Bedside Nurses Are Not Represented At California BON Meetings, Why You Should Be Concerned

Updated 12/8/2021

After careful review, we have updated this article to remove unsubstantiated information with respect to HealthImpact and the California Simulation Alliance.  We apologize for including them in the original post.  We have also updated the article with a Q&A with the Information Officer at The California Board of Nursing who responded to our request for comments on this piece.

Original 11/15/2021

The state of California has more than 500,000 Registered Nurses within its sunny borders, but can you guess how many showed up to the most recent completely public board meeting held by the California Board of Nursing for APRns? 

15. 

Fifteen people who were interested in advanced practice registered nursing issues. 

If that doesn’t mean anything to you, let’s put it another way––the California Board of Nursing plays a direct role in helping pass legislation that matters to nurses and future nurses. Including, 

• They play a role in setting curriculum and clinical standards to pass nursing school
• They play a role in if you can get a license and work in California
• They play a role in ensuring that there are enough nurses in California so that there is enough staffing.
• They play a role in Travel nurses coming in and becoming licensed in California and that affects how the hospitals spend their COVID money and how much staff nurses get paid based on how many travelers can be utilized in a hospital. 
• In short, they help to pull the strings of the nursing industry as a whole in the state of California. 

So, unless more bedside nurses speak up to tell the Board what they need and what their concerns are, there is a risk that key decisions will be made without input from the nurses who are out working each and every day and night. 

It’s also important to familiarize yourself with the nurses in executive leadership positions and how they got there. For instance, the CA Board of Nurses’ policy-setters include Mary Fagan, who was appointed directly by the Governor. The board members for the California Hospital Association, along with nursing leadership board members are all freely accessible to the public. Take a look and get to know who is representing you, where they work outside of the board, and what issues they support. 

3 Major Issues California Nurses Should Be Very Concerned 

Unfortunately, what’s happening in California is that nursing policies, from the workforce to schools educating future nurses, are not necessarily being shaped by the actual nurses working at the bedside.  

1. The CA Board of Nursing is being encouraged by nursing schools to offer fewer in-person clinicals and more virtual simulation - If increasing enrollment in nursing schools by decreasing the number of in-person clinical hours necessary to graduate (replacing them with virtual hours or lab simulations) is a “fix” for the nursing shortage, the result could be an influx of new nurse graduates who are not adequately prepared for the workplace.

But the bigger and more pressing question is: is that what’s best for nursing students? Are they being adequately prepared for an increasingly demanding workplace? Are these laws in benefit of nursing students and future nurses?

2. Low nursing faculty wages - A source familiar with the problems in the nursing industry in California points out how, typically, nursing faculty wages are at least half of what a bedside nurse can make––which leads many nurses to stay at the bedside until retirement, then transition into teaching. However, the reality is that there are huge benefits to having younger, currently working nurses in education roles as well. 

Nurses are leaving the bedside, but there’s no “nursing shortage” - A source familiar with the inner-workings of the California Board of Nursing tells Nurse.org that it’s important for nurses everywhere to understand that there is not a widespread nursing shortage. While regional pockets of shortages certainly exist, both nationwide and statewide, the problems that exist in the hospitals right now aren’t because there aren’t enough nurses in the country––they exist because there are not enough nurses who are staying in their jobs. And that’s a sign of a much deeper problem that needs to be addressed through policies and legislation. At a public meeting, last year where the California Board of Nursing was being evaluated a Senator even accused the BON Executive officer because she was an RN that she may be creating this nursing shortage so that nurses could demand more money. 

3. Failure to address the real issues causing nurses to leave the profession - Painting a convincing portrait that a nursing “shortage” is the real issue, allows healthcare administrators, lobbyists, and legislators to shift focus away from the actual problems that exist in nursing, as well as the healthcare industry as a whole. And long term, it could be a recipe for disaster. 

Their focus is not on staff retention and increased wages - But meanwhile, the solutions that will actually impact bedside nursing right now––from staff retention programs to training for new grads to wage adjustments that will address the drastic gap in traveling nurses’ wages and staff salaries to nursing faculty compensation––are not being addressed. Without an emphasis on funding and parameters for new grad training programs or staff retention who can actually show new nurses the ropes, all of those new nurses entering the workforce may be literally walking into a fire––where they will quickly burn out. Pumping out new nurses into a workforce led by travelers and no training programs will not produce the high-quality RNs committed to their specialties that we need. 

5 Action Steps to Get Your Voice Heard

It’s exhausting trying to think about making a difference in the world of nursing when you’re just trying to make it through your shift. It’s exhausting trying to think about planning on speaking up when you can barely get time to pee at work. It’s exhausting trying to think about how one person could make any type of difference, but guess what? 

It’s even more exhausting to think about nurses continuing to work in these conditions. 

This has to stop. And there is hope––many voices joined together can make a difference. This movement may start in California, but California leads the way for the entire country. If things can change in the nation’s largest state with the largest RN population, it will start a wave that will travel through to other states.

So if you’re a California RN, here’s what you need to do:

1. Attend a CA Board of Nursing virtual board meeting. All of the meetings are completely free, open to the public, and posted in advance on their website here.

• • Any and all RNs can attend the meetings and will have the opportunity to speak for a full two minutes during the meeting.
  • Additionally, you can see each meeting’s full planned agenda ahead of time, so you can prepare in advance for what message you want to convey.
  • There are 4 board meetings per year as well as 4 additional annual committee meetings, so in total, 8 different opportunities to join in and speak up.
  • APRNs also have 10 additional meetings on top of those. (Pro tip: you can log in with an alternate email address if you wish!)

2. Request an item be added to the agenda. The beauty of having a Board of Nursing is that everything the organization does has to be transparent. That means that the agendas for each board meeting are planned in advance, but if you see something that is not being discussed at the meeting, you can request that a topic be added to the agenda. You can do this both by formally requesting an item be added to a future meeting’s agenda during an active meeting, or email the board ahead of time to request it be added.

3. Email the leadership. Speaking of email, if you have concerns, want to request something be added to a meeting agenda, or simply want to get your voice heard, you have free and open access to email the CA Board of Nursing executive leadership at any time. All of their contact information is available on their executive leadership page: 

• • Loretta Melby, Executive Director: Loretta.Melby@dca.ca.gov
  • Evon Lenerd Tapps, Assistant Executive Director, Evon.Lenerd@dca.ca.gov
  • McCaulie Feusahrens, Chief of Licensing Division, McCaulie.Feusahrens@dca.ca.gov

Their phone numbers are also listed, so you can call them directly to voice your concerns. 

4. Flood social media. The California Board of Nursing has an active social presence that is monitored––and nurses can take advantage of it. Although currently, their socials don’t receive a high level of engagement or even follows, all of their accounts are freely accessible. Find them on.

• • Facebook
  • Twitter
  • Instagram 

Flood them with your voices. They will be heard. 

5. Join the CA Board of Nursing’s email list. Joining the CA’s Board of Nursing email list is a free and easy way to stay updated on new legislation that could affect nurses, get alerted about upcoming board meetings to attend virtually, and read through meeting agendas and minutes. 

Q&A With The California Board of Nursing

Vincent Miranda, Information Officer for the California Board of Registered Nursing, responded to Nurse.org's request for comments on this piece. Here are the answers to a few key questions.

We've learned that only 15 APRNs attended the last California BON meeting. Is that true? 

Near the start of the last BRN Board Meeting on August 4th, the board noted that besides board members and staff that were “panelists” on the WebEx, there were 69 people on the list of “attendees.”  That number likely includes some BRN staff, and possibly a small number of duplicate attendees, but still reflects a fairly significant number of stakeholders that were present.  We cannot identify which attendees were RNs or APRNs, unless they made a public comment and specifically identified themselves as such; as a result, it is difficult to confirm or accurately assess the number of actual licensees in attendance.  (Under Government Code section 11124, of the Bagley-Keene Open Meeting Act, “No person shall be required, as a condition to attendance at a meeting of a state body, to register his or her name, to provide other information, to complete a questionnaire, or otherwise to fulfill any condition precedent to his or her attendance.”)   

 

In your opinion, what is the greatest barrier as to why more nurses are not attending the board meetings? How might they overcome those barriers?

 

As far as barriers preventing nurses from attending board meetings, those reasons may vary. However, the Board takes significant effort to encourage participation, feedback, and attendance at meetings.  The board currently makes its meetings accessible remotely via WebEx, and can be accessed from a variety of devices.  Additionally, the board provides access to its meetings telephonically for those who would rather access the meeting by phone. It also often simultaneously webcasts its meetings, and posts recordings of them on YouTube. 

 

The recording of the board’s last meeting is available as a webcast on the board’s website at: https://rn.ca.gov/consumers/pastmtgs.shtml.  Furthermore, licensees and interested stakeholders have additional opportunities to participate during the board’s various committee meetings, which are scheduled on different dates from the meetings of the board itself.  The board posts notices of its meetings at least 10 days prior to scheduled meetings, sometimes sooner, so that interested stakeholders can be aware of the topics on the agenda and make necessary arrangements to be present if desired.  

 

Nurses and members of the public can sign-up for BRN email updates that include meeting agendas and minutes.  The board posts all upcoming board/committee meetings on our website along with meeting agendas and relevant materials. BRN creates official Facebook and LinkedIn events on our social media containing online attendance instructions and links to the relevant agenda and materials in an effort to engage our nurses and inform them of board meetings.  The board continues to promote relevant information to nurses and anyone who follows the board on Instagram, Facebook & LinkedIn to grow our audience and better inform nurses and all stakeholders of our public board meetings.   

 

Additionally, the board accepts written comments from public stakeholders and nurses who do not wish to make their comments verbally at board meetings.]  Currently, under temporary statutory authority (Gov. Code, § 11133), the board is able to conduct its meetings remotely, rather than at physical meeting locations.  Prior to the pandemic, the board’s meetings were typically conducted in person, which required attendees to travel to the destination where the meeting was being held.  If the law is not amended to allow meetings to be conducted remotely indefinitely in lieu of having a physical meeting location, the board may nevertheless look into the possibility of continuing to offer means for remote participation in addition to allowing physical attendance, in order to maximize opportunities for members of the public to participate in its meetings.  

The Nursing Field is In Danger - You Can Create Change

The bottom line is that the nursing field is in danger from:

• Lobbyists who have financial gains at stake
• Nursing School Administrators who stand to continue to profit from pumping nursing students through in an effort to combat the “shortage” 
• Healthcare Executives who will continue to make money off the backs of nurses who work themselves, sometimes, to the literal death

The problems that exist in the nursing industry aren’t your fault. And you shouldn’t be tasked with fixing it. It’s not fair and let’s face it: you do enough already. 

But your voice matters. And nothing will get fixed––for you or future generations of nurses––if your voice isn’t heard. 

So speak up. For all nurses. 

Click here to sign up to attend a California Board of Nursing Meeting.