Early on in this campaign, I requested a copy of the written official agreement between Marquette and the Wisconsin Department of Regulation & Licensing (DRL) regarding the licensure of Direct Entry students who do not hold a "diploma of graduation" as is required by the Wisconsin Nurse Practice Act. I requested this document, which I am calling the "Special Agreement," from both Marquette and from the DRL, but only the DRL responded (the DRL is legally required to provide this of information under the Wisconsin Public Records Law).
The DRL provided this document. It is a 1999 letter from Wayne Austin (then legal counsel for the Wisconsin Board of Nursing) to Madeline Wake (then Dean of Marquette University's College of Nursing). I never followed up with trying to get this information from Marquette as well since, as a private institution, they are not legally required to provide me with this information, and I thought that they would just produce the same document.
The most important sentence in the copy of the "Special Agreement" produced by the DRL can be found at the bottom of the second page (emphasis mine):
"If participants in the new program will also complete educational and training which conform to the curriculum standards cited above, it is our opinion that persons completing the basic nursing education phase of the program would qualify both to sit for NCLEX and for licensure to practice professional nursing."
Marquette University provided a copy of this 1999 letter from Wayne Austin to Madeline Wake to the Wisconsin Board of Nursing for review at the July 26th meeting, presumably in defense of the licensure of their Direct Entry students. But the most important sentence in the letter provided by Marquette is significantly different, in fact it completely changes the entire meaning of the letter. The text of the "Special Agreement" provided by Marquette is exactly the same as the one provided by the DRL except for that the sentence quoted above is replaced with this sentence (emphasis mine):
"If graduates of the new program will also have completed education and training which conform with the curriculum standards cited above, it is our opinion that graduates of the program would qualify both to sit for NCLEX and for licensure to practice professional nursing."
[I'm sorry I don't have a pdf of this version of the "Special Agreement" that I can link to yet]
The version of the "Special Agreement" provided by the DRL seems to answer Marquette's question (does "completion of the pre-MSN part of the Direct Entry program legally constitute "graduation" for the purposes of licensure in Wisconsin?) by indicating that, yes, this would be sufficient for licensure in Wisconsin.
The version of the "Special Agreement" provided by Marquette answers the same question exactly the opposite way: it clearly states that only graduates of the program will be eligible for licensure. I don't quite understand why Marquette is interpreting this letter as "permission" for Direct Entry students to become licensed at the end of the pre-MSN phase of the program without graduating.
There was one other small difference between the "Special Agreement" provided by the DRL and the one provided by Marquette. The letter provided by the DRL is not signed by Wayne Austin, and the one provided by Marquette is. It seems most likely to me that the version of the "Special Agreement" produced by Marquette, the one that specifically requires graduation and has Wayne Austin's signature on it, is the real document.
I would be interested to know why there are two versions of the "Special Agreement," and which one is real? Why does the DRL apparently not have on file the same letter as the one that Marquette has produced? Was the document tampered with at the DRL, or are they just being sloppy?
In any event, it really does not matter which version was actually sent to Marquette back in 1999. Either way the the licensure of Marquette's Direct Entry students who do not hold a "diploma of graduation" from a school of nursing is against Wisconsin State Law:
- If Marquette's version is the real one, then it clearly states that only graduates of the program are eligible for licensure. This is exactly what is required by the Wisconsin Nurse Practice Act 441.04 and the Wisconsin Administrative Code N 2.03 (1)(c). Marquette's Direct Entry program is operating in direct violation of this letter, which clearly requires graduation.
- If the DRL's version is the real one then Wayne Austin and the Wisconsin Board of Nursing were acting outside of their scope of authority to make such an exception to state law to allow the licensure of Direct Entry students who do not hold a "diploma of graduation" from a school of nursing. The letter is invalid because it violates Wisconsin State Law.
