mpgj83

So I spoke with my dean recently. The concurrency issue apparently has been a big agenda topic during their ADPCN meetings of late. I'm not really sure what they're planning to do about it but it seems to foster impassioned debate among their ranks. My dean told me that the case requirements existed since the 1950's. And it has existed as a tradition now, being passed down from one revised BSN curriculum to the next. However, she says she's always been for their abolishment, because the numbers (previously 5, 5, 5 and now 3, 3, 3) are rather arbitrary. Moreover, if there are going to be requirements for the DR and the OR, there might as well be case requirements for all areas in nursing. Why not set requirements for various ward procedures? She says these numbers aren't necessarily the best way to measure competency, because PRS rating scales, though standardized, are really hard to apply uniformly between all clinical instructors, across all hospitals, and among all students. There should be a better way to evaluate competency that doesn't require particular "cases." I guess I can see her logic, and I myself would support eliminating them as a formal requirement. Seems like everything would be so much easier if they never existed.

You all have excellent points. Thank you. :)

That will be a while, since I'm still in the Philippines haha. But if and when I do, I'll do just that! Thanks! :)

Ah ok so it means that you are endorsing a US RN license but had foreign education. Thanks, JustBeachyNurse.

I think the documents about your cases are what CA BRN will use to determine if your theory and clinicals are concurrent. I know cases are not necessarily the same as clinicals but that's a different issue. Maybe you can ask your dean to write a letter for you explaining that you fulfilled your case requirements. If you received a certificate of undertaking upon graduation, that would also be proof. But neither of these would prove exactly when you completed your cases and so I really don't know how CA BRN will respond to that. I think your scenario is unique. If you send a letter to CA BRN explaining all of this, please let us know what the response is. Good luck :)

Only an excellent nurse could reply so therapeutically! You must be a gem in the field. Even the username is telling. Thank you, one1morestep.. :)

Is this El Camino, California? If so, you should post this in the California section.

I was reading through the IL application packet and was off-put because of the note on page 5 saying, "Excelsior College is an unapproved nursing education program in the State of Illinois due to the fact that it does not have concurrent theory and clinical components as required by the Illinois Practice Act." Thatladinzip7001 was able to get his ATT here though. Maybe you didn't have a concurrency problem? I'm not from Excelsior College but I do have cases completed oncall, sigh. In addition, another issue that raises my brow is the section in the application for foreign educated nurses who can apply by endorsement (and not necessarily by examination). Does this mean that if I have a Phil license I can just fill this section out and bypass the NCLEX? Sounds too good to be true, haha.

I was under the impression that most Phil grads started being denied if you graduated 2009 or later? When did CA BRN start becoming strict anyway?

There's a section in the NYSED application that asks for your local license information.

I hope so! Thank you :)

Yeah, I'm aware that even getting that ATT will be very difficult. I guess I'm not anticipating to get my ATT any time soon, much less work as an RN, but I'd really like to start working even as a CNA or any job that will put me in contact with patients.

Let me preface by saying that reading through some of the posts on here about a lot of new local grads and even experienced nurses looking for jobs in CA kind of makes me hesitant and ashamed to ask, but for the sake of just courageously putting myself out there, I'm going to try anyway... So I'm a recent Philippine BSN graduate and am looking to apply for CA licensure by examination. The application is still pending and it will be a longgg wait. I'm still in the Philippines, but if I decide to relocate to CA within this year or early next year, I'm wondering how likely it will be for me to land any job in health care? I wouldn't mind being a CNA for a while, for example. I really need to get my feet in the door. What are my options? For what it's worth, I am a US citizen with a previous physiology degree from UCLA. (I was raised in California.) Unfortunately, I have zero work experience. So how employable am I? My only other pertinent information is that I was once licensed as a CNA in California, but I never worked as a CNA because I only used that certification to apply to certain California nursing schools. I was accepted to one but had to drop out after 2 days because of a family tragedy. And for this and other reasons beyond my control, I would end up finishing my BSN in the Philippines. Thanks for the advice!

Yeah I've read through those articles and they're pretty depressing for those of us foreign grads with legitimate credentials. About 5 years ago I had a cousin with a Philippine BSN and who had applied for CA licensure by examination, and it took only 2 months to get his ATT. Then he took his NCLEX and began working as a nurse shortly thereafter. Sigh, how the times have changed. So at the advice of my aunt, who is a nurse in CA, I shouldn't send that letter to CA BRN because it's may come off as argumentative or inflammatory in some way, possibly causing me to become profiled. So when I get my Philippine RN license in a couple weeks, I'm just going to send my application in the usual way. I'm hoping to get some advice as to how I should go about doing this... A. Should I just go the traditional route and send in the bare minimum for the initial application? (And then wait for CA BRN's response and request for follow-up materials, and then send those in at a later time?) or B. To save time, send in everything that CA BRN seems to have been requesting from Philippine grads as supplementary material after their initial application? This means I would also just send in: photocopies of US passport, SSN card, academic calendars, clinical rotation log, case forms, etc (hmmm...am I missing anything?) I would also probably send in a letter from my dean (if she will write one for me) explaining clearly that while I have had to do oncall duty to complete my case requirements, theory and clinical practice components per each given semester were indeed nevertheless still concurrent--that clinicals and case-completion duties are not the same.

I'm a recent Philippine BSN graduate and am looking to apply for NY licensure by examination. The application is still pending and it will be a longgg wait. I'm still in the Philippines, but if I decide to relocate to NY within this year or early next year, I'm wondering how likely it will be for me to land any job in health care? I wouldn't mind being a CNA for a while, for example. What are my options? For what it's worth, I am a US citizen with a previous physiology degree from UCLA. (I was raised in California.) Unfortunately, I have zero work experience. So how employable am I? My only other pertinent information is that I was once licensed as a CNA in California, but I never worked as a CNA because I only used that certification to apply to certain California nursing schools. I was accepted to one but had to drop out after 2 days because of a family tragedy. And for this and other reasons beyond my control, I would end up finishing my BSN in the Philippines. Thanks for the advice!

My course syllabus was around the equivalent of 34USD. It's a little more detailed than the syllabi we get for each class at the beginning of each semester, and printed on better quality paper. It's also optional. This was from a school in the Philippines.

Yeah I tallied those units and hours earlier, and correct me if I am wrong but it seems like per every area of nursing they are required 18 hours of theory and 54 hours of duty. We exceed that in the BSN curriculum here in the Philippines. Current Philippine BSN curriculum: Theory hours/Clinical "RLE" hours. (This list covers professional courses that have clinical components only, but there are many other courses in the curriculum.) Fundamentals: 54/102 Health Assessment: 36/51 Community Health Nursing: 54/102 Healthy Maternal/Child/Family: 72/204 Maternal/Child/Family at risk or with problems: 90/306 MS 1: 144/306 MS 2: 90/204 MS 3: 108/255 Psychiatric Mental Health Nursing: 72/102 Leadership and Management: 72/153 Intensive Practicum: 0/408

Yes! My biggest hunch is that when an applicant submits documentation of oncall duty, CA BRN thinks we have theory in one semester, and then duties in between semesters or during the following one. That is far from the case, as you are well aware. Our theories and clinicals are assuredly concurrent within the same semester. Some students just happen to have to extend clinicals beyond the semester, but in no way does this imply that they were grossly incompetent or failed either didactics or clinicals for that particular area of nursing. The last e-mails I sent to CA BRN ([email protected] , from their website) were on July 24 and July 31. No responses yet. Would graduating CA schools warrant this kind of delay? Yes, maybe they are busy, but a confirmation e-mail saying they received my e-mails would be nice. I also sent in request for fingerprint cards, but I have no confirmation for that either. It’s funny that I sent in requests to the CA Commission on Teacher Credentialing for fingerprint cards, and they replied within a couple days and said they would send me some. My only concern is…will this be the same card as the one I’d have to send to CA BRN??! Lol. Anyway, if and when I send them CA BRN another e-mail, I intend to state plainly that I had oncall duty to complete my handling and newborn care cases, but that I still had L/D clinical duty during the same semester as my maternal and child nursing semesters. Then I will ask if my application will still be denied. If they will say outright yes, then…well, I’m not yet sure what I’ll do. Maybe try to reason some more and insist, or maybe just save my time and money and no longer apply. I’ve noticed so many people on here every week complain that CA BRN denied them. I truly empathize with their feelings of being lost, surprised, frustrated, depressed, demotivated. With the number of so many foreign applicants being denied, one would think that CA BRN would update, clarify, and/or revise their requirements so that applicants will know if they have a chance to be accepted in the first place. It would save them a lot of time, heartache, and money.

Thank you for your very thoughtful input, steppybay! You're very well informed about these issues and I really appreciate your time in replying to me. =) My original queries still stand, however. None of the posts on here are able to answer them directly; they seem to get into tangents that are entirely different issues in and of themselves. So let me dissect my questions and thought process plainly: 1.) How does CA BRN precisely define "concurrent?" Embedded in question is the following line of reasoning: -Precisely what is supposed to be concurrent? [theory and clinicals?] -Precisely what do you mean by clinicals? [duties that occur within the same semester as its corresponding didactics?] -If so, then my theories and clinicals are indeed concurrent, and I satisfy this particular requirement to be issued an ATT. But the issue continues, as I illustrate in the following hypothetical exchange between CA BRN and me: -CA BRN: But you completed your delivery room and essential newborn care cases only after the semester finished! -Me: I still had duties, took care of patients, and observed deliveries and newborn care being performed if I couldn't directly assist with them myself. These occurred within the same semesters as my maternal and child nursing classes. -CA BRN: But you need to have performed your cases during the same semester as your didactics. -Me: Do you require nursing students in California to perform such cases during the same semester? -CA BRN: No. But they do have their clinicals, take care of patients, and observe these procedures within the same semester. -Me: So did I. I just happen to have additional duty beyond minimum clinical hour requirements to fulfill case requirements. 2. How does CA BRN precisely define "deficient" in terms of a particular area of training (e.g. OB/MS)? -Does it depend on a certain number of hours that need to be satisfied? -If so, how many hours do we need in each? -If it also depends on what the student applicant experienced personally during didactics and clinicals, precisely what are these things? Tell us so that we may document our required experiences to your satisfaction. Now I'd just like to respond to some of your input, in turn. I'm not arguing against the law. It does make sense to me that theory and clinicals should occur in the same timeframe, and I think it's good that more US states are enforcing this. All of them should. Theories and clinicals will complement one another and make learning more effective, producing more competent nurses. This is still what is occurring in the Philippines. But why does CA BRN enforce the case requirement on Philippine grads when this requirement does not even exist for CA grads? In other words, the issue does not seem to be one of concurrency between theory and clinicals (i.e. duties occurring within the same semester as didactics), but between theory and a particular component of Philippine clinicals (i.e. cases). CA BRN does not require CA grads to complete "cases" (i.e. actual, hands-on assistance of deliveries, newborn care, and major surgical operations), in the way that they seem to require Philippine grads to complete them. That policy information is exactly what needs to be made transparent so that foreign grad hopefuls can evaluate their educations against CA BRN standards and establish whether or not they meet specific requirements. If not, maybe they'd decide not to apply anymore, saving them their time and money. I realize she is a lawyer but it would still be nice if we could evaluate this ourselves. We don't even know what the issue at hand was here. I'll just try to contact CA BRN to pose these questions myself. It's best to just tap into the source. I've sent a couple e-mail inquiries about the application process a couple weeks ago, but I never got a response. (I still don't even know if my fingerprint cards are coming!) And so considering the unresponsiveness from those e-mails, I thought I'd read through posts and just ask people on this forum, but it seems like nobody really knows either. Somehow, I doubt these meetings took place because if they did I think I would have encountered them in newspapers, online articles, or whatnot. I understand the rationale why CA nursing students don't have these "case" requirements. But the question is why CA BRN is requiring that Philippine grads complete them within in the same semester, especially when CA nursing students have no such requirements of their own. I think this is now an entirely different issue here. CA BRN has stipulated that theory and clinicals be concurrent. If you fulfill this requirement (and others), you may receive an ATT as a chance to prove your competence on the NCLEX. Regardless of whether or not students had to exercise more independence in their duties because of staffing shortages and the large number of patients, or whether or not students were "joined at the hip" of their respective preceptors who constantly grilled them, the NCLEX would presumably weed out incompetent applicants. Yes, international applicants have lower passing rates on the NCLEX. But this doesn't mean it should be made more difficult for them to even just attempt it. There should be a level playing field. The original issue is about being approved to take the NCLEX, and not being approved to become an RN right away. Again, yes, educational requirements must be concurrent, like you say. In the Philippines, in terms of didactics and clinical exposure, they are. In terms of didactics and case requirements, they can't always be. Incidentally, just as an aside, I cannot speak for all Philippine-educated nursing grads, but my experience as a nursing student was also that I got grilled frequently, by clinical instructors, staff nurses, and sometimes even doctors alike. I may not have had a preceptor to shadow constantly, but I was supervised and I carried out my duties within my scope of practice. Yes, I imagine always having a preceptor around would make for a highly enriching learning environment, but I don't think it's the only way to learn. Philippine nursing education forces students to be highly independent and flexible. Only give the applicant a chance to prove his or her competence through the NCLEX. But again, the issue is not about what style of instruction must be implemented in order to qualify to sit in for the NCLEX. If it really were mandated that we had to have a preceptor, then CA BRN should say so. But so far, the issues are about concurrency and deficiency and CA BRN needs to be clear exactly what it means. It's hard to prove something if we don't know what they're looking for us to prove. Again, what are these concurrency and deficiency issues really about? Clinical exposure or cases? If cases, why cases when CA nursing students have none of their own? Is it about hours? How many do we need? If it's not about hours, then what? I don't know who those posters are but I agree completely that those who falsify documents should be reported. But for those of us who have honestly paid their dues with blood, sweat and tears in nursing school should be given a fair chance to prove themselves to be competent with the NCLEX.

Thank you JustBeachyNurse. I've come by one too many posts that implied otherwise, so I've been confused. Maybe I've just misunderstood. Thank you. :)

I was always under the impression that an applicant had to obtain his or her ATT first before sitting in for the NCLEX. So is it actually permissible to take NCLEX first without ever having yet applied to a state board of nursing?

Also, may I ask what the additional requirements that they asked of you were, aside from the clinical rotation booklet? Thank you! :)

So we are not required to get the ATT first before we take the NCLEX? This has been an issue that's confused me because I've read some people seem to have already taken there NCLEX before even applying to a nursing board.

So I've just reviewed Title 16 California Code of Regulations, Article 3 Schools of Nursing, Section 1426 Required Curriculum. (Board of Registered Nursing - Title 16, California Code of Regulations) Unfortunately, it doesn't state precise hour requirements. Does anyone know where these hours can be found? In addition, letter (d) of the same section does indeed say that "theory and clinical practice shall be concurrent..." But in any given semester, our theories and duties are concurrent. We just don't always accomplish cases in the same semester. But we do indeed still go to duty wherein we interact with patients, perform nursing care, and many times even at least observe deliveries and operations being performed. So what does "clinical practice" really mean here in the first place? I am told that many times CA nursing students also just observe such procedures.

I haven't categorically accused CA BRN of being haphazard in their evaluations of our applications. I've only implied that it is possible that evaluators could easily overlook certain aspects of it, especially considering how many applicants with similar backgrounds they may have to go through in a given day. Sure, there's no way to "prove" theory or clinical hours to anyone. The only way this could be done is if the evaluators themselves were physically present during every single lecture and every single clinical duty shift. Of course, this is impossible. But this is beside the point, because we are assuming that the applicant is submitting true documents averring such. CA BRN has the prerogative to define what constitutes proof, and this would presumably be embedded in its application process. I'm not asking CA BRN to "decipher" anything, but only a chance to help make their job easier. So on the one hand, if I knew their precise criteria for meeting certain requirements, I myself can make a letter, or have my dean or some official make a letter, showing them where in our curriculum this might be satisfied. BSN programs in the Philippines are required to follow a curriculum mandated by the government, and these requirements are viewable online for any nursing board to see. It is, however, a 129-page document, and certainly not every single CA BRN evaluator has the time to scrutinize it. On the other hand, if I see clearly that I really am deficient in terms of a certain requirement, then I will gracefully acknowledge this and understand why I have been declined, if it will turn out this way. I am not trying to be argumentative, but I don't want to be fatalistic as well; I am only trying to improve my chances. Ultimately, I seek only transparency. Yes, rules and regulations say that you need to have concurrent didactics and clinicals, and that you are required to satisfy a minimum number of hours of each. But how does CA BRN operationally define concurrent, and what precisely are these minimum hours?