Nursing license denied by California

[superveronica]

I am starting this thread to find out if anyone has run into problems with the California Registered Nursing Board. If you have, could you please give me some advise as to what I should do.

First I have a 4 year BSN (with honors) from Canada. I have written and passed, on the first try, the NCLEX-RN and the CRNE (Canadian Registered Nurse EXAM). I am a Registered nurse in 1 canadian province and in Nevada and Alaska. I have been working in a Nevada hospital for a while and have experience in both countries.

My husband, who is in the US military, has beed transferred to California. I have been trying to get my RN license in California for 4 months and I keep getting denied with "you don't have enough hours in obstetrics and pediatrics to qualify for a license."

What I don't understand is that I do have hours in pediatrics and obstetrics but it was during my community clinical and not in a clinical specifically called "obstetrics." I spent 160 hours assessing newborns (obstetrics) and immunizing infants and preschool children (pediatrics) in the community.

I've asked my school to send a letter to the nursing board to clarify this as they refused to look at my coursework when I brought it into the board. they still denied me even after the letter was written.

They told me that I should take two classes here in California to make up the hours. Okay I thought, I'll give in and do what they want. I called up about 20 schools on their list within 100miles from where I live and got the same response; you can not just take two classes, you have to be registered in the program full or part time, from the beginning, in order to do clinical.

I went to the nursing board again to talk to them about the impossible task they've given me. My licensing agent said "yes it's hard to get in to do classes, that's why we give you 3 years to do it, try university of Phoenix." So I called the university of Phoenix, same response, they just told me to do my NP, which will qualify me to work in California and I can get it in 2 years.

I am so incredibly frustrated that I don't know what to do. I have been commuting to Nevada to work one weekend a month so we have a little extra income but I can't keep driving 8 hours to work!!!

HELP!!

p.s. they will not let me do the hours at work, it has to be done though a school. My current hospital offered to send me to obstetrics and pediatrics as a clinical.

[RN_Canada]

also, canadian and american regulations are vastly different. there is no comparison, rn canada.

you and i know this but apparently nurses from other countries don't.

when the economy is poor and their own locally trained nurses aren't securing jobs, the bon can decide to limit the number of licenses granted by changing the requirements.

i will reiterate my original comment that this is not in the mandate of professional regulation for public protection so i guess the real question is who is monitoring this? and why are they allowed to get away with this?

to me this seems to be the larger issue in this whole matter.

[joanna73, BSN, RN]

Remember that the American health care system is largely focused on profits and the bottom line. This is a key factor in CA limiting the number of licensees. You're used to the Canadian system, whereby we are more flexible. From other posts here, it seems the CA is limiting their own local applicants. When there is no shortage, as long as the BON has written policies....they can and will do as they see fit. It doesn't need to make sense to any of us. It just IS.

[Fiona59]

It sounds like California is saturated with nurses. The Board can't limit the number of new grads churned out by the educational institutions, so they will just limit how many they permit to practice.

[RN_Canada]

it sounds like california is saturated with nurses. the board can't limit the number of new grads churned out by the educational institutions, so they will just limit how many they permit to practice.

well if the regulations that exist under legislation required public protection then they cannot do this. they can only determine if a person who applies for a license has met the standard to qualify for that license. once this is determined then they can grant permission to write the exam and license the applicant.

if the mandate of public protection is entrenched in regulation (that exists under legislation) labour market forces should have no influence whatsoever.

remember that the american health care system is largely focused on profits and the bottom line. this is a key factor in ca limiting the number of licensees.

and isn't this my original point that profits should not enter into the equation of public protection?

an organization that is charged with the protection of the public (under legislation) should not allow profit to influence their decisions.

that is not only a conflict of interest it is immoral and not in accordance with the code of ethics for nurses, especially in canada where nurses are required to work in the interest of the public, no matter who the employer is.

[Corey Narry, MSN, RN, NP]

Regardless of the outcome of California's assessment of the OP's eligibility for RN licensure in the state, I would have to say in California's defense that this is one of the few states in the union that has a clearly defined Code of Regulations surrounding Registered Nursing practice: Board of Registered Nursing - Title 16, California Code of Regulations. Everything is laid out in those rules. I think if anything, California was much too lax in the past and have approved aplicants who didn't meet the board's eligibility based on pre-existing regulations in a time when California needed many RN's. Surrounding the time when California's nursing union's successfully lobbied for a mandatory nurse to patient staffing ratio law in acute care settings, many nurses flocked to the state as they were needed badly for hospitals to comply with the new nurse to patient ratios that were signed into law.

Now many Philippine trained nurses are ineligible for licensure based on a technicality. Nursing programs in the Philippines require a set number of actual OR 1st assist, actual newborn deliveries performed, and actual newborn umbilical cord dressing performed per Philippine law. These are not required in any entry-level US nursing schools (APN programs do have this as a requirement). Because there are too many nursing schools in the Philippines in a setting where there aren't as much hospital cases to accommodate student clinical rotations, many schools there allow students to complete these cases throughout the last 3 years of nursing school. This goes against California's rule that clinicals are conducted side by side with classroom lectures. It's a tough pill to swallow as an applicant but one that is defensible on California's part because it's written in their rules.

There must be something with the OP's RN curriculum that does not meet required hours in California. The unfortunate part is that other states have granted the OP an RN license and though Califronia feels that her educational program is inadequate, the state does not offer any options as far as available remedial courses to make up the hours. I do wonder if out of state nursing schools (such as the one where the OP worked) could provide the OP with just the required didactic and clinical hours required by California. I will foresee that with so many recent denials of eligibility from many appliants, local schools in California would take that cue as a way to enroll "completion" students and generate revenue.

[joanna73, BSN, RN]

RN Canada, you are missing the point. I do understand your view; however, Canadian and American laws and perspectives cannot be compared. I've read your posts, and you continue to cite Canadian philosophies. It makes no difference within the American health care system.

[RN_Canada]

i do understand your view; however, canadian and american laws and perspectives cannot be compared.

that is my point...well not quite. they can be compared, but of course they are different because canada and the usa are different countries, with different cultures, and vastly different value systems that underpin the regulatory framework of nursing. you and i might know this but internationally educated nurses do not.

and of course i am seeking to understand what drives the american system as my only experience and understanding is canadian. what are the values and what is the regulatory framework?

i was especially interested in the link provided by

ccrn_marie that the california board of nurses has competency standards whereas in canada we have professional standards.

hmmmm.... i think they are different?

honestly... i get it that we are not helping the original poster by taking the discussion in this direction but it is an important discussion don't you think?

[DestinedTraveler]

Any luck so far superveronica?

I'm hoping to apply for my CA license next month, and I'm anticipating problems so I was wondering if you were successful?

[peachy_pie]

you're not alone! a lot of us who graduated internationally has been denied and we are all required to take obstetrics and MS class. called all the list of schools (private and community colleges) my licensing analyst provided me but they all tell me that i need to restart the whole program. =(

[danisweetcheeks]

Just a suggestion... I am also a Canadian trained RN and have friends who have recently graduated (therefore after changes to their requirements) and gone down to California through a travel nursing agency and have been issued a license... perhaps with the help of a travel nursing company there is some way around it and it is easier to get a CA license? once you've got your foot in the door, work your magic, start talking and apply for permanent positions before your travel assignment is up!

[steppybay]

Just a suggestion... I am also a Canadian trained RN and have friends who have recently graduated (therefore after changes to their requirements) and gone down to California through a travel nursing agency and have been issued a license... perhaps with the help of a travel nursing company there is some way around it and it is easier to get a CA license? once you've got your foot in the door, work your magic, start talking and apply for permanent positions before your travel assignment is up!

That's an interesting way to get to work in CA! While I'm also an international student, but not from Canada, I'm wondering if one is able to get a permanent job as a travel nurse in CA in that manner.

I would think that under the travel agencies you're under contract with them, not the hospital directly. Therefore, not only would you need a valid SSN, but also your college transcripts needs to pass the CA BON requirements, of which many other Canadian grads/nurses are unable to do so without having to make up the deficiencies by attending near impossible CA classes.

Plus it's just as difficult to have an out-of-state license to be endorsed into CA without having to apply as a new nurse, as it's the same thing, one must submit their transcripts and must pass their strict requirements. At best, the travel agency manner is only a temporary way to work in CA.

Since the travel agency job have limited time period on how long a hospital will pay for it, it's not a permanent job solution and you're not able to collect on the vacation pay, other benefits and retirement plans, as one would be if they are truly an "employee" of the hospital and not wanting to travel from San Diego one month or year, then to San Francisco the next week or month, then back to LA. I know assignments are usually for longer periods, but you may not be at the desired hospital of your choice, if the agency keeps moving you around.

[danisweetcheeks]

Many people continue re-newing contracts with their travel agency to remain at the same hospital or in the same city. As well, I have heard many times of nurses on travel assignments be offered permanent positions once working in a hospital as a travel nurse. Im not saying this would work for everyone, but if nothing else is working to get into CA, its worth a shot! If you do happen to get a permanent position in CA, whether u applied for it yourself or were offered a permanent position, at that time you can apply for permanent residency but i believe the hospital has to sponsor you through this process, it requires immigration lawyers and you have to be a permanent employee.