WEBVTT 00:00:04.729 --> 00:00:09.680 position:50% align:middle - [Jay] I just want to tell you sort of how this session came about. 00:00:11.104 --> 00:00:16.930 position:50% align:middle We asked you for questions that you'd like the board of directors answered and you, like you did 00:00:16.930 --> 00:00:20.300 position:50% align:middle last year, responded prolifically. 00:00:20.300 --> 00:00:31.934 position:50% align:middle So, a total of 69 individuals submitted questions for the board on a wide range of issues. 00:00:31.934 --> 00:00:37.694 position:50% align:middle Some of the questions covered multiple topics and for the purpose of responding to these various topics, 00:00:37.694 --> 00:00:42.024 position:50% align:middle these have been separated out in themes. 00:00:42.024 --> 00:00:47.324 position:50% align:middle I will be asking members of the board of directors to address them, so thank you all for your contributions 00:00:47.324 --> 00:00:53.704 position:50% align:middle and apologies if we interpreted anything incorrectly. We just had to go with what we thought the 00:00:53.704 --> 00:01:01.957 position:50% align:middle understanding was of what you were wanting us to speak to. 00:01:01.957 --> 00:01:07.267 position:50% align:middle I think we have a slide there that would show 21 topics that have been identified. 00:01:07.267 --> 00:01:13.357 position:50% align:middle We have about 30 minutes to do this, and so I will ask the board of directors as they 00:01:13.357 --> 00:01:21.157 position:50% align:middle respond to...and we have 21 questions or 21 groupings we've come up with, so if we can keep the responses 00:01:21.157 --> 00:01:25.147 position:50% align:middle succinct but provide the information that answers the question. 00:01:25.147 --> 00:01:32.883 position:50% align:middle We'll hope to get through all of it, but if we don't, we will provide the answers to you as follow-up. 00:01:32.883 --> 00:01:38.143 position:50% align:middle So, I am going to ask Sue Tedford to go first. 00:01:38.143 --> 00:01:46.133 position:50% align:middle She has a question related to legislative interference. 00:01:46.133 --> 00:01:49.453 position:50% align:middle The theme, I would say, you could call it the lawmakers. 00:01:49.453 --> 00:01:58.263 position:50% align:middle The question is, "Lawmakers have always played a role in establishing nursing practice scope and discipline. 00:01:58.263 --> 00:02:05.051 position:50% align:middle However, today, it seems the environment with the current nursing workforce shortage and politicization 00:02:05.051 --> 00:02:10.861 position:50% align:middle of healthcare issues, lawmakers are even more eager to propose policy changes 00:02:10.861 --> 00:02:13.701 position:50% align:middle to the status quo. 00:02:13.701 --> 00:02:19.831 position:50% align:middle What role can nursing regulatory bodies play?" 00:02:19.831 --> 00:02:25.471 position:50% align:middle And I just want to, before Sue speaks to that, reference the three individuals that proposed this 00:02:25.471 --> 00:02:30.941 position:50% align:middle question are Patricia Buffon, Ann Vermont, and Linda Young. 00:02:30.941 --> 00:02:32.171 position:50% align:middle So, Sue, take it away. 00:02:33.002 --> 00:02:36.591 position:50% align:middle - [Sue] Thank you, Jay. Is this on? 00:02:36.591 --> 00:02:38.261 position:50% align:middle Okay, good. Okay. 00:02:38.261 --> 00:02:44.031 position:50% align:middle With today's environment out there, it is so important for us as regulators to be involved 00:02:44.031 --> 00:02:49.991 position:50% align:middle in the legislative process to be at the table, to be one of the individuals that the legislators go 00:02:49.991 --> 00:02:52.181 position:50% align:middle to for information. 00:02:52.181 --> 00:02:54.561 position:50% align:middle I've been a nurse for over 40 years. 00:02:54.561 --> 00:02:58.641 position:50% align:middle Ever since I graduated nursing school, I've heard nursing shortage. 00:02:58.641 --> 00:03:02.835 position:50% align:middle It's been a problem, we all know that if you've been around very long. 00:03:02.835 --> 00:03:06.895 position:50% align:middle But one thing with the pandemic, it has brought the nursing shortage to the forefront 00:03:06.895 --> 00:03:08.785 position:50% align:middle of everybody's mind. 00:03:08.785 --> 00:03:13.365 position:50% align:middle Our legislators, non-healthcare people, they're all talking about the nursing shortage, 00:03:13.365 --> 00:03:14.475 position:50% align:middle what are we going to do about it? 00:03:14.475 --> 00:03:16.805 position:50% align:middle How can we fix the problem? 00:03:16.805 --> 00:03:19.535 position:50% align:middle Our legislators are just like us. 00:03:19.535 --> 00:03:25.375 position:50% align:middle We go to a national meeting, somebody talks about some fantastic idea and we go, 00:03:25.375 --> 00:03:27.395 position:50% align:middle "Let's take it back to our state." 00:03:27.395 --> 00:03:31.062 position:50% align:middle Sometimes that's a good idea, sometimes it won't work because our states are 00:03:31.062 --> 00:03:33.062 position:50% align:middle different in the way that we work. 00:03:33.062 --> 00:03:37.852 position:50% align:middle But it's our job as regulators to have a seat at the table and provide the education they need in order 00:03:37.852 --> 00:03:41.512 position:50% align:middle to make good decisions for our state. 00:03:41.512 --> 00:03:44.932 position:50% align:middle Legislators are not an expert on every single topic. 00:03:44.932 --> 00:03:49.772 position:50% align:middle Even if they're in healthcare, they don't know as much as you know. 00:03:49.772 --> 00:03:56.642 position:50% align:middle So, our job is to educate them so that they can make good evidence-based decisions when possible. 00:03:56.642 --> 00:03:59.502 position:50% align:middle Anecdotal information, that's great. 00:03:59.502 --> 00:04:04.183 position:50% align:middle But we need facts, we need statistics, and we heard research this morning, 00:04:04.183 --> 00:04:05.773 position:50% align:middle pull those reports out. 00:04:05.773 --> 00:04:10.203 position:50% align:middle I'm going to take those back and take those to the meetings that I'm sitting at when we're talking 00:04:10.203 --> 00:04:13.513 position:50% align:middle about workforce issues. 00:04:13.513 --> 00:04:17.993 position:50% align:middle Arkansas has tossed around all kinds of these great ideas, "This is going to fix the shortage, 00:04:17.993 --> 00:04:20.003 position:50% align:middle this is going to fix the shortage." 00:04:20.003 --> 00:04:26.573 position:50% align:middle And if some of these ideas are so new, we don't have data to support it'll work or to refute 00:04:26.573 --> 00:04:28.143 position:50% align:middle that it won't work. 00:04:28.143 --> 00:04:32.566 position:50% align:middle So, we have to be there and help them with how to interpret things. 00:04:32.566 --> 00:04:34.706 position:50% align:middle Let me give you an example. 00:04:34.706 --> 00:04:41.946 position:50% align:middle Back in 2018, one of our nursing programs decided they wanted to put a PN program in high school. 00:04:41.946 --> 00:04:47.976 position:50% align:middle It was a pilot project because our rules really did not allow it but we said, "Go for it." 00:04:47.976 --> 00:04:49.226 position:50% align:middle And they did it. 00:04:49.226 --> 00:04:53.746 position:50% align:middle It hasn't been the most successful program as far as number of graduates. 00:04:53.746 --> 00:04:58.656 position:50% align:middle They kind of figured out that high school students want to be high school students. 00:04:58.656 --> 00:05:01.099 position:50% align:middle They don't want to be sitting in class, they don't want to be doing clinicals, 00:05:01.099 --> 00:05:03.464 position:50% align:middle they want to have fun. 00:05:03.464 --> 00:05:07.059 position:50% align:middle The university made some changes in how they did the curriculum. 00:05:07.059 --> 00:05:13.274 position:50% align:middle They still have the program in place and it's working well as far as their pass rates. 00:05:13.274 --> 00:05:14.869 position:50% align:middle Number of graduates is not real high. 00:05:14.869 --> 00:05:18.849 position:50% align:middle So, when our workforce individuals come, one of them is just pro, 00:05:18.849 --> 00:05:23.689 position:50% align:middle "LPN programs in a high school, this is going to fix the pipeline of students." 00:05:23.689 --> 00:05:28.159 position:50% align:middle I'm like, "It's good, but it's not going to really fix the pipeline, 00:05:28.159 --> 00:05:32.269 position:50% align:middle not when you put out such few students." 00:05:32.269 --> 00:05:36.539 position:50% align:middle Another resolution to the nursing shortage I'm hearing is scope of practice. 00:05:36.539 --> 00:05:43.009 position:50% align:middle They're looking at scope of practice all the way from the UAP through the APRN. 00:05:43.009 --> 00:05:49.529 position:50% align:middle It's our job to educate them on what rules are out there on scope of practice, what guides the practice, 00:05:49.529 --> 00:05:54.029 position:50% align:middle what makes them safe, and can they practice to their full scope, 00:05:54.029 --> 00:05:57.789 position:50% align:middle because most individuals are not to their full scope of practice. 00:05:57.789 --> 00:06:03.634 position:50% align:middle Another example from Arkansas was last fall, one of our legislators who was an ER physician 00:06:03.634 --> 00:06:06.664 position:50% align:middle contacted me, which I'm glad we have a good relationship. 00:06:06.664 --> 00:06:11.974 position:50% align:middle He wanted to put legislation out there for scope of practice of the LPN. 00:06:11.974 --> 00:06:18.684 position:50% align:middle So, I provided him with more data than I think he ever wanted to read about scope of practice and I also 00:06:18.684 --> 00:06:24.004 position:50% align:middle explained to him a lot of times, scope of practice is limited by facility policies. 00:06:24.004 --> 00:06:30.910 position:50% align:middle So, we needed to go back to his facility and discuss scope of practice and regulations with his facility 00:06:30.910 --> 00:06:36.010 position:50% align:middle to determine is there a way to increase scope of practice without doing it legislatively. 00:06:36.010 --> 00:06:39.620 position:50% align:middle I never heard back from him, so it worked. 00:06:39.620 --> 00:06:45.580 position:50% align:middle Something else I'm hearing a whole lot about is the instructor-student ratio in clinical is a big barrier 00:06:45.580 --> 00:06:48.150 position:50% align:middle to enrolling students in clinical facilities. 00:06:48.150 --> 00:06:53.710 position:50% align:middle We're keeping universities and the programs for having enough students because we have 00:06:53.710 --> 00:06:55.831 position:50% align:middle these strict ratios. 00:06:55.831 --> 00:07:00.971 position:50% align:middle The Arkansas solution is, "Let the facilities decide what that ratio is." 00:07:00.971 --> 00:07:04.371 position:50% align:middle That gives me so much heartburn because it will be a business decision. 00:07:04.371 --> 00:07:13.251 position:50% align:middle Now, I could see letting a nursing program do the ratio of students to faculty because they know the 00:07:13.251 --> 00:07:19.191 position:50% align:middle competencies of those students and we have to keep patient safety at the forefront. 00:07:19.191 --> 00:07:24.511 position:50% align:middle History shows us that what we've always been doing, it's not working, we're going to have to change of how 00:07:24.511 --> 00:07:26.901 position:50% align:middle we do all parts of the workforce. 00:07:26.901 --> 00:07:32.614 position:50% align:middle Be a part of the decision-making process so that we can ensure that the ideas do not compromise patient safety. 00:07:32.614 --> 00:07:41.304 position:50% align:middle Main things for takeaway, have a seat at the table, provide reliable data, be willing to make change. 00:07:41.304 --> 00:07:45.644 position:50% align:middle We have to change things, so we have to be creative and be willing to change, 00:07:45.644 --> 00:07:49.724 position:50% align:middle and keep patient safety at the forefront of everything that you do. 00:07:50.651 --> 00:07:52.820 position:50% align:middle - Thank you, Sue. - Thank you, Jay. 00:07:58.232 --> 00:08:05.171 position:50% align:middle - Perhaps we can just hold the applause until the end so we get through as many questions as we possibly can. 00:08:05.171 --> 00:08:09.771 position:50% align:middle And, you know, to not confuse the board of directors anymore, I'll go back to the original order so we'll 00:08:09.771 --> 00:08:11.291 position:50% align:middle look at number one. 00:08:11.291 --> 00:08:14.621 position:50% align:middle And the question here has, "How do we balance..." 00:08:14.621 --> 00:08:19.241 position:50% align:middle This is around regulatory reform, "How do we balance public protection with the 00:08:19.241 --> 00:08:23.461 position:50% align:middle ever-growing need to increase the nursing workforce?" 00:08:23.461 --> 00:08:25.811 position:50% align:middle And Lori Scheidt is going to respond to this. 00:08:25.811 --> 00:08:32.602 position:50% align:middle The proposers of the question were Joe Baker, Lisa Emmerich, Mary Fortier, Carol Hawkins-Garcia, 00:08:32.602 --> 00:08:35.172 position:50% align:middle Carrie Olivieri, and Kathy Ship. 00:08:35.172 --> 00:08:36.742 position:50% align:middle So, Lori, if you'll respond, please. 00:08:36.742 --> 00:08:40.842 position:50% align:middle - [Lori S.] Thank you, and I echo a lot of the comments that Sue already made. 00:08:40.842 --> 00:08:45.882 position:50% align:middle But, you know, we all know that we're here for public protection, so we always have to have that hat on and 00:08:45.882 --> 00:08:51.382 position:50% align:middle make sure that anyone we're talking to knows that the hat we're wearing. 00:08:51.382 --> 00:08:55.472 position:50% align:middle I think for National Council, there are already two strategic initiatives pertaining 00:08:55.472 --> 00:08:56.312 position:50% align:middle to that focus. 00:08:56.312 --> 00:09:01.676 position:50% align:middle One is the nursing workforce modeling and incorporating feedback from the membership on a nursing model 00:09:01.676 --> 00:09:02.856 position:50% align:middle for the future. 00:09:02.856 --> 00:09:09.376 position:50% align:middle The other was the sessions that have already been held and work being done about support workers and what 00:09:09.376 --> 00:09:14.476 position:50% align:middle their role is in providing care to patients and clinical ladders. 00:09:14.476 --> 00:09:17.726 position:50% align:middle Beyond that, though, I want to take a step back and say there's 00:09:17.726 --> 00:09:18.973 position:50% align:middle other things we can do. 00:09:18.973 --> 00:09:24.116 position:50% align:middle The data collection piece, so you all know that I'm a big advocate of Nursys 00:09:24.116 --> 00:09:26.386 position:50% align:middle e-Notify for workforce data. 00:09:26.386 --> 00:09:28.217 position:50% align:middle That's very powerful. 00:09:28.217 --> 00:09:34.379 position:50% align:middle If every state would do that and require that nurses enroll and you have that data on the workforce, 00:09:34.379 --> 00:09:36.369 position:50% align:middle that tells a powerful story. 00:09:36.369 --> 00:09:43.469 position:50% align:middle And earlier when the research department was giving results of their excellent research, you know, 00:09:43.469 --> 00:09:46.579 position:50% align:middle they went from four years to two years looking at the nursing workforce. 00:09:46.579 --> 00:09:52.179 position:50% align:middle Imagine if everybody would do that and the power that you would have in that data that's almost real time. 00:09:52.179 --> 00:09:54.139 position:50% align:middle So, that would be very important to do that. 00:09:54.139 --> 00:09:59.439 position:50% align:middle And it would elevate your status as a regulatory authority on the nursing workforce because you would 00:09:59.439 --> 00:10:03.982 position:50% align:middle have good information to come to the table to help make and force some change. 00:10:03.982 --> 00:10:07.512 position:50% align:middle National Council has policy staff, so you need to keep a pulse on what's going 00:10:07.512 --> 00:10:08.912 position:50% align:middle on in the state legislators. 00:10:08.912 --> 00:10:15.202 position:50% align:middle And if you see bills that you think may put the public at risk, don't be afraid to reach out to the excellent 00:10:15.202 --> 00:10:21.452 position:50% align:middle policy staff that can help you maybe get data or navigate some of the language and get you to the 00:10:21.452 --> 00:10:22.902 position:50% align:middle table on that. 00:10:22.902 --> 00:10:27.592 position:50% align:middle The other thing I would say is on a state-based level, if you have the ability to do pilot projects, 00:10:27.592 --> 00:10:31.643 position:50% align:middle some of us do like in the nursing education area, don't be afraid of that as well. 00:10:31.643 --> 00:10:38.643 position:50% align:middle If you can set appropriate guardrails and time-limited pilot projects for innovative nursing education models 00:10:38.643 --> 00:10:46.473 position:50% align:middle and again, I think appropriate guardrails is the important piece where they report out outcomes and then 00:10:46.473 --> 00:10:48.003 position:50% align:middle see if it can work, right? 00:10:48.003 --> 00:10:52.163 position:50% align:middle Because I think one of the things we're faced with is you don't ever want to be seen as a very 00:10:52.163 --> 00:10:54.103 position:50% align:middle rigid regulatory body. 00:10:54.103 --> 00:10:56.383 position:50% align:middle We talk a lot about agility, right? 00:10:56.383 --> 00:10:58.083 position:50% align:middle But you don't want to do that. 00:10:58.083 --> 00:11:05.884 position:50% align:middle So, I think sometimes when I hear people say, "You know, we need data to support things," I'm 00:11:05.884 --> 00:11:09.294 position:50% align:middle cautious about that, that you also need to look at the other side 00:11:09.294 --> 00:11:10.204 position:50% align:middle of the coin. 00:11:10.204 --> 00:11:18.884 position:50% align:middle And are there other things that you can allow appropriately with a safe guardrail that foster 00:11:18.884 --> 00:11:21.494 position:50% align:middle innovation and not be so rigid in your regulations? 00:11:21.494 --> 00:11:25.664 position:50% align:middle And I think, lastly, a couple of other things that we don't pretend to have 00:11:25.664 --> 00:11:30.301 position:50% align:middle all the answers, but if there's...you know, we've talked a lot about Dr. Benton. 00:11:30.301 --> 00:11:34.541 position:50% align:middle And if anything, one of the things he's done, certainly for me and I think for this membership, 00:11:34.541 --> 00:11:41.231 position:50% align:middle is opened our eyes and minds to other international models that I think are very helpful as we 00:11:41.231 --> 00:11:46.611 position:50% align:middle move forward, that we need to not be so rooted in our domestic models. 00:11:46.611 --> 00:11:47.501 position:50% align:middle Thank you. 00:11:47.501 --> 00:11:48.901 position:50% align:middle - Thank you, Lori. 00:11:48.901 --> 00:11:54.371 position:50% align:middle The next theme is artificial intelligence, and the question is, 00:11:54.371 --> 00:12:01.040 position:50% align:middle "What are the significant regulatory implications of AI in the nursing field and its potential effects on the 00:12:01.040 --> 00:12:03.390 position:50% align:middle future of nursing regulation?" 00:12:03.390 --> 00:12:10.170 position:50% align:middle Questions around this theme were submitted by several people, Kristen Benton, Teresa Delahoyde, 00:12:10.170 --> 00:12:16.490 position:50% align:middle Brenda Manzana, Pam Zegafuse, Sheila Bouie, Stephanie Ferguson, and Paula Wilson. 00:12:16.490 --> 00:12:18.580 position:50% align:middle Adrian, would you respond to this, please? 00:12:18.580 --> 00:12:20.950 position:50% align:middle - [Adrian] Sure, I'd be happy to. 00:12:20.950 --> 00:12:25.580 position:50% align:middle Well, I think there's significant regulatory implications that could happen. 00:12:25.580 --> 00:12:30.272 position:50% align:middle But I think it's going to be kind of a multifaceted one, one that both has opportunities 00:12:30.272 --> 00:12:31.902 position:50% align:middle and has challenges. 00:12:31.902 --> 00:12:38.202 position:50% align:middle As you heard yesterday from Dr. Benton, it's a huge area of evolving things, 00:12:38.202 --> 00:12:41.242 position:50% align:middle this is going to impact every facet of our lives. 00:12:41.242 --> 00:12:48.102 position:50% align:middle But I think there's going to be some quick wins in areas where things need to become more efficient, 00:12:48.102 --> 00:12:52.842 position:50% align:middle where your tasks, potentially, you know, scheduling things, freeing up things, 00:12:52.842 --> 00:12:57.172 position:50% align:middle doing things for patient care to make it a little easier for the patients. 00:12:57.172 --> 00:13:01.900 position:50% align:middle It'll be used to help make decision-making with predictive analytics. 00:13:01.900 --> 00:13:08.210 position:50% align:middle I think one of the areas that has a lot of potential is in language translation. 00:13:08.210 --> 00:13:13.280 position:50% align:middle You know, I think of a time where you'll be able to talk to somebody and they'll understand what you're 00:13:13.280 --> 00:13:18.510 position:50% align:middle saying in a reliable manner with AI helping interpret some of that. 00:13:18.510 --> 00:13:20.930 position:50% align:middle As regulators, though, something came to mind. 00:13:20.930 --> 00:13:26.100 position:50% align:middle I'm a big fan of LinkedIn, so I kind of follow different individuals on there. 00:13:26.100 --> 00:13:30.839 position:50% align:middle And in our regulatory roles, there's a gentleman here somewhere, 00:13:30.839 --> 00:13:36.389 position:50% align:middle Kyle Martin from North Dakota, he's figured out how to use some AI in his nursing 00:13:36.389 --> 00:13:43.249 position:50% align:middle board to do some bots to make his processes a little faster for the folks in North Dakota. 00:13:43.249 --> 00:13:47.279 position:50% align:middle And I think those are some big wins, some easy things that we can do as regulators. 00:13:47.279 --> 00:13:52.369 position:50% align:middle But there's always going to be a need for the ethical considerations to make sure that you take out any bias 00:13:52.369 --> 00:13:54.529 position:50% align:middle or anything of that regard. 00:13:54.529 --> 00:13:59.159 position:50% align:middle And then us as regulators need to understand that technology so that when things happen or when nurses 00:13:59.159 --> 00:14:06.450 position:50% align:middle use them out in the field, if the AI is wrong, which is very much a possibility, 00:14:06.450 --> 00:14:12.660 position:50% align:middle what's the implications if the nurse, you know, uses that as the sole source of information? 00:14:12.660 --> 00:14:16.420 position:50% align:middle And then lastly, I'll say that data security is a huge thing. 00:14:16.420 --> 00:14:23.040 position:50% align:middle You know, people are starting to use artificial intelligence to attack one another with speeds that 00:14:23.040 --> 00:14:25.300 position:50% align:middle are just unimaginable. 00:14:25.300 --> 00:14:30.297 position:50% align:middle It will start to break encryption one of these days and things are going to be very difficult. 00:14:30.297 --> 00:14:33.977 position:50% align:middle And so, I think we're going to have to evolve and be ready for those challenges as regulators. 00:14:35.226 --> 00:14:36.427 position:50% align:middle - Thank you, Adrian. 00:14:36.427 --> 00:14:43.017 position:50% align:middle And now on to the next theme, which is diversity, equity, and inclusion, and the questions posed were, 00:14:43.017 --> 00:14:50.087 position:50% align:middle "What strategies can be used to make sure our actions are equitable, embrace inclusion, 00:14:50.087 --> 00:14:52.787 position:50% align:middle and support a diverse workforce?" 00:14:52.787 --> 00:14:58.650 position:50% align:middle And the questions were submitted by Nicole Kaminski, Christine Mula, and Roberta Hill. 00:15:00.223 --> 00:15:02.493 position:50% align:middle And Karen Lyon, I think, is going to respond to this. 00:15:02.493 --> 00:15:03.363 position:50% align:middle Please, Karen. 00:15:03.363 --> 00:15:05.045 position:50% align:middle - [Karen] I'm sorry. 00:15:10.649 --> 00:15:12.287 position:50% align:middle Did you ask me about DEI? 00:15:12.287 --> 00:15:12.991 position:50% align:middle - Yes. 00:15:12.991 --> 00:15:14.633 position:50% align:middle - Is that my question? All right. 00:15:14.633 --> 00:15:18.983 position:50% align:middle That's good because I was looking up a population statistic. 00:15:18.983 --> 00:15:25.933 position:50% align:middle Actually, I don't think that you could have gone to a meeting of NCSBN or probably in most of the states 00:15:25.933 --> 00:15:31.723 position:50% align:middle over the last three years where you didn't hear about diversity, equity, inclusion, and belonging. 00:15:31.723 --> 00:15:39.073 position:50% align:middle We've tried to thread those tenets throughout just about everything we do at NCSBN and it's, of course, 00:15:39.073 --> 00:15:43.183 position:50% align:middle a very important concept for us. 00:15:43.183 --> 00:15:50.423 position:50% align:middle The subject was on the agenda at our 2023 major meeting and we had a lot of discussions around it when we were 00:15:50.423 --> 00:15:55.333 position:50% align:middle in California, all of the executive officers at the summit. 00:15:55.333 --> 00:16:03.461 position:50% align:middle There is an upcoming ICRS DEIB course in the curriculum through the International Center for Regulatory 00:16:03.461 --> 00:16:10.571 position:50% align:middle Scholarship and it's supposed to be launched, I think, in spring of 2024, so I would encourage all of you 00:16:10.571 --> 00:16:11.801 position:50% align:middle to take that. 00:16:11.801 --> 00:16:16.631 position:50% align:middle Just personally, I'm really proud of what we've done in Louisiana. 00:16:16.631 --> 00:16:28.301 position:50% align:middle The overall black population of Louisiana is about 38.4% in 2023 and in my workforce at the Louisiana 00:16:28.301 --> 00:16:33.485 position:50% align:middle State Board of Nursing, I'm just truly proud that more than 50% of our staff 00:16:33.485 --> 00:16:35.245 position:50% align:middle are black men and women. 00:16:35.245 --> 00:16:42.135 position:50% align:middle So, we are working with the Louisiana Action Coalition on doing health summits and our health summit 00:16:42.135 --> 00:16:47.355 position:50% align:middle in October is going to be completely focused on diversity, equity, inclusion, and belonging. 00:16:47.355 --> 00:16:54.085 position:50% align:middle So, I think that both at the state level and at the national level, we're doing a lot with DEIB. 00:16:54.085 --> 00:17:01.295 position:50% align:middle And so, I just encourage you all to keep abreast of what comes out in regards to NCSBN's efforts 00:17:01.295 --> 00:17:03.525 position:50% align:middle in this area. 00:17:03.525 --> 00:17:04.945 position:50% align:middle - Thank you, Karen. 00:17:04.945 --> 00:17:09.865 position:50% align:middle And in a follow-up to the panel we heard earlier, the theme of fraud. 00:17:09.865 --> 00:17:17.615 position:50% align:middle "The fraudulent activities uncovered by Operation Nightingale investigation have caused national alarm. 00:17:17.615 --> 00:17:22.595 position:50% align:middle What is NCSBN doing to help nursing regulatory bodies prevent fraud?" 00:17:22.595 --> 00:17:28.535 position:50% align:middle And this question was submitted by Kristin Benton, Teresa Delahoyde, Brenda Manzana, Pam Zegafuse, 00:17:28.535 --> 00:17:35.784 position:50% align:middle Patricia Bufa, Dawn Gerencer, Janice Hooper, Lee Anne Teshima, and Linda Young. 00:17:35.784 --> 00:17:39.254 position:50% align:middle And, Tony, I would like you to...if you would please respond to this question. 00:17:39.254 --> 00:17:41.009 position:50% align:middle - [Tony] I'd be happy to. 00:17:41.009 --> 00:17:47.054 position:50% align:middle NCSBN has compiled resources from multiple divisions and departments to help the board of nursing address 00:17:47.054 --> 00:17:48.974 position:50% align:middle the Operation Nightingale cases. 00:17:48.974 --> 00:17:54.544 position:50% align:middle There's been a creation of Operation Nightingale member of board notifications in Nursys for those 00:17:54.544 --> 00:17:57.364 position:50% align:middle nurse-licensed records that match the list. 00:17:57.364 --> 00:18:02.402 position:50% align:middle We've created another member board notification to boards that could indicate that they've completed their 00:18:02.402 --> 00:18:06.962 position:50% align:middle review of the particular license that matches the list. 00:18:06.962 --> 00:18:14.652 position:50% align:middle We've implemented an ongoing monitoring process to continuously match nurse-licensed records in Nursys 00:18:14.652 --> 00:18:18.322 position:50% align:middle against the list and apply member board notifications. 00:18:18.322 --> 00:18:23.612 position:50% align:middle We've deployed an automated process for sending information to the Department of Health and 00:18:23.612 --> 00:18:28.942 position:50% align:middle Human Services, Office of the Inspector General, about nurse license discipline due 00:18:28.942 --> 00:18:31.568 position:50% align:middle to Operation Nightingale. 00:18:31.568 --> 00:18:40.678 position:50% align:middle Monthly, we host a discussion call for all of our NRB staff members to share ideas, strategies, 00:18:40.678 --> 00:18:46.998 position:50% align:middle and challenge relations to...all related to Operation Nightingale cases. 00:18:46.998 --> 00:18:54.038 position:50% align:middle We're working with members to ensure that Operation Nightingale cases are correctly reported to Nursys and 00:18:54.038 --> 00:18:56.468 position:50% align:middle to the NPDB. 00:18:56.468 --> 00:19:02.777 position:50% align:middle We're serving as a resource for members to obtain information and guidance regarding best practices 00:19:02.777 --> 00:19:05.587 position:50% align:middle related to Operation Nightingale case reporting. 00:19:05.587 --> 00:19:11.237 position:50% align:middle Also, we've collected and disseminated resources from jurisdictions to provide templates, 00:19:11.237 --> 00:19:15.177 position:50% align:middle examples for other members. 00:19:15.177 --> 00:19:20.487 position:50% align:middle In addition to the other fraud resources that NCSBN has available for members, 00:19:20.487 --> 00:19:25.517 position:50% align:middle we continue to work with boards of nursing, the Federal Bureau of Investigations, 00:19:25.517 --> 00:19:31.409 position:50% align:middle and Health and Human Services Office of Inspector General as Operation Nightingale continues to unfold. 00:19:33.345 --> 00:19:36.099 position:50% align:middle - Thank you, Tony. 00:19:36.099 --> 00:19:39.589 position:50% align:middle Now, we move to questions related to professional protection. 00:19:39.589 --> 00:19:44.849 position:50% align:middle "How do we protect the profession from mission/profession creep 00:19:44.849 --> 00:19:49.179 position:50% align:middle from under-credentialed/non-credentialed entities?" 00:19:49.179 --> 00:19:54.139 position:50% align:middle And the proposer of this question was Sheila Bouie, and Phyllis Johnson is going to respond to this. 00:19:54.139 --> 00:19:54.629 position:50% align:middle Phyllis? 00:19:54.629 --> 00:19:58.079 position:50% align:middle - [Phyllis] Thank you, Madam President. Great question. 00:19:58.079 --> 00:20:07.093 position:50% align:middle As you all know, the pandemic provided opportunities for individuals of all healthcare entities to come 00:20:07.093 --> 00:20:11.603 position:50% align:middle into the profession and work, many of the credentials were waived. 00:20:11.603 --> 00:20:17.773 position:50% align:middle And so, it's easy to become distracted from the public protection mission and I think we should always 00:20:17.773 --> 00:20:26.223 position:50% align:middle remember our public protection mission with concerns about what we call the scope creep by some support 00:20:26.223 --> 00:20:29.323 position:50% align:middle workers that were allowed to work. 00:20:29.323 --> 00:20:33.058 position:50% align:middle During the pandemic, many healthcare workers had to step up and fill 00:20:33.058 --> 00:20:40.298 position:50% align:middle those critical, critical gaps in the system to ensure that patients were cared for during those desperate 00:20:40.298 --> 00:20:42.648 position:50% align:middle and difficult times. 00:20:42.648 --> 00:20:51.588 position:50% align:middle And as the effects of the pandemic start to recede, I think everyone in here that is the board of nursing 00:20:51.588 --> 00:20:59.198 position:50% align:middle could probably raise their hand and reflect on lessons learned from that experience. 00:20:59.198 --> 00:21:04.495 position:50% align:middle So, rather than focusing...because a lot of those requirements now, they were allowed to do things that 00:21:04.495 --> 00:21:11.505 position:50% align:middle they probably would not have been allowed to do and some of those did those things very successfully. 00:21:11.505 --> 00:21:16.145 position:50% align:middle And so, now they want to continue to do things without being properly credentialed. 00:21:16.145 --> 00:21:22.605 position:50% align:middle So, rather than focusing on the negative aspects of an increased scope of practice for certain 00:21:22.605 --> 00:21:28.595 position:50% align:middle support workers, it seems prudent...and I think we heard it in the discussion also 00:21:28.595 --> 00:21:37.592 position:50% align:middle with Dr. Spector's panel, to work with education and practice and regulation 00:21:37.592 --> 00:21:44.172 position:50% align:middle to use an evidence-based approach to identify those areas where support workers could be utilized and 00:21:44.172 --> 00:21:51.712 position:50% align:middle provide additional services to free up those vital nursing resources for tasks that require greater 00:21:51.712 --> 00:21:53.622 position:50% align:middle training and skill. 00:21:53.622 --> 00:21:58.752 position:50% align:middle This includes working with our stakeholders to ensure that the workers have the necessary knowledge, 00:21:58.752 --> 00:22:04.115 position:50% align:middle the skills, and the training to safely perform those services. 00:22:04.115 --> 00:22:09.695 position:50% align:middle And on Monday, we had a focus group and we talked about, NCSBN had a focus group, and talked 00:22:09.695 --> 00:22:15.015 position:50% align:middle about support workers, what can we do collaboratively. 00:22:15.015 --> 00:22:22.916 position:50% align:middle And we've heard that word used consistently throughout this meeting, collaboratively, 00:22:22.916 --> 00:22:25.535 position:50% align:middle how do we all work together? 00:22:25.535 --> 00:22:31.056 position:50% align:middle So, nursing has always been a collaborative profession and it is important, 00:22:31.056 --> 00:22:37.486 position:50% align:middle important to remember that it's going to take everyone working together to meet the healthcare needs 00:22:37.486 --> 00:22:41.517 position:50% align:middle of a growing population. Thank you. 00:22:41.517 --> 00:22:43.226 position:50% align:middle - Thank you, Phyllis. 00:22:43.226 --> 00:22:46.846 position:50% align:middle And moving on to global regulatory entry. 00:22:46.846 --> 00:22:55.458 position:50% align:middle "How can the work of Nursys Canada or NGN be advanced to support global regulatory efforts?" 00:22:55.458 --> 00:23:01.151 position:50% align:middle Tammy Buchholz and David Alfred submitted questions around this topic and I'm going to ask Susan VanBeuge 00:23:01.151 --> 00:23:03.251 position:50% align:middle if you would please respond. 00:23:03.251 --> 00:23:07.108 position:50% align:middle - [Susan] Thank you. First, I'll talk a little bit about Nursys. 00:23:07.108 --> 00:23:14.021 position:50% align:middle The Nursys system was redesigned to allow for needed customization for Canada based on the regulatory 00:23:14.021 --> 00:23:16.231 position:50% align:middle requirements and practice. 00:23:16.231 --> 00:23:21.551 position:50% align:middle This was achieved through multiple configuration settings to make this implementation of the Nursys 00:23:21.551 --> 00:23:30.897 position:50% align:middle system in the different region of the world that was efficient, agile, and responsive to local needs. 00:23:30.897 --> 00:23:37.927 position:50% align:middle This localization of the system requires the regulatory body's data to stay within individual regions, approved 00:23:37.927 --> 00:23:44.417 position:50% align:middle by those geographic restrictions and complies with local data security and privacy laws. 00:23:44.417 --> 00:23:51.551 position:50% align:middle Within the system, there's a common set of application program interfaces, or API, that allows seamless 00:23:51.551 --> 00:23:56.307 position:50% align:middle exchange of public protection and patient safety. 00:23:56.307 --> 00:24:01.707 position:50% align:middle I'm sorry, seamless exchange of public-approved datasets between global regions to enhance public 00:24:01.707 --> 00:24:03.717 position:50% align:middle protection and patient safety. 00:24:03.717 --> 00:24:10.317 position:50% align:middle This cross-border collaboration truly makes the connected regions into a global village. 00:24:10.317 --> 00:24:18.787 position:50% align:middle The public version of each of these global regions implemented in the Nursys system enables that seamless 00:24:18.787 --> 00:24:24.737 position:50% align:middle data flow between Nursys and other health system information databases. 00:24:24.737 --> 00:24:33.148 position:50% align:middle The system allows for dissemination of the NCSBN unique nurse ID number for accurate workforce analytics and 00:24:33.148 --> 00:24:37.718 position:50% align:middle planning and nursing healthcare research, something that we've been talking about for the 00:24:37.718 --> 00:24:39.608 position:50% align:middle last few days. 00:24:39.608 --> 00:24:45.718 position:50% align:middle The implementation of Nursys into different global regions will allow for the engagement with the global 00:24:45.718 --> 00:24:51.528 position:50% align:middle healthcare organizations, policymakers, and regulatory bodies beyond nursing. 00:24:52.026 --> 00:24:59.638 position:50% align:middle We're talking about the Next Generation NCLEX or NGN, it's an enhancement of the previous exam and it 00:24:59.638 --> 00:25:07.918 position:50% align:middle reflects the increasing complexity of care, and NCSBN's commitment to improving public safety. 00:25:07.918 --> 00:25:13.618 position:50% align:middle As you know, new questions were added that are specifically designed to measure a test taker's 00:25:13.618 --> 00:25:20.328 position:50% align:middle clinical judgment ability and includes case studies that depict real-world scenarios to apply clinical 00:25:20.328 --> 00:25:23.348 position:50% align:middle judgment in order to answer the questions correctly. 00:25:23.348 --> 00:25:30.436 position:50% align:middle The exam provides a more precise measurement of the test taker's ability and more fidelity 00:25:30.436 --> 00:25:32.426 position:50% align:middle to measure nurse competence. 00:25:32.426 --> 00:25:39.176 position:50% align:middle While this test does not affect the global regulatory efforts, the addition of clinical judgment measurement 00:25:39.176 --> 00:25:46.226 position:50% align:middle of the NGN provides more fidelity to measurement of nurse competence and could be utilized to enhance many 00:25:46.226 --> 00:25:52.016 position:50% align:middle global regulatory efforts related to readiness to practice. 00:25:52.016 --> 00:25:53.566 position:50% align:middle - Thank you, Susan. 00:25:53.566 --> 00:25:57.956 position:50% align:middle And now to standardization of regulations. 00:25:57.956 --> 00:26:03.638 position:50% align:middle "How can nursing regulatory bodies become more standardized, especially in the areas of education, 00:26:03.638 --> 00:26:06.078 position:50% align:middle discipline, and fraud protection?" 00:26:06.078 --> 00:26:12.728 position:50% align:middle And this question was submitted by Dawn Gerencer, Dwayne Jamison, Aisha Nicks, Roberta Hill, 00:26:12.728 --> 00:26:14.398 position:50% align:middle and Edward Pareo. 00:26:14.398 --> 00:26:17.528 position:50% align:middle And Lori Glenn is going to respond to this. Thank you, Lori. 00:26:17.528 --> 00:26:20.318 position:50% align:middle - [Lori G.] Thank you, Madam President. 00:26:20.318 --> 00:26:26.928 position:50% align:middle So, we had this great panel this morning that showed how we can come to standardization across different 00:26:26.928 --> 00:26:29.328 position:50% align:middle bodies and that's very important. 00:26:29.328 --> 00:26:34.318 position:50% align:middle But remember that the NCSBN does have several resources available to you. 00:26:34.318 --> 00:26:39.568 position:50% align:middle There are evidence-based guidelines for the approval and continued monitoring 00:26:39.568 --> 00:26:42.528 position:50% align:middle of pre-licensure nursing programs. 00:26:42.528 --> 00:26:47.918 position:50% align:middle These resources can help you detect early on if a program is getting into trouble with their 00:26:47.918 --> 00:26:49.738 position:50% align:middle NCLEX pass rates. 00:26:49.738 --> 00:26:54.788 position:50% align:middle And remember, we already heard today about the annual education reports that are available, 00:26:54.788 --> 00:27:00.471 position:50% align:middle and they're a great resource with that data that can be reviewed. 00:27:00.471 --> 00:27:04.871 position:50% align:middle I don't know if anybody remembers that we had the disciplinary decision pathway introduced 00:27:04.871 --> 00:27:06.011 position:50% align:middle in the past year. 00:27:06.011 --> 00:27:11.891 position:50% align:middle It is now called the board action pathway, a fabulous resources in terms of disciplinary 00:27:11.891 --> 00:27:17.291 position:50% align:middle decision-making that is evidence-based and quite a lot of work went into that. 00:27:17.291 --> 00:27:22.541 position:50% align:middle And definitely want to think about having your discipline bodies look at that. 00:27:22.541 --> 00:27:25.681 position:50% align:middle especially our newer members who are making those decisions. 00:27:25.681 --> 00:27:33.069 position:50% align:middle And they use just culture principles applied to those decisions. 00:27:33.069 --> 00:27:36.609 position:50% align:middle Of course, fraud has been a huge topic this morning. 00:27:36.609 --> 00:27:43.809 position:50% align:middle And I'll just touch on the fact that the ICRS does have a foundation fraud prevention course and as we learned 00:27:43.809 --> 00:27:48.489 position:50% align:middle about earlier today, additional guidelines will be coming out and toolkits 00:27:48.489 --> 00:27:53.749 position:50% align:middle to help boards move forward to being more efficient at detecting fraud. 00:27:53.749 --> 00:27:58.529 position:50% align:middle And finally, don't forget the NCSBN has their Model Acts and Rules. 00:27:58.529 --> 00:28:03.778 position:50% align:middle It's always a good idea to go back and look at your own and see how they are reflective of what NCSBN has 00:28:03.778 --> 00:28:11.428 position:50% align:middle recommended with the idea that it is evidence-based and really does help promote standardization 00:28:11.428 --> 00:28:14.898 position:50% align:middle across the country. Thank you. 00:28:14.898 --> 00:28:17.578 position:50% align:middle - Thank you. 00:28:17.578 --> 00:28:25.328 position:50% align:middle Now on the theme of reimagining discipline, "Discipline and remediation consumes a large portion 00:28:25.328 --> 00:28:28.028 position:50% align:middle of the board's time and resources. 00:28:28.028 --> 00:28:33.257 position:50% align:middle And recently, NCSBN has been talking about "reimagined discipline." 00:28:33.257 --> 00:28:40.869 position:50% align:middle What will that look like and how will it help nursing regulatory bodies protect the public?" 00:28:40.869 --> 00:28:46.189 position:50% align:middle Jose Castillo, Catherine Miller, Stephanie Ferguson, Donna Hanley, Roberta Hill, 00:28:46.189 --> 00:28:51.019 position:50% align:middle and Edward Pareo submitted questions related to this. 00:28:51.019 --> 00:28:54.749 position:50% align:middle And Carol, I would ask you if you would please respond to this question. 00:28:54.749 --> 00:28:57.369 position:50% align:middle - [Carol] Thank you very much, Madam President. 00:28:57.369 --> 00:29:02.775 position:50% align:middle So, many of you may...excuse me, many of you may have heard some conversations underway 00:29:02.775 --> 00:29:08.085 position:50% align:middle about reimagining discipline and of course, are curious about what that really means. 00:29:08.085 --> 00:29:13.405 position:50% align:middle How can we reimagine processes that are so legislatively driven? 00:29:13.405 --> 00:29:19.435 position:50% align:middle And it's certainly an area where our respective boards of nursing spend a lot of time as we carry out our 00:29:19.435 --> 00:29:21.565 position:50% align:middle mandate of public protection. 00:29:21.565 --> 00:29:29.135 position:50% align:middle But our overall goal as we regulate the profession in the public interest is to take action that supports 00:29:29.135 --> 00:29:34.506 position:50% align:middle safe practice, remediates nursing practice where possible, and of course, 00:29:34.506 --> 00:29:41.246 position:50% align:middle take more stringent disciplinary actions, if needed, to promote public safety. 00:29:41.246 --> 00:29:48.246 position:50% align:middle But when our boards take disciplinary action, it's really not intended to be punishment. 00:29:48.246 --> 00:29:58.096 position:50% align:middle Through discipline, the goal really is for the nurse to emerge stronger, more insightful about their practice. 00:29:58.096 --> 00:30:05.223 position:50% align:middle We want nurses to engage in self-reflection and to learn from the scenario, to be able to return 00:30:05.223 --> 00:30:13.863 position:50% align:middle to practice having gained new insights, new skills, and actually have learned from the experience. 00:30:13.863 --> 00:30:19.593 position:50% align:middle In some instances, the actions that are taken by boards, actually, when we look back, 00:30:19.593 --> 00:30:25.153 position:50% align:middle probably does little to help the licensee really learn from their mistakes. 00:30:25.153 --> 00:30:32.420 position:50% align:middle Rather, what we're finding out is that the experience of discipline on the nurse ends up being an incredibly 00:30:32.420 --> 00:30:41.250 position:50% align:middle stressful one and can further erode their confidence as a nurse and makes them question their own competence. 00:30:41.250 --> 00:30:46.000 position:50% align:middle It can sometimes be experienced as a penalty, as a punishment, and in fact, 00:30:46.000 --> 00:30:56.480 position:50% align:middle those nurses that ended up being identified on public registers can see this as very stigmatizing. 00:30:56.480 --> 00:31:03.058 position:50% align:middle Sometimes when we look at the environment that nurses are practicing in, I think it's important as we 00:31:03.058 --> 00:31:09.928 position:50% align:middle reimagine discipline to consider more broadly the working conditions that the individual nurse 00:31:09.928 --> 00:31:11.968 position:50% align:middle is practicing in. 00:31:11.968 --> 00:31:18.588 position:50% align:middle Is it that that environment itself could have contributed to the practice concern that came to us 00:31:18.588 --> 00:31:20.958 position:50% align:middle about that individual nurse? 00:31:20.958 --> 00:31:26.688 position:50% align:middle And in reimagining discipline, NCSBN is putting forward that this broader 00:31:26.688 --> 00:31:32.964 position:50% align:middle understanding of the context of practice, the environment, the policy environment that nurses 00:31:32.964 --> 00:31:41.144 position:50% align:middle practice in, is going to be key to building our understanding as regulators and also to inform the 00:31:41.144 --> 00:31:48.584 position:50% align:middle educational pathway that we may recommend as regulators to support that nurse to avoid making a similar 00:31:48.584 --> 00:31:51.784 position:50% align:middle practice error in the future. 00:31:51.784 --> 00:31:58.844 position:50% align:middle In a reimagined disciplinary process, the goal for board actions is to encourage the nurse 00:31:58.844 --> 00:32:05.204 position:50% align:middle to self-reflect and ultimately take accountability for their actions. 00:32:05.204 --> 00:32:09.164 position:50% align:middle The nurse needs to lead in the learning experience. 00:32:09.164 --> 00:32:15.124 position:50% align:middle It can't only be something that as regulators we prescribe or assign, 00:32:15.124 --> 00:32:18.634 position:50% align:middle we want to see the nurse engaged in that learning. 00:32:18.634 --> 00:32:26.414 position:50% align:middle And in remediation, or sometimes known as the recovery process, we want that nurse to actually continue 00:32:26.414 --> 00:32:32.365 position:50% align:middle to learn, reflect, and improve their competencies throughout their nursing career. 00:32:32.365 --> 00:32:37.935 position:50% align:middle We want them to emerge from a disciplinary process...unless it was an egregious action, 00:32:37.935 --> 00:32:43.375 position:50% align:middle we want the nurse to emerge as a more confident nurse. 00:32:43.375 --> 00:32:47.775 position:50% align:middle And this is a process that can also involve peer support. 00:32:47.775 --> 00:32:53.315 position:50% align:middle In those instances where remediation is not the appropriate regulatory action, 00:32:53.315 --> 00:33:00.629 position:50% align:middle the approach can still be strengthened so that it is experienced by both the nurse and the public who has 00:33:00.629 --> 00:33:03.719 position:50% align:middle made the complaint or the employer report. 00:33:03.719 --> 00:33:08.639 position:50% align:middle It's really important that it be timely, that we are agile as regulators, 00:33:08.639 --> 00:33:13.979 position:50% align:middle and ensuring that the process is fair, that it's objective, 00:33:13.979 --> 00:33:22.049 position:50% align:middle that we communicate it clearly to both parties and that no one at the end of this is caused a disproportionate 00:33:22.049 --> 00:33:26.699 position:50% align:middle amount of stress or distress, regardless which party you are 00:33:26.699 --> 00:33:29.299 position:50% align:middle in the disciplinary process. 00:33:29.299 --> 00:33:37.992 position:50% align:middle So, NCSBN in the coming months is going to be developing and sharing with you resources that are 00:33:37.992 --> 00:33:42.902 position:50% align:middle going to talk to you a little bit more about what reimagined discipline can be. 00:33:42.902 --> 00:33:47.532 position:50% align:middle You've heard yesterday about the reference, and I'm sure you're familiar with, 00:33:47.532 --> 00:33:53.512 position:50% align:middle right-touch regulation, so that our regulatory oversight is really commensurate 00:33:53.512 --> 00:33:59.282 position:50% align:middle with the magnitude of the disciplinary concern that has taken place. 00:33:59.282 --> 00:34:03.764 position:50% align:middle We can imagine discipline, and I'm sure many of you already do this, 00:34:03.764 --> 00:34:10.514 position:50% align:middle that considers a compassionate approach, that's built around safe practice, public safety, 00:34:10.514 --> 00:34:16.744 position:50% align:middle and trustworthiness of our profession, and that we are there to uphold the profession in the 00:34:16.744 --> 00:34:19.074 position:50% align:middle best interests of the public. 00:34:19.074 --> 00:34:25.134 position:50% align:middle But that in doing so, we're not regulating in a restrictive and punitive way, 00:34:25.134 --> 00:34:34.635 position:50% align:middle but actually one that considers all parties and is one that can support the profession to practice and uphold 00:34:34.635 --> 00:34:36.665 position:50% align:middle their standards in the public interest. 00:34:36.665 --> 00:34:42.225 position:50% align:middle So, I think we're all looking forward to those resources that will come your way from NCSBN and that 00:34:42.225 --> 00:34:49.685 position:50% align:middle we continue as regulators working in this space to share what's emerging in our regulatory worlds. 00:34:49.685 --> 00:34:56.995 position:50% align:middle I know at the College of Nurses of Ontario, we've done a lot of work in right-touch regulation and 00:34:56.995 --> 00:35:02.520 position:50% align:middle have advanced that work by learning from some of you and are happy to share that as well. 00:35:02.520 --> 00:35:07.750 position:50% align:middle So, thank you for the question that came forward to the board and for the opportunity to respond. 00:35:07.750 --> 00:35:09.320 position:50% align:middle - Thank you, Carol. 00:35:09.320 --> 00:35:12.930 position:50% align:middle I think we have time for one last question. 00:35:12.930 --> 00:35:17.470 position:50% align:middle We're not going to get to all the questions and we have a plan for what we're going to do with that. 00:35:17.470 --> 00:35:22.900 position:50% align:middle But I'm going to ask Phyllis as president-elect to take the second question, 00:35:22.900 --> 00:35:25.410 position:50% align:middle and we won't get to all the other questions. 00:35:25.410 --> 00:35:32.432 position:50% align:middle And this was a question related to the APRN Consensus Model. And it was, 00:35:32.432 --> 00:35:37.872 position:50% align:middle "There have been no revisions to the APRN Consensus Model in the 15 years since it was released. 00:35:37.872 --> 00:35:44.242 position:50% align:middle Is there a process for revising the Consensus Model, and what are the benefits and risks for nursing?" 00:35:44.242 --> 00:35:48.172 position:50% align:middle Shawn DeGarmo and Diane Tyler submitted this. 00:35:48.172 --> 00:35:50.952 position:50% align:middle Phyllis? 00:35:50.952 --> 00:35:56.512 position:50% align:middle - Okay, Madam President, this is such an interesting question. 00:35:56.512 --> 00:36:02.849 position:50% align:middle And since I am an APRN, I'm going to take a stab at it, dealing with the Consensus Model and you may see me 00:36:02.849 --> 00:36:08.609 position:50% align:middle referring to my notes a little bit on this one. 00:36:08.609 --> 00:36:16.159 position:50% align:middle The APRN Joint Dialogue Group which developed the Consensus Model...and there's been talk, 00:36:16.159 --> 00:36:22.699 position:50% align:middle as we all know, about changes needing to occur with the Consensus Model. 00:36:22.699 --> 00:36:26.269 position:50% align:middle But when you look at the Joint Dialog Group, they developed this Consensus Model, 00:36:26.269 --> 00:36:30.740 position:50% align:middle they set a goal of full implementation of all elements by 2015. 00:36:30.740 --> 00:36:32.910 position:50% align:middle So, I'm going to give you a little background here. 00:36:32.910 --> 00:36:37.320 position:50% align:middle Although there has been some progress and some significant progress, 00:36:37.320 --> 00:36:41.940 position:50% align:middle the work towards uniformity continues. 00:36:41.940 --> 00:36:48.150 position:50% align:middle With an add toward the future, the model provided for the possibility of new roles and 00:36:48.150 --> 00:36:55.700 position:50% align:middle population foci to meet evolving needs and advances in the healthcare environment. 00:36:55.700 --> 00:37:05.054 position:50% align:middle The LACE network was established in the model to provide a process for ongoing communication 00:37:05.054 --> 00:37:08.830 position:50% align:middle about this regulatory framework. 00:37:08.830 --> 00:37:16.314 position:50% align:middle So, potential changes to the Consensus Model would either originate in this group or require the 00:37:16.314 --> 00:37:19.194 position:50% align:middle support of LACE. 00:37:19.194 --> 00:37:26.984 position:50% align:middle The LACE network surveyed its member groups about their experiences with the Consensus Model in 2022. 00:37:26.984 --> 00:37:34.377 position:50% align:middle Based on those survey results, groups were formed to evaluate or revise the existing 00:37:34.377 --> 00:37:40.987 position:50% align:middle physician statements and FAQs for clarity and currency. 00:37:40.987 --> 00:37:47.357 position:50% align:middle After this work is completed, there may be additional discussions to consider if 00:37:47.357 --> 00:37:52.707 position:50% align:middle there are opportunities for modernization of the model. 00:37:52.707 --> 00:38:01.664 position:50% align:middle As you all know, there are currently two professional organization-led groups considering the feasibility 00:38:01.664 --> 00:38:04.884 position:50% align:middle of new population foci. 00:38:04.884 --> 00:38:11.624 position:50% align:middle That's the emergency nurse practitioner group and acute care across the lifespan. 00:38:11.624 --> 00:38:19.684 position:50% align:middle Although these groups include some LACE organizations, this work is not under the auspices 00:38:19.684 --> 00:38:22.444 position:50% align:middle of the LACE network. 00:38:22.444 --> 00:38:26.754 position:50% align:middle So, your question was risks and benefits, I believe. 00:38:26.754 --> 00:38:34.951 position:50% align:middle In light of the fact that regulatory uniformity has not been realized, revisions to the model may exacerbate 00:38:34.951 --> 00:38:44.581 position:50% align:middle this issue by creating another standard by which nursing regulatory boards and maybe educators, 00:38:44.581 --> 00:38:49.801 position:50% align:middle certifiers, and accreditors may have to align. 00:38:49.801 --> 00:38:56.811 position:50% align:middle Adoption of changes could take years if statutory change is required, essentially creating what we call 00:38:56.811 --> 00:39:00.151 position:50% align:middle a two-tiered alignment. 00:39:00.151 --> 00:39:05.941 position:50% align:middle With every benefit...with every risk, I'll look at opportunities, what are the benefits then? 00:39:05.941 --> 00:39:11.491 position:50% align:middle We have opportunities to provide further clarity after 15 years. 00:39:11.491 --> 00:39:12.961 position:50% align:middle We should address those areas. 00:39:12.961 --> 00:39:17.331 position:50% align:middle We should be stronger to assist nursing regulators. 00:39:17.331 --> 00:39:21.207 position:50% align:middle And the model should be viewed like the U.S. Constitution, 00:39:21.207 --> 00:39:27.501 position:50% align:middle with the opportunity to make amendments as needed. 00:39:27.501 --> 00:39:28.061 position:50% align:middle Thank you. 00:39:28.061 --> 00:39:30.414 position:50% align:middle - [Man] Thank you very much, Phyllis. 00:39:30.414 --> 00:39:33.683 position:50% align:middle Please join me in congratulating the board of directors.