NCLEX: How many times is enough?

Very interesting question. I happen to know a very, very smart girl who has taken and failed the NCLEX at least 3 or 4 times. She graduated school something like 2 or 3 years ago, and is still working as a tech because she hasn't passed. It's so sad, because she is fantastic with pts, and will be a fantastic RN. She just has a really hard time with tests.

I have also worked with people who are...not quite so gifted...who passed on the first try - but I wouldn't want them taking care of me!

Aren't there already some kind of rules in place about how many times you can take it and what happens if you don't pass?

Last I heard, you could take it as many times as you cared to pay for it. For some people, it's ALOT of times. Most I heard of was 7. And still didn't pass, just gave up finally.

I guess I'll get flamed for this, but I think three strikes and you're out. If you can't pass a minimum competency test with three shots at it, you probably aren't suited for the game. Yeah, yeah, we all know about the bad test takers, test anxiety, etc. But it's not like it's the person's first test: how many final exams did it take to graduate nursing school? And if the anxiety of the test is enough to make you screw it up that badly, what would the anxiety of the RN's responsibilities do to you (and your patients??).

Flame away.

If someone's desire to become a nurse is so strong that they are willing to spend years trying to pass the NCLEX and take it nth times, then they should be able to take it as many times as the rules allow. They are the ones that have to keep paying for it and being disappointed. Bless their hearts. I commend them for being so tenacious and going after what they want.

My best friend from nursing school possesses so much knowledge and is so intelligent, but her test anxiety kept her teetering at the edge of failing every semester. So I know for a fact that test scores are not always equivalent to knowledge and ability. If she doesn't pass the NCLEX on her first, second, or fifth time, I would encourage her to keep trying, because if she walks away. . .the world will miss out on a great nurse.

Last I heard, you could take it as many times as you cared to pay for it. For some people, it's ALOT of times. Most I heard of was 7. And still didn't pass, just gave up finally.

I guess I'll get flamed for this, but I think three strikes and you're out. If you can't pass a minimum competency test with three shots at it, you probably aren't suited for the game. Yeah, yeah, we all know about the bad test takers, test anxiety, etc. But it's not like it's the person's first test: how many final exams did it take to graduate nursing school? And if the anxiety of the test is enough to make you screw it up that badly, what would the anxiety of the RN's responsibilities do to you (and your patients??).

Flame away.

Fair points. I have considered them when thinking about this person. But I'd rather have someone who took a few times to pass than someone who guessed and got lucky and really has no clue what to do in an emergency. I'm sure it's different for every person. The one I am thinking of has great critical thinking skills - questioning things that some RNs miss, stays calm in an emergency, knows what to do. Just has no confidence left after not passing the first time.

What about a situation where, if you don't pass say 3 times, they have some kind of written test or something where there is a panel that scores the test/interview/etc and decides either, yes, you've got the appropriate knowledge, or no, you really don't. I just think there is so much more to being a good nurse than a high pressure multiple choice test. I wish there was another way to decide who gets to be a nurse and who doesn't. It's such a shame that they have all this education (this particular girl has a BSN) and they can't use it. At least, not the way they want to.

It can also be said that someone who is willing to fight that hard to reach their goals will be willing to fight that hard, if not harder for their patients. People tend to appreciate what they work hard for.

If the rules say they can take it as many times as they would like, then the authorities must not feel the same way that some people on this board does.

Last I heard, you could take it as many times as you cared to pay for it. For some people, it's ALOT of times. Most I heard of was 7. And still didn't pass, just gave up finally.

I guess I'll get flamed for this, but I think three strikes and you're out. If you can't pass a minimum competency test with three shots at it, you probably aren't suited for the game. Yeah, yeah, we all know about the bad test takers, test anxiety, etc. But it's not like it's the person's first test: how many final exams did it take to graduate nursing school? And if the anxiety of the test is enough to make you screw it up that badly, what would the anxiety of the RN's responsibilities do to you (and your patients??).

Flame away.

It may be an unpopular opinion, but I totally agree. Standards are in place for a reason.

When I graduated, candidates could only test three times. If they failed the third time, they had to repeat their nursing program.

I think it is highly unlikely that anyone could guess at the answers, "get lucky" and pass.

Some of my class mates did not have a clue in lab, clinical, or theory. They did not pass the NCLEX, and this is a good thing.

Lowering standards does not benefit anyone.

Flame away.

Fair points. I have considered them when thinking about this person. But I'd rather have someone who took a few times to pass than someone who guessed and got lucky and really has no clue what to do in an emergency.

Well, of course, and no one would argue that. But the thing is, everyone likes to use that kind of analogy, and it doesn't hold water, really: WHY does everyone say "I'd rather have the person who's lousy on tests but an awesome clinical nurse than the person who is a lousy clinical nurse and great on tests"? Why does it have to be so ridiculously unbalanced? Have we never seen, in normal life, someone who is bad on tests and really IS a poor nursing candidate, and someone who is adequate to good on tests and a great nursing candidate?

Not trying to pick at you, please understand, I guess I'm just hating that particular "I'd rather have the good nurse than the booksmark person" that gets thrown out there all the time.

'Cause you know, sometimes a person who can't pass the danged exam is also someone who kept skating through clinicals by the grace of their classmates and just shouldn't be ANYBODY's nurse. I have seen a couple of those firsthand.

It can also be said that someone who is willing to fight that hard to reach their goals will be willing to fight that hard, if not harder for their patients. People tend to appreciate what they work hard for.

If the rules say they can take it as many times as they would like, then the authorities must not feel the same way that some people on this board does.

Yes indeed. Until it gets changed, which I imagine at some point it will. The history of GNs is an indication of that change of thinking, I believe.

At one time, it took several months to find out if you'd passed the boards, and so GNs worked until such time as they got results. Now, it takes a mere couple of days to discover if you're an RN or have zip, so there's really not much point in the whole GN thing anymore. It's nice to be able to work while studying for your license, but there are enough States that no longer allow GNs to work to tell me they don't like it. Work as an RN after you ARE an RN, not before. I also imagine the hospitals who have been burned one too many times by spending on orientations for GNs who don't pass their exams might be behind THAT push.

Well, of course, and no one would argue that. But the thing is, everyone likes to use that kind of analogy, and it doesn't hold water, really: WHY does everyone say "I'd rather have the person who's lousy on tests but an awesome clinical nurse than the person who is a lousy clinical nurse and great on tests"? Why does it have to be so ridiculously unbalanced? Have we never seen, in normal life, someone who is bad on tests and really IS a poor nursing candidate, and someone who is adequate to good on tests and a great nursing candidate?

Not trying to pick at you, please understand, I guess I'm just hating that particular "I'd rather have the good nurse than the booksmark person" that gets thrown out there all the time.

'Cause you know, sometimes a person who can't pass the danged exam is also someone who kept skating through clinicals by the grace of their classmates and just shouldn't be ANYBODY's nurse. I have seen a couple of those firsthand.

I guess I've just seen the opposite of what you describe. I'm going to keep using this person as an example since she is the one I started with. She is totally booksmart, and a great clinical person (at least, in her current capacity). It's test anxiety that throws her down. I don't understand why you say the argument of "I'd rather have the good clinician" doesn't make sense or is ridiculous,. It's a fact. Some people are super smart but terrible in real world situations. I never said that was everybody. Most people take the test, pass it, and move on.

I also have worked with someone who passed the test by some strange miracle and has run an entire bag of heparin (500 ml, 25,000 units) over an hour because she thought it was vanco! That's just one of many serious mistakes she either made, or someone stopped her from making. So yeah, people with common sense are the ones I would want taking care of me, whether they can take tests well or not.

Questions that must be answered, when asking this question, include:

Does the NCLEX accurately predict RN competency? Is it valid?

Even if the answer is yes, we can't absolutely conclude that it is therefore the ONLY predictor of RN competency. That would be illogical. Even if the NCLEX successfully filters out/predicts individuals who will better perform nursing duties safely and effectively this does not mean there are not other filters that would not achieve the same function (or that the two filters would not overlap for some individuals and not for others).

Is the NCLEX even necessary? (I believe that good on the job training plus good performance evaluations would eliminate the need for the NCLEX, if necessary. Obviously we do not face that necessity. I'm just saying: if for some reason we could no longer adminster the NCLEX, I find it hard to believe the RN workforce would suddenly be filled with incompetents. Nursing school and competent supervisors plus competent training should be filter enough.)

We know the NCLEX itself can be taught. There are ample review courses out there that can teach enough NCLEX strategy to enable many to passt his exam who otherwise could never do so on their own, with their own independent thinking. Yet we have many who never seek out (or who are unable to pay for) these instructors.

To arbitrarily pick a number (three times) when there are so many variables out there (far more than I mentioned here) seems senseless to me. What is the reason for picking the number three?

And, in defense of those who need to take the exam five times or more, let me ask this question: do you assume that if someone fails three times, they are incapable of "improving?"

What exactly does the NCLEX test, in your opinion, that cannot be learned? If you are not simply applying arbitrary punishment according to your timeline, you must be operating off an assumption that the NCLEX tests something that cannot be learned. Otherwise,why not give someone the chance to learn whatever "it" is and demonstrate they've learned it on the NCLEX?

If the NCLEX is truly valid, as you seem to believe, then it should be valid whether someone passes it the first time of the 30th time, should it not? The million or more reasons it may take someone that many times to pass it should have no meaning if the test is TRULY valid.

I'm not saying it is. I'm just pointing out that your own faith in the NCLEX defeats an arbitrary "three strikes and you're dumb" belief.

Either you believe someone can improve their nursing critical skills set or you do not.

Also, just because someone is anxious when it comes to exams, they will not necessarily be anxious during a medical emergency. This is more bad logic and it would be sensless at best, and cruel at worst, to judge someone as incompetent to be in medical situations simply because of their assumed test anxiety and your belief this anxiety is universally transferrable.

I would be disappointed if someone took these statements to be "flames."

I appreciate the questions asked, the ability to participate in this discussion, and I stand behind my points pending better points.

Have we never seen, in normal life, someone who is bad on tests and really IS a poor nursing candidate, and someone who is adequate to good on tests and a great nursing candidate?

Of course, most people's test scores reflect their knowledge/ability; but, there is a big difference between someone who does poorly on tests because they don't have the required nursing knowledge (the poor nursing candidate) and someone whose testing anxiety effects their ability to test well. My question is: have you ever seen, in normal life, a great clinical nurse who wasn't the best at taking tests?