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unpaid opportunities to gain hospital experience through internships or even paid for college courses that, like the Rio Hondo program, matched them up with work experiences at nearby hospitals. Whereas hospitals used to take on the responsibility and role of helping new nurses transition into the workforce, now that burden is appearing to increasingly, and permanently, shift onto individual nurses. When the worst of the recession had passed and hospitals started hiring again, they saw no need to restart their new grad pro- grams or reestablish their education departments and preceptor pool. A new terminology that's gaining in usage and popularity is the idea of nurses completing "residencies" after graduating, a period of time spent working in school-affiliated, hospital-affiliated, or even for-profit "internship" programs and doing additional online learn- ing that is unpaid or very low paid compared to a staff RN position. Many nursing schools are partnering up with hospitals (where their students might have once moved into regular employment) to create these "transition" programs and are even receiving government grants to do so. Registered nurses who keep tabs on the challenges of new nurses entering the profession are disturbed by this growing trend away from regular employment with preceptorships to new grads working for cheap. These programs also raise a whole host of legal and work- place issues such as the liability of the RN in cases of malpractice suits, the vulnerability of the RN's license, questions about RN scope, coverage of the RN under workers' compensation and the lack of other worker protections, potential abuse of federal labor laws governing what counts and doesn't count as an internship, and, in cases where the RN workforce is unionized, possible violation of the contract. "This shift toward residencies and transition-to-practice pro- grams is the hospital industry exploiting a crisis that it created," said DeAnn McEwen, RN and a CNA staff member who works on nurs- ing practice issues. "Nursing is an art and a science and also a craft. More experienced nurses know how to validate competencies and, [with preceptorships], new grads know who their go-to person is. This is a loss for the profession. I don't believe nurses or patients are served by removing that method [of learning]." N ot that long ago, RNs graduated from school, got their license, found jobs, completed a traditional three-month long preceptorships under the supervision of a senior RN (while collecting a regular salary), and gradually transitioned into taking on a full load of patient assignments by themselves. Diane Jones, who has been an RN at San Francisco General Hos- pital for 32 years and is now head of the University of California, San A P R I L | M AY 2 0 1 5 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 17 Hello Ms. Hwang, Thank you for the opportunity to share with you the RN Transition Program at Rio Hondo College. I will answer each of the questions posed below. I was curious to find out how the program came into being, whether it was the college's idea or California Hospital approached your school. - Rio Hondo College applied for and was awarded grant funding through the Office of Statewide Health Planning and Development. The grant is directed through the Song-Brown Healthcare Workforce Training Act and provides on opportunity for Nurses recently licensed but unable to find employment to have a Cooperative work experience at a clinical site. (http://www.oshpd.ca.gov/hwdd/Song_Brown_Prog.html ). The course is outlined through the Song-Brown Grant as to the guidelines of the course for the students and the instructor. - We first received grant funding in 2011 and the grant was renewed in 2013. This is a course that has been used throughout the state of California, at multiple locations, administered through various colleges. Currently, Riverside Community College (cohort started March 3, 2015) has a RN Transition course, and Mt San Antonio Community College has also held RN Transition programs that are/were funded through Song-Brown Grants. - Our current course is the third time we have held the course. We have partnered with various facilities (Kaiser Downey, PIH Health Downey, Whittier Hospital Medical Center, California Hospital Medical Center) to provide students with the opportunity to further develop or strengthen their clinical skills as they continue to pursue employment. The partnership with California Hospital Medical Center came about through our participation with the Song-Brown Grant. When California Hospital Medical Center found that we offered the course – they offered to partner with our college to provide clinical education and experience for students. Was there any concern by the college or you that the participants in this program were licensed RNs working for free? - The new RNs that take the course do not "Work for free". The new RNs are recent graduates from a nursing program and are licensed within the last 18 months, but they have not yet found employment for one reason or another. The applicants to the program are screened per the guidelines of the Song-Brown Grant process. Those that meet the requirements are offered a place in the course. The intent is to strengthen their skills so that potential employers will be more likely to hire them. If the student is lacking in basic clinical skills, then they are required to come to our skills center to practice those skills until they are deemed safe in their practice (as they were at the time that they graduated from their nursing program). All facility partners provide a preceptor – a one-on-one experienced nurse, that works with each of the students to improve their clinical reasoning and time management skills. Never are these students allowed to practice independently at the facility. - The overall course is a hybrid course - there are distance education components to the course. The students will also complete the online / distance education components in addition to the clinical portion of the course. Is it true that the college received some kind of grant to run the program? - See answer to the first question. Also, since the program was suspended, does the college plan to refund the participants' tuition payments and other fees? - This is a college course. It began in February 2015 and will end in May 2015. - With the current course, the clinical preceptorship at California Hospital Medical Center was suspended while California Hospital Medical Center resolved logistical issues. The students were advised that the course would resume once California Hospital Medical Center resolved their issues, and the students patiently waited. As of April 7, the course resumed and all students were advised as such. The course will be completed as planned in May 2015. The students that have chosen to complete the course will be awarded their units. All of the stu- dents that have started the course in February 2015 have been offered positions as new graduate registered nurses at California Hospital Medical Center (a wonderful and successful outcome for the course and for the new RNs). - As the course is continuing and will be completed in May 2015, there is no need to refund any student any of the course fees / tuition. I look forward to answering any other questions that you may have regarding the R.N. Transition Course. Catherine Page Professor, Health Science Rio Hondo College cpage@riohondo.edu 562.463.3237 The new RNs that take the course do not "Work for free". As the course is continuing and will be completed in May 2015, there is no need to refund any student any of the course fees / tuition.