Randolph-Macon College’s Department of Nursing faculty request revisions to BON regulation 18VAC90-27-110: Clinical practice of students as it relates to public and population health nursing clinical learning experiences. The requirement of direct supervision by faculty severely limits our BSN program’s clinical placement of students in public health and population health clinical experiences.

For example, VDH Chickahominy district is a collaborative clinical agency partner, yet we cannot currently use VDH experiences for direct clinical learning hours due to faculty and space constraints. There are opportunities for small student groups of 2-4 students to provide community-based clinics (BP, foot, refugee) or home visits within their student scope with a faculty available as needed but not directly at each site. These clinical experience opportunities, supporting our local VDH district’s needs and aligning with public health nursing standards, cannot be implemented. These experiences are not feasible financially from a faculty resource perspective or clinically necessary to have a faculty member onsite for this type of community-based clinical placements. This prevents us from using this clinical site and supporting student experiences in public health.

Serving their community is relevant and necessary to building a cadre of BSN-prepared public health nurses in the future and there are numerous opportunities available for which we cannot plan as clinical experiences. It drives our program to an acute care focus for clinical learning which does not best align with our curriculum or the Commonwealth’s nursing professional current and future needs. We request that the regulations be revised to allow flexibility for what counts as direct care hours specifically for community, public, and population health clinical practice to align with the best practices outlined in VACN’s public comment.