Position Statement: Concurrency of Clinical Experience of Philippine Nursing Schools

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By: PNAA | Several nurses who graduated from Colleges of Nursing in the Philippines applying for licensure in the state of California (CA) are now required to complete additional course work, in both theory and clinical practice to be done concurrently, in an accredited or CA Board of Registered Nursing (CA BRN) approved school of professional nursing.

BACKGROUND:

The Philippine Nurses Association of America (PNAA) Human Rights Committee received numerous letters from Filipino-American graduates of several Colleges of Nursing in the Philippines applying for licensure in the state of California (CA). They expressed concern in having to be required to complete additional course work, in both theory and clinical practice to be done concurrently, in an accredited or CA BRN- approved school of professional nursing. The courses identified were medical-surgical and obstetric nursing courses. In addition to having difficulty in finding nursing schools in the state that will allow them to take only those courses in their program, these requirements are causing financial burden to the applicants.

The California Code of Regulations (CCR) Section 1426(d) states that theory and clinical practice shall be concurrent in the following areas: geriatrics, medical-surgical, mental health/psychiatric nursing, obstetrics and pediatrics. This means that all clinical components must be completed concurrently with the theoretical instruction.

A joint meeting by the Philippine Commission on Higher Education (CHED) and the California Board of Registered Nursing (CA BRN) was arranged by PNAA Human Rights Committee on December 13, 2012. The purpose of the meeting was to discuss issues and concerns relating to documentation on concurrency of clinical experiences and theory courses of applicants for CA RN licensure.

The CA BRN shared that (1) required documents from schools on behalf of the applicants for licensure does not reflect concurrency of clinical experiences with theory courses; (2) some transcripts did not follow the required contents specified on the CHED Curriculum for Bachelor of Science in Nursing; and (3) the concurrency issue is a global concern for nursing schools and not limited to graduates of schools in the Philippines.

The Philippine delegation of CHED explained that the Philippine BSN curriculum requires concurrency of theory and related/enhancement learning experiences (RLEs), however, are not well documented in the transcripts. To help resolve the issues, the delegates will (1) arrange for an urgent meeting with all the Deans of College of Nursing to discuss and develop a template for transcripts and related documents that will reflect accurate documentation of students' educational experience; (2) CHED will monitor concurrency of theory and related experiences in

existing programs in the Philippines; (3) CHED will work closely with Philippine Department of Health (DOH) in monitoring health facilities used for the Related Learning Experiences (RLE) of nursing students; and (4) CHED Executive Director will communicate closely with the Executive Officer of the CA BRN.

STATEMENT OF POSITION:

The Philippine Nurses Association of America (PNAA) supports the California Code of Regulations and other State Board of Registered Nursing where concurrency of clinical experience and theoretical instruction are required.

RECOMMENDATIONS FOR ACTION:

That the Philippine Nurses Association of America will:

1. Assign the Office of International Affairs (OIA) to raise awareness and support graduates of Philippine Nursing schools in their compliance with the requirements needed to practice nursing in the United States.

2. Provide subject matter experts for proper case referral and follow-up.

3. Disseminate information through the PNAA website and provide link to colleges where students can apply to take the courses being required by the CA BRN.

4. Collaborate with CHED and the Association of Deans of Philippine Colleges of Nursing (ADPCN) in facilitating meetings with the CA BRN or other state Board of Nursing.

Prepared by:

Nancy Hoff

President, PNA Central California

Member, PNAA Human Rights Committee

Marife Sevilla

Chairperson, PNAA Human Rights Committee

Collaborated by:

Victoria B. Navarro, President, PNAA

Remedios Solarte, PNAA Director of International Affairs

Dr. Germina Risos-Rio, Chairperson PNAA Legislative Committee

Reviewed by:

Arnedo Valera, ESQ, Legal Counsel, PNAA

Dr. Clarita Miraflor, First President and Founder, PNAA

Legislative Committee:

Dr. Marife C. Aczon-Armstrong, PNA Hawaii - Western Region

Linda Gonzales, PNA Ohio - North Central Region

Nelson Tuazon, PNA San Antonio, Texas - South Central Region

Marissa Usman, PNA MDC - Eastern Region

http://pnasc.org/position-statement-concurrency-of-clinical-experience-of-philippine-nursing-schools-graduates

Thanks for posting this, I had mentioned I did read something like this before, but I couldn't remember where. So the PH nurses of CA also agrees with the CA BRN decision to allow the enforcement of the concurrency rules.

At the same time, the CHED and other Phils nursing agencies were to get new "approved schools" in the Phils so that previous PH grads were able to re-take the deficient courses in the Phils (not in CA or other US states) and made to qualify their education to meet the concurrency rules (finally).

The approved "list" has still yet to be seen (as far as I know), maybe someone else has more concrete proof if they were able to get these approved schools done.

It remains to be seen if these "approved schools" will still pass the CA BRN requirements, as they would mean re-taking the same deficient course(s) over again, BUT all the current enrolled PH students will have to be told to "please make room for your past student grads and previous PH nurses, so please kindly let the previous grads/nurses get in front of you, while you already enrolled students step to the back of the line, I know you guys waited your 1-2 years to get in your clinicals, but sorry, the new priority is to take care of those mad parents and disappointed previous students".

The PH process now is so impacted and how to do they plan to re-do this mess? Go from 20-30 students to 40-60 or more and who's going to monitor that kind of number? CA BRN sees or hears this, they will know it's going to make the curriculum even worse.

The bigger question will these attempts even meet the CA BRN requirements?

Unless the CHED hires someone with CA BRN complete knowledge and that person(s) is an on-site reviewer, it could meet the same old thing. I mean when the CHED knew of the concurrency issues, the solution was to reduce the 5-5-5 cases to 3-3-3, guess what? As of 2013, PH grads trying to apply into CA, it's the same old thing....denied.

I don't know the solutions, other than to drastically restrict the student enrollment, close down all PH schools that have NLE passing rates of less than 75% first-time passers and instruct new students so that they learn how to "think critically" versus practical methods, so that it's more NCLEX driven like how it's done in the States.

I mean the CA BRN will take away any CA school off their approved list if that school's NCLEX passing rate drops below either the 65-75% NCLEX first-time passing rate within a couple of years to improve their student's scores or face closure.

If they did that, the majority of PH schools/colleges (even the top ones), well, let's say, there will be a lot of very disappointed students that can't get into a nursing program.

Thanks for posting this, I had mentioned I did read something like this before, but I couldn't remember where. So the PH nurses of CA also agrees with the CA BRN decision to allow the enforcement of the concurrency rules.

At the same time, the CHED and other Phils nursing agencies were to get new "approved schools" in the Phils so that previous PH grads were able to re-take the deficient courses in the Phils (not in CA or other US states) and made to qualify their education to meet the concurrency rules (finally).

The approved "list" has still yet to be seen (as far as I know), maybe someone else has more concrete proof if they were able to get these approved schools done.

It remains to be seen if these "approved schools" will still pass the CA BRN requirements, as they would mean re-taking the same deficient course(s) over again, BUT all the current enrolled PH students will have to be told to "please make room for your past student grads and previous PH nurses, so please kindly let the previous grads/nurses get in front of you, while you already enrolled students step to the back of the line, I know you guys waited your 1-2 years to get in your clinicals, but sorry, the new priority is to take care of those mad parents and disappointed previous students".

The PH process now is so impacted and how to do they plan to re-do this mess? Go from 20-30 students to 40-60 or more and who's going to monitor that kind of number? CA BRN sees or hears this, they will know it's going to make the curriculum even worse.

The bigger question will these attempts even meet the CA BRN requirements?

Unless the CHED hires someone with CA BRN complete knowledge and that person(s) is an on-site reviewer, it could meet the same old thing. I mean when the CHED knew of the concurrency issues, the solution was to reduce the 5-5-5 cases to 3-3-3, guess what? As of 2013, PH grads trying to apply into CA, it's the same old thing....denied.

I don't know the solutions, other than to drastically restrict the student enrollment, close down all PH schools that have NLE passing rates of less than 75% first-time passers and instruct new students so that they learn how to "think critically" versus practical methods, so that it's more NCLEX driven like how it's done in the States.

I mean the CA BRN will take away any CA school off their approved list if that school's NCLEX passing rate drops below either the 65-75% NCLEX first-time passing rate within a couple of years to improve their student's scores or face closure.

If they did that, the majority of PH schools/colleges (even the top ones), well, let's say, there will be a lot of very disappointed students that can't get into a nursing program.

@ steppybay , do u think cabrn will allow us to take the ob and ms in the philippines, if that school will meet the cabrn educational requirments?

No it would never happen as Steppy has kindly written explanations why. The CA Bon wants and quite rightly wants control of nurses education, why should any country argue with this.

The Phillipines is not the only country with concurrency problems nor being short in the curriculum, if they allow this in the Phillipines then they would have to start allowing the courses allowed in other countries that made up shortfalls, as they have nowd disallowed Australian nurses to attend at Australian universities....and clinicals done in Australia for student nurses post grad or undergrads are one on one, one mentor and the mentors patients for the shift, no extra students allowed.

This PNAA group needs to let those students of only PH citizenship that in order to apply into CA (whereby by CHED's own report stated that 33% of all PH grads either go back to CA or want to go to CA, that without having a SS#, it's not a viable option and has been the case since April, 2010 (in CA).

PNAA and CHED needs to put on a BOLD disclaimer that there's very little demand today for PH nurses and give them real numbers that in the States alone, they are producing more local US student nurses than what the US can even absorb today AND to proceed with caution.

It's not impossible (to get a hospital position) just that it's not like business before with signing bonuses, having multiple job offers, working two hospitals, hospital sponsorship give-aways like there's no tomorrow, hard to find nurses as so many vacant job spots open. The faucet has been closing off fairly quickly.

Hiring practices in the States are preferring the local grads, out of state grads, grads that did their clinicals in their hospitals (and those that did, are not guaranteed a job at all). I mean how many recent PH grads have reported they got an RN job inside a CA hospital lately? Yes, outside of the fact that many have not been given the ATT since Nov. 2011, those that did were most likely got in prior to the Nov. 2011 enforcement period.

No it would never happen as Steppy has kindly written explanations why. The CA Bon wants and quite rightly wants control of nurses education, why should any country argue with this.

The Phillipines is not the only country with concurrency problems nor being short in the curriculum, if they allow this in the Phillipines then they would have to start allowing the courses allowed in other countries that made up shortfalls, as they have nowd disallowed Australian nurses to attend at Australian universities....and clinicals done in Australia for student nurses post grad or undergrads are one on one, one mentor and the mentors patients for the shift, no extra students allowed.

i think australia is better when it comes to getting in the program , unlike here in usa u need to be on the waiting list for years and years

what do u think will happen for the nurses who got licensed in CA before 2011 but graduated in 2005 to 2010?

An Australian citizen will not get into the courses required at Californian colleges/universities for insufficiencies more than anyone from any other country.

What I am saying is Australian nurses, to be considered sufficiently educated by CA standards, required to completer courses also. They could do it through Deakin University in Victoria, this is now not allowed by the CA BON, not how easy it is to get into nursing in Australia!

what i mean is , if u are a foreign grad and u want to be a nurse in australia , it is easy to get into the program , unlike here in usa , u need to wait for a long time just to get into the nursing program

what do u think will happen for the nurses who got licensed in CA before 2011 but graduated in 2005 to 2010?

If they are already licensed in CA prior to 2011 , then they are okay, unless they let their CA license expire after 8 years, then they will be required to re-take the NCLEX again (as a first-time applicant and true for any domestic or foreign), they must meet the more stricter CA requirements and any current changes, meaning they could very well be denied to re-take the exam in CA due to the concurrency rules or lack of sufficient courses or lack of clinical hours.

It's more of the ones applying for the first-time in CA if one graduated between the 2005 - 2010 (and into the 2013), that will most likely get denied. There will always be a few of those that somehow did manage to get thru the CA BRN process, either they truly got their cases done concurrency (kind of rare), but there's been other posters here who knows of their friends or others who have "manipulated" their courses and cases to get their transcripts to look "correct".

Then there are those who's friends or batchmates who got their ATT's in CA, but they didn't?? Even being from the same class taking, same courses, same semesters together, same graduation year, how is that possible?

Wonder why the CA BRN is reviewing more closely of those situations?

It's called fraud (in my books, that's being a low-life and worse than scum) and I have said in my earlier postings that if I knew of my own mother, aunt, sister, brother, uncle (luckily, none of them are nurses or in the medical fields and lucky them), best friends did that, I will have absolutely zero problems with reporting their names to the CA BRN Enforcement Dept. and you can go on-line or write to the CA BRN Enforcement Dept. without giving out your name to have their license investigated.

This is a great part on why the CA BRN has been coming down so hard on the Phils applicants lately and why everyone that got denied the ATT should give out the names of these greedy and extremely selfish individuals.

You can "thank them" for the misery and disappointments and frustration. While they became nurses in CA, everyone else is scrambling to other states, some having to move from other parts of the State, while their hearts, families and friends are all in CA.

Is that fair that these self centered "nurses" and I use that term loosely, as I fear if they are willing to cheat their way thru the system, not play by the rules, that the real hard working PH students and nurses went thru, that they will also most likely cheat on their charting, short change their patients and overall possibly one day, injure, maim or even the worst of the worst thought to an innocent patient.

I don't care if today they are DON's, hospital office managers, clinical director, nurse manager, I would not blink an eye to report them.

But guys, don't shoot an e-mail that you know so and so, I don't and can't vouch for that person, you must simply do it yourself.

Guys, the idea is that if we "self-police" our own PH nurses to help the CA BRN weed out these undeserving so-called "nurses" and in helping them, we may turn the tide, the CA BRN sees that we're willing to show we will not stand for this either, it's not a guarantee, but it's a start in the right direction. If you guys know of someone like this and don't do anything, while these "nurses" smile at you and say "bummer, sorry, you can't work in CA", while they just deprived you of getting a nursing job in CA, then you just become a part of the problem and can't complain of the CA BRN stance.

You got your nursing job taken away from your "friend(s)", who really just stabbed you in the back.

Ok, off my soapbox now.

There was another PH poster who said that he spoke with his dean where there was a meeting of many PH deans to discuss the concurrency issues that has drawn so much attention. One of the subjects was some wanted to just abolish the cases of cord dressing and deliveries, some wanted to keep it, so clearly, an unsettled debate and not sure it's been resolved from last year.

My personal thoughts if the CHED and other powers to be, does want to do away with the above mentioned: who's going to do these tasks for free, not have to pay a nurses's salary for the services, not to take care of the newborns, etc?

The PH hospital system has it all backwards to have to ask the poor new grad nurse to have to pay for their own training, that's such a slap in the face. Plus there's no guarantee after the training is done that you'll hired on a permanent job.

Then there's the old "backer" system to get in.

Stepping off the box now till later, lol.

There was another PH poster who said that he spoke with his dean where there was a meeting of many PH deans to discuss the concurrency issues that has drawn so much attention. One of the subjects was some wanted to just abolish the cases of cord dressing and deliveries, some wanted to keep it, so clearly, an unsettled debate and not sure it's been resolved from last year.

My personal thoughts if the CHED and other powers to be, does want to do away with the above mentioned: who's going to do these tasks for free, not have to pay a nurses's salary for the services, not to take care of the newborns, etc?

The PH hospital system has it all backwards to have to ask the poor new grad nurse to have to pay for their own training, that's such a slap in the face. Plus there's no guarantee after the training is done that you'll hired on a permanent job.

Then there's the old "backer" system to get in.

Stepping off the box now till later, lol.

what r u doing right now? did u try to apply on other states? or you r still looking for a school that will accept foreign grads with deficiencies?

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