Schools producing good NCLEX takers? Or good nurses?

  1. I graduated from Indiana University in 1975[FONT=Franklin Gothic Medium]obviously I took the old 2 day exam in 5 sections; the one with the least questions was Psych Nursing with 90. The passing score for most states was 250 on each test section, except for California and New York who required 500. My scores ranged from 723 (Surgical Nursing) to 606 (Psych Nursing) which was the only one that was below 700. So, yes I passed, but talk about STRESS. And I have never studied for large comprehensive exams since I had one instructor who claimed, (and I believed her), that it is impossible to "cram" or even to raise one's scores by "studying" for a test that covered such a massive amount of material. She likened it to studying for an IQ or SAT tests. I took the CCRN exam in 1982 and passed it the same way--never studied for it or took any CCRN review class, but I had been a Critical Care nurse for 6 years and had taken a lot of CEU classes during that time. I took it again in 1994 and passed the CCRN once more and the same way. I AM NO GENIUS. MY IQ IS ABOVE AVERAGE, THAT'S ALL. BUT ONE THING I CAN SAY IS THAT I REALLY DEDICATED MYSELF TO LEARNING EVERYTHING I COULD BECAUSE I LOVED THE SUBJECTS AND BECAUSE I WANTED TO BE THE BEST NURSE I COULD BE. I always went into a test with confidence that what I needed to know was in my brain, simply waiting there to be retrieved. I also ALWAYS had a very good breakfast with lots of protein, carbohydrates and some fats to keep my in working order.

    Call me stupid and crazy, not to mention old fashioned, but I cannot see how any 75 questions could accurately measure the knowledge and apptitude of a person regarding such diverse areas as sterile technique, care of the woman pre and post partuem as well as during labor and delivery, infection control, pre and post op care of adults with a variety of medical and surgical diagnoses and possible complications to watch for as well as the most common drugs used, care of infants and children and their anatomical differences that must be regarded and the concerns that arise because of them during different disease states as well as post op. Knowledge of all of the organ systems and the potential disease processes and the care of all of them. Drugs, drug calculations, adverse reactions; Transfusion of various blood products and the precautions for all.

    In the AZ. Board of Nursing Journal, nursing schools with NCLEX pass rates of 83-88% decided to review their curriculum and adjust them to more accurately reflect what NCLEX wants in order to pass it.

    My question is this: Are we teaching people the knowledge and skills needed to safely care for a diverse patient population or are we teaching people to pass one exam??

    I welcome your opinions.

    Celeste7767
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    About celeste7767

    Joined: Dec '04; Posts: 56; Likes: 52
    unemployed; disabled
    Specialty: CVICU, PICU, ER,TRAUMA ICU, HEMODIALYSIS

    13 Comments

  3. by   destiny5
    I don't believe anyone can accurately compare the "old school" method and the "new school" method unless they took both tests. I can only give my opinion and say that I do not believe it's easier now than it was back then. Actually, just the opposite. I am sure back then 1 + 1 = t w o. With all of the prioritizing and the "all 4 answers are appropriate, but select the one that is most appropriate" questions on the NCLEX now-- not only tests us on basic "rote" memorization ex: names of drugs, anatomy, psychiatric responses but it requires that we have exceptional critical thinking skills.
    In addition, no amount of schooling will determine if we are good nurses. The proof is in job/floor performance and that comes after the test is over.
  4. by   mbell42
    I think in general, schools with an major exam tend to teach the test in some ways. You can't avoid it. Outsiders and prospective students want to know that the education there is valid, and one easy way to compare is to see how many graduated passed the test.

    I foudn my NCLEX VERY hard, with questions that required yout o do things like look at four patients, and given very little information no which assessment finding were normal for a disease process, which werent and which were more alarming than others, or required immediate action. It was alot more thinking and alot less definition/memorization.
  5. by   MissJoRN
    my take is that NCLEX does not test if someone is capable of being a good or safe nurse, it tests whether someone is capable of becoming one. Make sense? Look how much nursing and medical knowledge has expanded since 1975. Have any of us kept up with all the changes and new information and skills since our graduations? Of course not, we just keep up with what pertains to us. My point is with such a large body of potential knowledge schools can only touch the basics and key areas and teach nurses how to think (and how to learn) not how to be good nurses in all, or even any, specialty (including med-surg) This took me a while to figure out, frustrated with orienting nurses who don't know things I consider obvious skills- like getting lasix syrup out of an amber bottle and into a syringe- but once I accepted that, orientation became much better for me, the new grad, and the patient/family. I do think they "teach the test" to a point, but thats not the real reason new grads cannot (and I'm sure never will again) hit the ground running like 10 years ago.
  6. by   nurse4theplanet
    Quote from celeste7767
    Call me stupid and crazy, not to mention old fashioned, but I cannot see how any 75 questions could accurately measure the knowledge and apptitude of a person regarding such diverse areas as sterile technique, care of the woman pre and post partuem as well as during labor and delivery, infection control, pre and post op care of adults with a variety of medical and surgical diagnoses and possible complications to watch for as well as the most common drugs used, care of infants and children and their anatomical differences that must be regarded and the concerns that arise because of them during different disease states as well as post op. Knowledge of all of the organ systems and the potential disease processes and the care of all of them. Drugs, drug calculations, adverse reactions; Transfusion of various blood products and the precautions for all.


    Celeste7767
    This is what the actual nursing program is designed to do throughout the course. We started with 70+ students and are down to less than 15 of the original. I think schools should, and do, teach to test. I would hate to get all the way through nursing school without ever having experienced an NCLEX style question. But they also teach critical thinking, time management, how to research/reference material that you are not familiar with, etc. Only experience and dedication will prove if a new grad will blossom into a good nurse. I'm the first to admit how much that I really don't know...but I know how to get the information I need to know...through books and more experienced nurses, thus I am building my own reference of experience and knowledge. It just takes time.
  7. by   scaredofshots
    WE WERE TOLD THAT OUR SCHOOL GETS MONEY FROM THE STATE FOR HAVING A HIGH NCLEX PASS RATE... THEREFORE WE ARE GIVEN HARD TEST QUESTIONS TO WEED OUT THE ONES WHO WILL MOST LIKELY FAIL THE NCLEX!!! I THINK THAT IT IS A **** THING THAT THEY DO...:flamesonb
  8. by   NursKris82
    Quote from MissJoRN
    my take is that NCLEX does not test if someone is capable of being a good or safe nurse, it tests whether someone is capable of becoming one. Make sense? Look how much nursing and medical knowledge has expanded since 1975. Have any of us kept up with all the changes and new information and skills since our graduations? Of course not, we just keep up with what pertains to us. My point is with such a large body of potential knowledge schools can only touch the basics and key areas and teach nurses how to think (and how to learn) not how to be good nurses in all, or even any, specialty (including med-surg) This took me a while to figure out, frustrated with orienting nurses who don't know things I consider obvious skills- like getting lasix syrup out of an amber bottle and into a syringe- but once I accepted that, orientation became much better for me, the new grad, and the patient/family.
    Very well said. My sentiments exactly!
  9. by   P_RN
    I thought that I remembered Oklahoma was the only one requiring a higher Comprehensive State Board score. I took it in 1974 in SC. Like you I made Nationals.
  10. by   november17
    The school I went to focused HEAVILY on the NCLEX. That being said, since I've started working, I've heard many comments about my school. "Oh, you're a Delta nurse, no wonder you catch on so quick." Our school also focused on clinicals too. However, I've noticed that alumni from my school do seem to orient faster and be less stressed out than nurses from other schools.

    By the end of my clinicals (at an NCLEX oriented CC), I was managing ten patients on my own. It was very stressful.
    I also ran into other students that were ready to graduate from NCLEX oriented CCs that were managing 3 patients in their last round of clinicals.

    I don't think it is just the curriculum, but how hard they are driving the students to learn. Also, if a school's NCLEX pass rate is below a certain percent the BON requires them to adjust their curriculum accordingly, that might answer your question about why that school is changing theirs.

    How could 75 questions measure your ability to be a nurse? Although you're pretty young *wink*, the new computerized way asks harder question after harder question until it decides that you're alright. I legally can't divulge some of the questions it asked me (but believe me, I remember), but some of them were so off the cuff difficult and off the wall that no one except someone that knew what they were talking about could answer.

    Here's a sample question from the NCLEX:
    "You are taking care of a 96 year old hassidic jew that just died from a massive brain tumor, the family is outside and is very upset, what kind of post-mortem care do you provide?"
    A: Wrap a rope around their wrist and drag them from the room
    B: Call the organ donation society
    C: Douse the body in gasoline and light it on fire
    D: Wash the body carefully and throw it out the window

    That's a completely made up sample question, with completely made up answers, but I mean, seriously, the NCLEX is that ridiculous. I don't know how anyone could pass that test unless they had some serious critical thinking skills. The NCLEX isn't just about "knowledge" it's about how you use your brain to apply the small amount of knowledge you hopefully remember.

    Like you said, you're not a genius, you have a slightly higher than average IQ. I'm the same way. There is NO WAY I could remember all that stuff from nursing school. It's just how nursing school taught me how to think is what makes me a successful nurse. I'm sure it is the same way across the board. As a patient, I'd rather have a nurse thinking critically about my situation than one that just follows physician orders to a tee (as you may know, physicians aren't always right). Just my two cents
  11. by   Babs0512
    Quote from destiny5
    I don't believe anyone can accurately compare the "old school" method and the "new school" method unless they took both tests. I can only give my opinion and say that I do not believe it's easier now than it was back then. Actually, just the opposite. I am sure back then 1 + 1 = t w o. With all of the prioritizing and the "all 4 answers are appropriate, but select the one that is most appropriate" questions on the NCLEX now-- not only tests us on basic "rote" memorization ex: names of drugs, anatomy, psychiatric responses but it requires that we have exceptional critical thinking skills.
    In addition, no amount of schooling will determine if we are good nurses. The proof is in job/floor performance and that comes after the test is over.
    I was the last class in NY to take the written, 2 day exam in April 1992. I remember NUMEROUS questions like: Out of the Four correct answers below, choose the BEST answer to the following question.... Yep, we had them!!

    That test was brutal! I agree with the OP, 75 questions isn't nearly enough to show whether or not the person knows his/her stuff. I agree, they are teaching nurses to been good nclex takers, more so than producing good, quality nurses - at least that has been my experience over the past 5 years or so with GN's
  12. by   Virgo_RN
    I think my program did a good job of both preparing us for the NCLEX and for nursing practice. I really think the quality of nursing programs is variable. I went to one of the best community college programs in the U.S. I've met new grads from other programs who seemed woefully unprepared for clinical practice. So, in a nutshell, I think it's possible for a program to achieve both a high NCLEX pass rate and produce top notch graduates.
  13. by   blondy2061h
    I also think my program prepared as well for both "real" nursing and NCLEX. Our clinicals obviously focused mostly on the "real nursing" side of things (though I wish we had more time devoted to clinicals) while classes focused on fundamentals. We were prepared for the NCLEX simply through suggestions on study techniques being weaved into the program, and tons, and tons, and tons of NCLEX questions on exams and mandatory practice tests.

    I did think it was odd that my NCLEX didn't question me at all on some areas. I passed with 75 questions, maybe 45 of them being infection control questions. I had maybe 3 drug questions, and no labor and delivery or psych.

    Yet I was very nervous about NCLEX and did tons of practice questions.

    NCLEX studying was good for picking on some tips- like things to assess for in a patient receiving beta blockers, and random facts (cross sensitivity between lasix and sulfa), but, as hard as it tries, very little applies to real nursing.

    I agree with you that it's difficult to cram for such an exam. I also agree that it's easier to get a grasp on material if you're "enjoying the process of learning" as my dad always says.

    Experience really is the best teacher.
  14. by   woknblues
    Tests are just to show an arbitrary required amount of knowledge to be licensed in a profession. I doubt if even the 2 day test encompassed "all of nursing". Entire books are written to cover esoteric subjects such as ECG interpretation, pediatric psychiatric modalities, etc. Since they can't teach everything there is to know in nursing school, they better not test us on everything either, I say.

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