Attrition/Retention rate at your School

ixchel · May 19, 2013

*giggle* I think I blended 2 metaphors there.

Sadala, ADN, RN · May 20, 2013

You are not wrong....it is all about the money $$$. Certain schools obviously admit a larger less select group of candidates with the intent of the program to "weed them out" after a period of time thus keeping the NCLEX pass rates of GRADUATED students remains intact.

One of the instructors vociferously denied that this is the case, but all available evidence points to it being true, unfortunately. In the case of my institution, I do see that some candidates are less select. However, I also see intentional weeding out of other students. This is done in various ways. The program difficulty gradient increases if there are too many students left at the end of a particular semester, and it appears to me that some students are truly bullied into quitting.

I'm at the head of my class and not terribly concerned about failing out of the program. I have no concerns about passing the NCLEX. I just... have issues with the process, given that most students who come in are far younger and perhaps, more trusting, than I am. They have no idea this is coming, and it seems somewhat, to put it kindly, disingenuous, since the school does not publicize its retention rate (and in fact, when I specifically asked about it during orientation, the director hemmed and hawed and then flat out misled folks, claiming a higher percentage than what I am actually seeing).

It's not about retention levels when deciding accreditation...it's about content and graduation/NCLEX pass rates.

I was afraid that retention probably wasn't even considered. I think perhaps that it should be. SOME states seem to be factoring this in and working towards increased retention, quality, and NCLEX pass rates. That seems to me to be a move in a better direction.

Sometimes here, I almost get the impression that new students are being sold a pig in a poke.

Sadala, ADN, RN · May 20, 2013

You may be hitting the nail right on the nose with your thoughts. Is your program accredited? I thought I read on here some time ago that a program stands to lose its accreditation if it loses too many students over the course of its curriculum.

It is accredited. Apparently though, in my state, retention is not an accreditation issue. I would be absolutely most interested in receiving any updates about the study being completed by folks at your program.

I've actually been doing a good bit of research on this. A neighboring state to me IS focusing on retention as part of its program quality measure for accreditation. This school has offered me a transfer in and also a full scholarship without losing time. I am very seriously considering it. It is situated such that it is actually somewhat closer than the school I attend in my own state.

Additionally, the clinical sites are numerous, and fairly close to the school. At my present institution, clinical sites can be more than an hour apart and one may need to attend sites in numerous cities during the course of a single semester.

MommaTy · May 20, 2013

I think mine said something like 80% pass rate first time on NCLEX.

nurseprnRN, BSN, RN · May 20, 2013

I'm afraid that I suspect that my institution enrolls far more students than it would ever be able to put through the program due to available clinical space/clinical staff. And I'm afraid that this occurs due to the $$ generated from those additional students. I've been keeping track of the numbers, and it seems that less than 1/3 of the students who enroll actually graduate.
I would really love to be wrong about this, but I'm scared that I might not be. I'm not scared for myself. It's more that I'm questioning the integrity of the process and it concerns me.
I would also like to know if there are factors in pre-screening that predict success. I suspect that there are, and I suspect that the results of that research may be what you'd imagine they would be. I suppose though, that I would further like to know what about how a program functions predicts student success. And then there's the question of... what is success? How is that defined? Is it just the percentage of those who pass the NCLEX after they graduate? What about all of those other students? Having the majority fail out doesn't seem terribly successful to me in terms of what the outcome of an educational program should be...

Every year our program would admit about 25% more students than we knew we would be keeping, because no matter how well-qualified the applicants, in about three weeks about that many would be in our offices crying because they 1) didn't know they'd have to see naked old people, 2) didn't know school would be so hard, 3) thought it would be more like on TV, 4) thought they could just do mother-baby and didn't have to do med-surg and psych and all that other stuff too in school, 5) didn't know how much responsibility a nurse has, 6) were shocked that they had to see/hear/smell/touch things like .... etc., etc. "I always wanted to be a nurse like my mother/my auntie/my neighbor/my pediatrician's nurse/Cherry Ames," they wail as they come to withdraw.

I don't know the answer to this. These kids were academically qualified to do the work but they just had a totally weird idea of what nursing is or a distorted view of how they would be doing it. We didn't admit them for the money, we admitted only people who could do the rigorous academic work required; we knew that about a quarter of them would leave fast but we just didn't know who. Hope those PhDs are looking at that.

Then, of course, there were the ones who did well in high school science but didn't make the transition to college-level work, couldn't learn to think like nurses, or had other academic challenges, often general maturity issues. I am not sure how you'd screen for that, either.

Sadala, ADN, RN · May 20, 2013

Every year our program would admit about 25% more students than we knew we would be keeping, because no matter how well-qualified the applicants, in about three weeks about that many would be in our offices crying because they 1) didn't know they'd have to see naked old people, 2) didn't know school would be so hard, 3) thought it would be more like on TV, 4) thought they could just do mother-baby and didn't have to do med-surg and psych and all that other stuff too in school, 5) didn't know how much responsibility a nurse has, 6) were shocked that they had to see/hear/smell/touch things like .... etc., etc. "I always wanted to be a nurse like my mother/my auntie/my neighbor/my pediatrician's nurse/Cherry Ames," they wail as they come to withdraw.

I don't know the answer to this. These kids were academically qualified to do the work but they just had a totally weird idea of what nursing is or a distorted view of how they would be doing it. We didn't admit them for the money, we admitted only people who could do the rigorous academic work required; we knew that about a quarter of them would leave fast but we just didn't know who. Hope those PhDs are looking at that.

Then, of course, there were the ones who did well in high school science but didn't make the transition to college-level work, couldn't learn to think like nurses, or had other academic challenges, often general maturity issues. I am not sure how you'd screen for that, either.

I totally see this. And particularly with some of the younger students, I suppose. They don't really know themselves quite as well yet. And nursing courses are different than general science and other educational courses. I completely expect some attrition and I expect that some students will discover (or staff may discover) that nursing really is not for them. Or that perhaps it at least isn't for them at the present time.

But what if you watched your 5 semester program failing or driving out around 65% of the students initially accepted - and this seemed about on par with the number of clinical spaces available for the next semester? And what if they really only had clinical space/clinical instructors for 35% of them by the final semester (in fact, I think this actually may be a generous take on the percentage on my part). And what if your school, while doing this, had a 100% pass rate on the NCLEX? For a few years running. Such that basically anyone who wasn't a sure pass on the NCLEX NEVER graduated. Would you find the situation to be a little... I don't know. Odd?

And what if the students coming in had NO idea that the attrition would be this high. Could you just in all good conscience continue in such a program even if you were confident that you yourself would make it through? I'm having some difficulty not advocating for these other students who seem to think they are coming into a program to become nurses, but most of whom will be failed and will be left both demoralized and badly in debt. I don't think I can continue to watch without addressing it, and addressing it would be the end of my own academic career there. And I don't think I can stay and sit idly by. I just don't. This is not supposed to be a for profit nursing program.

Basically, your program had about a 25% attrition rate. But in the case I'm describing, it would appear that roughly the inverse is true.

Since I have the rare opportunity to transfer intact and receive funding from a school I've investigated more thoroughly (than I had this one before I applied), I'm thinking that it would be best for me to do that while I have the chance.

ixchel · May 20, 2013

Related to what GrnTea is saying, for the life of me I do NOT understand how someone goes to school for several semesters and after doing all of that work, THEN decide they don't like what they've chosen. Does no one research this stuff beforehand anymore? If there is anything I am going to beat into the heads of my children, it will be REALISTIC DECISION MAKING when choosing a career path. Talk to people in that career. Learn the salary. Talk to people in that career. Learn the market. Learn the expectations to get hired. Talk to people in that career. Learn what degree you need. Learn what licenses you need. And then, talk to people in that career. (I'm repeating myself intentionally.) You need to understand what people enjoy about that career, what they hate about that career, what they go through to get and stay employed, how hard that job is, and anything else I am leaving out that might give a well-rounded picture of what that career will bring. I think it's insane to go through all of that education and to waste all of that money to realize you don't actually like the field and drop out.

Although...... If we're going to talk about ridiculous decision-making in degree choices, I have a fellow classmate who is in the program to meet her future husband. lol

Anyway, sorry for the hijacking. I do think if people are frequently dropping out due to lack of desire to go into nursing, that seems crazy to me that they wouldn't do the thorough research beforehand. Reminds me of the article on Cracked.com, I believe, that talks about how our parents let us all down by telling us we could be whatever we want when we grow up.

nurseprnRN, BSN, RN · May 21, 2013

It might have been in this thread or somewhere else, but someone thought that my post indicated only a 25% attrition rate. No, that was 25% in the first three or four weeks of school.

The overall attrition rate was somewhere between 40-60% from year to year; that is, about half the people who were admitted to a class finally graduated. Nursing school is harder than a lot of folks thought, and some people really aren't cut out for it at this stage in their lives.

nurseprnRN, BSN, RN · May 21, 2013

Basically, your program had about a 25% attrition rate. But in the case I'm describing, it would appear that roughly the inverse is true.

No, that was 25% in the first three or four weeks of school.

The overall attrition rate was somewhere between 40-60% from year to year; that is, about half the people who were admitted to a class finally graduated and pretty comparable to a lot of programs I read about on AN. Nursing school is harder than a lot of folks thought, and some people really aren't cut out for it at this stage in their lives.

BeenThereDoneThat74, MSN, RN · May 22, 2013

Apparently, it doesn't happen everywhere (two people so far have responded that they don't lose that many but still have high NCLEX pass rates). I wonder why. I wonder what those schools do differently.
i.e. is it something about the school's programming or is it that they manage their acceptances differently, or what?

They have a stringent admission criteria. They don't take people just to fill the seats. My school has gone through periods where application numbers were low, and almost anyone who applied got in. Most people are pretty close to the 'ideal' criteria, but trust me, it shows in the high attrition rate and not-so-high NCLEX rates when this happens.

My school fluctuates with NCLEX rates, but the attrition stays about the same. Roughly 50% of our students need to repeat a class. Most of the failures are in 2nd and 3rd semesters. Those who fail the 2nd, repeat (then pass) it, tend to do poorly (or fail out) in the third semester.

BeenThereDoneThat74, MSN, RN · May 22, 2013

You may be hitting the nail right on the nose with your thoughts. Is your program accredited? I thought I read on here some time ago that a program stands to lose its accreditation if it loses too many students over the course of its curriculum. I may be remembering incorrectly. It might seem unfair to hold a program responsible for the success of its students so strictly, but at the same time, it would weed out the programs doing exactly what you suspect - admitting far more with the intention of collecting a tuition check.

You are correct, NLNAC (now known as as ACEN) looks at attrition rates. They want to know how you are justifying taking in certain applicants who fall below the criteria. Or, if they met the criteria, what is going on that they cannot get through. And, what support services do you have in place to assist at-risk students, or those who are not passing?

calivianya, BSN, RN · May 22, 2013

My school has the best of both worlds: we only lost 2 people after admission to upper division out of I think 91, so we were down to 89 by graduation, and my school had a 97% pass rate last year. The key is EXTREMELY supportive faculty who are also excellent educators. They took time to make sure we really understood things and posted lots of supplemental materials if we didn't. If we weren't doing well, we could always visit them anytime and they would help us understand. I think a high rate of people flunking out is a sign of poor instruction. My school doesn't always take the people with the best GPA, either - there were some in my class who had GPAs under 3.5 when they were accepted, so it's not about taking only exceptional students.

I don't know why nursing school instructors feel the need to eat their young by creating impossibly hard tests and not teaching to the level. My school is a case in point that that does not need to be done to pass boards and be good nurses. We've all learned in psych about the study with the bright mice and the stupid mice about how a nurturing environment will help even not so smart mice perform on the brilliant level... this is basic common knowledge that nurturing others helps them do better. It always blows my mind when people talk about rude teachers and clinical instructors in nursing school. How can you TEACH the concept of nurturing if you're incapable of doing it? What hypocrisy.