Executive Order creates pathways for Nurse, CNA graduation

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Temporary Regulatory Changes Smooth Nurse, CNA Pathways to Graduation During COVID-19 Healthcare Crisis

Dear Board of Nursing stakeholders:

Governor Jared Polis issued Executive Order D 2020 038 on April 15, 2020, removing regulatory barriers that will provide nurse and nurse aide students in educational programs throughout Colorado avenues towards spring and summer graduation, while bolstering the ability of nurses and Certified Nurse Aides to enter or remain in the workforce.

Nursing student externs are also granted the ability to continue in paid positions as the state continues to prioritize essential healthcare services in lockstep with state agencies during the ongoing Novel Coronavirus (COVID-19) emergency.

The Department of Regulatory Agencies worked closely with the Governor and his staff to address unintended collateral consequences the COVID-19 state of emergency may have created for the nursing and nurse aide educational programs.

As you likely know, nursing students would have forfeited tuition, and in many cases been unable to enter the workforce in May, without a temporary suspension of Board of Nursing statutes and rules within the next week. Nurse aide students would have either lost their long-term care training positions, or completed their school-based program but would have been unable to enter the workforce.

The Order, effective for at least 30 days, provides the Division of Professions and Occupations authority to promulgate rules to create temporary licenses for nursing graduates who are eligible for licensure except for completing the required examination. This temporary license will allow the new graduate to work under certain conditions until the testing centers open.

We are asking that you share this, and the following, information with impacted nursing and certified nursing aide students so that they may take advantage of new opportunities created by the Order, which will enhance students’ ability to find pathways to licensure and clinical hours.

Here is how the regulatory changes for nursing students will work in practice:

  • The Board of Nursing requires 750 clinical hours for Registered Nursing programs; 400 for Licensed Practical Nurses. Nursing student policy allowed students in a nursing education program to practice in a clinical setting while enrolled. But students were unable to get these clinical hours because facilities – such as hospitals, nursing homes, home health settings, and rehabilitation centers – were closed to students because of dwindling resources, health-related concerns, etc. Graduation is now possible through the Executive Order, which allows for several options. Nurses falling under these exceptions still must pass the written exam to be fully licensed in Colorado.
  1. a)    An expansion past the normal allowance of 50 percent clinical simulation accepted towards clinical hours.b)    Faculty or administrators at academic institutions may deem students competent to graduate with reduced clinical hours, based on a demonstrable skill set established over the course of their nursing education.c)    Students volunteering their time and skills during the pandemic can count these hours towards clinical hours without faculty supervision, allowing them to complete courses which would result in them meeting the requirements for graduation.d)    The Board of Nursing student extern policy allows students that are enrolled in a nursing education program to practice in a clinical setting while enrolled in a paid position for four months. These students may continue working, when normally they would be prohibited once they graduate.
  • First-year students excelling in their clinical work to date can progress to the second year without delay, as these provisions allow them to postpone half of their clinical hours until the fall, or by completing all clinical hours this semester through clinical simulation.
  • Board rules had prohibited the employment of an uncertified graduate of a nurse aide program for longer than four months until passage of the CNA test. Unavailability of the test due to test site closures prompted the Center for Medicare and Medicaid Services (CMS) to recently issue a waiver allowing nurse aides, once graduated, to work beyond 120 days, as long as they were in line to take the test for certification. The suspension of statutes in Colorado makes that possible.
  • Nurse aides may enter the workforce with a temporary certification from the State. The written and skills-based exam must be completed prior to full certification, but will allow these students to enter the workforce.
  • Clinical hours for CNAs may be completed through simulation instead of a face-to-face setting.
  • Nursing students currently in their last semester are authorized to provide volunteer services delegated and supervised by a healthcare professional.

Please visit DORA’s COVID update page for more information. For further inquiries or clarification on the emergency suspension of statutes and rules, please email dpo@state.co.us.


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