NTCX requirement

JustBeachyNurse, LPN · Aug 7, 2014

I have drafted and will later today submit my withdraw from the program. It saddens me but I see that this goal will just not be attainable.

I fully understand. I wouldn't even mind if they added clinicals throughout but adding extra costs & time to the challenge exams is pushing me to the edge.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Aug 7, 2014

I have drafted and will later today submit my withdraw from the program. It saddens me but I see that this goal will just not be attainable.

I hate to hear this but I truly understand especially since none of the nursing coursework will transfer. I fail to see the need in sinking more money into something that one knows he or she cannot attain.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Aug 7, 2014

It's not just a matter of who they admit; every US state BON has rules about minimum numbers of supervised clinical hours and classroom time to be eligible for licensure. Without saying anything one way or the other about the quality or validity of the EC program or its students, I've never understood why EC, and only EC, gets a pass on those requirements, why it gets such special consideration from most US BONs. I suspect maybe other people are starting to wonder about that, too.

But that's the thing! EC is NOT addressing the clinical aspect of the program at all. Most states that have an issue with EC has a problem with the clinicals, not the exams. But the exams are where changes are being made. To introduce clinicals at a competitive price would mean (possibly) the end to the money-maker at the end of the program (CPNE). I've sung the praises of EC ever since I enrolled in 2009. Now I see them in a totally different light because what they are doing now no longer meets the needs of its intended audience, in my opinion (working adults with obligations that prevent them from sitting in 16-week classes for another few years).

Medic85907 · Aug 7, 2014

Here's my take...

Excelsior's current model of nursing education is going to undergo major changes, none of those changes will be painless or pleasant compared to days of old.

A couple of things are forcing these changes and those things are unavoidable. The number of states with differing requirements for licensure of EC grads is growing and that trend will continue. This measure will slow students down while requiring participation, which will improve student success.

Excelsior's CPNE concept is not widely understood or accepted and the current class action lawsuit is going to effect the process. Class action lawsuits cost lots of money to defend and settle and even more money to defend and litigate. Once an entity is hit with a class action suit, whatever process that was the cause of the suit will change to prevent further bites at the proverbial apple.

EC needs to take a more aggressive approach in educating the nursing community about the CPNE process, including evidence showing that the CPNE is a valid test of clinical skills and knowledge. EC also needs to get more CPNE test sites, preferably one in each state and preferably in prominent teaching hospitals (easier said than done). This will do two positive things, this will streamline the EC experience for students and help to educate the nursing community about the CPNE process and it's validity.

If EC really wanted to improve their program they would do like every other school and take more control of the required learning resources. Under the current system students can go and buy some notes, study those and pass an exam. As it stands now EC has no control over what students are learning while independent education providers make money hand over fist by providing content tailored to EC's modules. Why EC isn't taking control over that is beyond explanation. The process of doing it would be simple. Develop the content, deliver it electronically and then tack on the cost to the price of each exam and effectively eliminate the third party entities that are currently raping some of EC's students.

Aside from all that. I don't think this change was really all that smart of a move on EC's part. This is going to negatively impact enrollment by slowing down the process and increasing costs. Combine that with licensure difficulties in some states, the lack of financial aid and the difficulties some students have finding jobs and all of a sudden a brick and mortar nursing school doesn't seem like such a bad option after all. I am glad this won't effect me at all. If this had been in place when I enrolled, I would have just gone the traditional BSN route.

A bit off topic... As for the clinical stuff, as a paramedic student I had to do 400 hours of clinical time. 200 hours on an ambulance with a minimum of 50 ALS calls (no boo boo runs allowed towards that fifty calls) and 200 hours in a level one trauma center divided as follows, 100 hrs of adult ER time, 12 hours CVICU, 12 hours STICU, 12 hrs PICU, 6 hrs NICU, 30 hrs PEDS ER and 30-36 hrs OR time(intubations and RSI). What are the hourly requirements for LPN and traditional RN programs?

elkpark · Aug 7, 2014

Here's my take...
Excelsior's current model of nursing education is going to undergo major changes, none of those changes will be painless or pleasant compared to days of old.
A couple of things are forcing these changes and those things are unavoidable. The number of states with differing requirements for licensure of EC grads is growing and that trend will continue. This measure will slow students down while requiring participation, which will improve student success.
Excelsior's CPNE concept is not widely understood or accepted and the current class action lawsuit is going to effect the process. Class action lawsuits cost lots of money to defend and settle and even more money to defend and litigate. Once an entity is hit with a class action suit, whatever process that was the cause of the suit will change to prevent further bites at the proverbial apple.
EC needs to take a more aggressive approach in educating the nursing community about the CPNE process, including evidence showing that the CPNE is a valid test of clinical skills and knowledge. EC also needs to get more CPNE test sites, preferably one in each state and preferably in prominent teaching hospitals (easier said than done). This will do two positive things, this will streamline the EC experience for students and help to educate the nursing community about the CPNE process and it's validity.
If EC really wanted to improve their program they would do like every other school and take more control of the required learning resources. Under the current system students can go and buy some notes, study those and pass an exam. As it stands now EC has no control over what students are learning while independent education providers make money hand over fist by providing content tailored to EC's modules. Why EC isn't taking control over that is beyond explanation. The process of doing it would be simple. Develop the content, deliver it electronically and then tack on the cost to the price of each exam and effectively eliminate the third party entities that are currently raping some of EC's students.
Aside from all that. I don't think this change was really all that smart of a move on EC's part. This is going to negatively impact enrollment by slowing down the process and increasing costs. Combine that with licensure difficulties in some states, the lack of financial aid and the difficulties some students have finding jobs and all of a sudden a brick and mortar nursing school doesn't seem like such a bad option after all. I am glad this won't effect me at all. If this had been in place when I enrolled, I would have just gone the traditional BSN route.
A bit off topic... As for the clinical stuff, as a paramedic student I had to do 400 hours of clinical time. 200 hours on an ambulance with a minimum of 50 ALS calls (no boo boo runs allowed towards that fifty calls) and 200 hours in a level one trauma center divided as follows, 100 hrs of adult ER time, 12 hours CVICU, 12 hours STICU, 12 hrs PICU, 6 hrs NICU, 30 hrs PEDS ER and 30-36 hrs OR time(intubations and RSI). What are the hourly requirements for LPN and traditional RN programs?

I said a few years ago on this site that I thought the trend was in the direction of more states setting restrictions on licensure of EC grads, and I got roundly hooted down. It's looking more and more, as time goes on, like I was right in the first place.

Here's the thing -- regardless of how valid or invalid a test the CPNE may be of clinical nursing skills and judgment and readiness to enter practice, the fact remains that every single US state BON has rules about how many hours of classroom time and supervised clinical time students have to complete in order to be eligible for licensure. EC students have no formal classroom and supervised clinical time as part of their program. No one has ever given me a reasonable answer about why EC students get treated soooo differently from students in every other nursing program in the US by most states. Just from a basic "fairness" perspective, how does EC get away with that? If it's okay for EC students, why not just do away with all the rules about nursing school, and all formal nursing programs, and let everyone self-study and then "test out" for licensure when they feel like it?

"As for the clinical stuff," I assume you're making the point that you had a plenty of clinical hours in your paramedic program. However, none of that time was spent learning to practice as an RN. Paramedic programs, time working as a paramedic, time working as an LPN, whatever; none of that time is time spent learning to function as an RN.

Medic85907 · Aug 7, 2014

I said a few years ago on this site that I thought the trend was in the direction of more states setting restrictions on licensure of EC grads, and I got roundly hooted down. It's looking more and more, as time goes on, like I was right in the first place.
Here's the thing -- regardless of how valid or invalid a test the CPNE may be of clinical nursing skills and judgment and readiness to enter practice, the fact remains that every single US state BON has rules about how many hours of classroom time and supervised clinical time students have to complete in order to be eligible for licensure. EC students have no formal classroom and supervised clinical time as part of their program. No one has ever given me a reasonable answer about why EC students get treated soooo differently from students in every other nursing program in the US by most states. Just from a basic "fairness" perspective, how does EC get away with that? If it's okay for EC students, why not just do away with all the rules about nursing school, and all formal nursing programs, and let everyone self-study and then "test out" for licensure when they feel like it?
"As for the clinical stuff," I assume you're making the point that you had a plenty of clinical hours in your paramedic program. However, none of that time was spent learning to practice as an RN. Paramedic programs, time working as a paramedic, time working as an LPN, whatever; none of that time is time spent learning to function as an RN.

First, I wasn't here when you were "hooted" down and I didn't do the "hooting" down. I'm glad you were able to come back here and have your "I told you so!" moment if that's what makes you happy.

Second, I cant answer your next question as I have absolutely no experience in dealing with any BON in any kind of official capacity. All I know is that I called the TN BON and made sure they would license EC grads and were not in any sort of process to change licensure requirements for EC students. They acted like I was crazy for even asking, take from that what you will.

As for the rest, your assumption is wrong. That wasn't my point at all. If that was my point I would have said something along those lines. I didn't and as a matter of fact, I didn't even come close to saying that. My question was quite clear and it was spawned by a comment I had just read about some states only licensing EC grads that were prior LPN's. I was asking how my hours compare to RN and LPN clinicals as I wanted to know what kind of clinical time LPN's and RN's had to do in traditional programs. I asked that question because I genuinely don't know. Besides that, clinical hours aren't the only thing that separates RN's from paramedics. The processes and skills of each are different. Nursing has a more holistic approach to pt care while paramedicine focuses more on correcting immediate life threatening conditions. It's two totally different ball games and I'm well aware of that.

Lastly, you seem angry about this subject. This is the internet so obviously it's impossible to pick up on tones and inflections but the passive aggressive nature of your post is obvious for the whole world to see. The frequent italicizing, underlining of your points and the "soooo different" comment make it appear as if you have some sort of issue with Excelsior, it's students and graduates. I'm sure you have your reasons, which is fine, but perhaps you should dial back the emotion a bit. If you were a coworker of mine and attempted to converse with me in the same manner in which you did here, I'd be doing my best to avoid interacting with you as much as possible.

Editorial Team / Moderator · Aug 8, 2014

"As for the clinical stuff," I assume you're making the point that you had a plenty of clinical hours in your paramedic program. However, none of that time was spent learning to practice as an RN. Paramedic programs, time working as a paramedic, time working as an LPN, whatever; none of that time is time spent learning to function as an RN.

In my paramedic program, I had hundreds of hours of in-hospital clinicals over four semesters, and my preceptors were RNs, not paramedics. I consider myself blessed in that regard. We also did a lot of EMS ride-time, of course, so it was a really well rounded education.

I agree that this is probably an effort on EC's part to make the program easier to digest for people who don't feel that the program is a valid bridge. I don't know if it's preemptive or in response to something in particular, but either way, EC is going to price itself out of many, many students. I am glad I finished when I did! Today is actually the 6th anniversary of my RN licensure via EC's ADN program. :)

LPN2RNLIZ · Aug 9, 2014

I really have loved getting on this blog for support, but lately it all seems so negative. Always thanks to Pixie R.N., for trying to keep things POSITIVE AND IN PERSPECTIVE. Honestly, we are all here for the greater good and there's a few RNs on here who seem to forget that..... I am almost finished and don't want the negativity..... Going to give this blog a rest........All of this veteran RNs need to give these folks a break..... Love to you all and best wishes!!!!!!

TiffyRN, BSN, PhD · Aug 9, 2014

I think their main reason is to raise their perceived legitimacy with different audiences such as State BONs & other colleges/universities. Let me be clear, I don't personally have such an issue.

I do wonder though if part of their reasoning is to attract more students who are dependent on financial aid? The tests at present aren't eligible and some students will opt to attend outrageously expensive private RN programs because these are eligible for grants & loans (these large loans being something that will haunt those students for years). Current EC ADN program on the other hand has to be paid out of pocket.

Medic85907 · Aug 9, 2014

I really have loved getting on this blog for support, but lately it all seems so negative. Always thanks to Pixie R.N., for trying to keep things POSITIVE AND IN PERSPECTIVE. Honestly, we are all here for the greater good and there's a few RNs on here who seem to forget that..... I am almost finished and don't want the negativity..... Going to give this blog a rest........All of this veteran RNs need to give these folks a break..... Love to you all and best wishes!!!!!!

Yeah, I've noticed some new nurse bashing as well.

Some people forget that just about everything in life is cyclical. There will always be new nurses and there will always be old nurses who feel superior to the new nurses. New or old, common courtesy is expected and age and status doesn't remove that expectation.

I'm a grown man and I treat everyone I meet with respect whether that's online or in person. I expect others to treat me the same way.