Children's Hospital of Los Angeles urges pediatric‑focused training; BRN says programs may already create pediatric tracks

Representatives from Children—s Hospital of Los Angeles told the Nursing Education Workforce Advisory Committee they want clearer pathways to prepare new graduates for pediatric practice and asked whether the Board of Registered Nursing would allow pediatric‑focused prelicensure tracks.

Why it matters: CHLA said newly graduated nurses lack consistent preparation for pediatric work and that specialty tracks could accelerate readiness and reduce the length or cost of transition‑to‑practice programs for employers.

CHLA presentation and request Jean Daugherty of CHLA, joined by Jenny Baird, associate chief nurse officer, said the hospital is partnering with local schools to develop alternative approaches to pediatric education and transition‑to‑practice support. "We are kind of wanting to innovate and change... the way that we are training new graduate nurses specifically in the realm of pediatrics," Baird said.

BRN response: flexibility within minimum standards Loretta Melby, the board—s executive officer, told the committee that the board sets minimum standards and that programs are free to organize curricula so long as they meet those minimums. "Our minimum is that they have 864 hours of clinical lab experience. Of that 864 hours of clinical lab experience, 500 of those hours must be in direct patient care," Melby said. She said the board set a 30‑hour minimum for content areas to avoid scenarios where a single one‑unit course (48 hours) would be treated as 50 percent of a specialty area.

Melby explained how programs can create specialty tracks: a program could offer a multi‑unit pediatric clinical (for example, a 5‑unit course equals 240 hours) and allocate other units across remaining specialty content, or use simulation to assure comparable experience for students who do not attend the same clinical sites. "If they choose to do a 5 unit pediatric clinical, that is 240 hours dedicated directly to the preparation of a nurse that would go into pediatrics," she said.

Concurrency and make‑up clinical hours Melby also clarified the concurrency requirement (theory and clinical scheduled in the same semester or quarter). She said programs may roll uncompleted direct patient care hours into the next semester if scheduling problems prevent completion, provided required simulation hours are completed in the same semester as theory. "Any direct patient care hours that you are not able to complete in that semester can be rolled into the next semester and made up," Melby said, describing flexibility introduced in the most recent sunset legislation.

CHLA—s approach CHLA representatives said their goal is voluntary, track‑based partnerships with schools to admit students who choose a pediatric focus rather than privileging particular students within general cohorts. "We want to build tracks for those students that have a vested interest," Jean Daugherty said. She and Baird emphasized that admission to a pediatric track would be by student choice and that each track—s students would receive comparable pediatric clinical experience.

Ending Committee members expressed support for innovation and thanked CHLA for raising the issue. No regulatory changes were proposed; BRN staff invited academic programs to submit curricula proposals demonstrating how their objectives would be met under existing minimums, and offered to clarify flexibility for schools that have questions.