Board of Registered Nursing Takes Action in Response to COVID-19 Pandemic

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By Kendra J. Muller

Starting in August 2020, the Board of Registered Nursing (BRN) took the following actions to address consumer protection and nursing issues related to the COVID-19 pandemic:

On August 11, 2020, BRN issued a news release stating that nursing students who meet CDC guidelines for healthcare workers may supplement existing medical personnel in certain healthcare settings. The Board confirmed that the COVID-19 pandemic was an “emergency” as defined in section 2727(d) of the Business and Professions Code, and therefore, nursing students would not violate the law by supplementing needed health care in both long-term care settings and acute care hospitals. This news release came after a large surge in COVID-19 cases in California, and BRN’s Executive Director Loretta Melby explained the purpose: to help ease the burden on California’s healthcare system. Ms. Melby encouraged health care facilities to use a specified Emergency Care Matrix to assess nursing students’ and graduates’ skill level and determine appropriate assignments to ensure competency.

On October 2, 2020, in accordance with the Governor’s ongoing proclamation of a state of emergency, the California Department of Consumer Affairs (DCA) extended the prior order waiving nurse practitioner supervision requirements, and the order waiving nurse-midwife supervision requirements. Both orders have been extended to December 10, 2020, but may be further extended or amended, as necessary. The order is consistent with the Governor’s Executive Order N-39-20, which allows the Director of the DCA to waive statutory professional licensing changes due to the state of emergency as a result of COVID-19.

During its September 16–17, 2020 meeting, the Board discussed section 1426, Title 16 of the California Code of Regulations, which allows nursing schools to change minor curriculum aspects at their institutions. Twenty-four out of the thirty-three nursing schools who submitted revisions asked the Board for temporary changes due to COVID-19. For example, one nursing program requested minor curriculum revisions to reorder classes for future semesters, as well as to pause several cohorts from face-to-face clinical classes. Other colleges sought revisions to decrease enrollment to fewer students in anticipation of a possible COVID-19 surge, and to replace certain classes with a faculty-led capstone project. Other schools asked for virtual or videoconferencing modality revisions to instruct students during COVID-19 pandemic. The Board accepted these requests.

Additionally, at its September 16–17, 2020 meeting, the Board discussed the quarterly reports of the NCLEX-RN nursing exam, the nationwide examination for the licensing of nurses. The Board reported that the National Council of State Boards of Nursing temporarily modified the exam length and lowered the maximum number of scored questions, both due to COVID-19.

The Board announced at its September 16–17, 2020 meeting that the Board Enforcement Unit, in partnership with the Division of Investigation, has transitioned to a paper-free system and will use the BreEZe system to ensure that enforcement is adequately conducted during COVID-19. The Board took measures to increase monitoring of licensing enforcement cases and continues to work with the Division of Investigation on the Complaint Resolution Pilot Project, which gives priority to urgent cases alleging significant harm or death for BRN investigation. The Project also provides case tracking measures in order for the Board to closely watch caseloads during the COVID-19 pandemic.

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