WSR 97-08-093
PROPOSED RULES
DEPARTMENT OF HEALTH
[Filed April 2, 1997, 11:56 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 95-09-058.
Title of Rule: Clinical requirements in nontraditional nursing education programs.
Purpose: We will be combining existing RN/LPN language from chapters 246-838 and 246-839 WAC to WAC 246-840-030. To establish a method for a clinical component in nontraditional nursing education programs, so graduates of these programs may test for registered nurse licensure in Washington state.
Statutory Authority for Adoption: RCW 18.79.160.
Summary: This rule will allow graduates of nontraditional nursing programs without a clinical component a method to meet that requirement.
Reasons Supporting Proposal: Creates a means for graduates of a nontraditional nursing education program to meet the requirements for registered nurse licensure in Washington state. Nontraditional programs allow working adults to continue their education, which might be difficult or impossible in a traditional setting.
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Patty Hayes, 1300 S.E. Quince, (360) 664-4100.
Name of Proponent: Washington State Nursing Care Quality Assurance Commission, governmental.
Rule is not necessitated by federal law, federal or state court decision.
Explanation of Rule, its Purpose, and Anticipated Effects: This rule will expand the WAC to include provisions which allow graduates of nontraditional nursing education programs to meet the clinical requirement of the WAC in ways other than through a traditional nursing education program. The Nursing Commission must either enforce the current law and deny the licensing applications as not meeting the clinical requirement or change the law to provide the means for these candidates to meet this requirement. This will allow working adults to continue their education, which might be difficult or impossible in a traditional setting. This will expand opportunities for registered nurse licensure.
Proposal Changes the Following Existing Rules: The rule establishes a method to meet the clinical component requirement for nursing education programs. It states the specific requirements of the exception.
A small business economic impact statement has been prepared under
chapter 19.85 RCW.
In Washington state, individuals must pass the National Council Licensure Exam-RN (NCLEX-RN) to work as a registered nurse. Further, prior to sitting for the NCLEX-RN, one must meet certain requirements, including hands-on clinical training. In 1995, it came to the attention of the Nursing Commission that Regents College - part of the New York State University system - does not require clinical training in its nursing degree program. The Nursing Commission discovered that students of Regents College and other nontraditional nursing schools had sat for the NCLEX-RN without meeting this eligibility requirement.
Since that time, the commission has been gathering information from interested groups and individuals about providing Regents students a mechanism to meet the clinical training requirement. Without a rule change the commission must enforce the WACs as they are currently written, preventing students of nontraditional schools from taking the NCLEX-RN and practicing as registered nurses. This would obviously adversely affect place bound individuals who need the alternative to traditional nursing programs that nontraditional schools offer.
Is a Small Business Economic Impact Statement Necessary? This rule does not fall into any of the categories designated as exempt from a small business economic impact statement by the Regulatory Fairness Act. Furthermore, at a potential cost of $500 per Regents College nursing graduate, the rule exceeds the more than minor cost threshold. Therefore a small business economic impact statement (SBEIS) is necessary.
Determine the Size Distribution of Affected Businesses: The sole affect of this rule is on individuals who desire to become registered nurses in Washington state. Therefore the affected businesses (individuals) are by definition all small (less than fifty employees). Since, in this case, small businesses do not bear a disproportionate proportion of the rule's cost - no large business is affected - mitigation is not required.
Nevertheless, the Department of Health believes that this rule benefits nursing students of Regents College and other nontraditional education programs. The proposed rule change provides an alternate method for individuals without clinical training to qualify to take the NCLEX-RN. Practical nurses interested in pursuing RN licensure by a nontraditional educational program will benefit from this change. The consumer will benefit as well, because [of] the additional clinical experience component required in the proposed revision.
How the Agency Involved Small Businesses in the Development of the
Rule: The following groups were asked to provide input to the process.
This input was in the form of open forums, letters and written answers
to specific questions.
Students enrolled in the Regents program
Graduates from the Regents program
Educators from Washington state nursing programs
Nursing administrators from health care facilities
Nursing organizations such as Washington State Nurses Association
List Industries Required to Comply with the Rule: No industries or individuals are required to comply with this rule. Rather this rule provides an alternative mechanism for individuals to meet the clinical training requirement for taking the NCLEX-RN.
A copy of the statement may be obtained by writing to Washington State Nursing Care Quality Assurance Commission, Clinical Rule, P.O. Box 47864, Olympia, WA 98504-7864, phone (360) 586-1355, or FAX (360) 586-5935.
Section 201, chapter 403, Laws of 1995, applies to this rule adoption. These rules are significant under section 201, chapter 403, Laws of 1995, because they establish, alter or revoke qualification or standard for the issuance, suspension or revocation of a license or permit.
Hearing Location: Sea-Tac Airport, GFP Business Center, Board Room Main Terminal, South Mezzanine, on May 7, 1997, at 7:00 p.m.
Assistance for Persons with Disabilities: Contact Nursing Commission by April 30, 1997, TDD (360) 664-0064, or (360) 586-1355.
Submit Written Comments to: Joan Reilly, FAX (360) 586-5935, by April 30, 1997.
Date of Intended Adoption: June 13, 1997.
March 26, 1997
Patty Hayes
Executive Director
REPEALER
The following section of the Washington Administrative Code is
repealed:
WAC 246-839-030 Qualification/eligibility to take the
licensing examination.
NEW SECTION
WAC 246-840-030 Examination and licensure. (1) Graduates from Washington state board approved schools of nursing holding a degree/diploma from such a school shall be eligible to write the examination provided all other requirements are met.
(2) Graduates from a nursing school approved by a board of nursing in another U.S. jurisdiction shall be eligible to take the examination provided that:
(a) The nursing school meets the minimum standards approved for state board school of nursing in Washington at the time of the applicant's graduation;
(b) Graduate has completed all institutional requirements for the degree/diploma in nursing education per attestation from the administrator of the approved nursing education program;
(c) All other requirements of the statute and regulations shall be met.
(3) Graduates of a nontraditional school of nursing which meet the requirements of subsection (2)(a), (b) and (c) of this section, are eligible to take the registered nurse examination provided that the following conditions are met: (For purposes of this section, nontraditional schools of nursing are defined as schools that have curricula which do not include a faculty supervised teaching/learning component in clinical settings.)
(a) The candidate is a licensed practical nurse in Washington state; and
(b) There is documentation of at least two hundred hours of supervised clinical experience (preceptorship) in the role of a registered nurse. The required elements of a preceptorship are as follows:
(i) Acceptable clinical sites - Acceptable clinical sites include acute care or subacute care settings or skilled nursing facilities. Other sites must be approved by the commission.
(ii) Qualifications of preceptor (instructor) - The preceptor must be a licensed registered nurse in Washington state with at least two years experience in a practice setting and have no history of disciplinary actions. The candidate must provide documentation that the preceptor meets these requirements when he/she applies for licensure and must also provide a written agreement between the candidate and the preceptor (or facility) that preceptorship supervision will occur.
(iii) Experiences in the preceptorship - Experiences must include delegation and supervision, decision making and critical thinking, patient assessment as part of the nursing process and evaluation of care. A checklist, provided by the commission, must be completed by the preceptor which indicates the candidate's satisfactory completion of the identified skills. This checklist must be submitted with the candidate's application for licensure; and
(c) The candidate receives a satisfactory evaluation from their preceptor meeting commission requirements as previously identified ((b)(iii) of this subsection); and
(d) All other requirements of the nursing statute and regulations
are met.
[]