Yet another excelsior college question r/t reciprocity in Calif

RN34TX · Oct 4, 2005

The problem with trying to answer your questions is that the CA BNE ruling is still very recent and we have yet to see the full effect it will have in years to come.

In other words, the cut-off date for CA licensure of EC grads only dates back to Dec. 2003. So the only people who would be affected at this point would be those who enrolled after this date, are already RN's in another state, and are now attempting to get endorsement into CA, which they currently cannot do.

There are most likely very few, if any people at all, who fit into this category at this time. If one enrolled just after the cutoff date, completed the program in one year (which is not easy to do) then even in that case they still would only have been RN's for 9 months tops.

In years to come, these post Dec. 2003 enrollees will be working as RN's in other states, getting a ton of experience, and will then begin to attempt to get endorsed into CA.

At this point CA will be faced with applicants with years of experience under their belts and if CA wants to stick to it's current ruling, they would basically be telling these experienced RN's to literally go back to school and go through clinical rotations as nursing students.

Could you imagine telling a 10-15 year seasoned RN who works let's say in the ER or ICU that they need to go back to school and go through Med/Surg and OB rotations to satisfy CA's requirement?

As it stands right now, that's exactly the way it would be.

I personally don't think that CA actually thought that far ahead as to what they intend to do with these experienced applicants years down the road.

They intended on eliminating incompetent nurses who lacked enough clinical experience to be RN's so they stopped recognizing EC, but in years to come they will be throwing out the baby with the bath water as they turn down endorsement applications of experienced nurses wanting to work in their state.

As far as travel nursing in CA goes, again, one has to be experienced to travel so any of the EC grads that are working as travel nurses in the state graduated long before the cutoff date.

Sheri257 · Oct 4, 2005

Ok. I know this topic has probably been beat to the bone, but there's something I don't understand. If California does not accept EC grads, and we all take the same NCLEX-RN, is it possible to work for a certain # of hours in your home state and then apply for reciprocity in California, or does the fact that you went to EC in the first place make California a No-Go zone forever? I am having a hard time with that concept. what about travel nurses? You wanna tell me none of the ones that travel there went to EC? Help me understand please...

I guess people keep looking for some other way but, the bottom line is ...

Deadline, deadline, deadline ... that's it. You either meet the cutoff date for enrollment or you don't (December 6, 2003).

EC specifically asked for reciprocity and the board denied it. The reason was state law requires all out-of-state license applicants to have graduated from schools with the same cirriculum and clinical requirements as California schools.

It's state law. Unless somebody changes the law, a court interprets the law differently or ... EC changes their clinical requirements, there's no way around it.

:nurse:

Sheri257 · Oct 4, 2005

They intended on eliminating incompetent nurses who lacked enough clinical experience to be RN's so they stopped recognizing EC, but in years to come they will be throwing out the baby with the bath water as they turn down endorsement applications of experienced nurses wanting to work in their state.

I see your point but, it's a lot more complicated than that. First, the law would have to be changed. And I'm not just talking about one law. There are multiple requirements set by statute that would have to be changed. No easy task.

Second, how do you start making exceptions to your requirements? Any exceptions would also have widespread implications. How do you say one school doesn't have to follow this set of rules but all the other schools do? How you do set up completely different criteria for one group of nurses where everybody else has to follow the existing criteria.

And how do you document all of these other nurses' experience and verify that they have training in all of the areas required by law ... you could easily end up where you started with the problem of people slipping through the cracks.

Sure ... they may have experience in ER or ICU but, for example, the law requires psych, geriatric, cardiac, ob, peds etc. training with specific cirriculum and clinical instruction requirements in each area.

Again, I do see your point. But I'm just wondering if you're considering what the board would have to do from a practical standpoint. Their hands are tied in many ways with the multiple requirements set by statute. And, even if they were so inclined, the California Nurses' Association and other groups that lobbied against EC in the first place would probably be opposed to making any special exceptions just for one school and one group of nurses.

:nurse:

Jo Dirt · Oct 4, 2005

I fit in with the group that graduated after the deadline. I'm not interested in moving to CA but might like to work there as a travel nurse oneday. I was told by the board that even though as a rule they do not accept EC grads anymore they still look at each applicant on an individual basis and as a new grad I could still become licensed if I completed 360 hours of clinicals though a preceptorship at a hospital or the community college. I contacted the local community college in Tullahoma TN and if I am a licensed registered nurse in this state I would be allowed to go through just the required hours of clinicals with the nursing students.

If you want the name and contact info. of the licensing analyst I talked to pm me.

Alibaba · Oct 4, 2005

Thanks everyone for replying. Maan!! This is a complicated issue. I have my evaluation from EC and now all I need to do is take the big plunge. I used to live in Calif and loved it, so the reciprocity issue is really big for me coz I've got a 'special interest' over there that may become DH some time in the future. I would hate to spend all that money with EC only to find that I can't go back to practice there. You are right about one thing though, if someone has all kinds of experience in ICU, ER etc...then it really should be a case by case situation. Does anyone think EC will eventually change their clinical requirements in response to all the external pressures?

Sheri257 · Oct 4, 2005

I fit in with the group that graduated after the deadline. I'm not interested in moving to CA but might like to work there as a travel nurse oneday. I was told by the board that even though as a rule they do not accept EC grads anymore they still look at each applicant on an individual basis and as a new grad I could still become licensed if I completed 360 hours of clinicals though a preceptorship at a hospital or the community college. I contacted the local community college in Tullahoma TN and if I am a licensed registered nurse in this state I would be allowed to go through just the required hours of clinicals with the nursing students.
If you want the name and contact info. of the licensing analyst I talked to pm me.

Well, as I said before, that still wouldn't comply with board's publicly posted requirement on their website which states clinicals have to be conducted concurrently with theory. If you want to take the chance, that's your choice but it's very risky and could be a big waste of time.

Personally, if it came down to the word of one bureaucrat over the board's publicly posted policy, I'd side with the official policy in making the decision but, that's just me.

It's important to remember that the board did initially state that EC grads would have to go through 360 hours of clinicals to qualify. The board later changed that statement, citing the statute requirements as well as the requirement of clinicals concurrent with theory.

So ... I'm wondering if this analyst is referring only to the previous board statement ... not the amended policy which is now posted on the website and has been on the website for some time. I think this analyst may be mistaken.

:cool:

Sheri257 · Oct 4, 2005

Does anyone think EC will eventually change their clinical requirements in response to all the external pressures?

It's been nearly two years since the board debated this issue and EC still hasn't made any changes so, I wouldn't count on it. Quite frankly, the clinical requirements are so detailed and involved i.e. state certified instructors, multiple clinical sites, clinical content that has to correlate with lecture content, etc. they probaby couldn't do it without spending a ton of money and dramatically increasing their tuition.

:smokin:

Jo Dirt · Oct 4, 2005

Well, as I said before, that still wouldn't comply with board's publicly posted requirement on their website which states clinicals have to be conducted concurrently with theory. If you want to take the chance, that's your choice but it's very risky and could be a big waste of time.
Personally, if it came down to the word of one bureaucrat over the board's publicly posted policy, I'd side with the official policy in making the decision but, that's just me.

Well, I don't know, this is what the woman from the board of nursing told me. Maybe you should take it up with the president of the board instead of a licensing analyst.

RN34TX · Oct 4, 2005

"I see your point but, it's a lot more complicated than that. First, the law would have to be changed. And I'm not just talking about one law. There are multiple requirements set by statute that would have to be changed. No easy task.

Second, how do you start making exceptions to your requirements? Any exceptions would also have widespread implications. How do you say one school doesn't have to follow this set of rules but all the other schools do? How you do set up completely different criteria for one group of nurses where everybody else has to follow the existing criteria."

But......IL does it. And IL is the only state that has never acepted EC from the beginning and it is specifically because of the same problems CA has with theory concurrent with clinical in all of the required areas. Very similar language used on their website regarding non-recognition of EC grads.

However, IL has a specific clause in the rules that allows EC grads to be licensed in IL who have worked a minimum of 2 years full time in a clinical area as an RN. Obviously none of these candidates would meet IL's rules for complying with theory concurrent with clinical, yet they can be granted licensure by working as an RN elsewhere for 2 years.

So why would that be so hard for CA to do?

"And how do you document all of these other nurses' experience and verify that they have training in all of the areas required by law ... you could easily end up where you started with the problem of people slipping through the cracks."

Let me tell you how.

State boards verify nursing experience all of the time right now.

When I attempted to endorse into PA as an LPN, the program I graduated from fell a mere 10-12 hours short of PA's clinical requirement for LPN grads in their state.

Would you believe that I actually had to get my manager to submit very specific documentation with the payroll dept. actually verifying that I was clocked in and working on the floor as an LPN for X number of hours over the past year? They wanted manager and preceptor evaluations with specific documentation that I was checked off by a preceptor and demonstrated specific nursing skills/competencies, etc.

It was the absolute worst endorsement process I'd ever been through.

Definitely not the norm, but you can believe that state boards definitely put people on the payroll to comb through someone's academic and employment records very meticulously in the name of beaurocracy.

"Sure ... they may have experience in ER or ICU but, for example, the law requires psych, geriatric, cardiac, ob, peds etc. training with specific cirriculum and clinical instruction requirements in each area."

I see what you're saying here. But again, could you truely imagine telling someone who graduated from EC 15 years ago and has worked in the acute care arena full time since that they need to go back to school with RN students who are still struggling with inserting foleys, NG tubes, drawing up insulin, hearing lung sounds, etc. to meet their state laws?

Ask RN's that you have contact with now who have worked for years in a given area, let's say Med/Surg, ER, ICU, etc.

Ask them how much they remember their psych, peds, and OB clinicals and if they could get floated to one of those units, take an assignment and be ok?

I'd be willing to bet that none of them will tell you that they remember a heck of a lot from those days and certainly would refuse to be floated to those specialty areas.

So my question then is this: What difference does it make if you have 2 adult Med/Surg RN's of 10 years trying to endorse into CA. One went the traditional route in a program that meets all of CA's laws, one went through EC.

Both would be clueless if asked to work OB or psych without additional training.

"Again, I do see your point. But I'm just wondering if you're considering what the board would have to do from a practical standpoint. Their hands are tied in many ways with the multiple requirements set by statute. And, even if they were so inclined, the California Nurses' Association and other groups that lobbied against EC in the first place would probably be opposed to making any special exceptions just for one school and one group of nurses."

I just don't see why their hands are so tied but states like IL are not. Both states have identical problems with EC complying with their statutes.

The second part of your statement is where I think you hit it on the head:

The groups lobbying against EC and putting pressure on the CA BNE.

Like in all of our discussions on this topic, I know that your standpoint is the law is the law, which we agree on.

I'm not questioning what the law states, I'm questioning it's valididty and the effectiveness of it's original intent. I seriously question, especially in years to come, who truely benefits and who ends up getting hurt over it.

In an age of a serious nursing shortage in that state, along with backed up waiting lists, faculty shortages, etc.

Is it truely in the best interest of the citizens of CA, who the state board is supposed to be protecting, to leave this law as it stands without amendment/ratification?

Is turning away experienced endorsement applicants in favor of waiting for the CA schools to pop out fresh new grads to fill positions in the best interest of CA's citizens?

RN34TX · Oct 4, 2005

I guess people keep looking for some other way but, the bottom line is ...
Deadline, deadline, deadline ... that's it. You either meet the cutoff date for enrollment or you don't (December 6, 2003).
EC specifically asked for reciprocity and the board denied it. The reason was state law requires all out-of-state license applicants to have graduated from schools with the same cirriculum and clinical requirements as California schools.
It's state law. Unless somebody changes the law, a court interprets the law differently or ... EC changes their clinical requirements, there's no way around it.

I don't blame CA for denying reciprocity, even though I disagree with their law.

If you're going to make a law banning EC grads, what sense would it make to allow them to go over to NV or AZ and get licensed, only to turn around and apply for endorsement into CA? Why bother making the law at all?

But that's how GA works. You can work as an RN in their state but are not eligible to take the NCLEX in GA. So people just get licensed in another state, then endorse into GA. Insane.

RN34TX · Oct 4, 2005

It's been nearly two years since the board debated this issue and EC still hasn't made any changes so, I wouldn't count on it. Quite frankly, the clinical requirements are so detailed and involved i.e. state certified instructors, multiple clinical sites, clinical content that has to correlate with lecture content, etc. they probaby couldn't do it without spending a ton of money and dramatically increasing their tuition.

Two years is not a very long time. I don't think that there are very many people out there who are affected by it at this time. How many RN's could there be that enrolled after the deadline and are already attempting to endorse into CA?

The full effect will be seen in years to come.

My personal prediction is that both will eventually cave in and compromise on some level.

If the nursing shortage continues, I don't see how CA can continue to ignore a pool of applicants who come to their state with differing expertise under their belts. 10-15+ years from now CA will be getting applications of many who are disqualified from licensure under their current laws and I just don't see them all just walking away quietly.

As far as EC goes, they too, will eventually need to change. They've long relied on their smugness of being the largest nursing program in the country and have long been the exception to most state's rules. EC grads are allowed licensure while bipassing the clinical rotations required of students who go to regular state approved schools.

With a state as large as CA questioning and outright banning their program, with smaller states looking to CA as an example, EC eventually will be forced to revamp their program and give way to their current arrogance of refusing to find common ground and working out the problems CA has with them.