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The Board lists many, but does not endorse particular ones.
If a nurse has already gone through the licensing process in another jurisdiction, the candidate may be eligible for licensure by endorsement. A nurse who has passed an acceptable exam will not need to go through the examination process again. California is not, however, a member of the nurse compact. Graduates of programs approved in other states are eligible for licensure as are individuals who complete equivalent education and training while in the military. There is an additional pathway for candidates who have done bedside nursing and completed training that is considered equivalent.
See: LVN programs in California The Board has issued a warning, though, that schools that are not approved to teach nursing within the state do sometimes claim approval status; if a student opts for a school that is misrepresenting itself in this manner, he will not be eligible for licensure.
The Board recommends that candidates give thorough consideration to program quality before enrolling. Application Process Fingerprinting is an additional requirement for licensing.
Candidates residing in California use a Live Scan process. There is a form available for download on the Board site.
As part of the application process, candidates must verify their high school education or equivalency. California must approve candidates before they can be authorized to test. The Board has issued a warning, though, that schools that are not approved to teach nursing within the state do sometimes claim approval status; if a student opts for a school that is misrepresenting itself in this manner, he will not be eligible for licensure.
The Board recommends that candidates give thorough consideration to program quality before enrolling. Fingerprinting is an additional requirement for licensing.
Candidates residing in California use a Live Scan process. There is a form available for download on the Board site. Application forms are available on the same page http: As part of the application process, candidates must verify their high school education or equivalency.
California must approve candidates before they can be authorized to test. The exam is computerized and can be scheduled at any testing site, either in California or another state http: A candidate who does not pass is eligible to retake after 45 days but must again pay Pearson and the California Board. Graduates of California programs may work under an interim permit while waiting to take the licensing exam.
Out of state candidates must meet similar requirements, but the process is slightly different. They will need to verify their license status using a paper form or an online system. Candidates who initiate the fingerprinting process while residing outside California will not be able to use the Live Scan fingerprinting and will use cards instead.
Foreign applicants are also eligible for licensure by endorsement, provided they take the NCLEX or took its predecessor in an earlier time. RN programs in California. A prospective RN should enroll in an approved program in professional nursing. A list of programs that have been approved within California can be found on the RN site http: The application process has several steps, but some may be completed in advance.
Candidates must have a criminal background check. California residents are generally required to use Live Scan for their fingerprinting, though Live Scan exemptions are sometimes granted. A 2" by 2" photograph must also be included with the application materials.
Analysis Congruent with the constructivist-interpretative paradigm, data analysis was conducted using a grounded hermeneutic editing approach Addison , whereby data analysis is inherently linked to the data collection process and progresses in a circular pathway that repeatedly alternates between interpretation and understanding.
As previously described, the researchers reviewed emergent themes until saturation and duplication of themes emerged during data collection, linking data collection to data analysis. This process provided multiple opportunities for the team to clarify initial understandings and ensured reflexivity, an important component of constructivist-interpretative qualitative work.
Once data collection was complete, the first author re-read the interview data transcripts and identified any discussion in relation to the three research questions, including delegation strategies and processes, perceived barriers to effective delegation, and potential benefits of delegation.
Within each of these three domains, open coding, including in vivo coding Addison , was conducted of 19 of the 31 separate interview transcripts the 3 respondents in the group interview generated one interview transcript to capture all aspects of what the respondents described, resulting in a final code list of concepts.
This process facilitated the circular progression from initial interpretation and understanding, to deeper understanding and interpretation. Next, each domain was then read and analyzed in relation to the coded concepts for emergent themes.
Visual networks of coded concepts within each domain were constructed, and annotations were made of each theme and the relationships of concepts to themes. Domains were reviewed by two additional research team members to assess reliability of emergent themes, and validity of the network of concepts to themes. Results What are the strategies and processes used to delegate care? When RNs used this approach to delegation, they would emphasize how they were responsible to ensure that nursing staff followed the rules and policies connected to a specific job description, whether by monitoring or enforcing rules, or by in-service education.
Following the chain-of-command was a commonly described approach to delegation. Everybody is held accountable. Right down the line. Because the focus of delegation was on the job description and chain of command rather than scope of practice, this Director of Nursing found no conflict with stating that unlicensed assistive personnel may delegate, although delegation is beyond the scope of practice of certified nursing assistants.
In fact, as another Director of Nursing explained, the job description may ultimately supercede the level of licensure and scope of practice, I am the RN in charge, I have several RNs on staff.
Procedures and facility systems implemented by the RNs were oriented toward monitoring successful task completion, rather than resident outcomes. I can read the report sheet, I can read the charting, I can read the assessments, I can see my wound sheets. The RN did not differentiate between supervising task completion of delegated care and evaluating the outcomes of delegated care.
In another example, the interviewer provided more explanation for the Director of Nursing to respond, Interviewer: Ok, how are the outcomes of the delegated care evaluated?
Interviewer: Ok, let me, let me throw out an example and see if that helps. For example…in long term care a lot of things related to…continence…bathing…toileting and feeding are usually delegated care.
How would you evaluate the outcomes related to that care? DON: Well we have different groups or different committees, we have a weight variance group, and we have a falls group, and so we evaluate those things at those weekly meeting that we have…. Once the interviewer probed for outcomes of resident care, the DON was able to provide a comprehensive response to how her facility assesses for resident care outcomes. However, both the resident care outcomes and the systems used to track these outcomes were considered completely distinct from delegation and the delegation processes used to provide the care that lead to these outcomes.
Ultimately, adherents to this perspective defined successful delegation as staff following the chain of command and accurately completing the assignments connected to their role, irrespective of scope of practice. Assessment has to be done by an RN, so in the case an assessment gets made, and the LPN can always evaluate someone and then call the attention of the supervisor who is an RN or the charge nurse, who is an RN. In this facility, all licensed staff who could delegate needed to consider scope of practice to effectively work with nursing assistants in providing care.
At times, these nurses recognized gaps and pitfalls in care systems resulting from paying attention to scope of practice differences among staff. In effect, they faced inherent conflict between how their facilities might be structured and staffed, and what professional and practical nursing regulations required.
One DON described what happens as a result of not having 24 hour RN-level on-site coverage of nursing care in the context of delegation regulations, Interviewer: Then how does accountability occur [when the RN is available by telephone]?
DON: By indirect supervision. Interviewer: Ok…how is she making sure that that task is done? Response: She may not, um…it would almost be by assumption or by outcome.
The DON acknowledged the limitations to effective delegation when supervising by telephone, when there is no ability to provide immediate supervision. Specifically, she acknowledged how the delegating nurse may look at outcomes as a means of ensuring that the original, delegated care task was completed.
And a lot has to do with resident outcome…depending on what was delegated…Certain things that are delegated, you know, you would be hoping for just status quo, certain other things that would be delegated, you might be looking for some type of patient improvement. Because delegated care in this approach was viewed as linked to resident care outcomes, RNs can draw upon resident care outcomes to inform the delegation process, rather than seeing resident care trends as distinct from the delegation process.
As such, these RNs often had both routine and non-routine ways of evaluating outcomes, and were open to how outcomes might inform systems-level changes. However, this uncertainty fostered a focus on assessing resident quality of care outcomes of the delegation process.