High Fail Rate for new Grads on Boards

Nurses General Nursing

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I work in East Texas and have noticed a alarming trend, our new grads are failing their state boards at a alarming rate (60 % from our local junior college). Moreover, all these new grads that were hired as GNs cannot be fired to make room for nurses that have passed their boards for a least 3 months ( when they retest).

Is this trend national or local in nature? Also, as a preceptor I have noticed that many of our new grads are competent in clinical skills ,but have no idea of what is going on with their patients (disease process). Can I get some feed back and possible suggestions on what can be done to fix this problem?

Thanks Jerry RN, BSN

National pass rate on the NCLEX-RN for 2001 was 85.43%. The test plan has not changeed for about three years. Drop down calculators have been part of the computerized testing for several years.

In West Virginia the state pass rate for 2001 was 87.29%, above the national average. Pass rates for ADN programs was 88.71% and for BSN programs pass rates were 87.15%. All above the national pass rates.

State Board of Nursing need to become actively involved in monitoring of programs. If schools are scoring below the national average, especially two or more years in a row, there is a problem.

Program results should be posted on each state board web-site. If not there perhaps go to the NCSBN web-site to try and get scores.

pama

Dittos to mattsmom and babs! Surprising how much has changed everywhere over the last 10-15 years! I still have my expandable files full of handwritten (very small writting) 10-20 page careplans. They were so in depth in every aspect. I have never seen careplans or written that way since. I have no idea why I keep them!

As far as the boards go: I don't think everyone who fails is or would be a bad nurse. They are tests and some people do better on written, or choice, or matching, or verbal tests than others. The tests reflect if someone is able to take a test. I have gotten where I can pass just about any test I take with mild study and just looking at the questions. There are tricks to choosing the best answers. Sometimes I don't have to know anything about the subject to pass or answer correctly because of the way the questions are written. Especially with multiple choice! Some schools take the time to teach these skills and some don't. Some even provide or atleast encourage the RNCLEX reviews. The schools want a high pass rate to attract students. The statistics don't tell everything.

The tests change from year to year. If you take a review with someone who knows what is on the test you will most likely pass. And believe me those folks who give the reviews do everything they can to find out what is on that test! The reviews also teach you the skills to take tests and how to identify types of questions (umbrella, which one doesn't belong, etc.), disect, and answer correctly. So my question is how could any one test ever truley measure the capabilities and competency of a nurse at the entry level?

It's interesting to read about the various schools. I graduated May 2001 from an ASN program in southern California. I had checked around before I registered and one of the questions I asked was the pass rate on state boards. The school I chose had a 96-98% pass rate. They had a waiting list, but I just kept working on my prerequisites until I was in.

We had 30 students and only about a third of the original class made it to graduation. Everyone constantly complained about how hard the tests were. But I felt that it would be better to have a hard school and feel confident that I could pass boards.

The boards were actually much easier than the tests in school. The only thing I would have changed in my school would have been to have more clinical time. We had the summer off between semesters and I would have liked to have used that time to practice clinical competency.

I came out of school and went directly to a medical cardiac stepdown unit at a teaching hospital and it was quite overwhelming. However, we had a critical care component in school and I had worked in ICU/CCU, ER etc as a student. They even gave me 2 patients in ICU! Talk about stress! The other new grads at the hospital did not have that advantage and it took them longer to finish their competencies.

I think that it's definitely a school by school basis for passing. Some of the state boards of nursing post the pass rates for their schools. I know that North Carolina does.

I don't think that the test has gotten any easier. Although all but two of our class passed the boards the first time, most felt that the test was really difficult.

I'd like to reply to the message written by LauraRN0501. I really resent your comment on the lack of clinical experience of BSN students-I am currently a junior in a BSN program. By the time I graduate next year I will have 3 full years of clinical experience. I think its the nurses you have come in contact with. Personally I dont feel that i would be ready to be out there after getting rushed through a 2 year program. and for those of you who think you are prepared that's great. But the education that I'm getting is allowing me to understand the whole patient, disease process and all. Thus far the understanding of patho and the reasoning for nursing interventions that i have seen in clinical from new 2 year grads have been lacking. Granted the clinical skills may be there, but they are in any good nurse, new or old, 2 year or BSN. But if you dont know why you are doing something whats the point? what can you tell the patient? so the theory also needs to be there. and as for the boards graduates from the program i'm in have a 94% pass rate the first time.

Originally posted by sls0831

The following is a condensed quote:

I'd like to reply to the message written by LauraRN0501. I am currently a junior in a BSN program.

But the education that I'm getting is allowing me to understand the whole patient, disease process and all. Thus far the understanding of patho and the reasoning for nursing interventions that i have seen in clinical from new 2 year grads have been lacking.

But if you dont know why you are doing something whats the point? what can you tell the patient?

I think I have an important question to ask you, dear. Just who has given you the impression that ADN's and Diploma nurses " are clinically OK BUT don't know why they do the things they do?"

I would really like to know who started this ugly rumor. I have NEVER encountered a diploma or ADN nurse who fits this description....:rolleyes:

Specializes in ER, ICU, L&D, OR.

Howdy Yall

from deep in the heart of texas.

Speaking as a person from Texas. ThoughI went to Oklahoma to go to nursing school.When you look at Texas, undeniably one of the single richest states in the union.Financially,economically, stability and all other sorts of categories untill you get to the Texas school system which ranked 48th or thereabouts for the last decade. Then you look at who was governor during that time and you see only detrimental effects arising from his tenure in office. And you hear about about the increaseing number of nursing students failing to pass the boards. Makes you wonder how what he is going to do to this country now.

Now I know this is going to spark criticism because of my stand. But I didnt like him as governor and I dont particularly like him now. Im just a hardcore democrat living in a land of republicans.

Keep it in the short grass yall

teeituptom

Specializes in Cardiac.

I've read these posts with much interest, having gone to an ADN school that had a very high passing rate at the time (I don't know about now, I've moved from the area). I was perhaps a little too proud of my school, when I learned an area BSN program had a lower passing rate. I took the old 2 day pencil and paper test back in 1981 and while I didn't find it that easy, it was easier than the CCRN exam I took 3 years later. Our instructers informed us, though, that State Boards only measured safety. I remember a classmate who was very book smart and got straight A's in school and did very well taking tests, but she wasn't very good at applying the knowledge to real life. I haven't seen her in years, so I don't know if she is still in nursing.

I don't know if the 60% (was it that many who passed or that many who failed?) information is accurate. Sometimes we hear things from other people and take it to be true when we really don't have the facts. (I know I've been guilty of that)

I also can't help but comment on the issue of drug calculation and some statements made. I sat on a Task Force for Medication Safety and assisted in answering questions on a hospital self-assessment and doing drug calculations (beyond the simple ones, such as with Morphine 4 mg/ml, 2 mg is 1/2 ml) in your head or even with a calculator isn't always the best thing. Double checking with someone else is a good thing, but I also think we were blessed to have a Pharmacy with the foresight to purchase a program that included doing the calculations when the medications were entered into the computer. I realize many people will disagree with me, so I suggest going to the AHA web site at http://www.aha.org/medicationsafety/medsafety.asp and the JCAHO web site at http://www.jcaho.org/ptsafety_frm.html to read the information. The statistics on med errors and the cost to patients' lives are staggering.

Just had to put my 2 cents worth in on that issue.

Specializes in Cardiac.

PS:

To clarify: I have nothing against nurses knowing how to do drug calculations, I think it's important, but we also need to recognize that we are human and can make mistakes, especially in today health care climate.

I also realize that my comments were a bit off topic, but that issue was mentioned in the discussion and it obviously is an important one to me.

Originally posted by RNinMay

I graduated with my ADN in May of last year. We had to go get our patient assignments the day before, spend hours with the chart and then all night looking up drugs, making cards, researching all the labs, pathophys reports, just like Babs did. Same kind of careplan too, with nursing diagnoses and rationales for every single intervention, referenced in APA format. I guess my program was "old fashioned"? But then again our school has a high pass rate also.

I am working in the ICU, have been since last July. There is still so much I don't know!! I think it will be at least 2 years before I can confidently call myself a "critical care nurse". The staff I work with is wonderful and honest, and the feedback I have so far is very good from them. Even the ones who don't think new grads should be allowed to go into critical care (and they will tell you to your face) say that they "got lucky" when they hired me. That makes me feel good! I am doing my best to learn more every day.

One "veteran" nurse told me she still learns something new everyday, that's the great thing about nursing.

Lots of people in my class were there for the wrong reasons, to capitalize on the shortage or as a stepping stone to working for a pharmaceutical company. And yes, many acted like they "knew it all" when the opposite was true. It was mostly the younger ones (I am 29). I hope the "real world" of nursing set them straight.

As for the money issue of it being cheaper to hire new grads, my pay rate is not very much below what the 15 year nurses are making (much to their dismay--- and they have every right to be paid much more than me). Plus the hospital paid for me to go thru a 3 month critical care internship program. I realize this did not come out of my nurse managers budget, but the cost had to be figured in somewhere. It is also true that I am more amiable and don't argue with the administrative changes and all the things the other nurses complain about---I am too busy learning to do my job safely and effectively---but that is changing quickly! Especially the other day when I had FOUR patients assigned to me. You betcha I was in her office about that one. So yes, at first we are more meek, but we catch on to what is going on and start speaking up within the first year :)

Hi there !:)

You sound like you have a good head on your shoulders and I wish you only good luck. I have worked with several excellent nurses who went to ICU right out of school and did well....they were exceptional and if you are doing well, you probably are one in that category!

Don't close your mind to medsurg, as critical care without the strong medsurg background tends to leave some learning 'holes'.....with organization and prioritizing, and basic skills!

I've always said a good medsurg nurse is worth her/his weight in gold...can't beat the knowledge base you get there...and ICU can miss the boat as far as baseline knowledge..... JMHO.

Best wishes,

Deb (mattsmom81)

Here in So. Calif. the community colleges produce the majority of the new graduate nurses. The current mandate is "everyone has an equal right to fail." What that boils down to is that schools have to take all those who are qualified. Qualified can mean different things and because of more candidates than places menas the shcools can set prerequisites that must be met before you can even seek admission. Then, the student gets placed in a lottery and with any luck gets picked, eventually. There is no place in the system for selection of the best qualified, or the one person who may lack certain qualifications but is well suited to nursing. It's no wonder we're seeing higher failure rates.

We have also noticed that with the rolling NCLEX dates, new grads are often reluctant to set a date as they don't "feel ready" to take the test. No one every feels ready to take it. As our director of education tells them, every day grey cells are dying.

To SLS0831--Try not to be so defensive and testy about your BSN. There are great nurses from every educational background. Education is at base more about what you put into it than what is put into you by it. Nurses judge new grads first by their skill set. Nurses judge their peers by what they're able to do with that skill set. In other words, by the ability to think critically, make quick, informed decisions, and do the best for the patient.

k

I'm still a student, but that stereotype is inaccurate. I choose the school I'm attending now because it has the highest pass rate in the area (95 % or higher for over ten years). The graduates from the school I'm in are sought after because they DO know what they are doing. The trend here is that certain schools have higher fail rates. I challenge you, all of you, If the new grads are so 'bad', then teach them!!!

Babs, I must be going to the same school you went to. Guess what its an ADN program(for those who think they are inferior). I don't know about other states, but here in Ill. the only classes I would have to take to get my BSN are business and management classes. At least in my ADN program, we have to go to the hosp the night before, get pt information for 2 pts, write care plans(without a book) and meet all eleven basic needs, fill out medication cards for every medication, lab cards, diagnosis cards and yes ADN do have to know why for every med, lab and test. If we can't tell the pt why they are taking every med and what side effects they can expect, as well as inform our instructor what we will assess before and after each med and what interventions we will perform we are sent home and given an absence. I started nursing school in 1990 and left two weeks before graduation to go to desert storm, if anything it is much harder now than it was then.

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