California needs nurses. So why is the state giving up 10,000 prospects?

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<img class = "caas-img has preview" alt = "Rancho Santa Margarita's Ryane Panasewicz is a nursing student due to graduate from the West Coast University Nursing School in Anaheim in June due to coronavirus, nursing students, faculty and administrators across the state, the California Board of Registered Nursing is calling on its requirements to be changed so that students can do more of their clinical training through simulations. (Gary Coronado / Los Angeles Times)“src =” https://s.yimg.com/ny/api/res/1.2/HBg0sa_Gz1zYg2yuFZaB4A–/YXBwaWQ9aGlnaGxhbmRlcjt3PTcwNTtoPTQ3MA–/https://sy / – ~ B / aD004MdH7d0BMDH7c .com / en / la_times_articles_853 / 3fc14af2a85b8e95f0e03ddd5d6f3bcy /YXBwaWQ9aGlnaGxhbmRlcjt3PTcwNTtoPTQ3MA–/https://s.yimg.com/uu/api/res/1.2/DGJ7WyH89Glh8Wv7GoTThw–~B/aD01NjA7dz04NDA7c209MTthcHBpZD15dGFjaHlvbg–/https://media.zenfs.com / en / la_times_articles_853 / 3fc14af2a85b8e95f0e03ddd5d6f3bc4 “/>
Rancho Santa Margarita’s Ryane Panasewicz is a nursing student who will graduate from the West Coast University Nursing School in Anaheim in June. Because of the corona virus, nursing students, faculties, and administrators across the state are asking the California Board of Registered Nursing to change its requirements so that students can do more of their clinical training through simulations. (Gary Coronado / Los Angeles Times)

Amid the hectic efforts to open hospitals and increase the number of healthcare workers, California nursing schools are warning government officials that an estimated 10,000 nursing students are at risk of graduation, meaning they will be evaluating and treating patients in the midst of the coronavirus -Pandemic cannot help.

State regulations require nursing students to spend a significant portion of their clinical training in hospitals, but they are now prohibited from doing so by orders to block hospitals. If the state doesn’t relax its rules, it will be impossible for students who will graduate in the coming months to become a licensed nurse.

As a result, public and private nursing schools are asking Governor Gavin Newsom and the State Board of Registered Nursing to allow more flexibility in meeting their clinical education requirements after many hospitals have dropped out of internships for safety reasons, and to focus on nursing tidal wave of COVID-19 patients.

“I trained for 19 months and the end is near and everything comes to a standstill,” said Ryane Panasewicz, 27, who attends the nursing school on the West Coast University campus in Anaheim. “If you keep nursing graduates out of the healthcare system at this point, the problems will worsen.”

<img class = "caas-img caas-lazy has-preview" alt = "Ryane Panasewicz is a nursing student who will graduate from the West Coast University Nursing School in Anaheim in June. (Gary Coronado / Los Angeles Times)“src =” “data-src =” https://s.yimg.com/ny/api/res/1.2/bGc4S6.oLpB0_gaa8.aQUQ–/YXBwaWQ9aGlnaGxhbmRlcjt3PTcwNQ–/https://s.yimg.com/ uu / api / res / 1.2 / BGRNrYS<img alt = "Ryane Panasewicz is a nursing student who will graduate from the West Coast University Nursing School in Anaheim in June. (Gary Coronado / Los Angeles Times)“src =” https://s.yimg.com/ny/api/res/1.2/bGc4S6.oLpB0_gaa8.aQUQ–/YXBwaWQ9aGlnaGxhbmRlcjt3PTcwNQ–/https://s.yimg.com/uu/api/res/ 1.2 / BGRNrYS.WqfXoaFIkl0JFQ– ~ B / dz0wO3NtPTE7YXBwaWQ9eXRhY2h5b24- / https: //media.zenfs.com/en/la_times_articles_853/8dbb840ced9ebf107364bc>
Ryane Panasewicz is a nursing student who will graduate from West Coast University Nursing School in Anaheim in June. (Gary Coronado / Los Angeles Times)

California has prepared for a rush of COVID-19 patients. Newsom said this week that the state will need 50,000 additional beds and many additional healthcare workers. With the number of confirmed COVID-19 cases increasing daily, nursing schools say the background to their urgent request is clear.

On Wednesday, an Kaiser vice president and infectious disease expert said that about half of Kaiser Permanente’s hospital in San Jose was filled with patients who were confirmed or suspected of having the new coronavirus, leading to a need to increase staff . California has since started leasing medical facilities. One in Daly City is admitting up to 220 COVID-19 patients this week, which may require more healthcare workers.

On Monday, Newsom said the state was looking into ways to license nursing students earlier, but its administration had given no additional details on Wednesday.

The Board of Registered Nursing, a designated body that enforces nursing education and licensing laws, has not publicly disclosed what changes may be sought. Michael Deangelo Jackson, president of the board of directors, and Loretta Melby, acting director of the board of directors, referred questions to a spokeswoman who refused to comment and said they expected “more up-to-date information in the coming days”.

“We could now deploy these 10,000 nurses,” said Joanne Spetz, deputy research director at UC San Francisco’s Healthforce Center, who makes supply and demand forecasts for registered nurses in the state. “It’s incredibly important to get her out of the door and practice.”

The Idaho Board of Nursing announced an apprenticeship program to bring nursing students to hospitals last week and a temporary emergency license for students nearing graduation. This month, in response to the pandemic, the Texas Board of Nursing relaxed its rules on how many hours of nursing students have to work in hospital education rotations.

Critics say California’s slow response is due to a lack of urgency on behalf of the State Nursing Committee.

<img class = "caas-img caas-lazy has-preview" alt = "Nursing students and trainers are waiting for a shift change in the intensive care unit of the UCLA Medical Center in Santa Monica in 2014. (Mel Melcon / Los Angeles Times)“src =” “data-src =” https://s.yimg.com/ny/api/res/1.2/TKD9WwZIRDPCGhcK8_G6gA–/YXBwaWQ9aGlnaGxhbmRlcjt3PTcwNQ–/https://s.yimg.com/ res / 1.2 / t.pp_MD1lavbWGnS11JhPQ– ~ B / dz0wO3NtPTE7YXBwaWQ9eXRhY2h5b24- / https: //media.zenfs.com/en/la_times_articles_853/87b037ef228ac88aecc59ff25b<img alt = "Nursing students and trainers are waiting for a shift change in the intensive care unit of the UCLA Medical Center in Santa Monica in 2014. (Mel Melcon / Los Angeles Times)“src =” https://s.yimg.com/ny/api/res/1.2/TKD9WwZIRDPCGhcK8_G6gA–/YXBwaWQ9aGlnaGxhbmRlcjt3PTcwNQ–/https://s.yimg.com/uu/2//. pp_MD1lavbWGnS11JhPQ– ~ B / dz0wO3NtPTE7YXBwaWQ9eXRhY2h5b24- / https: //media.zenfs.com/de/la_times_articles_853/87b037ef228ac88aecc59ff2589b74as>
Nursing students and nursing instructors are waiting for a shift change in 2014 at the UCLA Medical Center in Santa Monica. (Mel Melcon / Los Angeles Times)

“So far, our governor and the California Board of Registered Nursing have taken no action and we are simply stuck,” said Scott Casanover, senior vice president of government affairs at West Coast University and American Career College, who operate nursing schools in Anaheim , Los Angeles and Ontario.

“We started three weeks ago to appeal to the board that if we can’t lock in nurses, this will be a big problem,” said Casanover. “There are no more nurses in the pipeline until we resolve this.”

The University of California, California State University, and California Community Colleges, each of which runs care programs at different locations, sent letters asking the governor and the State Nursing Board to indicate the number of clinical hours that nursing students can complete through simulations to increase temporarily.

The state currently requires that 75% of the clinical training of a nursing student takes place in a hospital, the remaining 25% can be simulated. Students must also pass the board exams after graduation.

Nursing schools are calling on the state to reduce the number of hours spent in hospital to 50% of a student’s clinical education so that schools can do more computer simulations with courses already online due to the campus closure due to the outbreak of the coronavirus .

Alison Wrynn, vice chancellor for academic programs, innovation and faculty development at California State University, said the vast majority of students expected to graduate this spring have closed their clinical internship positions, largely due to a lack of available personal protective equipment.

The California State University system, one of the state’s largest issuers of nursing degrees, completes approximately 4,000 nursing students each year.

Wrynn said there was a need to provide more simulation education because only a small number of nurses in Cal State continued to do clinical internships in hospitals.

“Other states have initiated a 50% simulation and their graduates are successful,” said Wrynn. “We have high quality simulation software from respected providers. Our faculty monitors this experience and evaluates the students. We did that and we did it well … This will not affect the quality of our nursing education. “

Carole Goldsmith, President of Fresno City College, said the State Nursing Board would be “incredibly nearsighted” if it didn’t ease the graduation requirements. Fresno City College produces approximately 200 nursing graduates each year, and it is unclear how many students could graduate without the change in May, Goldsmith said.

Goldsmith closed the school campus, but personal elements for programs that train workers in key services such as policing, firefighting, and nursing will continue according to instructions from the Chancellery and requests from local health and safety agencies.

Goldsmith said her college worked with almost a dozen local locations to offer clinical internships to nursing students. Only one of them, the St. Agnes Medical Center, still accepts students.

“Our capacity … has been greatly reduced,” said Goldsmith.

With a limited number of healthcare workers and many of them in a high-risk group for COVID-19, “there are so many things our students could do,” said Goldsmith, such as: B. First preventive examinations, vital examinations and triage.

She said that temporarily easing state rules on how much time a nurse would have to spend in a hospital rotation to graduate would not cost patients. She pointed to a comprehensive 2014 National Council of State Boards of Nursing study showing that there is no significant difference in learning or clinical performance between students who have completed 25% of their clinical training in simulations, and students who have completed 50%.

“And that was in 2014,” said Goldsmith. “The technology has improved over that time.”

For now, nursing student Brea Ortiz von Whittier said it was a waiting game. She watches every Newsom press conference hoping to hear that there will be some changes so that she can graduate.

“We need something and can be helpful,” said Ortiz, 24, who is scheduled to start hospital rotation on April 10, or her graduation in August will be pushed back. Hospital rotation in an intensive care unit is currently suspended.

“All of these new beds will need staff,” said Ortiz. “Those at the front will experience burnout or exposure and the need for us is there. We only need help so that we can get in there. “

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