicants;

+ EXPLORE more efficient ways of communicating application status, rather than constant busy phone lines and the necessity to drive long distances to the Board of Registered Nursing office;

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(1) California Department of Consumer Affairs, Board of Registered Nursing. "2011-2012 Pre-Licensure Program Annual School Report: Data Summary"

Anyway, I hope there was nothing inappropriate about me posting this here... anyone named in this post is a public figure, and this isn't self-promotion, but rather trying to see if we can come together as nurses and advocate for something to make things better on the policy end of things, just as we are challenged to do in the clinical setting.

[jacksonleo]

I hope it is helpful. I sent in my application for endorsement on November 25, 2013, with any all documents requested and I am still waiting to hear anything from these people. It is about the most ridiculous thing I have ever seen. I have called three times and emailed twice and have yet to receive any information. However, the check that I sent along with the application was cashed the day after receipt. Nice one California! The most progressive State in the Union cannot get it together to get the nurses, needed to take care of the population, the license to do so in a timely manner. Ridiculous! ... and all this crazy strictness about transcripts from other states... what? I have a bachelor's and experience and passed the same NCLEX that California nurses passed so get a clue people!

I will sign your petition and spread the word.

[NRSKarenRN, BSN, RN]

Change.org. petitions are not the way to go.

What WILL WORK:

1. Contacting your state legislators on impact underfunding and state employee cutbacks effect on BON.

2. Getting the word out to international nurses hoping to move to US to stop applying to California for initial nursing license as springboard to endorsing license to another state when they never plan to live or work in CA --- help reduce boards workload.

[Esme12, ASN, BSN, RN]

In the old days we waited 4-5 months. I think CA is overwhelmed with national as well as international applications as the pay is amongst the highest in the country. CA has always been the state with the highest, most stringent requirements of most of the states....for both US grads and IEN grads. California is just as stringent with US grads and denies nurses who have completed certain programs within the US like excelsior.

I agree with Karen...I don't think change.org petitions are going to affect change.

[vickymarie]

I don't think I assumed much that the petition itself was going to be the specific agent of change. But, what I've seen in the past is that having something online and shareable has been a helpful way of reaching out to people. I saw it with the movement against the MTV show, "Scrubbing In", which gained a lot of its voice because of a well-maintained Change.org petition, paired with a Facebook community that encouraged supporters to network and speak out on social media.

But I agree, there is more that needs to be done than signing a petition. I just think that the petition is a helpful deliverable to have on social media to help get the message out and encourage others to reach out to elected officials directly. :)

[Esme12, ASN, BSN, RN]

It is just that the BON members are nothing similar to the producers of a TV show that base their success on popularity. The broad could care less about popularity.

[vickymarie]

It is just that the BON members are nothing similar to the producers of a TV show that base their success on popularity. The broad could care less about popularity.

I agree... that's why I said that I didn't think the petition itself was going to be the agent of change, but that it would be helpful as a sort of community-building and awareness-raising gesture. I think that nurses as a community, especially new grads and new nurses, have still yet to fully come into their own as a community with a collective voice, so that voice is something that needs to be gathered and developed before it can more actively be used in more effective ways to bring about change.