These days, you may find various career opportunities that can make your work and life interesting.
Pediatric nurse is a registered nurse who has special education and skills in the field of children health. Pediatric nurses know almost everything about the growth and development of children and can help in the proper or healthy growth and development of a child. As they are registered nurses, they have advanced medical knowledge and can treat minor and sometimes major health problems in children. Experience matters a lot and only an experienced and skilled nurse can handle kids in any situation. Parents play an important role in the growth of their child because only they can teach their child what is good and what is bad. In the case of teens, pediatric nurse can be very beneficial as she can understand the problems of the teens and can help them. The main role of the nurse is that she can provide primary care to infants, toddlers, and teens. A pediatric nurse can work as a coordinator and can coordinate between the mental and physical health of a child. The main role of a pediatric nurse is that she can contribute to the social development of a child.
A pediatric nurse plays an important role in the overall development and growth of a child. Nurse practitioners are responsible for taking care of patients in a variety of specialized settings. A nurse practitioner (NP) provides primary care to patients in hospitals and other healthcare facilities. While completing a Master of Science in Nursing is generally enough to enter the profession, students may opt to complete a doctoral degree program to further enhance their career opportunities and expertise. Obtaining licensure as a registered nurse through the National Council Licensure Examination – Registered Nurses (NCLEX-RN), is required for all nurse practitioners. After completing master’s degree programs, graduates are eligible to obtain professional certification as NPs. In recent years, there have been increasing concerns regarding a potential mismatch between the demand for registered nurses and the size of the registered nurse workforce. California’s higher education system plays a major role in training and supplying the state’s registered nurses.
Currently, there are approximately 230,000 registered nurses working full or part time in California. Registered nurses are employed in the public and private sectors and operate in various settings, including hospitals, medical offices and clinics, skilled nursing facilities, and patients’ homes.
The primary responsibility of just over one-half (53 percent) of all registered nurses is to provide direct care to patients. All registered nurses in the state must have a license issued by the California Board of Registered Nursing (BRN).
In California, there are four types of pre-licensure educational programs available to persons seeking to become a registered nurse. Students that complete nursing program requirements are eligible to take the National Council Licensing Examination. Currently, 110 public and private colleges in California offer a total of 123 pre-licensure nursing programs. A total of 26 nursing programs have been added in California since 2000-01—an increase of 25 percent. In contrast, ADN programs at community colleges rely heavily on nonmerit-based or only partially merit-based selection processes. Because there are more applicants that qualify for admission than enrollment slots, community college nursing programs must decide which applicants to admit. Until the early 1990s, many California Community College (CCC) nursing programs chose students by ranking them according to factors such as grades in prerequisite classes and test score results. The organization agreed to drop the lawsuit in 1991 after the CCC Chancellor’s Office committed to develop a new set of regulations.
Nursing programs have also expanded capacity through partnerships with hospitals and other institutions (such as foundations). In addition to expanding nursing programs, recent legislative actions created new programs to recruit and retain nursing faculty, and to provide new forms of financial aid specifically for nursing students.
As noted above, roughly 230,000 registered nurses currently work part or full time in California.
Like most forecasts, these occupational-demand studies rely on a series of assumptions that may or may not prove to be correct.
Projecting changes in the supply of registered nurses is difficult, as well, since the future total depends on a number of factors. Taking into account recent increases in capacity and building in a growth factor (10 percent growth annually through 2008-09, and 2 percent annually thereafter), the adjusted model forecasts that the supply of registered nurses would total about 228,000 FTEs by 2014. The above analysis suggests that, to accommodate the projected demand for roughly 240,000 FTE registered nurses by 2014, the state will need to increase the number of FTE nurses by at least 12,000 over our office’s supply projection (from 228,000 to 240,000 FTE nurses).
Further increases to the nursing supply could be achieved if employers recruited more registered nurses from other states to work in California. Finally, there are about 7,000 actively licensed registered nurses in the state that are currently employed in a non-nursing field. In combination with other strategies mentioned above, we believe accommodating the demand for registered nurses will require only modest increases in nursing program capacity. The segments, therefore, expand nursing enrollment each year using their regular enrollment growth allocations. In recent years, the Legislature has responded by providing supplemental funding on top of normal per-student funding.
In fact, certain state laws serve as barriers to hiring and allocating nursing faculty resources, particularly as regards the community colleges.
Another provision restricts the number of semesters that a “temporary” faculty member can teach in a three-year period. Nursing students that leave a program prematurely tend to do so relatively late in the program. The study noted that entering students are often underprepared in core subjects such as mathematics, science, and English. The CPEC study also found that the nursing programs with the highest success rates tended to offer more comprehensive student-support services, including tutoring, mentoring, and programs for students that speak English as a second language.
In this report, we have discussed the state’s role in training registered nurses and the challenges to further expanding their supply to meet projected future demand.
In order to address the shortfall in registered nurses, we recommend that at least for the next several years the Legislature provide supplemental funding for each new nursing slot.
As discussed earlier, the annual budget includes funding for overall enrollment growth at each segment. In recent years, however, the demand for nursing enrollment slots has exceeded the growth rate for overall programs.
We see justification for providing the segments with supplemental funding for nursing students above what segments receive for other students. Nursing programs train professionals who serve critical functions relating to public health.
To address the shortage of nurses in California’s workforce, nursing programs must expand much more rapidly than average enrollment growth. As we discuss in our 2007-08 Analysis of the Budget Bill, these special factors make nursing a unique case.
We recommend the Legislature amend statute to expand the pool of applicants eligible for the State Nursing Assumption Program of Loans for Education (SNAPLE) in order to attract and retain more nursing faculty. As noted earlier, many nursing programs have indicated that they are having difficulty filling faculty positions, which creates a barrier to expanding nursing programs. Currently, SNAPLE is only available to persons who have not yet completed their degree in nursing. We recommend the Legislature amend statute to temporarily exempt community college nursing faculty from certain restrictive hiring policies. As we discuss earlier in this report as well as in our 2007-08 Analysis of the Budget Bill, there are various laws and regulations in place that limit how community colleges can use faculty. We recommend the Legislature link funding for new nursing facilities to programs’ use of existing facilities in order to encourage more efficient use of resources and more options for students. As noted earlier, the segments have indicated that nursing programs are outgrowing their classroom and laboratory facilities.
We believe that there would be several benefits to expanding the number of nursing programs that offer these types of nontraditional course schedules.
To accomplish these goals, we recommend the Legislature link any new funding for nursing program facilities to programs’ more efficient use of existing facilities. We recommend the Legislature provide “completion bonuses” to community colleges that increase nursing student completions.
As discussed earlier, the state’s higher education segments receive funding based largely on the number of students they serve.
We recommend the Legislature enact legislation to better align the admissions process at community college nursing programs with qualifications for student success. As discussed earlier, community college policies in such areas as student assessment and placement stem largely from a nearly 20-year old lawsuit settlement involving Mexican American Legal Defense and Educational Fund. While this analysis finds that the mismatch between the supply of and demand for registered nurses is not as large as has been reported elsewhere, the state needs to continue to increase its supply of nurses in order to meet projected growth in demand.
Make sure children are properly buckled up in a car seat, booster seat, or seat belt, whichever is appropriate for their age, height and weight. For the best possible protection, infants and children should be buckled in a rear-facing car seat, in the back seat, until age 2 or when they reach the upper weight or height limits of their particular seat. When children outgrow their rear-facing seats they should be buckled in a forward-facing car seat, in the back seat, until at least age 5 or when they reach the upper weight or height limit of their particular seat. Once children outgrow their forward-facing seat, (by reaching the upper height or weight limit of their seat), they should be buckled in a belt positioning booster seat until seat belts fit properly. Install and use car seats and booster seats according to the seata€™s ownera€™s manual or get help installing them from a certified Child Passenger Safety Technician. Buckle children in car seats, booster seats, or seat belts on every trip, no matter how short. Zaza, S, Sleet DA, Thompson RS, Sosin DM, Bolen JC, Task Force on Community Preventive Services. Patient information: See related handout for caregivers of persons with mental retardation, written by the authors of this article.
A nurse informatics specialist has the responsibility to manage and communicate information regarding nursing information and data to improve the decision making process for nurses, consumers, healthcare providers, and patients. This sub-discipline of health informatics merges information science, the science of nursing, and computer technology to ensure the integrity and quality of nursing practices through improved communication, and documentation. The job of a nursing informatics specialist may include assisting at all levels of nursing, including any aspect of patient care from admission to discharge. Integrating technology into nursing allows the flow of data collection by nurses to operate smoothly.
Nursing informatics makes it possible for nurses to have a greater level of interaction with their patients. The field of nursing informatics requires a minimum education level of a Bachelor of Science in Nursing (BSN). A few of the possible course that are needed to become a nursing informatics specialist include Healthcare Data Analysis & Evidence-Based Practice and Information Applications. A nursing informatics specialist must receive the credentials to become a registered nurse prior to earning the title of nursing information specialist.
Potential employers look for the most experienced and educated nurses for positions as nursing informatics specialists. A continuous increase in the need for nursing informatics specialist is expected for at least the next 10 years.
The field of nursing informatics seamlessly merges the love of technology and nursing into a very exciting career. Enter your email address below and hit "Submit" to receive free email updates and nursing tips. We run network of high quality 50+ high niche websites with millions of regular visitors, Please connect with us. If you are eligible, skilled and have required abilities then you can get better career opportunities. Pediatric nurses can perform immunization, some tests, procedures, and can treat various childhood ailments.
She can easily understand the needs and requirements of children and can perform various procedures. An experienced and skilled pediatric nurse can make toddlers and teens understand the importance of health and healthy life. Pediatric nurses can educate parents and can give them several effective tips on childa€™s health and healthy growth.
She can provide a moral as well as an emotional support to the child and can help him to get rid of various emotional, mental, physical, and health related problems. She is able to recognize and manage emergencies in children, can provide nursing care to critically ill children, and can help in various ways. She has advanced medical knowledge and can perform required medical tests and procedures for the ill child. She can work as a health educator, consultant, counselor, researcher, and can even contribute to the welfare of the society.
Aside from publishing a bevy of life improvement guides, Dr Prem runs a network of 50 niche websites that attracts millions of readers across the globe. Nurse practitioners must generally obtain at least a master’s degree, and must be both nationally registered nurses and certified nurse practitioners. He or she is responsible for recording and analyzing a patient’s history, performing physical exams, ordering diagnostic tests, prescribing physical therapy and other similar tasks.
They focus on providing students with the skills necessary to enter professional health settings as nurse practitioners.
This is a post-undergraduate prerequisite to becoming an RN, which is a prerequisite to becoming a NP.
Nurse practitioner programs normally focus on one specialty area of nursing and graduates generally choose to seek certification in the same specialty.
While the mismatch in coming years may not be as large as forecasted, the state needs to continue its efforts to increase the number of nurses to meet projected need. These concerns have been expressed in a number of states, including California, and in both the public and private sectors.
Under the direction of a physician, registered nurses perform such tasks as administering medications, performing diagnostic tests, and monitoring and recording patients’ condition. About 18 percent of registered nurses serve primarily as supervisors or managers of health care personnel. About two-thirds of registered nurses work full time (defined in a survey of nurses as working over 32 hours per week). The average annual salary for a full-time nurse increased from about $52,000 in 2000 to $69,000 in 2006, an increase of 32 percent over the six-year period (13 percent after adjusting for inflation). To obtain a license, students must complete a number of steps, including graduating from an approved nursing program and passing the national licensing examination. All four types are generally full-time programs, and each combines classroom instruction and “hands-on” training in a lab with clinical placement in a hospital or other health facility. Applicants that pass the examination and a criminal background check are licensed by BRN to practice as a registered nurse in California. As Figure 2 shows, most of these are ADN programs offered at CCC, which graduated almost two-thirds of nursing students in the state in 2005-06.


Statewide, the number of applicants to nursing schools in California far exceeds the number of available slots. California nursing schools have developed different strategies in order to decide which applicants to accept into a program.
Students in various other programs also were required to take assessment tests for course placement purposes. Under these regulations, nursing programs, for example, are allowed to continue requiring prospective students to complete (with at least a “C” grade) science prerequisite courses (such as anatomy and microbiology) to be eligible to apply.
Figure 4 shows that nursing programs have increased the number of graduates significantly in the past few years. These organizations provide funding or other in-kind support, often matched with federal Workforce Investment Act funds, in order to improve the pipeline of nursing graduates. For example, the 2006-07 Budget Act authorizes 140 new loan forgiveness awards for nursing students. A large number of nursing students, particularly at community colleges, never complete their degree.
Specifically, Chapter 837 allows community colleges to administer a diagnostic assessment test to admitted students before they start a nursing program.
This translates into about 200,000 full-time equivalent (FTE) registered nurses (a measure which converts part-time employment into the equivalent full-time basis). This is primarily because California’s population is projected to increase and grow older, two key drivers of health-care service demands. For example, forecasts of the supply of foreign nurses working in California could change if the federal government modified its immigration policies. First, the UCSF model is based on an “inflow” assumption that California nursing schools would graduate about 6,200 students annually throughout the forecast period (the number during the 2003-04 school year, which was the most recent data available at the time of the 2005 report). The UCSF model suggests that if all working nurses under the age of 50 increased the average time worked per week by just one hour (through regular time or overtime), the state’s supply of FTE registered nurses would increase by almost 4,000 FTEs by 2014.
An increase in the annual number of out-of-state nurses that migrate to California from approximately 5,200 to 5,500 would further increase the statewide supply by about 2,000 FTEs by 2014.
A 2004 BRN survey of nurses indicates that a major reason they no longer work in nursing stems from dissatisfaction with the profession (such as relations with management). There are two major approaches to increasing the number of nurses graduating annually from the state’s higher education system: (1) add more slots in ADN, BSN, and ELM programs, and (2) reduce the attrition rate in nursing programs, thus increasing the number of graduates. The following section discusses challenges to increasing the output of new nurses, and the concluding section offers recommendations for addressing those issues. Typically, the Legislature provides funding in the annual budget act for enrollment growth at each of the three segments. However, in recent years the segments have contended that this funding approach impedes their ability to respond quickly to the increased demand for nurses. As we discuss in the 2007-08 Analysis of the Budget Bill, however, funding for nursing enrollment has varied considerably among and within the segments, with some enrollment slots supported by supplemental amounts of varying size and others receiving only the normal per-student funding rate. For instance, the state Education Code places limitations on the percentage of part-time and temporary faculty that are employed by a community college district. Although the allowable number of semesters for temporary clinical nursing faculty (four) is larger than for other temporary faculty (two), this still limits colleges’ flexibility in hiring nursing instructors. According to the California Postsecondary Education Commission (CPEC), about one-quarter of dropouts leave their program by the beginning of their second year. Of the various factors that contribute to students dropping out of a program, BRN’s 2005-06 survey of nursing programs cites academic failure as the top reason. In fact, programs that offered at least two support services had significantly higher graduation rates than programs that offered one or no service. Based on the findings of our review, we recommend (1) removing fiscal disincentives for segments to rapidly expand enrollment slots, (2) expanding the state’s nursing faculty loan forgiveness program to attract more educators, (3) temporarily exempting community college nursing faculty from certain hiring restrictions, (4) encouraging nursing programs to use existing facilities more efficiently, (5) providing “completion bonuses” to community colleges that improve student outcomes, and (6) implementing a merit-based admissions policy for community college nursing programs to address attrition concerns. Because the cost of educating nursing students is unusually high, there is a disincentive for segments to rapidly expand enrollment when the state provides only the regular per-student funding rate for these slots. For this reason, we have recommended against supplemental funding for other courses (such as certain science classes with above-average costs.
To address this issue, the 2006-07 budget package authorizes nursing student participation in new APLE programs.
Consequently, the benefits of SNAPLE will not be realized until award recipients complete their nursing program and obtain a faculty position—which could take several years.
For example, current policies require a certain ratio of full-time faculty to part-time faculty employed by a district and limit the number of terms temporary faculty can teach within a three-year period. Segment officials cite increasingly limited classroom and laboratory space as a barrier to expanding nursing enrollment. First, a more intensive, year-round use of existing instructional space would help to avoid major costs in building new facilities. For example, the Legislature could choose to withhold funding for new facilities unless nursing programs already use existing facilities a certain percentage of the time year-round (such as 80 percent). We recommend the Legislature give the community colleges significant flexibility in how they use these funds to enhance nursing student outcomes. For example, the amount of funding a community college district receives from the state depends primarily on the number of students enrolled at a point early in the semester.
Given the state’s strong interest in increasing the supply of nurses, we recommend the Legislature strengthen incentives for nursing programs to increase the number of nurses by reducing attrition. The regulations that resulted from the legal dispute require, among other things, that districts use nonevaluative admissions strategies (such as random selection) when selecting students for oversubscribed programs. Given the state’s interest in reducing attrition, we recommend that the Legislature enact legislation to improve the admissions process in a way that promotes fairness as well as student success. Our report has focused on ways the Legislature can increase the supply by creating additional enrollment slots in nursing programs.
Seat belts fit properly when the lap belt lays across the upper thighs (not the stomach) and the shoulder belt lays across the chest (not the neck). Restraint use and seating position among children less than 13 years of age: Is it still a problem? Interventions for promoting booster seat use in four to eight year olds travelling in motor vehicles. Primary medical care of persons with mental retardation should involve continuity of care, maintenance of comprehensive treatment documentation, routine periodic health screening, and an understanding of the unique medical and behavioral disorders common to this population. Providing caregivers in advance with a referral sheet documenting the information expected for each office visit can be helpful (Figure 1). Furthermore, physicians should incorporate surveillance for these medication-related movement disorders in patients taking these medications. The advances in technology have dramatically influence the manner in which patients are managed, diagnosed, treated, and cared for while receiving services from a nurse.
Nursing informatics has created many improvements in the way that nurses access patient information during care, and it has enhanced a nurse informatics specialista€™s ability to monitor, audit, and benchmark quality measures.
By joining the passion for people, technology, and nursing, the field of nursing informatics leads to a greater level of patient quality and patient outcomes while under the care of a nurse informatics specialist. It is possible to earn a bachelora€™s degree in nursing by combining specialized nursing diploma from an accredited nursing school, an associatea€™s degree in nursing, and additional coursework to meet the minimum requirements. It is also necessary to take part in a nursing informatics practicum to earn a nursing degree. Some choose to earn an advanced degree in a technology field or take additional technology courses if they plan to delve deeply into the computer and technology aspects of nursing informatics.
It is very important to make sure that the attending nursing school is accredited by an accrediting commissiona€” such as the National League of Nursing Commission (NLNAC)a€” to ensure that the earned degree has value after graduation. With an advanced degree in nursing and experience, a nurse informatics specialist can earn wages well over $100,000 annually in hospitals and clinics around the country.
The new technologies and advancements in computers and nursing will continue to fuel the need for qualified, highly trained nursing informatics professionals. The greatest opportunities for nursing jobs in informatics specialist are in Boston, Madison, Orlando, and Dallas.
The advancements in technology and nursing make it possible for nurses to have a more intimate relationship with the patients who are under their care. We strive for 100% accuracy, but nursing procedures and state laws are constantly changing. When we talk about pediatric nurse, it is one of the best career opportunities for those who enjoy the company of children.
These nurses have a post- graduation or mastersa€™ degree in nursing from a certified medical institute or college. Thus far, Dr Prem has traveled to more than 40 countries, addressed numerous international conferences and offered his expert training andA consultancy services to more than 150 international organizations. Nurse Practitioner education requirements to enter the career can vary slightly depending on the specialty, but at least a master’s degree education is necessary.
The American Academy of Nurse Practitioners and the American Nurses Credentialing Center are two credentialing bodies that offer certifications in nursing. Increasing the supply of nurses relies in large part on the state’s higher education system, which trains the majority of registered nurses in California.
Numerous studies have warned that the need for registered nurses is likely to increase in future years as the population grows and ages. In particular, recent state budgets have augmented funding to the California Community Colleges (CCC), California State University (CSU), and University of California (UC) segments to increase the number of nursing enrollment slots. Registered nurses often supervise other health care personnel such as licensed vocational nurses and certified nurse assistants.
About two-thirds of registered nurses are white, 22 percent are Asian, 6 percent are Latino, and 4 percent are African-American.
The remaining registered nurses in the state work in fields such as education, research, and consulting. On average, full-time nurses work 42 hours per week, and part-time nurses work 23 hours per week.
The first two options are for students to enroll in either an associate degree in nursing (ADN) program at a two-year college, or a four-year bachelor’s degree in nursing (BSN) program at a university. In addition, there are 17 BSN programs offered by CSU and UC, and 12 BSN programs offered at private four-year institutions. According to a 2007 BRN study, for example, California nursing programs received a total of 28,410 eligible applications for just 11,000 first-year slots for the 2005-06 school year.
Generally, nursing programs at four-year institutions and two-year private colleges require students to take certain prerequisite courses (such as anatomy and microbiology) as well as a standardized test before applying to the program. All community college nursing programs require at a minimum that applicants obtain at least a “C” average on multiple science prerequisite courses in order to qualify for admission.
Many programs use a lottery system, which randomly selects students from a pool of applicants. In 1988, the Mexican American Legal Defense and Educational Fund (MALDEF) filed a lawsuit against the CCC system. Community colleges are permitted to require applicants to take and pass nonscience classes (such as English composition), though districts must first conduct a validation study showing that students who fail to satisfy such requirements are “highly unlikely” to succeed in a nursing program. A total of about 7,500 students graduated from a nursing school in California during the 2005-06 school year, which exceeds the prior year’s level by 800. For example, in recent years a number of health care organizations (such as Sutter Health and Kaiser Permanente) have supplied faculty, equipment, facilities, and financial aid to increase enrollment at nursing programs. These Assumption Program of Loans for Education (APLE) awards are available to students that teach in a nursing program or work in certain state health care facilities upon graduation. As Figure 6 shows, about one-half of the roughly 6,000 students that enrolled in a community college ADN program in 2002-03 graduated on schedule—that is, in two years. Students that are unable to obtain a passing score must demonstrate readiness for the program by, for example, passing remedial courses (such as English or math classes) or receiving tutorial services from community college staff.
In recent years, health care employers have indicated that the size of the nursing workforce is making it increasingly difficult for them to adequately staff health care facilities.
Between 2007 and 2014, for example, the state’s population is projected to increase by almost 10 percent, or 3.6 million residents.
These demand studies also assume that there will not be any significant differences in how health care is delivered to patients over the next several years.
As noted earlier, however, in the past few years both private and public institutions have significantly increased enrollment capacity.
To the extent that employers such as hospitals make nursing a more attractive occupation, they may entice many of these people back into direct patient care.
As noted in the previous section, about one-quarter of ADN students leave their program prior to receiving a degree. With minor exceptions, each segment’s enrollment augmentation is based on a single rate of funding for each new FTE student. This is because the costs to educate a student in a nursing program are much higher than the nominal per-student funding rate.
The different funding rates can depend on whether the student is filling an existing slot, a new slot within the segment’s overall enrollment growth allocation, or a new slot created outside the regular growth allocation. Nursing programs require faculty (generally nurses with a master’s degree or higher) to educate students in the classroom, laboratories, and clinical settings. One provision requires that at least 75 percent of all credit instruction be provided by full-time faculty.
Nursing programs require classroom facilities as well as laboratory space to educate students. In particular, a reduction in attrition rates at community college nursing programs would increase considerably the state’s supply of nurses.
A major focus of the study was the extent to which CCC admissions processes allow for the identification of those students that were most prepared for and, therefore, most likely to succeed in a nursing program. Based on the success of programs that had more selective admission requirements at the time, the study recommended that at least a portion of enrollment slots be reserved for the most qualified applicants (such as those with the highest grades on their prerequisite courses). As a result, CPEC recommended that nursing schools offer English-as-a-second-language instruction, remedial support services in math and science, and tutoring programs—three programs associated with program success. We believe that these recommendations would help to close the gap between the supply of and demand for registered nurses (forecasted to grow to roughly 12,000 FTE registered nurses by 2014, as discussed earlier).
This funding rate is intended to cover the costs of serving an “average” student, recognizing that students in some disciplines (such as the social sciences) may impose lower costs, while students in other disciplines (such as nursing) may impose higher costs. As noted earlier, while the Legislature has at times provided supplemental funding beyond the regular growth funding, the funding approach has been inconsistent.
In addition, we recommend that the supplemental funding for nurses be provided only for a limited time period and ended once enrollment growth for nurses is more in line with overall enrollment growth. Specifically, the budget directs the California Student Aid Commission to issue 40 new loan forgiveness awards for the Nurses in State Facilities APLE, and 100 new awards for SNAPLE. To realize a more immediate benefit from SNAPLE and increase the pool of potential applicants, we recommend the Legislature amend statute to offer SNAPLE awards to nurses interested in a teaching career who already have a nursing degree. As we discussed in the 2001-02 Analysis of the Budget Bill, we find no evidence that these policies improve student outcomes.
Yet, our review indicates that most nursing programs are not using their existing space to full capacity. Second, programs may be able to grow more quickly to the extent that they would not have to wait for new buildings to be constructed in order to accommodate additional students. This would ensure that the state did not provide funding for increased instructional space until the segments fully used their existing space.
Generally, funds are provided regardless of student outcomes (such as the number of graduations from a program or even the number of students completing a class).
As a result, nursing programs cannot choose the most qualified and best prepared students from among the pool of applications they receive. This could include implementing merit-based admissions policies that take into account applicants’ academic performance as well as other skills and special circumstances (such as the ability to speak a second language, community service, and life experiences). Recommendations to this end include creating incentives for nursing programs to expand capacity and use existing facilities more efficiently, as well as modifying policies to attract more nursing faculty. Remember to keep children properly buckled in the back seat for the best possible protection.


National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (producer).
Office visits can be successful if physicians familiarize patients with the office and staff, plan for difficult behaviors, and administer mild sedation when appropriate.
Particularly prevalent in persons with Down syndrome, GERD may cause unexplained sore throat, choking, cough, or changes in behavior.33 Esophagogastroduodenoscopy may be better tolerated and require less patient cooperation than radiographic procedures.
Consultation with an orthopedic subspecialist for significant curvature is important because surgical intervention may be required to limit curve progression, respiratory compromise, and pain.43,44Contractures can develop in persons who do not have use of their lower extremities.
Although some etiologies of mental retardation may have associated behavioral phenotypes (Table 4),10–18 most challenging behaviors are caused by the same neuropsychiatric disorders that affect the general population54 and respond to the same treatments.
At one point in history, a nurse was only expected to provide specialized care to patients in need, but now the field of nursing has crossed over the lines of technology. Next, a nurse must earn the certification to become a nursing informatics specialist by taking the test administered by the American Nurses Credentialing Center (ANCC). Working in areas with a shortage of qualified nurses may also increase the income potential of a nurse informatics specialist. A career in nursing informatics has the potential to be very rewarding for the right people.
By accessing any content, you agree never to hold us liable for damages, harm, or misinformation. Infants, toddlers, and teens need special care and a pediatric nurse can deal with these children. They should have advanced or special qualification, education, skills, and training in caring for newborns, toddlers, and adolescents. He also owns and leads a web services and technology business, supervised and managed by his eminent team. These certifications must be renewed every five years in order to continue development within the profession. In this report, we recommend ways the Legislature can increase enrollment in state nursing programs as well as reduce attrition rates, particularly in the community colleges. Unless the supply of registered nurses keeps pace with growing patient demand, the delivery of health care services to the public could be adversely affected. In addition, new laws such as Chapter 837, Statutes of 2006 (SB 1309, Scott), have sought to improve the nursing pipeline by addressing matters such as student attrition and faculty recruitment. Third, we discuss oft-cited challenges to increasing the supply of nurses, particularly as regards the state’s higher education system.
In addition to providing and supervising direct patient care, registered nurses also work in areas such as administration, teaching, and research. Slightly more than one-half (55 percent) of the state’s registered nurses received their nursing education within California. In addition, individuals who are already licensed vocational nurses may choose to enroll in an accelerated nursing program at a two-year college. Applicants are then ranked by criteria such as the applicant’s grade point average on the prerequisites and test score results. Some nursing programs require that applicants meet stricter criteria (such as at least a “B” average on prerequisites) in order to apply, though these requirements must be justified through validation studies. Others admit students on a first-come, first-served basis, or give priority to “wait-listed” applicants that were not chosen in prior years.
The MALDEF contended that CCC’s assessment, placement, and prerequisite policies were disproportionately excluding Latino students from certain courses and programs (including nursing). Validation studies also must be conducted in order for districts to require applicants to obtain grades higher than a “C” on prerequisite classes.
This is largely because recent state budgets have included augmentations to fund expansions of nursing programs at all three segments. This is particularly true for hospitals, which are statutorily required to maintain minimum nurse-to-patient ratios. To the extent that these assumptions do not hold true, demand for nurses will differ from projected levels. Using data from BRN and other surveys to estimate future inflows and outflows, UCSF forecast the supply of registered nurses to grow by 11,000 FTEs (from 200,000 to 211,000 FTEs) between now and 2014, as the number of new nurses in the state is largely offset by factors such as retirements. As a result, the number of students graduating from nursing programs exceeded 7,500 in 2005-06. Yet, there are a number of other ways to help close the gap between projected supply and projected demand.
If that rate were 7 percent (the approximate attrition rate for UC and CSU nursing students), the state would graduate hundreds of additional nurses each year. Yet, a number of nursing programs have reported difficulty filling faculty positions, particularly as programs expand. Districts that fall below targets set by the Chancellor’s Office may be subject to financial penalties. The remaining one-quarter of dropouts do not leave a program until sometime after their second year. As a result, they do not receive passing grades in their classes and eventually leave the program. The study found that the community colleges’ admissions policies rely heavily on random selection, and identified this as a possible source of the attrition problem. The CPEC recommended that the remaining students be chosen using a nonmerit method such as random selection. The latter program forgives up to $25,000 in student loans for graduates of nursing programs who teach for three years in a California college or university.
We also recommend the Legislature increase the number of SNAPLE awards to accommodate the larger pool of nurses that would be eligible for this program. To maximize community colleges’ flexibility to meet enrollment demands, we thus recommend the Legislature exempt nursing faculty from these restrictions for a limited period (for example, through 2010). Currently, most nursing programs are full time, and courses generally are offered only during daytime hours and during the traditional work week. Third, such a change would provide more choices to students, which could reduce attrition and even accelerate the graduation timeline for certain students.
For example, nursing programs could be eligible to receive extra funding (in addition to per-student enrollment funds) for every student completion above currently projected levels. Second, we project significant base increases over the next several years in the amount of new discretionary Proposition 98 funds—the primary funding source for the community colleges.
We believe that such a comprehensive and evaluative approach would serve state interests by more effectively identifying applicants that are most likely to succeed in a nursing program.
In addition, we recommend actions the Legislature could consider to reduce student attrition rates, particularly at the community colleges.
Some syndromes that cause mental retardation have specific medical and behavioral features. One notable exception is benzodiazepine therapy, which can precipitate paradoxical reactions of increased irritability and aggression in 10 to 15 percent of patients with mental retardation.55Once pharmacologic or behavioral intervention is deemed appropriate and informed consent has been obtained, the goal is to minimize physical and emotional trauma to the patient and caregivers while maximizing community integration. The duty of pediatric nurse is to provide care, diagnose injuries, and identifying common health problems in children. In case, they have several credential like CPNP or CFNP they can perform the duty of family nurse practitioner. Taken together, these measures would increase significantly the supply of registered nurses, and address concerns about the adequacy of the size of the nursing workforce.
Finally, we recommend actions for the Legislature’s consideration to increase the number of completions from state nursing programs. About one-quarter of the state’s registered nurses were educated in other states, and the remaining nurses (18 percent) were educated in other countries—such as Canada and the Philippines. About 8 percent of nurses are employed by staffing agencies that provide nurses to service providers on a temporary basis. In 2004, over 90 percent of surveyed nurses reported working 9 or more hours per day, with one-third of nurses regularly working 12-hour shifts. Finally, students that already hold a bachelor’s or higher degree in a non-nursing field are eligible to apply for an entry-level master’s (ELM) program at a university.
The mismatch between potential students and actual slots applies to all types of nursing programs in the state, including the ADN, BSN, and ELM programs. The students with the top overall scores are admitted to the program in accordance with the number of available first-year slots. As discussed above, the community colleges do not select from among eligible students based strictly on merit criteria.
In addition, community colleges must offer basic skills courses (such as English-as-a-second-language instruction and elementary mathematics) to help applicants achieve minimum eligibility requirements.
These augmentations include both one-time and ongoing appropriations, and fund both undergraduate and graduate enrollment. Taking into account these projected demographic changes, several recent studies have attempted to estimate the demand for registered nurses in future years.
This acts as a fiscal disincentive for segments to increase nursing enrollment slots more rapidly than the funded growth rate for overall programs. The result is an increasingly complicated and confusing set of expectations with regard to nursing enrollment. This provision can influence campus decisions to expand nursing programs, because about one-third of nursing faculty works part time at the college.
Unless new facilities are constructed, they contend it will be increasingly difficult to accommodate additional nursing students. Other students may have the necessary skills but need to work full time to support themselves, making it difficult to devote sufficient time to their studies. As a result of the lottery process, some of the most prepared applicants are not selected, while many lesser-prepared students are admitted.
The purpose of SNAPLE is to recruit faculty to educate the increasing number of students in state-supported nursing programs.
If, for example, the Legislature increased the number of awards by 50, it would cost about $1.2 million. We also note that hiring and retaining faculty is greatly affected by the salaries and benefits that campuses offer. An increase in part-time programs, for example, could give students that work more time to devote to their studies. Alternatively, nursing programs could receive a completion bonus by reducing attrition rates.
We believe that this approach, in combination with other measures such as a completion bonus and the new diagnostic assessment test (discussed earlier), would help to reduce attrition and increase the number of nurses.
These recommendations include offering bonus funding to nursing programs that increase completion rates, and amending statute to allow for merit-based admissions policies. Health issues in these patients include respiratory problems, gastrointestinal disorders, challenging behaviors, and neurologic conditions.
Maintaining continuity of care and a complete record of all medical interventions is vital. These conditions may be caused by an innate predisposition, but medical causes or medication side effects should be considered. Counseling and psychotherapy should be considered for persons with mild to moderate mental retardation.56 Except for short-term intervention in patients determined to be potentially harmful to themselves or others, medications should not be used to restrict behaviors.
Nursing informatics is for anyone who wants to combine the love of technology and nursing for one amazing career.
One-quarter of nurses work at least some mandatory overtime, with the average amount of their mandatory overtime totaling about six hours per week.
Generally, students in an ELM program complete educational requirements for a registered-nurse license in about 18 months, then continue for another 18 months to obtain a master’s degree in nursing.
For example, the 40 highest-ranking applicants would be admitted into a program with space for 40 nursing students.
The regulations require nursing programs to adopt nonevaluative selection methods when there are more eligible applicants than enrollment slots.
Most recently, the 2006-07 Budget Act provides support for a number of nursing program expansions, as shown in Figure 5. The attrition rate for the community colleges is much higher than that of UC and CSU nursing students (about 7 percent).
The California Employment Development Department, for example, projects that the state will need approximately 240,000 FTE registered nurses by 2014. We think a more reasonable assumption is that capacity will continue to increase throughout the forecast period. Generally, the segments themselves make decisions about how the new enrollment slots will be distributed among the programs they judge to require expansion. Given that a registered nurse can often earn a higher salary in the medical field than at a community college, many colleges are finding it harder to hire full-time nursing faculty than part-time nursing faculty.
For example, according to BRN, only 23 of the 70 CCC nursing programs offer evening courses.
A year-round program could allow other students to graduate sooner than they would otherwise. The fiscal impact of a completion bonus for the community colleges would depend on the size of the bonus and growth in the number of completions from nursing programs, but would likely be only a small portion of projected new Proposition 98 funds.
Taken together, we believe that these measures would result in a significant increase to the state’s supply of registered nurses, and address concerns about the adequacy of the size of the nursing workforce.
Some commonly overlooked health concerns are sexuality, sexually transmitted diseases, and end-of-life decisions. Besides providing direct care, nurses with a master’s degree often serve as educators, researchers, and administrators. Approved methods include randomly selecting students and selecting students based on a “first-come, first-served” basis.
In the next three years, we expect to see a significant year-to-year increase in graduations (approximately 10 percent annually) as students occupying enrollment slots that were created as a result of recent funding increases graduate from a nursing program. The inclusion of the latter requirement would ensure that programs do not lower their academic standards to obtain bonus funding.
For example, a per-student bonus of $5,000 paid on an increase of 500 additional registered nurses per year (about 10 percent more than current levels) would cost $2.5 million annually. Furthermore, accurate data collection by caregivers is crucial in identifying disorders, monitoring treatment response, and documenting behavioral problems.Routine periodic health screening should be offered to patients with mental retardation as it is for other adults.
In future years, even without any further specific policy actions by the Legislature, we would expect future nursing enrollment to grow on the natural with overall enrollment growth at institutions—which is generally around 2 percent annually. Recipients of these bonuses would have flexibility to spend the funds in whatever way they felt would increase nursing completions.
Under an alternative approach, a reduction in attrition from 25 percent to 15 percent from a cohort of 6,000 students would yield 600 additional graduations.
A University of California—San Francisco (UCSF) study conducted for BRN in 2005 forecast a statewide demand of between 241,000 and 257,000 FTE registered nurses by 2014. This might include additional support services, which research has shown can be an effective tool for improving student success.
If these forecasts are accurate, the state will need a net increase of more than 40,000 FTE registered nurses within the next decade in order to meet projected demand. Regardless of the Legislature’s preferred approach, we recommend that additional funding be provided for a limited time period (such as five years). This would give the Legislature an opportunity to assess the impact of the program and reassess the continued need for such an incentive program based on the labor market for registered nurses at that time.



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