Yet another excelsior college question r/t reciprocity in Calif

Sheri257 · Oct 4, 2005

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?

That's an interesting point. I guess you'd have to do a thorough analysis of how much discretion the Illinois board has in making their own rules versus what rules are set by statute. I do remember that the California board did repeatedly cite statutes in their EC decision. Perhaps they don't have as much discretion as the Illinois board.

As far as other states ... Californians have never really cared about what other states or, for that matter, what the federal government does either. We have tougher emissions standards for cars. We have a higher minimum wage. We don't allow medication aides. We have a ratio law. The list goes on and on.

But I still think it all boils down to the question of special treatment because, that's essentially what EC and their graduates are asking for. Everybody else, all over the country, has to go through all these clinicals and meet all these requirements to practice here. For better or for worse, these are the standards of nursing education these days.

So ... What makes EC so special that they deserve a completely different deal than what everybody else has to follow? Why would anyone reasonably expect the board to make an exception for only one school and a few thousand graduates when they make a hundred other California schools and hundreds of thousands of graduates jump through a ton of hoops to meet their requirements?

Is it really fair to say the rules don't apply to EC but they do apply to everybody else? Even if you could do that, is it right to do it? Not really. When you think about it ... it's actually unfair to everybody else who does follow the rules.

When you set aside all of the other arguments and debatables over politics, standards, experience, quality, etc. ... the issue really boils down to fairness. And what EC grads are asking for is special treatment that just isn't fair.

That's the heart of the issue, IMHO.

:smokin:

MedictoRN · Oct 4, 2005

I think the whole point is we all have or will take the SAME NCLEX exam. And the point of this exam is to give reasonable certainty that those that pass it are capable of competent practice. If they don't agree that that is what it does they should find a different testing vehicle. Perhaps they should just write there own test and do there own thing. And while we are at it maybe the rest of the states should shut out there nurses as well. That would get some attention. I think it's pretty arrogant of CA to proclaim that their standards are so much better than everyone else.

AS IF!!

Don't forget that you only have to be licensed in one of the 50 states to work at a Veteran's Hospital. I hear they pay very well.

fergus51 · Oct 4, 2005

The NCLEX is not the end all and be all for licensing. Every state has the right to determine their own minimum qualifications for licensure. Some states require that you have CEUs to renew, some states require you to have some recent education on certain subjects (like HIV), etc. I really don't think California is being unreasonable, and I doubt they will have to change their policies any time soon. The number of nurses registering here has increased pretty dramatically since the ratio laws were passed.

Sheri257 · Oct 4, 2005

I think it's pretty arrogant of CA to proclaim that their standards are so much better than everyone else.
AS IF!!

Actually there are lots of people who come from out of state who qualify for licensure here. Obviously most nursing schools around the country meet California's requirements, which pretty much match the basic standards of nursing education around the country.

As RN34TX pointed out, a lot of states tend to exempt Excelsior from their rules ... but the rules are still required for the vast majority of schools.

If anyone is arrogant ... it's EC for expecting California to make a special exemption for them.

:rolleyes:

RN34TX · Oct 4, 2005

That's an interesting point. I guess you'd have to do a thorough analysis of how much discretion the Illinois board has in making their own rules versus what rules are set by statute. I do remember that the California board did repeatedly cite statutes in their EC decision. Perhaps they don't have as much discretion as the Illinois board.
As far as other states ... Californians have never really cared about what other states or, for that matter, what the federal government does either. We have tougher emissions standards for cars. We have a higher minimum wage. We don't allow medication aides. We have a ratio law. The list goes on and on.
But I still think it all boils down to the question of special treatment because, that's essentially what EC and their graduates are asking for. Everybody else, all over the country, has to go through all these clinicals and meet all these requirements to practice here. For better or for worse, these are the standards of nursing education these days.
So ... What makes EC so special that they deserve a completely different deal than what everybody else has to follow? Why would anyone reasonably expect the board to make an exception for only one school and a few thousand graduates when they make a hundred other California schools and hundreds of thousands of graduates jump through a ton of hoops to meet their requirements?
Is it really fair to say the rules don't apply to EC but they do apply to everybody else? Even if you could do that, is it right to do it? Not really. When you think about it ... it's actually unfair to everybody else who does follow the rules.
When you set aside all of the other arguments and debatables over politics, standards, experience, quality, etc. ... the issue really boils down to fairness. And what EC grads are asking for is special treatment that just isn't fair.
That's the heart of the issue, IMHO.

I think you have it backwards. I was saying that other states look to CA as an example, if for no other reason, because of it's large size and influence, not the other way around.

It's not fair. If I were going through clinical rotations while another LVN passed the 3 day CPNE and was an RN working while I was still in school struggling, I'd feel cheated too.

But what LVN who was capable of passing it wouldn't do it?

What's the alternative? A state school system that in many cases, forces an LVN to complete most if not all of an entire ADN program with little or any recognition for clinicals and theory already completed.

Even the 30 unit option, at least in my case, would have only shaved off a negligible amount of coursework and you might as well just get the whole ADN in case you decide to work elsewhere.

And let's not even get into the waiting lists.

After getting accepted into a traditional transition program and having my co-workers in the class ahead of me tell me tales of spending clinicals making beds and hanging IV antibiotics, not one LVN-RN graduate I knew felt that they learned much of anything besides how to appease a particular instuctor's little ideosyncracies. So I dropped my spot in the program and went through EC.

Would I have done that had I known in 2000-2001 that all of this bad stuff about EC would be happening? Heck no, and in the midst of all of this, I certainly do not recommend that anyone go this route unless it is basically their only hope of ever getting their RN.

It's not fair and yes, EC and it's graduates are basically asking for exceptions to the rules while others spend weeks and months jumping through hoops in their rotations.

But keep in mind that for those of us who graduated long before any of this stuff started, that we were all told by our respective boards that this degree was recognized for licensure and most of us already worked with or had bosses that were EC grads so we had no reason to believe that it was frowned upon by anyone (except IL at that time.) I even called about 10 different boards in states where I thought I might live someday and they all (including CA at that time) had no problem with EC grads and most said that "we've issued licenses to them forever."

Who knew then?

It's not fair, very inconsistant, and EC needs to do something about it on their end unless they want more state boards closing doors to them.

But as far as the CA BNE is concerned, how fair is it to both the post cut-off date grads as well as the people of CA in years to come when these RN's want to work there, there continues to be more need for nurses than the CA schools can put out, and these RN's are coming with a wealth of experience without the performance issues feared by CA, and they are still denied licensure based on their current statutes?

You never know how well a new grad will perform until they start working no matter where they went to school.

What better evidence exists to predict performance than the performance of someone who's already been working independently as an RN?

A new grad from any program will always, good grades or not, be more of a gamble as far as safety, performance, and clinical judgement is concerned than an experienced nurse. (Not that there aren't dangerous experienced nurses out there, we've all seen them.)

But new grads are always very unpredictable. If employers could tell on paper who is going to do well and who isn't, they'd be on it.

So, CA has concerns that prompted state action regarding EC grads because of the fly by night medical assistants becoming RN's who have serious safety and performance issues as RN's. Fine.

But what about all of these experienced people who are doing just fine?

Should they all be lumped in together?

RN34TX · Oct 4, 2005

Actually there are lots of people who come from out of state who qualify for licensure here. Obviously most nursing schools around the country meet California's requirements, which pretty much match the basic standards of nursing education around the country.
As RN34TX pointed out, a lot of states tend to exempt Excelsior from their rules ... but the rules are still required for the vast majority of schools.
If anyone is arrogant ... it's EC for expecting California to make a special exemption for them.

Not to agree with CA, but in light of these events I found it very disappointing and definitely arrogant on EC's part that there has been no mention anywhere on EC's website since this ruling (going on two years now) about what they plan to do for CA students to be in compliance besides to not recommend anyone in CA to attend their program.

To clarify my statement about a lot of states exempting EC from their rules, the PA BNE explained it best to me:

I looked at their numerous regs for RN programs such as they all need to have lab along with lecture for all lab science courses. I asked the BNE if I could challenge exam A&P and micro without lab and still be licensed as an RN in PA and she told me yes.

I asked how that was possible if PA had all of these requirements for RN programs. She told me that every state regulates their own state's RN programs but most will recognize out of state programs if the program is accredited by the state board where the school is located.

EC is accredited by the NY BNE and therefore, is automatically recognized by the PA BNE, even though lab science and clinical requirements are much different in NY than in PA.

I worked with several EC grads there and none of them had any trouble with licensure.

I found this funny because I had so many extra hoops to jump through when trying to endorse into PA as an LPN. My LPN school was both state and NLN accredited, yet I did not receive any "automatic" recognition and had to come up with extra documentation to meet their standards.

Is EC the only school afforded this privilege? It seemed that way to me at the time.

RN34TX · Oct 4, 2005

I think the whole point is we all have or will take the SAME NCLEX exam. And the point of this exam is to give reasonable certainty that those that pass it are capable of competent practice. If they don't agree that that is what it does they should find a different testing vehicle. Perhaps they should just write there own test and do there own thing. And while we are at it maybe the rest of the states should shut out there nurses as well. That would get some attention. I think it's pretty arrogant of CA to proclaim that their standards are so much better than everyone else.
AS IF!!
Don't forget that you only have to be licensed in one of the 50 states to work at a Veteran's Hospital. I hear they pay very well.

The current trend here is that people are putting less and less faith into the NCLEX and it's validity as a tool to test for minimal competence has gone downhill in recent years.

This is evidenced by hospital's increasing use of testing tools such as the PBDS to validate a nurse's knowledge, judgement, performance, etc.

I've worked at facilities where a new grad was top of her class or an experienced nurse came with great recommendations and a ton of experience but it was all down the toilet if they couldn't pass the PBDS.

BTW, CA did indeed conduct it's own unique state board exam for RN's and LVN's for many years before switching to the NCLEX.

That's neither the problem nor the answer.

CA BNE was responding to intense pressure from both nursing unions and big hospital organizations.

I too, enjoy pointing the finger of blame between the two of them (EC and the CA BNE) for my own enjoyment but it really doesn't get us anywhere.

Until the two entities start working together and stop putting us in the middle of the crossfire just to satisfy political agendas and egos, no one will get a fair shake in this, traditional or EC grad.

Sheri257 · Oct 5, 2005

After getting accepted into a traditional transition program and having my co-workers in the class ahead of me tell me tales of spending clinicals making beds and hanging IV antibiotics, not one LVN-RN graduate I knew felt that they learned much of anything besides how to appease a particular instuctor's little ideosyncracies. So I dropped my spot in the program and went through EC.

There are five LVN's in my class. Two are fresh out of school and haven't spent one day in a hospital outside of school clinicals. The other three are experienced.

Is school a waste of their time? Probably to some extent, especially with the experienced LVN's. But the LVN's who just attended school and never worked tell me they are learning things they were never taught in LVN school. And the experienced LVN's are getting exposure to specialities they've never studied or worked in.

Despite all of the BS with instructors and everything else, I do see a method to the madness, so to speak. There is so much to learn and, let's face it, you can't learn enough as a student or nurse IMHO. Is some repetition for some students really that bad of a thing?

What do you do? Make one set of rules for working LVN's versus LVN's who are fresh out of school who clearly need training? How many different sets of standards can you, for all practical purposes, have?

But as far as the CA BNE is concerned, how fair is it to both the post cut-off date grads as well as the people of CA in years to come when these RN's want to work there, there continues to be more need for nurses than the CA schools can put out, and these RN's are coming with a wealth of experience without the performance issues feared by CA, and they are still denied licensure based on their current statutes?

As we all know California gave ample notice on the cutoff date. And it applied to enrollment so nobody who was in the middle of the program would be screwed, so to speak. It even gave people who hadn't enrolled yet, and wanted to get a California license through EC, a chance to do so. Those people who made the cutoff date can still practice here. Those who can't were warned in months in advance. I don't know what else the board could have done. It was totally fair.

But what about all of these experienced people who are doing just fine? Should they all be lumped in together?

This gets back to the same problem I mentioned with experienced LVN's versus LVN's fresh out of school. And we all know there are 20 year veteran RN's who are lousy nurses, just as we know there are new grads who are lousy nurses.

Yes, there are always exceptions to every rule. But, at the end of the day, you can't make a ton of exceptions. You have to set up standards that apply to everyone. Is the system flawed? Yes. But, by and large, it's the only practical thing to do.

My school is working on a more flexible weekend program for working adults that will hopefully alleviate the waiting list to some extent and meet the BORN standards. It will probably take years but at least they're trying to do what EC has failed to do.

I too am disappointed in EC's response to this issue. Other than filing the lawsuit and disallowing MA's and surgical techs, they really haven't done much else in the last two years to address the problem. It's kind of surprizing, actually.

:coollook:

SierraC · Oct 5, 2005

There are five LVN's in my class. Two are fresh out of school and haven't spent one day in a hospital outside of school clinicals. The other three are experienced.
Is school a waste of their time? Probably to some extent, especially with the experienced LVN's. But the LVN's who just attended school and never worked tell me they are learning things they were never taught in LVN school. And the experienced LVN's are getting exposure to specialities they've never studied or worked in.
Despite all of the BS with instructors and everything else, I do see a method to the madness, so to speak. There is so much to learn and, let's face it, you can't learn enough as a student or nurse IMHO. Is some repetition for some students really that bad of a thing?
What do you do? Make one set of rules for working LVN's versus LVN's who are fresh out of school who clearly need training? How many different sets of standards can you, for all practical purposes, have?
As we all know California gave ample notice on the cutoff date. And it applied to enrollment so nobody who was in the middle of the program would be screwed, so to speak. It even gave people who hadn't enrolled yet, and wanted to get a California license through EC, a chance to do so. Those people who made the cutoff date can still practice here. Those who can't were warned in months in advance. I don't know what else the board could have done. It was totally fair.
This gets back to the same problem I mentioned with experienced LVN's versus LVN's fresh out of school. And we all know there are 20 year veteran RN's who are lousy nurses, just as we know there are new grads who are lousy nurses.
Yes, there are always exceptions to every rule. But, at the end of the day, you can't make a ton of exceptions. You have to set up standards that apply to everyone. Is the system flawed? Yes. But, by and large, it's the only practical thing to do.
My school is working on a more flexible weekend program for working adults that will hopefully alleviate the waiting list to some extent and meet the BORN standards. It will probably take years but at least they're trying to do what EC has failed to do.
I too am disappointed in EC's response to this issue. Other than filing the lawsuit and disallowing MA's and surgical techs, they really haven't done much else in the last two years to address the problem. It's kind of surprizing, actually.

My husband works in a hospital in S .Cali that had a problem some time ago with EC grads ...rumor has it that it had alot to do with the CA decision ( they employ many EC grads there at this point). The nurses in question were LPN's before they were EC RN's.....NOT CMA's or SURGICAL TECHS! I tested in Ny for my clinical with EC in July..i passed..i tested with 4 Lpns...one of those Lpn's could not do an IV push ....the other failed on vital signs. i went into EC as a CMA and I did complete my first year of nursing school. Really ,nursing is not rocket science. There is such a huge shortage in nursing in CA... I live next to a travel OB RN ..she has been here for a year...they give her a 2500 bonus for every 3 months she signs up PLUS free housing and utilities....if you do a search of job openings .....CA has so many...the CA BON in the next few years will change their position on EC grads....they have too...they don't have the nursing schools to support the need.

Sheri257 · Oct 5, 2005

the CA BON in the next few years will change their position on EC grads....they have too...they don't have the nursing schools to support the need.

EC made this argument at the time of the decision. It didn't fly. The shortage was already really bad when the board made their decision. And the waiting lists at all the nursing schools was already miles long. If the California board was inclined to change their mind just because of the shortage they would have already done so in the last two years.

You're overlooking the fact that the board had a tremendous amount of support for their decision including three state nursing associations, Kaiser as well as other hospitals.

Really, nursing is not rocket science.

Well ... all I can say is that this kind of attitude is probably what got EC in the trouble in the first place. I'm sure that all of the nurses who work in ICU, cardiac cath labs, dialysis units, anesthesia and other highly specialized fields that require a tremendous amount of knowledge and training would be interested to learn that what they do is not rocket science. :chuckle

:rolleyes:

BBFRN, BSN, PhD · Oct 5, 2005

Well ... all I can say is that this kind of attitude is probably what got EC in the trouble in the first place. I'm sure that all of the nurses who work in ICU, cardiac cath labs, dialysis units, anesthesia and other highly specialized fields that require a tremendous amount of knowledge and training would be interested to learn that what they do is not rocket science. :chuckle

Hey, don't attach that attitude to EC- it belongs solely to the above poster(Sierra, not Lizz), whom I believe (based on her other posts) hasn't taken boards yet or worked as a nurse.

Sheri257 · Oct 5, 2005

Hey, don't attach that attitude to EC- it belongs solely to the above poster(Sierra, not Lizz), whom I believe (based on her other posts) hasn't taken boards yet or worked as a nurse.

Good point. My apologies.

:coollook: