The Connecticut League for Nursing’s Council of Deans & Directors Supports that National Policy Brief and Highlights below how our Colleges and Universities can Partner with Practice Settings to Support a Robust and Safe Nursing Workforce during the COVID-9 Crisis and Aftermath.
Purpose
This policy brief is a collaborative effort of nursing leaders who propose & support academic/practice partnerships between health care facilities and pre-licensure registered nursing (RN) and practical/vocational nursing (PN/VN) programs across the country during the COVID-19 crisis. This is one potential model to consider. It is not mandated, rather an innovative approach to meeting academic and workforce needs.

• The proposed model requires cautious evaluation at the local level with a clear understanding that:
  The participation of student nurses and faculty is voluntary and must comply with any additional requirements mandated in state emergency response provisions or through existing Occupational Safety and Health Administration (OSHA) requirements;
• The safety for all front-line providers of services across multiple points of care must be safeguarded through appropriate and prevailing infection control practices

Context
COVID-19 is a virus affecting the entire world. To date, thousands of people in the U.S. have tested positive for the disease, and it is anticipated that many more will be affected in the near future. After observing the pattern of the virus, the U.S. anticipates an overabundance of patients inundating hospitals and possibly overwhelming the entire U.S. healthcare system.

• A significant demand is being placed on the entire nursing workforce, and this is anticipated to increase at an alarming rate.
• Simultaneously, the pandemic has affected pre-licensure RN and PN/VN nursing students across the country. Clinical experiences with patients are an essential part of every nursing program curriculum and are mandated by the State Boards of Nursing for licensure. Many hospitals and health care facilities have determined that pre-licensure RN and PN/VN nursing students should not be in contact with patients and have discontinued student clinical experiences in their facility. Without this valuable experience, all nursing students will have a deficit in their education, are unable to meet their program requirements and will not be eligible for graduation at a time when RNs and PN/VNs are needed in the healthcare.

Proposal
Health care facilities and nursing education programs are encouraged to partner during the COVID-19 crisis.
CLN’s Response:
For the past 12 months the leadership of the Schools & Program of Nursing and of Acute Care practice Settings in Connecticut have been actively engaged in work to address:

• Promoting and Empowering Bedside Nursing
• Models to Embed Resources for Clinical Instruction
• Graduate Education & Counseling for Professional Development and
• Better understand the Nursing Workforce Demographics through EDUCATION, SUPPLY and DEMAND survey results- In January 2020, a Full Proposal was sent by the CT Center for Nursing Workforce, Inc. to the Dept. of Labor and in March 2020 to the Governor’s Office to fund these comprehensive Data Collection, Analysis, and Dissemination initiatives so that proactive nursing and healthcare workforce planning can be a top priority for the state to build a robust and sustainable nursing and healthcare workforce in Connecticut.

Workgroups have produced and disseminated white papers, partnership models and publications to all of the Chief Nursing Officers, Professional Development Nurse Educators, Deans & Directors and Faculty showcasing models to support a robust and sustainable nursing workforce in Connecticut. Among these options proposing solutions to enhance the Connecticut nursing workforce, the Council of Deans & Directors have proposed models as how nursing students directly supervised by nursing faculty can be utilized to support the COVID-19 response efforts.

Pre-licensure RN students from diploma, associate degree and baccalaureate degree nursing programs and PN/VN students from certificate nursing programs could augment and support nursing services in health care facilities.
CLN’s Response:
Propose that our pre-licensure nursing students and associated faculty from our Schools/Programs of Nursing augment the nursing workforce within healthcare facilities in the following areas:

• Increasing the number of Nurse Technicians or Nursing Assistants within the workforce with Sophomore, Junior and Senior level students using educationally sound approaches (see attached for an example of a model of engagement- Fairfield Univ.)
• Increasing the number of Graduate Nurses (GNs) (academically prepared, yet not licensed) within the workforce with newly graduating students in light of balancing the remainder of their nursing education and need to study for the National Licensing Exam (NCLEX), and
• Increasing the number of licensed Registered Nurses in the workforce by working with nurses re-entering practice via CLN’s 100% Online RN Refresher Course to support new hires into the practice settings.

Nursing students would be employed by the facility on a full- or part-time basis and work in the role of a student nurse for compensation and, in conjunction with the student’s nursing education program, would receive academic credit toward meeting clinical requirements.

• Programs would be developed in collaboration with academic and practice partners
• Nursing faculty must be engaged to supervise the work of the students’ in these programs if credit is awarded for this work

Nursing students would be required to be enrolled in a State Board of Nursing approved (or its equivalent) RN or PN/VN pre-licensure program.
CLN’s Response:
Connecticut practice settings would dictate the employment relationship directly with the pre-licensure student, and the awarding of academic credit for such experiences (Capstone’s) would be decided upon by each academic institution in alignment with current University/College policies and practices.
Moreover, NOT all students may choose to engage in these academic/employment opportunities as their participation is NOT mandatory.

Benefits:
This opportunity will not only provide much needed clinical education to assist in meeting program requirements, it is an unparalleled opportunity for nursing students to assist the nation in a time of crisis and learn the principles of population health and emergency management. This academic-practice model demonstrates that in the midst of a periling disruption in the environment, such as COVID-19, continuous innovation can occur.


Policy Recommendations:
1. Health care facilities and nursing programs are encouraged to promulgate plans to take advantage of this opportunity and make every effort to reach out to eligible nursing students and inform them of the opportunity.
CLN’s Response:
Practice Setting will share opportunities with the CT Nurses’ Association, CT Center for Nursing Workforce & CT League for Nursing- RN Student Day Attendees if registered directly with CLN, CT Center for Nursing Workforce to promote; and via their organization’s website, social media, and other communication platforms.
2. Health care facilities and nursing programs are encouraged to collaborate to identify ways to accomplish appropriate faculty supervision of the nursing student-employee to achieve the final learning outcomes of the nursing program. For example,
CLN’s Response:
Options for Engagement & Collaboration:

• The healthcare facility hires the Nursing Program Faculty to oversee the nursing student/employee
• The Nurse Program Faculty holds a joint appointment between the School and the health care facility
• The health care facility provides Preceptors to oversee the nursing student/employee with Nursing Program Faculty oversight in accordance with established CT regulation.

The above examples illustrate a few ways in which the Connecticut School & Programs of Nursing can support growth and development of the incumbent:

• Nursing faculty can oversee the employee who is a current nursing student to ensure competence, confidence and safety in performing Nurse Tech tasks,
• Nursing faculty can engage in a joint appointment to oversee and support employed Graduate Nurses to ensure competence, confidence and safety in the role of a new nurse,
• Nurse faculty can act as a supervisor to practice nurse preceptors to ensure educational best-practices are applied to the newly licensed RN Residency and Onboarding experiences, and
• Nurse faculty can act as an extension of the practice-based nursing education departments servicing the entry level, experienced nurse and advanced practice nurse with safe and quality care.

3. Nursing program leaders/faculty are encouraged to work with health care facility representatives to align clinical skills and competencies with the nursing student-employee work role/responsibilities.
CLN’s Response:
CT’s Schools and Programs of Nursing utilize the Massachusetts Nurse of the Future Core Competencies (MA DOE, 2016) in their curriculum design as well as other best-practice competency models including QSEN.


4. Nursing student-employees must have planned clinical practice experiences that enable the students to attain new knowledge and demonstrate achievement of the final learning outcomes of the nursing program.
CLN’s Response:
The Schools and Programs of Nursing have compiled best-practices, virtual experiences, and simulation that have been distributed to all faculty to ensure that program objectives and outcomes will be met at the end of the final year of study and program completion. As Simulation is an everchanging modality for nursing education, it is imperative that Connecticut Colleges/Universities have the needed resources to ensure program excellence. Through the Healthcare Simulation Network of CT (HSNCT) supported by the Connecticut League for Nursing, leaders of the Simulation Centers can best identify and recommend the critical resources for a robust Simulated Learning experiences that will meet program outcomes at all level.


5. Nursing programs should consult with their State Board of Nursing to ensure clinical requirement regulations would be met with this opportunity and experience.
CLN’s Response:
Through the Council of Deans & Directors, the CT SBEN approved a motion during the March 18, 2020 Nursing Board meeting to approve the use of alternative clinical experiences for nursing students of advanced standing.
6. Nursing programs are responsible for informing nursing students of the risks and responsibilities associated with working in a healthcare facility at this time. Additionally, nursing programs are responsible for communicating with students about their rights to be protected from infection and their options for completing the clinical practice requirements of the nursing program.
CLN’s Response:
Schools and Program of Nursing will not be soliciting students directly to participate in these voluntary work experiences.
Endorsement by National Nursing Organizations and Associations:

• National Council of State Boards of Nursing (NCSBN)
• National League for Nursing (NLN)
• American Organization of Nursing Leadership (AONL)
• Accreditation Commission for Education in Nursing, Inc (ACEN)
• Organization for Associate Degree Nursing (OADN)
• NLN Commission for Nursing Education Accreditation (CNEA)
• American Association of Colleges of Nursing (AACN)
• Commission on Collegiate Nursing Education (CCNE)
• National Student Nurses' Association (NSNA)
• American Nurses Association (ANA)

Dear Colleagues in Nursing,

The CLN Council of Deans and Directors had a strong and productive academic year. The Council, which is comprised of deans, directors and chairs from schools of nursing in the State of Connecticut representing all entries into nursing practice: LPN, Associate, Baccalaureate, LPN - RN, RN - BSN, Master’s and Doctoral levels, began the year engaging with our new meeting structure. We continued to meet regularly as a council of Deans and Directors, collecting and disseminating information on current issues and concerns that affect nursing education, nursing practice and health care in our state. Built on prior year relationship-building, this year we expanded our meeting schedule to include statewide nurse educators four times a year and the Chief Nursing Officers (CNOs).  This allowed the opportunity to expand our influence to ensure a robust nursing workforce for the state. 

• We conducted three joint meetings with the CHA educator group to facilitate dialog on common issues that affect both groups. From theses collaborative efforts, additional joint work groups were identified. These work groups focused on the following three issues: 1) why nurses are leaving the bedside, 2) what graduate education is available in the state and 3) create options for an innovative joint role utilizing both academia and practice settings. Each work group completed a comprehensive set of meetings and submitted recommendations to the larger group of nurse educators which were finalized on March 2, 2020. 

• The council, in fulfillment of our goal to establish stronger relationships with the CNO’s in the healthcare facilities, met with this group on June 18, 2019 and February 11, 2020. The product of the workgroups was shared to the great acceptance and enthusiasm of the CNOs.  A June 16, 2020 follow-up meeting is scheduled.

• The collaboration with CLN Leadership and the Connecticut Department of Public Health to implement, analyze and report out information gathered via the national minimum dataset for Education was conducted again this year. This dataset continues to capture both demographics for nursing faculty and students within the pre-licensure nursing pipelines, as well as, measures program capacities, enrollments, attrition and graduation rates.

• Continued to support CLN’s Healthcare Simulation Network of Connecticut (HSNCT) to develop and expand expertise and capabilities of our simulated teaching and learning directors, faculty and staff that will enhance our curriculum and student outcomes.

• The Council continues to support and promote CLN’s collaborative on- the-ground and online educational opportunities.  A special thank you to the faculty who developed and are teaching these courses to provide valuable educational opportunities for nurses across our state and nation:

• The Online Clinical Faculty Course since its inception has educated over 300 nurses from Connecticut and around the country. This Course is offered four times throughout the year.  Participants have provided very positive feedback about the Course and its content.

• The RN Refresher Course has been approved by several State Boards of Nursing, and the content has been approved by the ANCC for a total of 90 CEs for completion of the four modules.  This Course is offered four times throughout the year. 

• Standing items on the Council’s agenda such as educational initiatives from CLN, policy issues from CNA and updates from the Department of Public Health continue to be monitored and acted upon.

• Importantly, Deans and Directors mobilized collaborative efforts through the use of twice-weekly conference calls and email communication at the onset of the COVID-19 Pandemic. We organized six (6) work groups, to address the myriad of issues brought about by COVID-19 to continue educating nursing students and ensure a robust nursing workforce for the state. 
  • Communication with the Board of Nurse Examiners (BOEN)
  • Academic Progression Policies
  • Workforce Evaluation
  • Transition to Practice issues
  • APRN Clinical Experiences
  • Summer Clinical Experiences for RN and LPN students

​As a collaborative group of nurse educators, the CLN Council of Deans & Directors commenced quickly and effectively to ensure quality throughout the academic year and continuity throughout this pandemic.  These efforts were built on a strong foundation of trust, collegiality and a shared mission to ensure quality nursing care for the State of Connecticut.  We wish to thank Marcia Proto for her many years of service to this organization, and the entire staff of CLN for their dedication and unwavering support to nursing education across the state of Connecticut and beyond!

Respectfully submitted,
CLN Council Co-Chairs
Meredith Wallace Kazer, PhD, APRN, FAAN, Fairfield University Egan School      
Janice Watts, MSN, RN, Goodwin University

The Finance Committee membership is comprised of the Officers (President, President-Elect, Secretary, and Treasurer) and the two appointed members of the Board who make up the membership of the Executive Committee.

It is the responsibility of the Finance Committee to monitor the monthly income and expenditures and recommend to the Board yearly budgets and long-term financial plans for the organization. The committee met and approved a budget for the next fiscal year, July 1, 2020 to June 30, 2021 which was presented to the full Board and approved in May 2020.  The budget will be presented to the general CLN membership at the Annual Meeting on June 23, 2020.

Overall, for the fiscal year ending June 30, 2020, CLN has remained financially sound with positive cash flow to meet ongoing expenses to operate the CLN office and meet program plan needs.  Required financial documents (Federal 990 report) was placed on extension, were prepared and submitted on behalf of CLN by Seward & Monde, Certified Public Accountants, December 19, 2019 to meet federal filing requirements. 

Moreover, in light of the COVID-19 pandemic, the CLN in March 2020 applied for and received grant funding from the two federal Small Business Administration opportunities including:

• The Disaster Relief Fund, and
• The Payroll Protection Program 

Respectfully submitted,
Sheila

​Sheila B. Solernou, MSN, RN
Treasurer & Chair of the Finance Committee

Healthcare Simulation Network of Connecticut (HSNCT)
The Healthcare Simulation Network of Connecticut (HSNCT) is a group of healthcare simulation administrators, educators, and staff dedicated to providing resources, professional development, and networking opportunities in the field of healthcare simulation throughout the State of Connecticut. The mission of the network is to enhance the use of simulation and fully integrate it into academic curricula and assessment of healthcare competencies.

The HSNCT began in 2013 and meetings are hosted quarterly at various healthcare/academic locations across Connecticut.  The network continues to grow and provides opportunities for members to collaborate, share knowledge of simulation design, development, implementation, and evaluation strategies, and encourage continued innovation in the way we educate our future healthcare professionals.

In response to member needs during the 2019-2020 academic year, the HSNCT addressed the following topics through presentations and round table discussion: guiding simulation programs in developing a mission and vision statement and a policy manual following the Society for Simulation in Healthcare’s Accreditation Standards 2016; Oxford Medical Simulation Virtual Reality Presentation; developing an escape room. Participation and attendance were comprised of healthcare educators with various levels of expertise in simulation. The plan for the last meeting of the academic year was a four-hour workshop presented by Avkin on simulated participants (patient actors). However, this was canceled due to the Covid-19 pandemic. It is our plan to reschedule this presentation in the 2020-21 academic year.

To celebrate Healthcare Simulation Week 2019 sponsored by the Society for Simulation in Health, HSNCT created a CPR simulation and a Safety in the Home simulation. These were dispersed to the membership for use in their institutions to celebrate the week. The simulations could be modified as to the needs of each institution. Members were asked to share how their institution celebrated Healthcare Simulation Week 2019 at the September meeting.

The HSNCT initiatives for 2020-2021 will be guided by member needs and feedback gathered from our members and, will focus on building simulation best practices and promoting sustainability for simulation programs.
Membership in the network is open to those healthcare professionals involved in simulation teaching and learning within academia, practice and other organizations committed to excellence in Simulation. 

Respectfully submitted,

Co-Chairs:
Rose DeSiena, M.Ed., RN, CHSE, Simulation Coordinator, Southern Connecticut State University
Joan K. Graham, DNP, RN, CNE, CHSE, Professor of Nursing, Three Rivers Community College

Secretary:
Darlene Rogers, BSN, RN, Quinnipiac University

The Program Committee and the ANCC Accredited Provider Unit has supported the following initiatives on behalf of selected populations within the nursing community over the past fiscal year, some with CLN ANCC accredited contact hours and others without.
Accreditation

• Submitted the application for renewal of our Approved Provider Status to CNA on October 15th, 2019 and were approved for another three years from January 2020 to January 2023.

• Submitted the required annual report of all our programs on February 15, 2020. It was accepted with no need to provide additional evidence and received positive feedback in regard to the following: quality of the report; good schedule of activities that continue to meet the needs of our target audience; great registrations – 200 participants; excellent QI examples; great assessment of the provider unit.

39th Annual RN Student Day (No contact hours awarded)
CLN celebrated 39 years of its sponsorship of the all-day Annual RN Student Day on November 6, 2019 at the Aqua Turf Club in Plantsville, CT.  This program is a service to students and does not offer contact hours.  The theme for this event was “Transforming Your Dreams to Reality – Getting, Keeping, and Loving the Job” with Judith Herrman, PhD, RN, ANEF, FAAN, as keynote speaker.  Over 850 students and faculty, and 42 exhibitors were in attendance.  During the day students interacted with representatives of multiple employing agencies and other vendors.  Peer Recognition Awards are presented to one student from each of the nursing programs in the state.  This award, established by CLN, recognizes one outstanding senior nursing student from each member school or program.  New this year, a free 2-hour Suicide Prevention workshop was presented for faculty attendees and other CLN members during Student Day.  Contact hours were presented by the presenter Robert Havens addressing the QPR Strategy of suicide prevention (Question, Persuade, Refer – three simple steps that gatekeepers can learn to help save a life from suicide).

We extend our grateful thanks to the Sponsors of the 2019 RN Student Day: Charter Oak State College, Employers Reference Source, Inc., Fairfield University Egan School, Quinnipiac University School of Nursing, Sacred Heart University College of Nursing, Sacred Heart University Online Nursing Programs, Southern CT State University, Southern New Hampshire University, SUNY Delhi, University of Bridgeport School of Nursing, and UCONN School of Nursing.

On-the-Ground Workshops (ANCC contact hours for continuing education)
The program committee and the CLN ANCC Accredited Provider Unit offer workshops annually to address the high priority needs of the nursing educator community in the state as identified in a formal needs assessment.   Two programs were conducted in this fiscal year.

The first of these workshops titled “Innovations in Nursing Education” was offered on November 7, 2019 at Naugatuck Valley Community College for 4.0 contact hours, with 32 participants in attendance.
The workshop facilitators and topics included:

• Judy Herrman, PhD, RN, ANEF, FAAN, Professor Emerita/Adjunct Professor, University of Delaware  Engaging Millennials and Multi-generations in Active Learning; and How Best to Apply these Strategies in the Classroom & Lessons Learned; Innovation in Education for all Settings
• Tekisha Everette, PhD, Executive Director, Health Equity Solutions     Positioning Education with the LENS of Cultural Humility
• Sheila Molony, PhD, RN, APRN, FGSA, FAAN, Quinnipiac University School of Nursing    Gaming as a Creative Teaching Strategies in Academe
• Melissa Dibble, MSN, RN-BC, CAPA, Clinical Education Specialist, CT Children’s Medical Center  Experiential Creative Teaching Strategies in Practice

The participant responses were overwhelmingly positive for the speakers, regarding both their personal learning outcomes and positive reports of their intent to apply at least one of their new insights gained in the workshop in their educational practice.

As an alternate way of addressing the learning needs of its membership, CLN was a sponsor of the Gustin Conference presented by The Hospital for Special Care held on October 21, 2019 at Central Connecticut State University.  Karen Drenkard, PhD, RN, NEA-BC, FAAN, Senior Vice President, Chief Clinical and Nursing Officer at Get Well Network, Bethesda, MD was the Keynote speaker addressing the topic “Patient and Family Engagement”.  CLN provided 10 free registrations to CLN members with contact hours provided by The Hospital for Special Care.

A 3-hour workshop titled “Innovative Online Teaching Strategies” with Susan Deane, PhD, RN, CNE, was planned for the spring but was cancelled due to the Covid-19 restrictions.  It will be scheduled at a later date when possible.

CLN Continuing Education Online Courses (ANCC contact hours for continuing education)
The all-virtual, four-module 17-week “RN Refresher Course” was offered 6 times this past fiscal year by the CLN ANCC Approved Provider unit and awards (90) Contact Hours for the successful completion of the four modules. The enrollment in module one over this period was 73, a significant increase from any previous year.  The students come from a variety of states including California, Connecticut, Ohio, Rhode Island, South Carolina, Tennessee and Virginia. They learned of the course through their respective state boards, the local CLN affiliate, word-of-mouth or in an online search. The course continues to be highly rated by the participants and will continue to be offered at least four times a year.  Currently the course faculty are engaged in a continuing effort to review and update the content and format of the course.

RN Re-Entry Boot Camp (NEW Course Offered in May 2020)
In response to the COVID-19 pandemic and need to support nurses to re-enter the practice setting, a NEW RN Re-Entry Course was designed and implemented.  This “8-Week RN Re-Entry Boot Camp” is based off of our
successful Flagship 17-Week RN Refresher Course and upon completion by the nurse will award (70) Contact Hours.

This faculty led course will transition fully prepared nurses into the hospital setting in a medical/surgical capacity as the COVID-19 pandemic wains to backfill the staffing crisis due to "nurse fatigue" that is now occurring within our practice settings as well as will be evident over the years to come.
The 100% online Boot Camp supports licensed nurses with previous Acute Care, Long-Term Care, or Community/Home Care experience who have been out of the nursing workforce for LESS than 10 years and have an ACTIVE RN license to re-enter the workforce.

The 3-week “Clinical Faculty Course” was first launched for nurse educators in March 2014 and was offered 3 times this past fiscal year by the CLN ANCC Provider Unit.  Thirty (30) Contact Hours are awarded to the participant based on successful completion of the Course.  There were 45 participants and the Students came from a variety of states including Connecticut, Indiana, Ohio and Massachusetts. They learned of the course through our CT Schools of Nursing, CLN affiliates, word-of-mouth, or an online search. The evaluations continue to be outstanding and nursing faculty have written:

“Wonderful course for clinical instructors to learn and apply techniques to current clinical practice. At first, I was leery of its benefits to me as a practicing clinical instructor with a Master's in Nursing education. I have been pleasantly surprised and grateful for the opportunity to participate in this rich learning environment.”
“This was a very informative course for the novice clinical faculty. Having no experience instructing in the clinical setting, I found the text and supplemental documents valuable in my learning. I now have an increased level of confidence to perform effectively in my future role. I would recommend the course to all graduating MSN students planning on becoming clinical instructors.”

The course will continue to be offered at least 3 - 4 times per year or more frequently as needed.  A follow-up study of the participants and their employers was planned for the spring but was postponed due to Covid-19 restrictions.

Credit Course Offered in Partnership with Charter Oak State College
The online 3-credit “LPN to RN Articulation Bridge Course” that is part of the statewide articulation program, was offered collaboratively by CLN and Charter Oak State College once this year in Spring 2020 with 55 students enrolled from the associate degree programs in the state. The enrollment in the Summer 2020 “fast track” session which started in late May 2020 has 13 students.  These LPN students will be the first cohort to enter the course with the revised content of the Concept-Based Curriculum used by some of the participating schools.[JM1] 

We extend our sincere appreciation to all the members of the Program Committee for their dedicated support of CLN’s programming initiatives.  Their efforts have been a key ingredient in the success of the programming this year, and the planning of initiatives for the years ahead. 

Respectfully submitted,
Program Committee Co-Chairs
Jane E. Murdock, EdD, MSN           Kathy Murphy, EdD, MSN, RN, CHSE

​Program Committee Members:  Beth Boyd, Carol DeGennaro, Ann-Marie Evans, Kim Foito, Mary Joan Forstbauer, Miosotis Garcia, Ginger Goddu, Marlene Hageman, Linda Kapinos, Peggy Mallick, Susan McGinnis, Jane Murdock, Kathy Murphy, Katie Olive, Marcia Proto, Deb Tetreault, Jeanne Thomas, Alicia Zupan, Jillian Zupan.