The Status of Nursing Education in the California Community Colleges

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1 Adopted Fall 2005 The Stats of Nrsing Edcation in the California Commnity Colleges T h e A c a d e m i c S e n a t e f o r C a l i f o r n i a C o m m n i t y C o l l e g e s

2 Nrsing Task Force Karolyn Hanna, Santa Barbara City College, Principal Athor Ssan Herman, Chaffey College Wanda Morris, Compton College Dorothy Nnn, Cabrillo College Amy Shennm, College of the Canyons Paline Shoo, Pasadena College Shaaron Vogel, Btte College Edcational Policies Committee Mark Wade Lie, Ohlone College, Chair Cathy Crane-McCoy, Long Beach City College Greg Gilbert, Copper Montain College Karolyn Hanna, Santa Barbara City College Andrea Sibley-Smith, North Orange Conty CCD/Noncredit Beth Smith, Grossmont College Alice Mrillo, Diablo Valley College CIO Representative

3 Table of Contents Abstract Introdction Qestions for Consideration Conclsion and Recommendations References

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5 The Stats of Nrsing Edcation in the California Commnity Colleges Abstract The nrsing shortage in California has prompted legislators to propose soltions that may be well intentioned bt fail to recognize the complexity of the isses they are trying to address. In April 2005, the Academic Senate convened a nrsing task force, comprised of commnity college nrsing faclty from across the state, to examine the isses raised by otside grops, respond to these isses, and provide possible remedies. The task force organized the information collected arond six qestions: (1) What are the barriers to recriting nrsing stdents? (2) What are the barriers negatively impacting nrsing edcation on the campses of California Commnity Colleges? (3) What are the barriers making it difficlt for stdents to complete their corse of stdy? (4) What makes clinical placement for nrsing stdents so difficlt? (5) Why do stdents leave nrsing programs? Why is there sch a high attrition rate? (6) Once stdents complete their stdies and enter the profession, why do so many nrses leave within a short period of time? The responses and possible remedies reflect the diversity in nrsing programs across the California Commnity College System and the complexity of trying to find single soltions that work for all colleges. In some areas, there is general agreement, sch as the need for adeqate nmbers of fll-time faclty to provide spervision and participate in program development, or the challenge of finding adeqate slots for clinical placements. In other areas, responses differ greatly, as with respect to enrollment criteria and se of the Associate Degree in Nrsing (ADN) Model Prereqisites Validation Stdy (Phillips, 2002). The remedies proposed in the paper are those of the task force and not official positions of the Academic Senate. The paper concldes with recommendations that echo longstanding positions of the Academic Senate within the context of nrsing edcation in the California commnity colleges. 1

6 The Stats of Nrsing Edcation in the California Commnity Colleges Introdction Commnity college nrsing programs, the stdents they serve, the needs stdents have, and barriers stdents enconter vary widely. Becase commnity colleges reflect the stdents and isses of their local commnities, there is no one easy soltion to help every college. In fact, what may help one program and grop of stdents may not necessarily benefit another. With the intention of alleviating the crrent nrsing shortage, California legislators have been active in writing legislation proposing specific soltions. In many cases, the proposed soltions fail to recognize the complexity of the isses they are trying to address. Information that legislators have abot commnity college nrsing programs, stdents, and the needs of specific programs varies in completeness and does not reflect the variation in local context. In April 2005, a Nrsing Task Force formed by Kate Clark, then President of the Academic Senate for California Commnity Colleges, was charged with identifying and responding to qestions abot nrsing edcation being raised by legislators and other grops. The goal of the Task Force members report was to provide an overview of the complexity of the nrsing shortage that the Academic Senate cold share with legislators, otside grops, and its own faclty. In Fall 2005, the Edcational Policies Committee of the Academic Senate reviewed and refined the Task Force report to prepare it for adoption by the Academic Senate at its Fall Plenary Session. This report is organized arond six recrrent qestions being asked by those otside the commnity college nrsing programs: 1. What are the barriers to recriting nrsing stdents? 2. What are the barriers negatively impacting nrsing edcation on the campses of California Commnity Colleges? 3. What are the barriers making it difficlt for stdents to complete their corse of stdy? 4. What makes clinical placement for nrsing stdents so difficlt? 5. Why do stdents leave nrsing programs? Why is there sch a high attrition rate? 6. Once stdents complete their stdies and enter the profession, why do so many nrses leave within a short period of time? 2

7 The Stats of Nrsing Edcation in the California Commnity Colleges The breadth of the problem and responses provided make clear that the isses confronting legislators, as they seek effective soltions to California s nrsing shortage, are complex. Task Force members drew pon experiences, recent stdies, and professional research to respond to these qestions and to sggest possible remedies that policy makers, local senates, and bargaining nits might consider to alleviate identified problems. It is important to emphasize that the remedies proposed come from a diversity of perspectives and experiences and at times may even conflict. They are not data-driven remedies bt reflect the best thinking of Task Force members, all of whom are professional nrses and nrse edcators in California commnity colleges. The breadth of the problem and responses provided make clear that the isses confronting legislators, as they seek effective soltions to California s nrsing shortage, are complex. Inclsion of possible remedies in this report does not indicate endorsement of any single remedy by the Academic Senate. The paper concldes with recommendations that reaffirm the positions of the Academic Senate with regards to open access and eqal opportnity for all of California s residents. 3

8 The Stats of Nrsing Edcation in the California Commnity Colleges Qestions for Consideration 1. What are the barriers to recriting nrsing stdents? Isses being raised by otside grops: Local or cltral demographics High school preparation or corses offered General pblicly-held attitdes abot the profession Response by Task Force: Recritment Not Really the Isse Recritment of stdents is not perceived as a real isse. According to the most recent Annal School Report (2005) pblished by the California Board of Registered Nrsing (BRN), 103% of the designated admission slots in associate degree nrsing programs (ADN) were filled. It is noteworthy that althogh, on average, associate degree programs were filled beyond capacity, they also reported having 90 bdgeted, bt nfilled faclty positions. In programs where the nmber of admissions was restricted, the reasons indicated were lack of faclty, lack of space, and inadeqate fnding, with lack of faclty being the most common deficit. None of the programs indicated that they experienced a lack of stdents. In fact, waitlists for admission to programs generally extend for 2-4 years, and in some cases, even longer. Lengthy waitlists are viewed as a potential deterrent for some stdents and, in fact, may compond the problem becase many stdents apply to several programs with the hope that they might be admitted more qickly to any program. Limited Program Capacity How programs determine who is admitted each year varies. Some programs develop a qee type list, where everyone meeting admission criteria is placed on the list and simply waits for their projected entry date. Other programs se a lottery system to determine who is admitted in a particlar year. Stdents who aren t selected in the lottery one year are sally reqired to reapply in the following year. In general, for an applicant to be in the lottery pool or on a waitlist, they mst have met all enrollment criteria. In any given year more than half the qalified applicants are not able to be accommodated. In the year, there were 17,887 qalified 4

9 The Stats of Nrsing Edcation in the California Commnity Colleges applicants vying for 7,684 positions in California s nrsing programs (BRN, 2005). Ths, over the corse of ten years, thosands of qalified applicants may be trned away. What is lost in the data crrently collected is the aggregate nmber of potential nrses who give p on nrsing as a career becase of their inability to get into a nrsing program. In any given year more than half the qalified applicants are not able to be accommodated. This phenomenon is not niqe to California. The National Leage for Nrsing (NLN) review of data on nrsing edcation programs (2004a) reported that in Fall 2003, 16% of all qalified applicants to associate degree nrsing programs were waitlisted. Sbseqently, the Exective Director of NLN issed a wake-p call to the profession regarding the high nmber of qalified applicants being trned away from nrsing programs (NLN, 2004b). Demographics None of the Task Force participants felt that local or cltral demographics presented a barrier to recriting nrsing stdents. Diversity is represented in both applicants and the actal stdent poplation enrolled in nrsing programs. This diversity does vary by area. Generally, rban schools have larger nmbers of ethnically diverse stdents. All participants indicated experiencing some degree of difficlty in recriting males. The BRN Annal School Report indicates the distribtion of stdents enrolled in California associate degree nrsing programs as of the October 2004 censs date, was as follows: White 42%, Asian 10%, Hispanic 22%, African American 9%, Native American <1%, Filipino 12%, Unknown 5%. The male-to-female ratio in associate degree nrsing programs (ADN) was female 83% and male 17% (BRN, 2005). Contrasting these figres with national data indicates that the percentage of both men and stdents from minority grops in nrsing programs, with the exception of African Americans, is considerably higher for California than the rest of the United States. National percentages for stdents enrolled in associate degree programs are: White 76.4%, Asian 4.2%, Hispanic 5.9%, African American 12.6%, and Native American 1.1% (NLN, 2004a). Nationally the percentage of males enrolled in associate degree nrsing programs is 12% (NLN, 2004a). Nrsing Spport Corses Stdents inqiring into enrollment in nrsing programs are generally aware of the science reqirements (Anatomy, Physiology, Microbiology, etc.). However, there are some stdents who have difficlty being sccessfl in those corses. A stronger emphasis for potential nrsing majors on the biological sciences at the high school level, might better prepare them for sccess in the reqired science prereqisites dring their commnity college stdies. There are also a nmber of stdents who seem to 5

10 The Stats of Nrsing Edcation in the California Commnity Colleges have a fear of the math reqirements that are either prereqisite to science spport corses or reqired for gradation. At some level this anxiety may be a deterrent. Impacted Reqired Corses Task Force members reported that on many campses pre-nrsing stdents strggle to get into reqired prereqisite corses de to limited availability, particlarly the sciences. For science corses, existing lab facilities often limit the nmber of stdents that can be enrolled. Other corses have also been impacted by enrollment management strategies that reqire a minimm enrollment for a corse to be offered. This may preclde offering mltiple sections of corses reqired of pre-nrsing stdents. Lack of Understanding abot the Academic Rigor and Demands of Nrsing Many stdents who want to become nrses do not seem to have a clear nderstanding of what is reqired to be sccessfl in an edcational program or what the practice of nrsing is really like. They don t anticipate the high level of critical thinking and academic rigor involved. Nor do they always nderstand the physical and emotional demands associated with nrsing. This lack of nderstanding may contribte to some stdents being poorly prepared to take on the challenges of nrsing and nrsing edcation and may well accont for some of the attrition in nrsing programs. Given these extrinsic physical and emotional demands, conventional academic predictors sch as grade point average are not niversally predictors of stdent sccess; ths, as discssed in Qestion #5 below, determining appropriate admissions reqirements is a complex process. Pblic Perception Task Force participants believe that the pblic s perception of nrsing is positive. They view nrsing as a good profession to enter, find employment, and be paid well; however, here again there may be a misperception in the pblic s nderstanding of the academic rigor reqired to sccessflly complete a nrsing program. Possible Remedies proposed by Task Force (remedies are the views of the Task Force and inclsion here does not indicate endorsement by the Academic Senate): Pblicize the Rigor of Nrsing Edcation Althogh no real barriers to recritment are seen at this time, ensring that interested stdents have a more accrate nderstanding of the complexity and rigor of nrsing edcation and nrsing practice may positively impact pre-entry preparation and retention of stdents. (Note: See separate discssion on attrition, later in this docment.) 6

11 The Stats of Nrsing Edcation in the California Commnity Colleges Many stdents who want to become nrses do not seem to have a clear nderstanding of what is reqired to be sccessfl in an edcational program or what the practice of nrsing is really like. Present Realistic Pictre of Nrsing Opportnities for potential stdents to gain exposre and/or experience with nrsing prior to applying to and entering a nrsing program shold be fostered. For example, creating partnerships between nrsing programs and local high schools with opportnities to enroll in a Certified Nrsing Assistant (CNA) Program, to shadow nrses, or to become hospital volnteers, etc. Presentations to potential applicants by crrent nrsing stdents and/or employed nrses may also be sed to present a more realistic pictre of the profession. The Employment Development Department (EDD) has posters and flyers abot health care job opportnities that cold be shared with local high schools and placed on college campses. Increase Capacity of Nrsing Programs Legislative spport for increasing the capacity of existing nrsing programs and/or establishing additional programs wold be beneficial. Althogh the focs of this task grop is on California s commnity colleges, increased capacity at all levels (associate, baccalareate, and master s degree) is recommended. However, a word of cation is essential regarding increasing program capacity withot additional fll-time faclty positions. Adding large nmbers of part-time faclty increases the workload and stress on fll-time faclty who are reqired to mentor and/or spervise part-time faclty and decreases the continity of clinical instrction for stdents. In addition, it is freqently difficlt to find master s prepared nrse edcators who are willing to work on a part-time basis, as discssed later in this docment. (See response to Qestion #2). Program expansion shold not be proposed withot fiscal spport for additional fll-time faclty positions, since expansion that relies heavily on part-time faclty compromises the integrity of the nrsing program and may negatively impact other programs in the college that may be reqired to hire additional fll-time faclty to compensate for the increased se of part-time nrsing faclty. 7

12 The Stats of Nrsing Edcation in the California Commnity Colleges Ensre Adeqate Access to Science Prereqisites On campses where the reqired science corses (anatomy, physiology, and microbiology) are impacted, encorage and provide spport (and fnding incentives) to offer either additional sections of those corses or to offer them on a more freqent and/or reliable schedle. 2. What are the barriers negatively impacting nrsing edcation on the campses of California commnity colleges? Isses being raised by otside grops: Inability to hire fll-time faclty Inability to recrit part-time faclty Inability to retain part-time faclty Costs of eqipment and laboratories Limitations of class size Lack of prereqisite corses Reglations sch as the 75:25 1 ratio or the 60% law 2 Demands of external accrediting agencies Response by Task Force: Fll-time Faclty Isses As is tre for any program in the California commnity colleges, a cadre of fll-time faclty is essential to the health and well-being of any nrsing program. Fll-time nrsing faclty are responsible for nmeros professional tasks sch as revising crrent crriclm and/or writing new crriclm to reflect changing healthcare needs and standards; serving on hiring committees to interview and select new fll- and part-time faclty and then mentoring and spporting them; participating in college and district governance that directly impacts nrsing programs and faclty; meeting 1 The 75:25 ratio refers to the desired ratio for classes taght by fll-time and part-time faclty. The commnity college system has as a longstanding goal that 75% of all credit corses be taght by fll-time faclty. The goal is not program specific. 2 The 60% Law refers to the maximm load that a part-time faclty member may carry in a single commnity college district. Part-time faclty who have carried loads exceeding 60% have sccessflly sed to be granted fll-time faclty positions, so districts have become very sensitive to monitoring part-time faclty load assignments. 8

13 The Stats of Nrsing Edcation in the California Commnity Colleges accreditation mandates for ongoing program evalation (e.g. condcting srveys of program gradates and employers; monitoring gradates licensing exam scores); preparing annal reports; writing grants for additional fnding; maintaining significant liaisons with local hospitals, medical grops, and the commnity; and preparing self-stdies for periodic accreditation visits by mltiple agencies. Access to fll-time faclty has been shown to benefit all stdents and enhance their sccess. The California Legislatre, in enacting AB 1725, noted that the qality, qantity and composition of fll-time faclty have the most immediate and direct impact on the qality of instrction (Section 70 (a)). Nrsing stdents deserve this benefit no less than stdents in other programs. A nmber of isses identified by Task Force participants relate to hiring fll-time faclty. Nationwide there is a shortage of nrse edcators, and California is experiencing the same. The National Leage for Nrsing (NLN) reported a 6.8% faclty vacancy rate in associate degree nrsing programs in the western U.S. dring the academic year (NLN, 2003). According to the California BRN Annal School Report (2005), althogh the majority of programs were admitting stdent to capacity, for those that had redced the nmber of slots available, the primary reason was lack of faclty. Isses contribting to this shortage inclde: Limited Availability of Master s Prepared Nrses The limited availability of nrses with master s degrees for either fll- or part-time employment is one of the more significant isses impacting the enrollment and/or expansion of crrent nrsing programs 3. Many factors contribte to this phenomenon, sch as the cost of gradate edcation, increased employment opportnities for nrses with master s degree in clinical practice (e.g., nrse practitioner, clinical nrse specialist, etc), and a recent de-emphasis on the role of nrse edcator in gradate programs. According to the 2004 BRN Srvey of Nrses (Fletcher, 2004), only 9.2% of the working RNs in California have an advanced (master s or doctorate) degree in nrsing. (See Qestion #6 for additional discssion of data from this report.) Aging of Faclty One of the most critical problems is the aging of nrsing faclty. According to the Tri-Concil for Nrsing Policy Statement (2001), the average age of nrse edcators in the US is between 49 and 52 years. California BRN data indicates that 46% of the nrse edcators in California are 50 or older (BRN, 2005). 3 To be a nrsing faclty in the California commnity colleges reqires EITHER a Master s Degree in nrsing OR a Bachelor s Degree in nrsing with a Master s Degree in either health edcation or health science. (California Commnity College System Office, 2003b) 9

14 The Stats of Nrsing Edcation in the California Commnity Colleges Eliminating either the 60% law or the 75:25 reglation wold not alleviate faclty recritment isses for nrsing and in both the short- and long-term, wold not benefit stdents, nrsing programs, nrsing edcation, or the preparation of new nrses. Faclty Salaries Salaries for nrse edcators, prepared at (or above) the master s level are not commensrate with salaries for nrses with advanced degrees who work in clinical settings (i.e. nrse practitioners, clinical nrse specialists, researchers, etc.) This is particlarly tre for both fll- and parttime nrsing faclty employed in commnity college nrsing programs. Note: Crrent threats to the commnity college retirement program may frther impact recritment of faclty, becase participation in the State Teachers Retirement System (STRS) 4 is the one advantage that California commnity colleges have had over indstry in attracting qalified nrse edcators. Disproportionate Pay for Laboratory Classes On many campses the rate of pay for laboratory time is at a lower level than for lectre time in some cases, it is as low as 67% of the lectre rate. In nrsing, where p to 80% of a fll-time faclty load is for clinical laboratory, faclty members are working many more hors than their non-nrsing colleages. This frther exacerbates the disparity between nrse edcator salaries and the salaries of their conterparts working in indstry and/or faclty employed in other non-laboratory teaching positions. Lack of Spport at District/College Level Some Task Force participants reported a high degree of local district/college spport for their programs. Others described a lack of spport on their local camps, especially when reqesting new nrsing faclty positions. We sspect administrative refsals may be related to the high cost of operating a nrsing program. In other sitations, the district/college may have other pressing priorities. It was also reported that on some campses, there is resentment from other faclty who believe that the political emphasis on nrsing means those programs get whatever they want. 4 The California State Teachers Retirement System (STRS) provides retirement related benefits and services to teachers in pblic schools from kindergarten throgh commnity college. 10

15 The Stats of Nrsing Edcation in the California Commnity Colleges Part-time Faclty Isses Recritment and retention of part-time faclty carries additional challenges beyond those identified with fll-time faclty. For some programs, recritment and retention is a major obstacle, and for others, it is not as significant. Problems specifically related to hiring and retaining parttime nrsing faclty inclde: Lack of Teaching Experience and/or Expertise Teaching and learning are complex phenomena that reqire skills and abilities that nrses in the workforce may not possess. Faclty mst be able to teach critical thinking, nrsing process, application of theoretical concepts in the clinical setting, and performance of nrsing procedres. Nrses working in a clinical practice setting may possess exceptional clinical skills; however they may not have had formal corsework in teaching and learning. It has been well docmented that when one becomes an expert, many of the intermediate steps in performing a task or doing problem-solving become atomatic for that individal. When working with novices, those intermediate steps need to be identified and spported as stdents learn them (Benner, 1984). Salary and Benefits Isses For part-time faclty, salary is also a concern, particlarly as salary schedles for part-time faclty are generally significantly lower than for fll-time faclty. However an even greater concern is the lack of benefits for part-time faclty, which means that those individals need to maintain employment in another agency, at a level sfficient to qalify for benefits. The net effect is that they may not be available on an ongoing basis, even thogh they wold like to be. These ncertainties potentially affect continity of instrction and may deprive programs and stdents of very competent faclty. Impact of 75:25 and 60% Reglations These reglations were implemented to provide qality instrction by maintaining a core grop of fll-time faclty and enhancing faclty-stdent contact. While the 60% law does limit the amont of time that a part-time faclty member may teach in any given term, commnity college nrse edcators and the Academic Senate for California Commnity Colleges spport this reglation becase it prevents those individals from exploitation by creating a permanent nderclass of faclty. Some Task Force members reported that this reglation has, in fact, helped spport the hiring of additional fll-time faclty. Regarding the 75:25 reqirement, this reglation applies to the district as a whole and each department or program is NOT reqired to meet that ratio. Colleges already accommodate the high nmber of part-time nrsing faclty by hiring fll-time faclty in other areas. Eliminating either 11

16 The Stats of Nrsing Edcation in the California Commnity Colleges the 60% law or the 75:25 reglation wold not alleviate faclty recritment isses for nrsing and in both the short- and long-term, wold not benefit stdents, nrsing programs, nrsing edcation, or the preparation of new nrses. According to the California BRN Annal School Report (2005), the percentage of fll-time nrsing faclty in California commnity colleges decreased from 55% to 54% and part-time faclty increased from 43% to 46% between and Data for the year is even more alarming becase the ratio of fll-time and part-time faclty has decreased to 47% fll-time and 53% part-time faclty. Limited Faclty Diversity The lack of diversity among faclty is a more challenging isse than diversity of the stdent poplation. According to the most recent report on nrsing programs, pblished by the California Board of Registered Nrsing (2005), 72% of the nrsing faclty is White. Statistics for other ethnic grops are as follows: African American 7%; Hispanic 8%; Asian 6%; Filipino 3%; American Indian >1%; and Other/Unknown 4%. High Operating Costs for Nrsing Programs While the costs of operating a nrsing program are high becase of the need for facilities and eqipment in camps laboratories and low stdent-to-faclty ratios in the clinical area, members of the Task Force reported that throgh commnity partnerships and working with indstry, they have been able to meet many of their needs. Other programs have had less sccess in this area and find that they are working with older (and in some cases, otdated) spplies and eqipment. Low Stdent/Faclty Ratios Many states limit class size in clinical facilities to 10:1, and in some cases, those limits are even lower (i.e., 8:1 or 9:1). A review of the Profiles of Member Boards (Crawford, 2003), pblished by the National Concil of State Boards of Nrsing, indicates that 37 states have established stdent faclty ratios for clinical laboratory. Of those states with ratios, 40% are at 8:1. At the present time, the California BRN, has not established ratios for clinical laboratory instrction and in some colleges, The lack of diversity among faclty is a more challenging isse than diversity of the stdent poplation. 12

17 The Stats of Nrsing Edcation in the California Commnity Colleges administrators are reqiring clinical laboratory loads of p to 12 or more stdents per faclty member. With increasing acity of patients in hospitals and the need for close faclty spervision of stdents assigned to care for those patients, the level of responsibility (and stress) for faclty members is a major isse. Effort shold be directed toward changing BRN reglations to inclde specific ratios and ideally that ratio shold be 8:1 for reasons of patient safety. Sch a change will frther affect costs; however not changing the ratio potentially affects patient safety and may impact faclty retention. This low stdent:faclty ratio contribtes significantly to the high cost of nrsing programs compared to other academic programs bt is necessary to ensre program qality and safety. Accreditation by Otside Agencies The California Board of Registered Nrsing (BRN) serves a vital role in protecting the pblic by granting licenses to gradates of accredited nrsing programs and ensring that registered nrses meet the reqirements for ongoing licensre. The BRN also oversees the mandatory accreditation of all pre-licensre nrsing programs in California. While it is tre that compliance with varios reglations (e.g., approval of crriclm, verification of faclty expertise, preparation of annal reports, and periodic accreditation visits) all reqire additional time commitments, the role that this Board plays in maintaining standards for both nrsing edcation and the practice of nrsing, is essential. Many of the qalifications and licensre reqirements needed by nrse edcators are, in fact, a direct response to BRN mandates; becase those reqirements lead to improved training of others, nrsing faclty spport these reqirements. In addition to BRN accreditation, 60% of the nrsing programs in California also have elected to obtain and maintain volntary accreditation by one of the two national organizations, the National Leage for Nrsing Accreditation Commission (NLNAC) and the Commission on Collegiate Nrsing Edcation (CCNE) that offer this additional accreditation (BRN, 2005). Possible Remedies Proposed by Task Force (remedies are the views of the Task Force and inclsion here does not indicate endorsement by the Academic Senate): Spport Efforts to Recrit Nrses into Gradate Programs in Nrsing All avenes for increasing the nmber of RNs prepared at the master s and/ or doctoral level shold be explored. Providing grants, income tax credits, low interest loans, redced tition at CSUs and UCs, or other incentives to encorage and assist nrses in their prsit of advanced edcation shold be spported. Particlar emphasis shold be placed on recriting stdents from nder-represented ethnic grops into advanced edcation in nrsing. 13

18 The Stats of Nrsing Edcation in the California Commnity Colleges To become effective teachers, new faclty wold benefit from thorogh orientation to the program inclding information on sch topics as clinical teaching and evalation, promoting critical thinking, and linking theoretical content to clinical application. Spport Career Mobility For some stdents, particlarly those who are first in their family to attend college, the goal of advanced preparation in nrsing may be overwhelming. A career ladder approach may be a more realistic approach. Proposals that facilitate mobility from Certified Nrsing Assistant (CNA) to Licensed Vocational Nrse (LVN), Associate Degree Nrse (ADN), Bachelor of Science Degree in Nrsing (BSN) and Master of Science in Nrsing (MSN), or any variation of that rote, shold be spported and fnded. Promote Advanced Edcation in Nrsing Throgh targeted recritment efforts, promote advanced edcation in nrsing. Emphasize the need for nrse edcators to earn advanced degrees in nrsing rather than in related fields (e.g., health care management, bsiness management, etc.). While edcational preparation in those areas may be helpfl and perhaps more personally lcrative, it is imperative for the ftre of the nrsing profession that nrsing faclty do advanced stdy in nrsing, with an emphasis in edcation. Incentives and assistance in achieving advanced degrees shold be explored and provided. Spport Development of Paid Orientation and Mentoring of Faclty To become effective teachers, new faclty wold benefit from thorogh orientation to the program inclding information on sch topics as clinical teaching and evalation, promoting critical thinking, and linking theoretical content to clinical application. Opportnities to spport the recritment and development of faclty, inclding those working part-time, shold be developed and spported. Part-time Faclty Mentoring Part-time faclty shold be provided mentoring and be compensated for their participation in orientation and/or mentoring. This commitment shold fall otside of the reqirements of the 60% law. Work Toward Agmenting Salaries Efforts to enhance salaries of nrse edcators, inclding adjstments in the laboratory/lectre ratio and night/ weekend schedling (see Qestion #4 below), shold be encoraged. 14

19 The Stats of Nrsing Edcation in the California Commnity Colleges Spport Proposals to Revise Stdent/Faclty Clinical Ratios Clinical teaching is stressfl for both hospital staff and faclty members. They share accontability for care of assigned patients. When an instrctor is not readily available on a specific nit, staff nrses who are already maxed ot, mst deal with stdent qestions and provide direction. As indicated above, proposals to establish realistic stdent/faclty ratios for clinical instrction shold be spported. Refrain from Efforts to Alter Minimm Qalifications and/or BRN reglations regarding faclty preparation While altering the Minimm Qalifications 5 (MQs) or the BRN reqirements for nrsing faclty may appear to offer a potential soltion to the crrent shortage of nrsing faclty, that approach wold open the floodgates to a decrease in the qality of instrction and ltimately the overall qality of gradates from the nrsing programs in the California Commnity College System. There are provisions within Title 16 the BRN reglations in Section 1425(2)(f) for clinical teaching assistants who can work with master s-degree-prepared faclty. Where feasible, fnding for these positions shold be encoraged. Provide Fnding for Clinical Instrctional Assistants Instrctional Assistants are licensed nrses (RN) who do not provide actal instrction to the stdents bt are in the clinical setting to assist/spervise stdents with nrsing procedres. This category of employee wold allow for more one-to-one nrsing instrctional time between the nrsing faclty and stdent and increase stdent sccess. It wold also relieve some pressre on nrsing staff, as discssed above and in some cases may allow programs to accept more stdents. This sggestion calls for frther discssions with local bargaining nits as well as with the local senates and the Academic Senate for California Commnity Colleges. Avoid Mandated Increases in Program Enrollment Unless fiscal spport for hiring fll-time faclty is provided, program expansion shold not be mandated. Catiosly Promote Partnerships between Edcational Programs and Hospitals and/or Other Healthcare Indstries The creation of partnerships between hospitals (or other healthcare indstries) can be mtally beneficial. They may increase the nmber of stdents accepted into programs by fnding additional faclty positions or provide state of the art eqipment 5 Minimm Qalifications (MQ) refer to the minimm reqirements for a person to teach in California commnity colleges. The MQs are reviewed on a three-year cycle by the Academic Senate for California Commnity Colleges and changes sbmitted to the Board of Governors for approval. 15

20 The Stats of Nrsing Edcation in the California Commnity Colleges for camps laboratories. However, a potential downside may occr if the otside agency attempts to control the edcational program or draft crriclm narrowly focsed on their specific corporate needs. Ultimate responsibility for the edcational program, the crriclm, stdent admission criteria, gradation standards, and faclty hiring mst remain with the faclty within the edcational instittion. Avoid Radical Changes in STRS As indicated earlier, commnity college nrsing faclty salaries are generally lower than those for nrses employed in other healthcare settings. Proposals to radically alter STRS benefits will no dobt be detrimental to recritment and retention of ADN faclty. 3. What are the barriers making it difficlt for stdents to complete their corse of stdy? Isses being raised by otside grops: Lack of preparation (and hence, a need for prereqisites) Lack of available corses (e. g., programs ct back, classes that don t make ) Lack of spport services for nrsing stdents Response by Task Force: High Attrition in Nrsing Programs Attrition from associate degree nrsing programs is approximately 22%. Barriers to completion for commnity college stdents are mltiple. According to data reported by the California BRN (BRN, 2005), the two primary reasons for withdrawal are academic/clinical failre and non-academic demands (e.g., family/work responsibilities). This is followed by financial need and change of major. Task force participants also discssed some of the factors contribting to attrition. Specific concerns related to problems identified inclde: Academic and/or Clinical Failre»» Some stdents lack the ability to read, write, and critically think at a level reqired to be sccessfl. This is particlarly an isse with second langage learners who have not yet mastered the English langage. New resoltions by the Academic Senate to recommend raising math and English reqirements for AA/AS degree may have an impact on eligibility reqirements and actal enrollments. Thogh these increased reqirements are higher than the vast majority of nrsing programs reqire at this time, the ltimate impact is nknown. 16

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