Nurse, Legislation and Regulation
Identify a legislative issue/policy change related to a workforce/patient care issue that you believe to be a priority. Describe legislative efforts surrounding your interest.
The developments and strides in distance education has proved to be a worthwhile evolution in educating as well as practice of modern nursing construct that now requires some really fast and accurate means of knowledge dissemination (Benner et al., 2010; IOM, 2010; Jones & Wolf, 2010). The advanced technology helps in extending the reach of multifaceted nursing faculty, where the students might be placed in remote areas and lack access to quality education in pursuing their nursing dreams as a career option (Jones & Wolf, 2010). The predicaments faced in these newly evolved settings, as envisaged by Board of Nursing (BON), are noted as under:
BON needs that the local educational regulations match with their own while approving distance education programs.
The issue of licensing of clinical staff in practice and the faculty needs to be consistent across the teacher-learner community wherever the facility is sought.
3. In cases where students other than those from host states are involved in this learning, intimation to BON is mandatory. The issue of due importance to patient care gives rise to this requirement as practice follows important theoretical inputs. Quality Education in nursing requires that theoretical input during teaching be accompanied by clinical practice.
4. BON needs to be assured that the learners are supervised by proficient and qualified educators in the field.
5. Towards success of distance education, the communication modality between the learners, faculty, and staff in the recipient state and the providers in the host states should be seamless and well-defined prior to launching of the services.
6. Since the distance education programs are inherently more varied than the conventional teaching methods, BON needs that regular update on the teaching be supplied by the recipients in order to make necessary adjustments, if any, to impart quality in a consistent fashion (Lowery and Spector, 2014).
The ongoing frictions between nursing regulators and distance educators arise out of three prominent contentions:
1) Nursing regulators mistakenly point out the requirement that BONs stipulate two buildings, whereas that is stipulated by the of Higher Education
2) The regulators charge that the BONs demand very high fees, about $750 (Gormley and Glazer, 2012) for distance education), whereas, the fact, as asserted by NCSBN is that the fees are nominal at $250-500 (Chappy, Stewart, and Hansen, 2010)
3) the other charge is that BONs do not have consistent approval requirements regarding preceptors, a fact partly asserted by survey carried out by NCSBN (Finding: all 12 approve the clinical portion and five approve the clinical and didactic portion) (Gormley and Glazer, 2012).
In addition, Gormley and Glazer (2012) have found that BON is not enforcing the statutes of the U.S. Department of Education’s state authorization rule, offering legal obstacles as excuses. In as much, the authors infer that they concur with the view of IOM Future of Nursing report that BONs are proving to be impediments in propagating consistent and quality nursing education. The essence of the discussion is that BONs need to work collaboratively with other fields’ leaders to ensure adherence to IOM Future of Nursing recommendations (Lowery and Spector, 2014).
Incorporate aspects of the ethical, financial and social implications that you feel support your opinion for the recommended legislation/policy change.
Ethical issues affect nursing education and practice negatively if efforts to make them easy to follow and implement are not proffered (Lowery and Spector, 2014).
Ethical Implications:
According to Frith (2013) nursing being a practice profession, requires presence of a learned teacher in the learning process and cannot be taught online. The profession demands supervised clinical experience with qualified educators. The major limitation to conducting this online course is lack of knowledge about computers and mobile devices and lack of infrastructure for the training to be imparted to faculty members’ and even the students for providing online education (Frith, 2013).
As correctly pointed out by Zerwekh (2011), online education does not involve human interface and is a virtual exchange and is now a days turning into a profit making business. The students must be brought together to understand this noble professional skills which goes beyond words, expressions, non-verbal skills and help in building a caring fraternity (Zerwekh, 2011, p.180). Studies supporting best practices (Quality Matters, 2014) in distance education illustrate that there are ways to minimize the lack of a human relationship. The learning in distance education formats can be optimized through increased awareness of language, social interactions and previous knowledge and experience (Joyce & Brown, 2009). Social presence plays an important role in distance education as it creates awareness of different critical connections and develops relationships through critical connections, which increases student engagement and maximizes learning outcome (Joyce & Brown, 2009).
Social Implications:
The Federal Education Department in the U.S. carried out an analysis study of outcome-based peer-reviewed research studies involving face-to-face teaching vs. online learning (Means et al., 2010). It was found that the students in online courses diffidently outperformed those in face-to-face courses and the best results were achieved by students who attempted learning by blending both. However many studies have found no noteworthy differences amid the online and day-to-day courses (Billings et al., 2013). The results of the Carnegie research (Benner et al., 2010) along with that of Means et al. (2010) suggest that the finest nursing programs are a blend of online and face-to-face form along with faculty-supervised clinical experiences. The biggest advantage of distance education is its accessibility and flexibility to students as the program suits their requirement; they make connections with students without any demographic boundary (Frith, 2013). Web-based teaching creates deep reflection and foster meaningful exchanges (Zerwekh, 2011)
Financial implications:
According to at least 2 studies (Mancuso-Murphy, 2007; Zerwekh, 2011) certain issues arise in creation and implementation of online courses. More number of hours are spent in preparing online course, evaluating student performance and contacting the students. (Anderson and Avery, 2008). There are many faculty issued in creating online courses (Johnson and Meehan, 2013). Many of them find it difficult to shift from face-to-face teaching to web based approach. They do not have complete knowledge of all the online learning tools like blackboard, discussion boards and blogs (Hoffmann and Dudjak, 2012). More often slow educators are unwilling to include novel online applications in the educational programs (Skiba et al., 2008), therefore, increasing the gap amid digital immigrants (the teachers) and digital inhabitants (the students).
Discuss how you, as a nurse, could promote this change and shape the future of nursing/healthcare incorporating pertinent information you gathered from reviewing the IOM report.
The regulatory processes follow inputs and observations of scholarly studies and research to ensure public safety as the mechanism is based on credible evidence. The regulatory boards’ functioning started functioning way back in 1906, giving credence to its maturity and consolidation towards creating able, safe and competent nursing professionals’ workforce (Spector & Woods, 2013). The focus of my work is to attend to the inconsistencies amongst BONs regulations that would help streamlining the process of approval processes and thus facilitate nursing education programs.
References
Anderson, K. M., & Avery, M. D. (2008). Faculty teaching time: A comparison of Web-based and face-to-face graduate nursing courses. International Journal of Nursing Education Scholarship, 5, 1-12.
Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. Retrieved from www.carnegiefoundation.org/newsroom/press-releases/educating-nurses-call-radical-transformation
Billings, D. (2000). A framework for assessing outcomes and practices in web-based courses in nursing. Journal of Nursing Education, 39(2), 60-67.
Chappy, S. L., Stewart, S. M., & Hansen, T. S. (2010). Eliminate border wars. Nursing Education Perspectives, 31(6), 392-394.
Frith, K. H. (2013). An overview of distance education and online learning. In K. H. Frith & DH Clark (Eds.), Distance education in nursing (pp. 17-31). New York, NY: Springer.
Gormley, D. K., & Glazer, G. (2012). Legislative: Nursing distance learning programs and state board of nursing authorization. The Online Journal of Issues in Nursing, 17(3). Retrieved from www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANA- Periodicals/OJIN/TableofContents/Vol-17-2012/No3-Sept-2012/Nursing-Distance-Learning-and-State-Board-Authori- zations.html
Hoffmann, M. L., & Dudjak, L. A. (2012). From onsite to online: Les- sons learned from faculty pioneers. Journal of Professional Nursing, 28(4), 255-258.
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press.
Johnson, A. E., & Meehan, N. K. (2013). Faculty preparation for teaching online. In K. H. Frith & DH Clark (Eds.), Distance education in nursing (pp. 17-31). New York, NY: Springer.
Jones, D., & Wolf, D. (2010). Shaping the future of nursing education today using distant education and technology. The ABNF Journal, 21(2), 44-47. doi:50504341
Joyce, K., & Brown, A. (2009). Enhancing social presence in online learning: Mediation strategies applied to social networking tools. Online Journal of Distance Learning Administration, 12(4), 1. Retrieved from www.westga.edu/-distance/ojdla/winter124 / joyce124.html
Lowery, B. and Spector, N. (2014). Regulatory Implications and Recommendations for Distance Education in Prelicensure Nursing Programs. Journal of Nursing Regulation, Volume 5/Issue 3.
Mancuso-Murphy, J. (2007). Distance education in nursing: An integrated review of online nursing students’ experiences with technology-delivered instruction. Journal of Nursing Education, 46(6), 252-260.
Means, B., Toyama, Y., Murphy, R., Bakia, M., & Jones, K. (2010). Evaluation of evidence-based practices in online learning: A meta-analysis and review of online learning studies. Washington, DC: U.S. Department of Education. Retrieved from http://eprints.cpkn.ca/7/1/final- report.pdf
Quality Matters: A national benchmark for online course design. (2014). Retrieved from www.qualitymatters.org/
Skiba, D. J., Connors, H. R., & Jeffries, P. R. (2008). Information technologies and the transformation of nursing education. Nursing Outlook, 56(5), 225-230. doi:10.1016/j.outlook.2008.06.012
Spector, N., & Woods, S. (2013). A collaborative model for approval of prelicensure nursing programs. Journal of Nursing Regulation, 3(4), 47-52.
Zerwekh, J. (2011). Web-based teaching: Caution and suggestion. Journal of Nursing Education, 50(4), 179-180.
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