Why the high drop out rate of nursing students?

Specialties Educators

Published

Here is my question for educators.

I'm wondering how to decrease the drop out rate in nursing schools but I first need to know what the students reasons are for dropping out.

My thought is that some students apply because they want to be a nurse but like most of the general public don't know exactly what a nurse does besides follow MD orders, administer medications and make patients comfortable. They are surprised when they find out how much more is involved including the extra heavy load of coursework/study time and figured it was more then they bargained for and leave. Am I way off base here or is there a percentage of student's that fit this category?

What are the more common reasons for student leaving school?

What is the drop out rate at your school?

Thanks, Karen

Specializes in med/surg.

Just my :twocents: here, but nursing can be a very frustrating field to work in... you are often pressed to deal with situations that tangle your emotions & yes, at some point I believe it'll bring you to tears.... That said, about those who feel the tests did not cover what your lectures covered... THERE IS NO WAY to cover everything you'll need to know in 2 or even 4 yrs of schooling... nursing requires you to be flexible, able to roll with the flow & learn on the fly... medicine in general changes all the time... you cannot statically learn information in school & expect to have all the tools to become a nurse. I can't speak for other programs... but we were taught a knowledge base... from this information we had to critically think & base our answer on the knowledge we had applied to this specific situation... you cannot simply learn facts & expect to do well in school... you need to be able to take what was taught & apply it to what you are faced with... such is nursing in real life... there is not someone there to say hey, remember we covered this last week in lecture... you need to know how to use the information you gain in school... nursing isn't a black hole... there is a large amount of variable in what you do, see, learn, do in school & what will actually occur when your responsible for someone's loved one... so yes, nursing school should push you to tears... often you are all that you patient has to count on... after all you are responsible for someone's life, not just passing a test.

Specializes in Med/Surg, ER, L&D, ICU, OR, Educator.
... you cannot simply learn facts & expect to do well in school... you need to be able to take what was taught & apply it to what you are faced with... such is nursing in real life... so yes, nursing school should push you to tears... often you are all that you patient has to count on... after all you are responsible for someone's life, not just passing a test.

Utterly accurate! Great post!

I absolutely agree that there is no way to cover everything.

I am rather unclear on what, then, minimally needs to be covered for a consistent foundation across starting practitioners.

Should graduates of nursing programs be able to list from memory the signs and symptoms, pathophys, treatments, etc of all of the conditions their textbooks covered? Do instructors clarify whether students should be studying their text books ("pls read pgs 253-347 by Wed") or using them more as references to write care plans and work on case studies? Should graduates of nursing programs be able to write a 20 page detailed care plan with the latest nursing research referenced? Or should they be able to quickly pull together a 1-2 page care plan that applies currently accepted standards of nursing care? Again, how much time of a nursing curriculum should be devoted to each of those?

And given that textbooks simply list various conditions and their nursing care and lectures often follow the text, when and how are students supposed to learn and practice critical thinking and how to apply knowledge to unfolding clinical situations? During clinicals? That often doesn't happen with 10 students to one clinical instructor and many practicing nurses that students work under unable (due to time or lack of clinical teaching experience) to demonstrate or explain what they are doing, why, and how they processed the information along the way. In writing care plans? The ivory tower care plans where nurses have all the time and information available aren't very transferable when it comes to the realities of NOT having all the time and information available. Thus, when faced with that reality out of school, new grads often feel unable to *properly* practice nursing because they don't have all the time and information available. They can feel unsafe and unprepared and that the *professionally responsible* thing to do is to remove themselves from nursing.

Specializes in med/surg.

Actually yes, care plans are a way of learning to put your knowledge into practice of a sort... you need to understand the disease process vs. normal system functioning... the differences... & how the disease could & how it is actually affecting your pt & then design a plan of care utilizing this knowledge... your care plans in "real life" may not be as indepth, but many of the things you once listed as a student, you just automatically perform many of those nursing tasks...(i.e pt SOB, apply O2, sit them upright, etc...)

To bring it back to student drop outs, one issue I had with nursing school was that while it was difficult in terms of getting everything done (case studies, pre-clinical prep work, reading endless assignments from the texts, etc), the difficulty level of the content sometimes seemed to be inflated.

For example, if a student had a VALID issue with a test question and their point was backed up by the text, some instructors would simply say that the student just wasn't properly applying their critical thinking skills. They made it seem as if the reason the student got it wrong was because they weren't smart enough. The implication was if it wasn't that clear to the student why the correct answer was better than another was that the student just must not have what it takes to be a good nurse, which wasn't always the case. Someone insecure about their abilities can easily come to think that "this is just too hard for me" and give up.

Nursing school should weed out students who don't want to be nurses or can't be good nurses. But sometimes it seems that students are being weeded out for the sake of being weeded out - so schools can brag about how difficult it is - without any clear criteria over what exactly is needed to progress in the course. For example, there may be a clear requirement that 80% is needed to pass a test, but when the test doesn't resemble what was covered in class or text, scoring 75% doesn't necessarily mean that the student wasn't studying or understanding the content as presented.

On the other hand, one hears about schools that pass just about everyone, overlooking poor performance, and that's not right either.

I think the drop out rate is high for college students in general regardless of major. I do believe nursing students drop out rate is alot higher because it is a life and death career.

This is a comment and a question to see how my program compares to others. I am finishing up my first year of nursing school at Chemeketa Community College in Salem, OR. It is generally considered one of the best nursing programs in the state. It is difficult and comprehensive in its approach with many clinical opportunities in a variety of settings. Straight-A's are required for all prerequisites, and many more applicants apply every year than are accepted due to numbers. We have lectures two days a week, clinical rotations two days a week, exams every other week, check-offs on all skills before practicing in any clinical setting, required group community projects every quarter, and very specific performance-based outcome requirements in order to pass our clinicals each quarter. We must maintain an average of 75% on all theory material, and out of 54 students who entered we have 52 remaining. Apparently about more students drop out of 2nd year due to stress and increased theory difficulty. Our clinicals expose us to: long-term care; labor&delivery/postpartum; mental health facilities; surgery; medsurg; and a six-week preceptorship. We have a 100% pass rate for the LPN-NCLEX and 97% for the RN-NCLEX. So, how do we compare? Thanks!!!

Specializes in Behavioral Health, Show Biz.

:nono:

i'm against any

weeding-out

of nursing students.

once a student

is accetped

in nursing school,

the nurturing process

should begin---

if nursing schools don't nurture the students towards success, then how and where do students learn the beginnings of the nurturing process to administer to their patients? :smokin:

i not advocating

passing students

who obviously

don't make the grades.

but ambiguous test questions

and

unqualified/unfair educators

promote high student dropout rates

in nursing school

and

it's unfair to the students!!! :banghead:]

Specializes in Med/Surg, ER, L&D, ICU, OR, Educator.
:nono:

if nursing schools don't nurture the students towards success, then how and where do students learn the beginnings of the nurturing process to administer to their patients? :smokin:

i not advocating

passing students

who obviously

don't make the grades.

but ambiguous test questions

and

unqualified/unfair educators

promote high student dropout rates

in nursing school

and

it's unfair to the students!!! :banghead:]

i agree...to a point.

ambiguous test questions are exactly what you will see on your state board exam...that's why we attempt to indoctrinate you-all into "nursing school" style tests. it's not to try to trip you up. it's to begin to accustom you to the nclex style of questioning. students seem to really resent this...especially that first semester. if we did not do this, imagine the passing rates on the nclex! it is all a process! if you-all can just go with it, you will find out that there is a plan! instructors have your best interests at heart! it just amazes me that students might really think that we are purposely trying to torture them needlessly! what would our motivation be? come on!:no:

I agree...to a point.

Ambiguous test questions are exactly what you will see on your state board exam...that's why we attempt to indoctrinate you-all into "nursing school" style tests. It's not to try to trip you up. It's to begin to accustom you to the NCLEX style of questioning. Students seem to really resent this...especially that first semester. If we did not do this, imagine the passing rates on the NCLEX! It is all a process! If you-all can just go with it, you will find out that there is a plan! Instructors have your best interests at heart! It just amazes me that students might really think that we are purposely trying to torture them needlessly! What would our motivation be? Come on!:no:

It's not even "just" the NCLEX -- LIFE is ambiguous! The situations nurses encounter every day in practice do not have four possible choices and one of them is clearly the correct "answer" ... The point of nursing school is not just to acquire a set, defined amount of information and retain it, but to be able to think and respond flexibly and effectively in a wide variety of situations which involve lots of subtleties and ambiguities. The examinations in school need to reflect that, and not just ask students to regurgitate facts and information.

Specializes in Educator/ICU/ER.

:confused:

I am quite mystified by nursing students that work full time, have many family obligations and expect to make great grades! Med students and Law students check out of society while they are in school, why don't nursing students? We have critical information to learn! We stay with the patients and must be able to assess quickly at times. :banghead:

We use application type questions and usually do application type exercies in class. We try to teach our students to critically think in class for use on our exams. If they are successful with the exams, they will be more successful with the NCLEX-RN. This is our finally goal. We don't want to see anyone drop, but if their critical thinking skills are not up to par, they are not ready for client care.

We are all about nurturing, giving hugs when things are going wrong and crying with you. Would you want the guy who built your house to do just enough to get by? How about the pilot on your next trip? Would you want the people who built a ship you are vacationing on to do just enough to get by? Probably not! You want them to do their best! We are only getting our students to do just that.

I am looking forward to fall, when I get a new class! It is always neat to see the lightbulbs go on! Have an awesome week!

Specializes in Behavioral Health, Show Biz.
It's not even "just" the NCLEX -- LIFE is ambiguous! The situations nurses encounter every day in practice do not have four possible choices and one of them is clearly the correct "answer" ... The point of nursing school is not just to acquire a set, defined amount of information and retain it, but to be able to think and respond flexibly and effectively in a wide variety of situations which involve lots of subtleties and ambiguities. The examinations in school need to reflect that, and not just ask students to regurgitate facts and information.

***********************************************

Not to beat a dead horse about test questions....

While serving two terns as a Content Expert Panelist for the ANA/ANCC Certification Board, we learned what questions were psychometrically correct---meaning there is only ONE CORRECT ANSWER.

Poorly constructed test questions are as follows:

1) Negative questions whereby "all are correct except" , "not," are in the stem

2) "All except," "a, b, ,c," "all of the above," are in the key.

BOTTOM LINE...

ANA which is the largest professional nursing organization in the United States and certifies MOST of the nursing specialities at the generalist and advanced-practice level plainly stated that THE TEST QUESTIONS THAT WERE DESIGNED TO TEST THE KNOWLEDGE OF NURSING STUDENTS WERE PSYCHOMETRICALLY INCORRECTLY CONSTRUCTED---meaning that the test questions DID NOT correctly assess the knowldege base of the nursing students.

I wish ANA designed the test questions for the State Board of Nursing licensing exams

but hey...

that and five-dollars

can get me

a round-trip

subway ticket

in New York.

GOOD LUCK!!!!

:cool:

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