RoubRN

Where did you find the 15 states? Several states including Washington, Maryland, Georgia, and others may have additional requirements, such as additional clinical hours, etc. However, California is the ONLY state who will not license Excelsior grads not enrolled prior to 12/31/2003.

I would suggest meeting with your ICU Educator. You will as well need to join the AACN. Some hospitals will assist with part or all of the fees including the cost of the test. There is a minimum hours worked requirement and I think it's around 2 years in the ICU. I would highly recommend 3 months to prepare. There is a wonderful cd by Moseby called CCRN made easy. They provide many practice questions along with rationales for the answers. Obtaining your CCRN is an outstanding achievement. More importantly, it says to your patients and team members you are well prepared to handle critically ill patients.

First, congratulations on your interview in ICU. The ICU is a high stress, high acuity environment. As a previous peer interviewer, one of the most important qualities is the ability to recognize changes in your patient's condition immediately. ICU patients can take a dramatic turn in minutes. Based on the patients' medications and treatments (cardiac drips, CRRT, etc.), you may be required to take vitals every 5 minutes, and intake/outputs hourly. Being an ICU nurse is sometimes like completing a puzzle. Knowing their diagnosis, history, consultants, and trends is essential to advancing their healing. As for general guidelines, many ICU Managers are now utilizing the STAR method, or behavioral based interview questions. The managers are interested in your self-improvement. In other words, define a situation where you overcame an obstacle. You can review the STAR method on you-tube as well. Finally I would advise you that no patient planned to be in the ICU. The patient and their family are experiencing perhaps the most difficult time of their life. Remember that we don't always know what is happening at home, either. Many patients will lose their current living arrangements due to lengthy and complicated hospital stays. You are a patient advocate and showing compassion is a must. Additionally, you may want to shadow an ICU nurse, or at the very least, attend several codes if you don't already have sufficient experience in that. Finally I would suggest purchasing Critical Care Challenges by Lippincott Williams & Wilkins. No one nurse knows everything. But knowing you have resources in other team members and published materials will ensure your success. Good luck!

In April 2013 my husband and I relocated to California. After several months of acquainting myself with a new environment, I began the process of applying for my California RN. I completed the application, submitted my fingerprints for the background checks, requested transcripts from nursing school, and submitted the necessary fees. Unfortunately, after scrutinizing the CA board's website, I discovered the lengthy court transcripts regarding my school, Excelsior. Many of you may know already where this story is headed. However, the devil is in the details. My pre-RN background included six years as an LPN at a long term acute care facility where I typically cared for four to six ventilator dependent patients. In 2003, I began completing tests through Excelsior. Officially on 11/17/2006, I was awarded an ASN with a GPA of 3.47. And so I began my RN career working dayshift at Jewish Hospital/Louisville, KY, in their arduous ICU Towers. I as well worked in CVICU and trained in Open Heart Recovery. In 2009, after meeting AACN requirements, I achieved my CCRN. I have accumulated over six years of critical care experience, as well as being a physician extender for two Intensivists' Groups. Sadly, because I didn't pay my enrollment fee ($725) way back in 2003, the CA board will not accept my RN. After shedding many tears and spending long hours speaking with advisors in State Boards both at Excelsior and the CA board, I will not be issued a CA license. Why didn't I pay the enrollment fee in 2003? A very sweet older woman, Rose, who has since retired, advised me to "save my money." She told me to wait until I had completed Nursing Concepts 3 before sending the enrollment fee. At that time, my hourly wage was $13.25, and I appreciated her advice. However, both Excelsior and the California Board have repeatedly advised me that IF ONLY I had "enrolled" (enrolled by definition meaning paid their fee) I would be "grandfathered in." Wow. This in a state with a projected nursing shortage of 1.2 million by 2020, per the Federal Bureau of Health Professions. California as well leads the nation in hospital staff strikes, with two of the largest in the country. Some locations including Alta Bates and San Jose have had multiple strikes with protests as recent as February 13, 2014. They cite "staff shortages" as the basis for striking. On December 2, 2013, WKBN in Los Angeles delivered a segment on the state wide nursing shortage. They determined that California nursing schools accept only 18% of their applicants. When questioned, those schools cite faculty shortages and clinical site shortages as their rationale. With six years of ICU experience, a specialty certification, along with upwards of $50,000 spent on training this highly specialized RN role, it is a tragedy I cannot obtain licensure here. The CA board is quite specific about "concurrent clinical hours with theory." And to them I would suggest reading the US Secretary of Education's article on "competency education." To take it one step further, I would recommend that Excelsior implement a clinical regiment allowing the student to obtain independent, yet individually approved, instructors in the workforce. This is common practice for the PA and NP programs nationwide. Finally, who benefits from this stance, and who suffers from it? Based on the California Nurse Association's own website, there are a myriad of current patient care issues stemming from "chronic short staffing", as well as poor nurse to patient ratios. We all share one common role and that is to be a patient advocate above all. Denying my licensure because I failed to pay $725 before the 12/31/2003 deadline defies logic. I will leave it to the readers to decide who could possibly benefit from this.