Why so many fail out of our program?

[lizzyberry]

I know I hear how hard nursing school is I know because Im in it. Yeah it is hard yeah theres a lot of work but do nursing schools really need to fail out or "weed out" so many students. In our class only 11 out of 29 students are passing. Why is this normal? And I see on these threads other NS also have this problem. Many of my friends are studying so hard putting so much money into this program, and failing because the questions on the test were so tricky. Why cant these nursing schools and nursing instuctors teach students how to be better critical thinkers and teach students how to take these tests. Why does this have to be normal that so many students are failing just because of these tests. What about more hands on training and more experience to develop critical thinking. If someone really want to be a nurse and put all there effort and hard work into it, it should show. So these nursing tests really determine if we will be great nurses? What happened to experience doesnt that teach critical thinking. Why do Nursing programs or my nursing program feel like they are just trying to weed out so many students because there arent enough teachers? I swear I feel like when I asked my teacher a question after class she is thinking "All right ask what you need to ask and hurry up because I dont have time for this." And then when they ask in class "Does any one have any questions?" There are so many questions I have for them that I cant even think of one. All Im saying is that I dont like the way our program is ran and others as well. Is it just my program or are other programs like mine? Im just so burned out right now I am passing with high C's but I feel bad for my fellow students who seem to be studying just as hard as me but cant seem to pass these test. Who's really failing the instuctors or the students? Sorry if I sound pesimistic but why do things have to be this way?

[ZASHAGALKA, RN]

There are multiple reasons why. A few, if you will:

1. Most schools are rated on their NCLEX passing standards for graduates. In that case, anybody that doesn't actually graduate, doesn't count. There IS no incentive to reduce attrition.

2. Many programs use arbitrary admission standards, including the worst of all: lotteries for admission. The result is the need to resolve issues after matriculation, at the worst possible time as far as preserving seats.

3. Many instructors view themselves as gatekeepers to nursing, tasked with a florence-like devotion to weed out undesirables. Since there is no penalty for doing so, the result is high attrition.

Average nursing school attrition is 20-40% with some programs reporting routine attrition as high as 70%.

California did a study on this, and I'll find the link later. When schools actually TRY to reduce attrition, they can get attrition down to 10% with 6% being unavoidable attrition (students drop for personal reasons not related to the program or their academic standing) and 4% related to school related issues.

The solution is that, in addition to scoring programs on the basis of NCLEX pass rates, programs should be graded on attrition.

Programs that keep attrition under 10% should be rated as excellent. Programs that keep attrition under 12% as good. Programs that keep attrition under 20% as acceptable. Programs that allow over 20% attrition should be placed on probation.

Bottom line: a program that allows greater than 20% attrition is not the result of a failure of students but of a failure of the program, itself.

Rating programs based on attrition would force programs to front load success: they would be more interested in only accepting students already proven TO BE nursing material

Rating programs would force schools to carefully look at each individual drop: no more instructors bias about who is nursing material. Wasting precious program seats is NOT the right place to determine nursing material - the admissions process IS.

Rating programs would bring more minority candidates into nursing. A MAJOR consideration of whether to pursue a long term goal is the viability of attaining that goal. Arbitrary attrition could and SHOULD make most candidates wary about success. Many candidates feel that, given a chance, they WILL be successful. What about candidates concerned that attrition might not be completely arbitrary? It CERTAINLY isn't out of reach to suggest that some programs just do not care who gets dropped so long as the almighty NCLEX pass rate is maintained. Knowing that getting TO the front door creates a high probability of getting to the finish line might invite more diverse applicants to attempt to knock on the front door of nursing.

The answer to your question is arbitrary attrition is allowed because it isn't penalized. The solution is to penalize it, or, more to the point, to grade the programs based on attrition.

I'll say this again: 20% attrition should be viewed as an utter failure of a nursing program itself. That program should be placed on academic probation and heads should roll until it stops failing its students, and its communities.

~faith,

Timothy.

This is what I said, in another thread.

California study regarding nursing school attrition:

http://www.ucop.edu/cprc/documents/nursingprograms.pdf

~faith,

Timothy.

[Hellllllo Nurse, BSN, RN]

The thing about care plans (which I used to hate btw) is that they really do teach you to think critically and to know what to do for your patient and why. You can train just about anyone to do clinical skills, but not everyone that can perform a skill knows why they are doing it. Patients and family members can learn injections, suctioning trachs, administering feedings, caring for wounds, so on and so forth.... so why do they need nurses around?

I get really frustrated when I have to spend hours doing prep work and writing care plans for my patients before I even see them and then find out that half of my care plan may not fit because the patient isn't in the condition I expected them to be in. But after spending hours and hours focusing on what I need to do for someone in renal failure, CHF, COPD, Cirrhosis, etc I have really learned some valuable information. When I get to clinical and maybe the patient is better off than I thought they were and I don't need to use all the interventions I had decided on I can adjust my care plan. Next time I have a patient with similar problems My mind immediately starts going to the information I gathered last time that is now thoroughly stuck in my brain and I don't have to work so hard in knowing what to look for and do to care for my patient.

I don't know if I am talking in circles, but I hope I made a little bit of sense to you in explaining why careplans are such a necessary evil

You are not talking in circles- you are right on the money.

The reason nursing students must suffer through all that care plan writing is not to present the instructor with a perfect care plan and get a good grade- it is because of the way you are made to think in the process of writing the care plan.

Is is the process that is valuable, not the finished care plan itself.

[mcknis]

Sorry, I was up late that evening after working on nursing school work. it may or may not have been confusing, but my point was that nursing school is hard! That is probably the number one reason why people fail out. It requires so much time and energy, but some people may not be able to give their entire life away to schooling (which is requriedn when in nursing school.

[OnTheRoad]

Umm? They may be a necessary evil. I understand the importance of what care plans are trying to teach,however,there has got to be a better way to teach such evil. I spend more time doing the process than learning what is in the care plan.

I honestly don't think there is a better way. Depending upon how you are being taught or required to do them or how long you have been doing them will affect how much you learn from them though. When I started out, my goal was perfection and I didn't think I retained much. I got a week to formulate a single care plan (1 or 2 dx)and I would stress over it the entire week and it would be perfection. That is not practical, but unbeknownst to me I was actually learning a little. Then I graduated to prep work (check out my pt the night before and have care plans, pathos of disease, all labs, all meds, etc), when I started it took me at least 5 intense hours to do all this to my perfection standards but dang if I wasn't REALLLY learning and retaining info. Then I started being able to do all this work in 1 or 2 hrs, plus once I got my assessments and interventions and assessments done for the patient I had I would shadow my nurse and found I was coming up with care plans in my head based on assessment info on patients I knew nothing about 2 minutes ago.

I never realized I was learning what I was learning, but I have been learning. When I have my RN I am not going to have a week, or a day, or even hours most likely to decide how to best care for my patient. It has to happen now, because their health issues or emergencies are not going to wait for me to check all 50 million reference books I have sitting in my library.

Care plan at the most basic level = how will I care for this patient. Think of it this way... Dude can't breathe well (ineffective breathing pattern, impaired gas exchange whatever); what do I watch for assessment wise, labs, what can I do to help him out? OK did that, how did he respond, what helped, what didnt? Gotta use Nanda sure, but you really are just saying " this is the problem, this is how I think I can help the problem"

[kendel]

i was in med surge and had 18 students and every 2 weeks we lost one student. at end of semester we were down to 8 students.

some of the students failed because of little error in clinical

i know a straight A student with a 4.0 gpa who got kicked out because she didnt speak proper english-her accent was too strong

[wizard100]

we started with 32, 1 quit because she was failing in midterms and other got admission in MSN accelerated prog. We were 30 in 1st semester and graduated 100%. Our school has very high GPA criteria....3.5 or above when getting admitted to the nursing school.

I have to admit out of 4 instructors in 2 yrs.........one was evil and old school type. Our director was the worst.....the devil of all

[CT Pixie, BSN, RN]

I don't think is so much that they are purposely putting "tricky" answers on the tests to weed you out as they are trying to GET you to think criticially and weed out the answers that aren't the best.

It would serve no nursing student any good if the teachers fashioned their tests to make the questions straight forward and clear cut. Then those students get through school, only to fail over and over with the NCLEX. The way the put the questions is a necessiary evil in order to get you to think. Too many of my classmates can memorize and regurgitate the info for a test but ask them to think critically and they have NO idea what would be the best thing to do. They are also the ones who seem to "dump" all the info they memorized as soon as the test is taken. The thing is, memorizing isn't enough, you need to know how to apply that info.

My school told us from the get go that the test questions would be fashioned like the NCLEX questions. And they have been. Sadly, critical thinking isn't something that can be taught to someone by another, it has to be learned by the individual.

[ifixowies2]

I know exactly what you mean. The school I go to/went to has a nursing GPA expectancy of 85%. I've taken patho. now twice and failed it by 5 points. This isn't even a required class at some schools but so many students can only get a c+ in the class. If you fail it twice you're out of the program. That's where I am now. My husband and three kids were really counting on me becoming a nurse so we could have a better life and now I am feeling like someone is telling me to give up the career I've always wanted.

With the fail rate so high in nursing school shouldn't someone be looking at the professors and what they are teaching. How can so many students enter the nursing program as A, B students and then fail out of the program?! Someone needs to be looking at these programs and the way the material is getting through or not getting through to the students. With the RN shortage what it is....it's only getting worse by having teachers basically making the students teach themselves and expecting the students to meet higher and higher standards.

[soooosad]

Hi, I am an LPN.I have struggled from one semester to another.I am complimented time and time again on my clinical skills but I struggle through the exams no matter how hard I try.I am in school now to finish and get my RN but I'm going into my final with a 72 which is failing.The program changed the grading system when I was doing nursing 2. I felt it was unfair.It is now a 75. If they were going to change the grading it should of been for the nursing 1 students only.I also feel that we should be able to write papers,take quizes and do other things to help to improve.Not just fail us for exam grades only.I work hard in clinical-sometimes we have to write reports instead of careplans but it doesn't really count to me because you don't get a grade.A grade that could help me.We have to take something called ATI testing which tells us whether we have a chance to pass the NCLEX exam.I don't mind care plans.They do make me feel ready for my day on the floor.It gives me a chance to look up skills I may not be familiar with. Soooo do you have any suggestions about studing for my final??I need an 84 to pass.I think I'm just going to keep testing myself using the CD"s instead of trying to go back and read all the material.I know mistakes I make are stupid sometimes baecause the question is asking for a neg answer and I look for the pos. answer.But this is it.If I fail this class I can't take it again so I'll be an LPN..and feel like a failure.....

[NaomieRN]

Reasons so many students failed nursing schools:

*Not taking nursing school seriously

*Trying to only memorize information

*Lenghty care plans...only to find out the patient is no longer in the hospital, after spending hours on careplans (happened to me 5 times this semester)

*Not able to think critically

*Reading too much into questions by adding and making assumptions

*Test anxiety

*Overwhelm, juggling jobs; other classes, kids and family

*Not reading the book

*Lack of confidenceI am attending a nursing school in Connecticut, I completed 3 semesters.

My class had 40 students in nursing 101, we now down to 20 and may lose 2 more students.

You cannot teach anyone critical thinking skills.

[TAB_RN]

I just finished nursing school... actually yesterday. I keep reading here that A students and 4.0 students seem to be failing nursing school. I was one of those A students. I was a software engineer for many years and decided to go to college to become an RN. I will be graduating with a 3.13 GPA. That stinks for me, but I will tell you, that most 4.0 students have great memories and can retain alot of information for tests. The problem is, critically thinking. I had the hardest time with this part of learning, because one answer doesn't fit all. Critical thinking cannot be taught to somebody simply. It is an acquired learning that takes experience and patience.... and your patient's lives are relying on you for it. I think the show "House" gives a pretty good example of this type of thinking. If you notice, most of the people trying to get a slot on his team are brilliant... but only the most superb "critical thinkers" will make it.

Your teachers have to weed out the people that are unlikely to make it through the N-CLEX the first attempt. The schools accreditation relies on that. It is not the best system, but it is a reality.

[amybethf]

I don't think is so much that they are purposely putting "tricky" answers on the tests to weed you out as they are trying to GET you to think criticially and weed out the answers that aren't the best.

It would serve no nursing student any good if the teachers fashioned their tests to make the questions straight forward and clear cut. Then those students get through school, only to fail over and over with the NCLEX. The way the put the questions is a necessiary evil in order to get you to think. Too many of my classmates can memorize and regurgitate the info for a test but ask them to think critically and they have NO idea what would be the best thing to do. They are also the ones who seem to "dump" all the info they memorized as soon as the test is taken. The thing is, memorizing isn't enough, you need to know how to apply that info.

My school told us from the get go that the test questions would be fashioned like the NCLEX questions. And they have been. Sadly, critical thinking isn't something that can be taught to someone by another, it has to be learned by the individual.

Exactamundo! Memorizing the material isn't gonna cut it in nursing school!

You have to UNDERSTAND the what, how and why. That is critical thinking in a nutshell. You have to understand the stem of the question without reading into it. Is it a knowledge or priority question? Knowledge requires that you know if a pt. presents with whatever condition, that you know what is normal vs abnormal and can predict the manifestation. If it's a priority, always do ABC, then physiologic needs and safety and then the nursing process. Nursing is all about using judgment that is within the scope of nursing practice. But once you GET it, you begin to understand what is most important to study and the rationale. Get an NCLEX and use it along with your book to help guide you.

Nursing school definitely has a way of 'weeding' students out and it sucks to see friends fail but you have to concentrate on getting yourself thru. Tenacity and motivation will get you thru, believe in yourself and turn off the negative self-talk. Be proactive not reactive. You can do this!