I support the removal of the limitation on the number of clinical education hours that may be obtained outside the state of Virginia. Educating nursing students in rural areas, particularly those located near state borders, presents significant challenges. Rural hospitals tend to be small, with limited services and fewer opportunities for exposure to complex patient care situations. In southwest Virginia, many patients requiring complex, tertiary, and specialized care must travel to hospitals just across the state line into Tennessee, Kentucky, and West Virginia. Additionally, the region's sole children's hospital and specialized pediatric services are located in Tennessee.

Exposure to a larger, more diverse patient population in high-volume, tertiary facilities with complex health conditions is essential for the clinical education of nursing students in rural areas. This experience helps students build the knowledge and skills needed for clinical practice, even if they ultimately work in smaller rural facilities within Virginia.

The current requirement of VBON Regulation 18VAC90-27-19, is burdensome for academic nursing programs, as it necessitates frequent submissions for approval each semester, despite the fact that the same challenges and solutions arise consistently. Given the unprecedented nursing shortage currently facing our nation and region, the ability to educate more nursing students is critical. The existing regulation restricts the ability to admit more nursing students due to the limitations on clinical education hours.

For these reasons, I respectfully urge the removal of the limitation on the number of clinical education hours that may be obtained outside of Virginia. We appreciate your continued efforts to create optimal clinical education opportunities for nursing programs in Virginia.