To amend regulations to allow RN applicants whose educational programs did not provide the requisite hours of clinical education to be licensed based on other criteria set forth in regulation.

The Board will publish the petition for rule-making and request comment for 30 days beginning July 5, 2010, after which the request for amendments will be considered by the Board of Nursing at its meeting on September 14, 2010.

Take no action

The Board considered the petition on September 14, 2010 and decided to deny the specific changes requested to requirements for licensure by examination and endorsement. It would appear that the draft amendments presented in the petition could have unintended consequences and potentially be in conflict with the Code of Virginia, which requires an applicant for nursing licensure to complete an approved nursing education program as a minimal qualification for licensure. The proposed amendments would set one standard for Virginia schools and graduates and a different standard for all other schools and their graduates. Without an equal standard for curricula and clinical experiences, the determination of competency could be inconsistently applied by various schools and their faculty. The regulations proposed by the petition could have a chilling effect on the nursing workforce in Virginia, as the changes would limit the qualification for licensure to graduation from either Virginia programs approved by the Board or programs that admit only persons with previous health care licensure and/or experience. Other programs outside of Virginia that currently meet the educational and clinical criteria for approval would be excluded. Additionally, the Board discussed its commitment to precepted clinical hours of direct patient care in the role of a registered nurse as essential for evidence of competency for licensure. Years of experience as an LPN are certainly valuable but do not translate into experience in the RN role across areas of practice throughout the life span. Finally, the Board expressed its intent to address the issues raised by the petition and by a few recent applicants who have graduated from other out-of-state programs that do not meet all the Board's standards for approval. In the next two months, an ad hoc committee will review policies and rules in other states to determine whether there are alternatives that could accommodate the needs of Excelsior graduates and other out-of-state programs that do not have the requisite number of clinical hours and also provide assurance to the Board and the public that registered nurses licensed in Virginia have the didactic and clinical education necessary for safe, competent practice.