I fully support the removal of the limitation on the number/percentage of clinical hours that must be conducted in Virginia.  This regulation has become a barrier to programs, faculty, and students especially if your clinical facilities in your service region are not only in Virginia, but Tennessee, Kentucky, and West Virginia.  Due to the nature of the Southwest Virginia region and changes to healthcare, services for pediatrics and specialty services may be accessed only in Tennessee or other states.  I support using Virginia facilities when it is feasible and makes sense to the education of our students, but that should be a decision based on a program's service region, healthcare services, proximity to other states, and availability of resources.  

The current requirement in regulation 18VAC90-27-19 has caused barriers for nursing programs.  It has reduced the program's ability to offer students a variety of hospital and clinical experiences especially within the Southwest Virginia region and other more rural locations in Virginia.  It also prevents increasing the number of students that a program can serve or accept into our nursing program.  It has also affected retention of part-time clinical faculty due to changes in reducing clinical experiences in TN and other states.

I know that program directors across the state have attempted to work within this regulation the best that they could, but I feel that it is urgent that this regulation is removed.  I believe it will benefit not only our students, but all of the clinical facilities within our region both in Virginia and adjoining students.  The need for nurses is great and we need to eliminate barriers to creating more nurses.

Please approval and remove the limitation on the number of clinical education hours that may be obtained outside of Virginia.  

Thank you for working to continue to improve nursing education in our state.