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Calif Board of Registered Nurses and resources (Updated 3/31/2020)

March 31, 2020 Update

Board of Registered Nursing Urges Nursing Students to Help During the COVID-19 Pandemic

Business and Professions Code section 2727(d) provides that nursing services may be provided by unlicensed persons during an epidemic, which would include nursing students, without violating the Nursing Practice Act.

Nursing Services during Epidemic/Public Disaster AT-A-GLANCE

Nursing Workforce Resources and Circulars

Article: Statewide political activism for California academic nursing leaders

Letter: CACN/ COADN Letter to Governor

Letter: California Nursing Students Association Letter to membership

CALIFORNIA BOARD OF REGISTERED NURSES

https://www.rn.ca.gov/

March 20, 2020 Update

The CCCCO and HWI are working with the Board of Registered Nursing to assure information and communication provided to the field. Conference calls with the BRN to discuss the issues and concerns of the nursing programs and students are occurring to ensure this communication.

In the interim of any updates from the BRN directly, we have summarized our discussions here in these bullets points with the most frequently asked questions.  

  • Understand that all approved pre-licensure programs need to work directly with the Nursing Education Consultant (NEC) regarding any change of program and clinical changes
  • Any new clinical site agreements, even emergency must be approved with the BRN before implementation
  • Foundation/ Fundamentals course(s) can be in the skills lab
    • These initial courses can be held all in the skills lab for 100% of this course introduction course only
  • 75% clinical hours to be in direct patient care
    • Not primarily defined as direct patient care in an acute care setting
    • Examples discussed may include, but not limited to:
      • Face-to-face
      • Any clinic setting
      • Public health setting
      • Other areas of use (e.g., health fair)
      • Telehealth
      • Student triage with a script
      • ALL must be approved by NEC and meet the clinical objectives and student learning outcomes
  • 25% of the 100%
    • Not defined in the regulations
      • Must meet the clinical objectives and student learning outcomes
      • Simulation is an example (E.g., standardized patient, simulated clinical environments or virtual simulation)
  • Concurrent enrollment
    • Theory and clinical must be taken concurrently, and clinicals need to be scheduled with 75% in direct patient care
    • Clinicals can be after the theory course within the same semester or quarter, but not held before theory as they have not learned the knowledge and skill to perform
      • Some programs have chosen to do a “boot camp” of critical information that is needed to ensure the safe practice of their students during a clinical rotation that occurs prior to the majority of the delivery of the theoretical content.  This allows for a greater flexibility with scheduling and helps to ensure safe and competent care delivery.
  • All theory courses and exams can be taught/taken remotely.
    • Please submit a formal letter to your NEC requesting this temporary change along with an end date
    • When requesting this change, please speak to the platform you intend to use, student availability to the platform, and your ability to support this type of instruction
    • Viewed as a minor curriculum revision and the NEC can approve this immediately so that we will not delay your implementation
  • Program sequence changes to alleviate clinical hour displacement
    • To help alleviate some of the strain on your clinical situation you may consider resequencing your courses within your program
    • NEC can also process this as a minor curriculum revision
  • Regulations are set by the legislature
  • The BRN oversees policy and implementation
  • When you are reporting Clinical disruption information to your NECs please include:
    • Name of the facility that has closed
    • How long is this predicted to last
    • How many clinical groups are displaced from those locations
    • How many students are in each group
    • What nursing content area the clinical rotation was in
    • How many hours of clinical the students have completed for that rotation
    • How many hours of clinical are still needed to complete the rotation
    • How many hours (percentage %) has already been used in the simulation
    • What date does your semester/quarter is scheduled to end
    • Is your program year-round or traditional
    • Have you contacted other facilities for direct patient care clinical makeups (how many? What is their response?)
    • What is your program's policy on missed clinical days
  • All programs are approved on an individual basis
    • Work with your NEC to navigate these change requests
  • NECs are here to support the programs
    • Please submit all requests to the NEC directly
    • Response time is based on incoming and outgoing workflow
    • All requests are reviewed and may take higher-level supervisor support or approval

March 10, 2020

We have received several notifications and inquiries on what to plan for regarding clinical and theory hours as the CDC and CDPH continue to send out information on the coronavirus with suggested responses. Currently, our Board and DCA with legal counsel are monitoring the situation and are looking into various options. To date, we are still bound by our regulation (e.g. Theory and clinical must be taken concurrently and clinicals need to be scheduled with 75% in direct patient care).

I have asked all Nursing Education Consultants (NECs) to collect the numbers to speak to the current impact of disrupted clinical rotations.  When you are reporting this information to your NECs please include:

  • Clinical disruption
  • Name of the facility that has closed
  • How long is this predicted to last
  • How many clinical groups are displaced from those locations
  • How many students are in each group
  • What nursing content area the clinical rotation was in
  • How many hours of clinical the students have completed for that rotation
  • How many hours of clinical are still needed to complete the rotation
  • How many hours (percentage %)  has already been used in simulation
  • What date does your semester/quarter is scheduled to end
  • Is your program year-round or traditional
  • Have you contacted other facilities for direct patient care clinical makeups (how many? What is their response?)
  • What is your program's policy on missed clinical days

Additionally, we have heard that students may have limited experiences in facilities due to the lack of availability of personal protective equipment (PPE).  If your student is not able to meet the clinical/course objectives due to this please report that separately as we are tracking that as well. If they are able to continue and the objectives will be met there is no need to report this.

In regards to theory: All theory courses and exams can be taught/taken remotely. Please submit a formal letter to your NEC requesting this temporary change along with an end date. When requesting this change please speak to the platform you intend to use, student availability to the platform, and your ability to support this type of instruction.  This will be treated as a minor curriculum revision and your NEC can approve this immediately so that we will not delay your implementation.  If you are considering resequencing your courses within your program to help alleviate some of the strain on your clinical situation, your NEC can also process this as a minor curriculum revision as well.

Your NEC will work with your programs on an individual basis as we try to navigate this.  I appreciate all of you for working together and sharing our ideas.