November 3, 2003

TO: University of Montana Board of Regents


FROM: Dr. James Trudnowski, Vice President for Academic Affairs, Carroll College

Dr. Cynthia Gustafson, Chair of the Department of Nursing, Carroll College


RE: The University of Montana-Helena COT to establish an Associate of Science Degree in Nursing leading to Licensure as a Registered Nurse (Item No: 119-1901-R0503)

We have been asked to provide comments regarding the proposal indicated above and appreciate the invitation and opportunity. While we recognize the desire of colleagues at the University of Montana-Helena COT to offer the proposed program, we wish to express our concern with the proposal to establish an ASN-RN degree. Our overriding concern focuses on the need for continued high quality nursing education in this immediate area. We believe that the Helena community does not have sufficient clinical facilities to support the addition of this program and that this addition would compromise the quality of the clinical experience of our RN-baccalaureate students. Without quality clinical experiences, a nursing program cannot adequately prepare students, and thereby cannot meet state and national accreditation guidelines. Each semester, over 100 Carroll College nursing students are placed in clinical sites caring for patients; this experience is critically important in the education of these students.


Why are there limited clinical placements in Helena?

Helena has two hospitals, St. Peter's Hospital with 99 beds and VA Fort Harrison with 50 beds. These two facilities are the main sites for clinical learning experiences for RN students. If for example, Carroll College and UM-Helena were trying to use St. Peter's medical or surgical unit for clinical experiences on any given day, this would be the situation: the unit would be staffed by 3 RNs from St. Peter's, managing the care of 20 patients with support from staff LPNs, while trying to work with a combined load of 8 RN students from Carroll and UM-Helena, plus their instructors. The instructors would be trying to place their students directly to work with the staff RNs. The situation is even more compromised on the Family Birthing Unit at St. Peter's where there is an average census of 3 mothers/babies and 3 RN hospital staff and possibly 5 RN students at one time as this is the only unit where students can get this experience in the Helena community. These high ratios of students to patients and students to RN staff leads to overload for the staff nurses and patients requesting to not have students. Quality suffers for both programs.


Why cant Carroll or UM-Helena nursing programs go to larger medical centers for clinical experiences?

Benefis Health Care in Great Falls is 100 miles from Helena and the largest hospital in the state and is currently the clinical site for three nursing programs, MSU-Bozeman College of Nursing, MSU-Northern RN program and Great Falls COT LPN program. These programs are competing for the clinical experiences in their area. Butte is 60 miles from Helena and supports the RN and LPN nursing programs of Montana Tech. Missoula with two larger hospitals is supporting the nursing programs of MSU-Bozeman College of Nursing, UM-Missoula COT LPN program and Salish-Kootenai RN program. Bozeman Deaconess Hospital (100 miles) will now be supporting the baccalaureate nursing students for increased clinical experiences for the MSU-Bozeman campus.


What is the State Board of Nursing doing about this?

In July 2003, the State Board of Nursing at their meeting denied the request for expansion by UM-Helena and made the following motion:Charter an independent study of the proposal submitted by UM-Helena COT; specifically the quantity and quality of available clinical sites and the impact on other nursing programs in the state. At the October meeting the Board reaffirmed the need for this study and is seeking to complete it in a timely manner. We welcome this motion from the Board and will fully cooperate with this study. We feel that until that study is completed and the results made known, we cannot support the expansion of the UM-Helena ASN-RN program.


Thank you for the opportunity to express our concerns. As we've indicated in the past, we are certainly committed to exploring and developing valuable collaborative efforts with the UM-Helena to assure that quality nursing education is available in the Helena area.