Hundreds of registered nurses marched outside the 478-bed Riverside Community Hospital in California for eight hours Monday during the fourth day of a 10-day strike. They accuse their administrators of ordering staff reductions that have resulted in dangerously high nurse-to-patient ratios that put themselves and their patients at risk.
The nurses say they’re sometimes forced to work their 12-hour shifts without taking a break to eat, get a drink of water, or even use the bathroom.
It’s all the more troubling as COVID-19 case counts and deaths recently spiked in that Southern California county, they said.
“You have to sneak the break in, or you get to the end of the day and it dawns on you that you’re dehydrated and you haven’t been to the bathroom all day,” said Erik Andrews, RN, a rapid response team member at the hospital and vice president of the 1,200-member bargaining unit of Service Employees International Union (SEIU) Local 121RN. He said he’s held on for 10 hours without a bathroom break while wearing an airtight respiratory mask, feeling uncomfortable and dehydrated, yet without a backup if he steps away.
“Each nurse is entitled to three paid 15-minute breaks and a half an hour off the clock every day,” Andrews said. “If I could find a single member who got all those breaks every day, I would keel over from shock because it doesn’t happen. And now it’s expected and accepted; we’re just taking it … when it doesn’t need to be this way.”
“You can’t get away without a safe break,” said Monique Hernandez, RN, a Riverside Community Hospital telemetry nurse and a member of the mediation team for SEIU. “That means someone who says I’m going to watch your patients while you go and put your feet up, take your mask off, go eat something, clock out. You can’t do that legally if there’s no one that can watch for you, because if something happens, that’s on your license.”
Wearing purple shirts, several hundred strikers carried signs around the hospital block for the last four days starting at 7 a.m. Some of the signs said, “Imagine wearing N95 for 12 hours with no breaks,” “Caution, unsafe staffing ahead,” and “You call us heroes yet treat us like zeroes.”
Riverside Community Hospital: “Misguided Tactic“
In a statement, Riverside Community Hospital officials called the nurses’ job action “a misguided tactic” that “create(s) conflict and spreads misinformation” and has “everything to do with contract negotiations.” The statement said that Riverside Community has “not laid off or furloughed a single caregiver due to COVID-19 and has spent $160 million to pay workers, some of whom are receiving 70% of their pay even when there has been no work.”
But labor officials insisted their strike has nothing to do with money and nothing to do with their current contract, which doesn’t expire until September. They are not in negotiations now.
From the labor union’s view, the problem is that when Gov. Gavin Newsom (D) ordered the state to shelter in place in mid-March, and routine hospital operations like elective surgeries came to a halt, Riverside Community Hospital’s administrators took traveler nurses, per-diem and part-time personnel off the schedule and limited hours for other workers. Union representatives estimated that they are between 200 and 400 people below where they need to be.
Hospital officials failed to realize that even though the census has been low, the workload and burden of methodically taking extra precautions — for example cleaning reusable PPE equipment in short supply — turn what were once quick, routine tasks into more complicated, step-by-step procedures, Andrews said.
“When you’re dealing with a disease that presumably is aerosolized, and very contagious, you need people to slow down and think carefully,” he said. But there is no staff available to serve as a spotter, “for when you’re donning and doffing your protective equipment.” Also, COVID-19 patients are not always housed in separate parts of the hospital, complicating safety considerations further, and nursing staff don’t always know a patient’s status.
Nurses as Housekeeping Staff
Kerry Cavazos, RN, the labor union’s chapter president and a labor and delivery unit nurse, said Riverside’s owners, the Hospital Corporation of America, told many members of the housekeeping staff, who are represented by a different labor union, not to come to work. That meant the nurses have to do housekeeping work.
Women about to give birth are brought into rooms that are still dirty from the last delivery, she said. “There was no housekeeper to clean it and there is still blood on the floor, so we have to clean it up. The woman needs to get in the bed because she’s having a baby.”
She and her fellow nurses are told to strip the beds, wipe the poles and the IV, and stock the rooms. “Those were never nurses’ tasks. And it’s not beyond us to do that but we have other things (to take care of patients) that we need to do,” Cavazos said.
Cavazos echoed the concerns expressed by Andrews. “I honestly do not believe this is safe for any patient for a nurse to not have any nutrition or any fluids for 12 hours. But we do it because that’s who we are,” she said.
California’s Staffing Ratio Rules
The issue of hospital nurse staffing is an important one in California, which two decades ago passed the nation’s first set of maximum patient-to-nurse staffing ratios in acute care hospitals. For example, one med-surge unit nurse should take care of no more than five patients at a time. In a telemetry unit, the nurse-to-patient ratio can be no more than one to four.
But according to Hernandez, there has been no financial penalty against the hospital for violating the ratio unless there was documentable harm to a patient that the staffing lapse could be blamed as the direct cause. A new law took effect early this year, imposing fines of $15,000 to $30,000 on hospitals that failed to uphold ratios. Labor officials said that while that is a welcome fix, state health officials have not yet begun to enforce it due to the pandemic.
The history of the issue at Riverside Community Hospital regarding staffing ratios goes back several years, as the SEIU unit tried to get administrators to take the staffing issue more seriously. The bargaining unit got a contract amendment last year that required the hospital to pay a nurse a “monetary penalty” if he or she had been required to absorb more patients than the ratio allowed, regardless of whether the ratio lapse caused harm.
“Everyone was happy and they kept their part,” Hernandez said, until a few months ago when that monetary penalty agreement expired and, sometime in late May, hospital officials declined to renew it. Days after that, which was the weekend of June 13 and 14, Hernandez said, at least one unit at the hospital failed to meet the ratio, “and it’s happened repeatedly” since the agreement ended.
by Cheryl Clark, Contributing Writer, MedPage Today
Jane Gunter, a nurse practitioner in Tuolumne County, California, has long wanted to specialize in mental health so she can treat patients who have anxiety, depression and more complicated mental illnesses.
Her county, a rural outpost in the Sierra Nevada foothills with a population of about 54,000, has only five psychiatrists — “a huge shortage,” she said.
But Gunter, 56, wasn’t about to quit her job at the Me-Wuk Indian Health Center in Tuolumne and relocate to some distant campus for two years to get certified as a psychiatric nurse practitioner.
Then, in February, she learned that the University of California was launching a new program to provide that certification online in just one year. She fired off her application, and last month she received an acceptance letter.
“Sometimes I think, ‘What are you doing?’” Gunter said, referring to the online classes that will take over her nights and weekends once the program starts. “But I care about the community.”
The online certification program, conducted jointly by the nursing schools at the University of California-San Francisco, UCLA and UC-Davis, was scheduled to start in the fall, but it has been postponed until January because the on-site clinical hours required as part of the training are not possible during the COVID-19 shutdown.
Despite the delay, the potential expansion of psychiatric care is opportune given the expected increase in mental health problems due to the social isolation and financial stress stemming from the pandemic.
The need for more mental health nurses is about to be bigger than ever, said E. Alison Holman, a health psychologist at UC-Irvine who studies emotional responses to collective trauma.
“We now have 30 million Americans who have lost their jobs, who have no income — and how are they going to pay rent? How are they going to buy food?” Holman said. “And then you have to stay home. This event is rolling out like a long, chronic stressor.”
Even before the current crisis, California faced a serious shortage of mental health professionals, especially in rural areas. California’s psychiatrists and psychologists are approaching retirement age in large numbers, and fewer medical students are choosing psychiatry.
A UCSF study projected that the state would have 41% fewer psychiatrists than needed by 2028. More than half of Californians with mental illness receive no treatment, according to a February 2019 report by the California Future Health Workforce Commission.
UC’s online mental health nurse practitioner program is one of the solutions recommended by the commission, a statewide, multisector panel that created a master plan to address the Golden State’s shortage of health care workers.
The program is expected to put 300 more mental health NPs into California communities, particularly rural ones, over the next five years. Applicants such as Gunter, who live in underserved rural areas, will be given priority in the hope that they will stay in their communities upon completion of the training, said Deborah Johnson, a UCSF nursing professor who is co-director of the program.
Forty spots are available for the class that begins in January, and not all have been filled yet, Johnson said. Applications are being accepted until June 1, and 65 additional spots will open in fall 2021 and each fall thereafter for three more years, she said.
The UC system received a $1.5 million grant from the California Health Care Foundation to develop, design and launch it. But tuition is expected to make it self-sustaining. (Kaiser Health News, which produces California Healthline, is an editorially independent publication of the foundation.)
Applicants for the new program must already be advanced practice nurses, which means they hold either a master’s degree or doctorate in nursing. More than 27,000 NPs now practice in California, but only 1,200 are certified to treat psychiatric patients.
Three hundred more psychiatric NPs won’t completely fill the growing mental health care need, but they are expected to treat nearly 400,000 patients over a five-year period.
Though the online program means working nurses won’t have to leave their jobs and their lives to relocate, they will still face challenges.
For one thing, their certification will require 500 hours of supervised clinical training with patients in hospitals, jails or schools. And some applicants live in communities where such opportunities may not be available, which could require them to commute long distances to meet the requirement.
Another challenge is that, even after nurse practitioners are certified, state law requires they find a medical doctor to supervise them. Havilyn Kern, a school nurse in Nevada City, California, quit her job two years ago so she could spend three days a week at UCSF — 155 miles away — to train as a psychiatric nurse practitioner.
She graduates in June, so the new online program is too late for her. Kern, who plans to work in her own community, hopes she will find a psychiatrist in the Bay Area willing to tele-supervise her.
“It shouldn’t have to be this way,” said program co-director Johnson. “California is so archaic. It’s the most restrictive state in the western portion of the country.”
Twenty-eight states plus Washington, D.C., allow nurse practitioners to work autonomously. Santa Rosa Assembly member Jim Wood, a Democrat, has introduced a bill, AB-890, that would allow California NPs to practice without doctor supervision. It passed the Assembly in January and is pending in the Senate.
“If AB 890 passes, it will certainly help fill the loss of specialty physicians such as psychiatrists everywhere, including in underserved areas,” Wood said.
But that’s a big “if.”
California’s powerful doctors’ lobby, which has repeatedly scuttled similar legislation, is aggressively fighting it again. They argue that letting NPs order tests and prescribe medications independently would “dilute care.”
Doctors also have a financial incentive to keep things the way they are. It restricts competition, and they bill NPs between $5,000 and $15,000 a year to review their charts and prescriptions every few months, according to a report by the California Health Care Foundation and UCSF.
Johnson suggested it is time for a change.
“We are the workhorses,” she said. “Oh, my God, there is so much need. This new program could not come at a more important time.”
Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.
This KHN story was first published on California Healthline, a service of the California Health Care Foundation.
There is a nationwide call for travel nurses during the COVID-19 pandemic, and with the demand comes offers of substantial financial compensation for those willing to care for patients under conditions of extreme risk. Across the US—especially in states such as California, New York, and Washington—crisis pay for travel nurses is at record highs. The increased pay is tied to the rising hazard of working during the pandemic, but travel nurses are at least receiving better compensation for the risks they take.
nurse pay has risen by 76%, and has gone up by as much as 90% in
Washington state, the original hotspot of COVID-19. Further, the
healthcare industry news site HIT Consultant states
that “Hospitals are paying Crisis/Pandemic rates up to $4,400
weekly to quickly staff up for the caring of COVID-19 patients.”
registered travel nurses, already high before the pandemic struck, is
also spiking. Massachusetts, in which demand has quadrupled, appears
to be in the greatest need so far, and demand has doubled in
California and New York. The latter two states also display the
sharpest rise in pay, although Washington is still the location
offering the highest salaries. On average, according to HIT
Consultant, pay for emergency department nurses has almost quadrupled
with the spread of the pandemic.
Among the travel
hospitals are trying to fill, ICU RNs, ED RNs, and Respiratory
Therapists are particularly coveted. NuWest Group, a staffing company
placing travel nurses in New York, says that they are “Urgently
staffing ICU and Respiratory therapist travel nurses for NYC Health
CNBC notes that “As demand spikes, staffing agencies are offering unprecedented incentives for nurses willing to enter hot zones” and cites staffing agency NuWest as offering travel nurses as much as $10,000 in crisis pay, with relocation bonuses and tax-free housing and food.
For an extensive
assessment of the market for travel nurses right now, see this
story on HIT Consultant.
Coping With COVID-19
On Tuesday, Dr. Jeanne Noble devoted time between patient visits to hanging clear 2-gallon plastic bags at each of her colleagues’ workstations. Noble is a professor of emergency medicine and director of the UC-San Francisco medical center response to the novel coronavirus that has permeated California and reached into every U.S. state.
bags were there to hold personal protective equipment — the masks, face
shields, gowns and other items that health care providers rely on every day to
protect themselves from the viruses shed by patients, largely through coughs
and sneezes. In normal times, safety protocols would require these items be
disposed of after one use. But just weeks into the COVID-19 pandemic, supplies
of protective gear at UCSF are already so low that doctors and nurses are
wiping down and reusing almost everything except gloves.
is not a foolproof strategy at all; we all realize the risk we are taking,”
Noble said. But as supplies dwindle, she increasingly finds herself asking the
folks in charge of infection control at the hospital if they can make changes
to protocols. “As days go by, one regulation after the other goes out,” she
Noble is among the Bay Area physicians applauding the decision
this week by seven Bay Area counties and multiple others across California to
order residents to shelter
in place for the foreseeable future, directives that are
upending life for millions of people and shuttering schools and businesses
across the state. Without swift and dramatic changes to curb transmission of
the virus, hospital officials say, it is just a matter of time before their
health systems are overwhelmed.
with California physicians on the front lines of COVID-19 offer a sobering
portrait of a health care system preparing for the worst of a pandemic that
could be months from peaking. In the Bay Area, the battle is being waged
hospital by hospital, with wide variations in resources.
Waging the Battle, Hospital By Hospital
tent where Noble tended to patients this week was set up to deal with a recent
rise in people showing up with respiratory illness. Even without the
coronavirus threat, UCSF’s emergency room is a busy one, and doctors frequently
see patients in hallways and other spaces. But the current outbreak makes that
close contact unsafe. So instead, everyone who comes to the hospital is being
triaged. Most people with fever, cough or shortness of breath are diverted to
the tent, which is heated and has negative air pressure to prevent the spread
of infection. For now, the pace is manageable, but Noble fears what’s ahead.
south, in Palo Alto, Stanford Medical Center was testing patients with
respiratory problems in its parking garage. The private university hospital has
more protective gear than the public one in San Francisco; a global scavenger
hunt several weeks ago bolstered supplies, though Stanford, too, has adapted
protocols to be more sparing with some items.
don’t have an unlimited supply,” said Dr. Andra Blomkalns, professor and chair
of the Stanford School of Medicine’s Department of Emergency Medicine. “But at
least we’re not looking at our last box.”
entire country is short on protective gear, a result of both the surging demand
for such equipment as the virus spreads and the implosion of supply chains from
China, where much of the equipment is manufactured.
believes some equipment will need to be made locally. “If the [federal]
government doesn’t step in and force manufacturing of these products here now,
we are going to run out,” she said.
supply closets affect everyone who needs care, including heart attack victims
and people in need of emergency surgery, said Dr. Vivian Reyes, president of
the California chapter of the American College of Emergency Physicians and a
practicing emergency physician in the Bay Area.
know it’s really hard for us Americans because we’re never told no,” she said
of the shortfall of supplies. “But we’re not in normal times right now.”
protective equipment isn’t the only thing in short supply.
a few days ago, UCSF had to rely on the San Francisco Department of Public
Health for coronavirus testing, and a shortage of test kits meant clinicians
could test only the most critically ill. The situation improved March 9, when
the university started running tests created in its own lab. First, there were
40 tests a day. By Tuesday, there were 60 to 80. But a new shortage looms: The
hospital has just 500 testing swabs left.
pathologist Benjamin Pinsky built an in-house test that has been approved for
use by the federal Food and Drug Administration. Since March 3, Stanford has
used it to test more than 500 patients, 12% of whom had tested positive as of
Tuesday. The university has been running tests for other hospitals as well,
including UCSF. It’s a dramatic improvement from a few weeks ago, when Stanford
relied on its county lab.
saw a sick patient in mid-February, before the hospital had its own test kits,
who had symptoms of COVID-19 but didn’t qualify for testing under the narrow
federal guidelines in place at the time. He went home, only to return to the
hospital after his condition deteriorated. This time, he was tested and it came
Santa Clara County, home to Stanford, 175 people have tested positive for
COVID-19 and six have died. Late last week, the medical center’s emergency
department saw the highest number of patients in one day in its history.
Blomkalns doubts it’s because there are more cases in her area. “If you don’t
test, you don’t have any cases,” she said.
worries about staffing shortages as health care workers are inevitably exposed
to the virus. As of Tuesday, one doctor in the Stanford ER had tested positive.
At UCSF, six health care providers had.
all Bay Area hospitals are seeing a flood of patients. In fact, some have fewer
patients than usual, as they have canceled elective surgeries in anticipation
of a COVID-19 surge.
doctors treating COVID-19 patients say nearly all who test positive have a
cough. They complain of fatigue, body aches, headaches, runny noses and sore
throats. While most people are well enough to recover at home, those who get
critically ill tend to do so in their second week of symptoms, and can
deteriorate very quickly, several doctors noted. “We are recommending that
patients get intubated a little earlier than they might otherwise,” said Reyes.
COVID-19 in CA: The Symptoms They’re Seeing
general, officials are asking people who have mild cases of COVID-19 to treat
their symptoms at home, as they would a cold or flu, and refrain from seeking
care at hospitals. People experiencing shortness of breath, however, should
definitely go to the emergency room, said Blomkalns.
children, the criteria may be a bit different. Shortness of breath should
trigger a visit, as should altered mental state, excessive irritability, or an
inability to eat or drink, said Dr. Nicolaus Glomb, a pediatric emergency care
physician at UCSF Benioff Children’s Hospital.
Gavin Newsom said Tuesday that rough projections suggest the state could need
anywhere from 4,000 to 20,000 additional beds to treat patients with serious
cases of COVID-19.
testing problems worry Noble, as do the equipment shortages, but not nearly as
much as the potential for a lot of sick people. “I’m mostly worried about a
tsunami of very ill patients that we’re not equipped to take care of,” said
isn’t sure whether or when Stanford might exceed capacity, saying the caseload
trajectory may hinge on how aggressively state and national authorities move to
cut off routes of community transmission. “It all depends on what happens in
the coming weeks and days,” she said. “We know what we need to do, and we’re
doing the job.”
KHN Senior Correspondents JoNel
Aleccia and Jenny Gold contributed to this report.
This KHN story
first published on California
Healthline, a service of the California
Health Care Foundation.
Reposted courtesy of Kaiser Health
News, a nonprofit news service covering health issues. It is an
editorially independent program of the Kaiser Family Foundation, which is not
affiliated with Kaiser Permanente.
Yet another casualty of the COVID-19 pandemic may be the clinical training that’s so essential for America’s future nurses and doctors.
As university campuses close and disease prevention efforts intensify, hospitals, nursing homes and other health care venues in California and nationally are canceling clinical rotations for student nurses — and, in some cases, medical students. The rationale is to protect both students and patients from getting sick and to reserve personal protective equipment, including masks, that may be in short supply.
But medical educators worry the students won’t get the hours of direct patient care experience required to graduate on time, slowing the pipeline of new health care professionals precisely at a time when the country may need them most.
“We are in unprecedented times,” said Dr. John Prescott, chief academic officer of the Association of American Medical Colleges. “Medical education hasn’t faced anything quite like this since the beginning of the Second World War.”
The risk that hospitals and other health care facilities fear was underscored this month when an instructor was diagnosed with COVID-19 after bringing a group of nursing students to the Kirkland, Washington, nursing home where at least 63 residents have been stricken by the illness — 29 of them fatally, as of Monday afternoon. Those students are now in self-quarantine.
On March 5, Kaiser Permanente requested that nursing schools temporarily discontinue student clinical rotations in its 21 medical centers in Northern California. (Kaiser Health News, which produces California Healthline, is an editorially independent program of the foundation.) “We are in a dynamic situation and our highest priority is ensuring the safety of KP members, staff and students participating in clinical training,” a Kaiser Permanente executive wrote in an email to the nursing schools obtained by KHN.
A spokeswoman for the health system, which serves 4.4 million Northern Californians, confirmed the cancellations.
Two other large hospital chains in California, Adventist Health and Dignity Health, soon followed suit.
As a result, the nursing schools at the University of California-Davis and Samuel Merritt University have had to scramble to find new clinical training opportunities for dozens of students. Some landed at the University of California-Davis’ medical center or clinics and others at Veterans Affairs hospitals.
Nursing education leaders in California appealed to the state’s Board of Registered Nursing on Thursday to ease the number of on-site clinical hours required for student nurses to graduate and allow them to learn from simulations instead.
State law requires nursing students to receive 75% of their clinical training in health care settings such as hospitals or nursing homes approved by the board; only 25% can be completed using simulations, such as computerized mannequins. The educators, in a letter to the board, requested that students be allowed to do 50% of their training through simulation.
“Many schools in California are experiencing serious clinical displacement. The effects of the lost clinical hours will be devastating to the students we serve,” more than 60 officials from community colleges and nurse training programs around the state said in the letter.
As of Monday, Board of Registered Nursing officials had not responded to a request for comment.
Even before the COVID-19 pandemic, some private nursing schools had pressed state regulators to allow more simulation training, arguing it has advanced to the point where it can be as effective as training in a hospital or clinic.
The move to cancel clinical training is the opposite of what happened during the 1918 flu pandemic, when student nurses were called to hospitals to care for patients. Some fell sick and died along with those in their care.
Most hospitals have not canceled clinical rotations for doctors-in-training, but some have, and Prescott, of the Association of American Medical Colleges, said more may do so in the coming weeks.
On Thursday, the University of Arkansas for Medical Sciences asked all its students to immediately leave their clinical rotations to prevent the spread of COVID-19. The University of North Carolina School of Medicine canceled clinical rotations for visiting students from other medical schools from March 30 to April 24.
The University of Pennsylvania has suspended clinical rotations for some medical students, as has the University of Minnesota. SUNY Downstate College of Medicine also suspended emergency room rotations for its medical students.
Some teaching hospitals have banned medical students from emergency and intensive care units while allowing them elsewhere in their facilities.
For medical students in the University of California system, clinical training continues for now, but they’ve been directed to avoid contact with suspected or confirmed COVID-19 patients, as have medical students across the nation.
One Baltimore nursing student learned Friday that her psychiatric nursing rotation had been canceled for at least two weeks. She must complete more than 100 more clinical hours before graduation in May and has no idea whether her school, the University of Maryland, would be able to quickly find her a new placement.
“I understand why they did it, for the precaution and the liability,” said the 26-year-old, who asked that her name not be used to protect her future career prospects. “But I had eight shifts scheduled in those two weeks. I’m in a kind of panic mode, worried I’m not going to finish in time for graduation.”
This KHN story first published on California Healthline, a service of the California Health Care Foundation.
Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.
In an effort to address
of mental health providers in the state of California, UC San Francisco
(UCSF), in collaboration with UC Davis and UCLA, has announced the launch of an
online training program for psychiatric-mental health nurse practitioners (PMHNPs).
The program aims to train 300 new mental health providers to enter the state’s
workforce by 2025.
An estimated 17
percent of Californians live with mental health needs, according to ucsf.edu.
Many in that population lack access to mental health care and the problem is
expected to worsen as the psychiatrist workforce continues to dwindle.
Graduates of UC San Francisco’s new program are projected to serve as many as
378,000 patients over the next five years.
has 13,000 nurse practitioners in its workforce, many of whom care for
underserved populations in primary care settings including hospitals, prisons,
schools, and other outpatient medical practices. PMHNPs are specialized mental
health professionals authorized to prescribe psychotropic medications, treat
severe mental illness and substance abuse disorders, and offer psychiatric
Program co-director Rosalind De Lisser, MS, RN, NP, associate professor in the UCSF School of Nursing, tells ucsf.edu, “I am tremendously excited about this innovative multi-campus program. It has the potential to expand our reach as an educational institution by providing excellent clinical training and contributing to the workforce development needs of California.”
Her sentiments were echoed by fellow co-director Deborah Johnson, DNP, RN, NP, also an associate professor in the UCSF School of Nursing, who stated: “Building upon our successful history as a top-ranked public PMHNP program, this program eliminates geographical barriers and allows California NPs in primary care to gain the education and training necessary to provide behavioral health services in their communities. The three-school collaboration provides high-quality educational resources for students across the state.”
The new program
is scheduled to launch in fall 2020, with administrative offices located on the
UC San Francisco campus. Students will be able to complete their clinical
training component in the region where they live. The program aims to recruit
40 students for the first years and 65 students each following year, for a
total of 300 PMHNPs over five years.
To learn more
about the new online training program for psychiatric-mental health nurse practitioners
being launched by UC San Francisco in collaboration with UC Davis and UCLA,