Why are Hospitals so darn mean when someone fails the NCLEX?

[Roland]

My wife works at an Indianapolis facility and one of her friends (not the same one referenced in a seperate post) just failed the NCLEX. Here's how they handled the situation:

1. She was stopped midshift and called into the office after the hospital checked the Internet state site and learned that she failed.

2. Her patients were immediately taken away. She was bumped back down to a student nurse from $20.00 to $10.00 per hour base (which actually means she will go from about $28.00 to $11.00 per hour since she works weekend/nights).

3. The worst part is that they will put her name in the hospital newsletter as failing the NCLEX. When she asked why she was told that they do it to "help" the person since people will know they failed and can thus offer emotional support!

Look, I know that passing the NCLEX is a big deal. However, couldn't they just cut the pay by say $3,00 per hour and mandate some remedial classes (they don't even offer the remedial classes until you've failed at least twice). This girl was a good student, who took the Kaplan course and is considered excellent clinically.

[caroladybelle, BSN, RN]

There should be no change in what she is and is not allowed to do.

She was a GN yesterday - she is a GN today. :deadhorse

Actually, in the my state of graduation, in 1994, per the Board: a Graduate Nurse was only a "graduate nurse" until the NCLEX was taken at the earliest opportunity and must be passed, otherwise they legally lost the title graduate nurse.

If you either didn't take the first possible NCLEX test post graduation, or didn't pass, you lost the legal right to use that title.

This may vary state to state, but has been the rule of the BON in some places.

In one case the BON lost the GN's application...despite the fact that the error was that of the BON and not of the GN, she still lost GN pay/classification as she was not taking the NCLEX at the earliest opportunity. Unfair but true.

[Marie_LPN, RN, LPN, RN]

The journals or texts that can be cited should be agreed upon ahead of time by an appropriate nursing body. In this way the potential student knows exactly what knowledge (and indeed perspective on that knowledge) they are responsible for knowing.

However, they will have been informed ahead of time (under my system) that the appropriate journal to reference on this topic is the New England Journal of Medicine (or in the case of my hypothetical NCLEX perhaps it would be the American Journal of Nursing among others).

That would make some way too prepared to memorize, and not learn the material. The test is designed for testing on what you know in nursing, and that test could be anything.

I NEVER say the phrase "study for the NCLEX". You CAN'T actually study for it. You can review everything you learned in school, and read all the books, but the NCLEX tests you on what you know.

[Roland]

That would make some way too prepared to memorize, and not learn the material. The test is designed for testing on what you know in nursing, and that test could be anything.

I NEVER say the phrase "study for the NCLEX". You CAN'T actually study for it. You can review everything you learned in school, and read all the books, but the NCLEX tests you on what you know.

I see your point, but without an objective reference a correct answer is merely the opinion of an author rather than a fact or best answer. We shouldn't make decisions about people's lives and careers based on anything less than the best available objective evidence. Also, consider that someone could "ace the their SAT's" by memorizing the definition of every word in the English language (at least the verbal portion). However, this seldom actually happens (and besides if someone is actually capable of commiting that much information to memory then they are probably minimally competent anyway).

Also, if you are testing ability rather than attainment of a specific body of knowledge then it could be reasonably argued that the test is biased against those with lower intelligence or so called "G". In addition, the test could face legal challenges based upon so called "disparate impact" arguments which emanate from the 14th Amendment equal protection clause. Not to mention challenges under the American With Disabilities Act that the test discriminates too much against those with certain learning disabilities.

[Marie_LPN, RN, LPN, RN]

I see your point, but without an objective reference a correct answer is merely the opinion of an author rather than a fact or best answer.

Look that the front of textbooks. The MINIMUM amount of contributors i've personally seen is 15.

The words are not just submitted and printed, they're reviewed for accuracy and truth first.

The only time i've seen opinion in them are when a "recommendation" by a group or associated is used.

Not to mention challenges under the American With Disabilities Act that the test discriminates too much against those with certain learning disabilities.

Because there aren't any references for the NCLEX context ?????

Any way that you (yourself) are looking at it, you're going to see it as biased.

You cannot expect the NCLEX to accomodate you.

[Roland]

Look that the front of textbooks. The MINIMUM amount of contributors i've personally seen is 15.

The words are not just submitted and printed, they're reviewed for accuracy and truth first.

The only time i've seen opinion in them are when a "recommendation" by a group or associated is used.

Because there aren't any references for the NCLEX context ?????

Any way that you (yourself) are looking at it, you're going to see it as biased.

You cannot expect the NCLEX to accomodate you.

Good point. The Leftest Liberal part of my brain cries "All Tests are unfair at least to someone" while the right wing Libaugh faction screams that they may be necessary, but should emanate from the private sector. In all seriousness am I the only one that sees a qualitative difference between the NCLEX and other professional level examinations (in a bad way). How can that be? Almost everyone I know that's taken the darn thing decries how ridiculous, unreasonable and useless it was (especially the ones who do well). However, almost no one here has expressed these sentiments (at least that I've seen then again I have a tendency to read and post like a madman for two days and then go away for months).

[Marie_LPN, RN, LPN, RN]

In all seriousness am I the only one that sees a qualitative difference between the NCLEX and other professional level examinations (in a bad way).

That's because they aren't the same professions.

And i won't express how ridiculous the NCLEX was, because i went in not knowing what kind of questions i'd get, the format (i knew it was computerized and it would shut off at some point), etc.

Kinda sounds like the world of nursing, ya know, going in to work, not knowing what'll happen, what pts. you'll get, etc. And i think that's the point of the test, to expect anything, because that's the way the real world is. And you don't get references ahead of time to have a leg up on it.

[*PICURN*]

At the hospital I work at, you can work as an "IPRN" or Interim Permit Registered Nurse" until you take your boards (after you apply for the permit) If you pass, you become a Clinical Nurse I (CNI), and if you fail, you have to send your permit back to the state and the hospital may offer you a position as a CNA until you pass your boards.

The second an IPRN fails her boards, her permit is invalid and she can no longer function as a GN. The IPRN's basically function as a regular nurse, but with an RN supervising them (since most of the time when you are an IPRN you are just starting out and on orientation anyway).

[brina]

This is not a strong statement - any employer can fire any employee at any time for (almost) any reason. Its called at-will employment which is what all nurses have.

I think we are being too hard on Roland. We all know one person who failed NCLEX the first time and ended up being a very decent nurse anyway. I venture to say that the NCLEX is not a highly valid test of a good or safe nurse. Remember how we had to learn to differentiate between the actual answer and the "ivory tower nursing" answer that was actually the correct answer on the NCLEX?

Or that we would get practice questions wrong because we answer the question in terms of the current technology that we actually use during clinical, forgetting for a moment that all NCLEX questions are at least 3 to 5 years old?

Or that you sometimes wanted to add "and then get sued for malpractice" to what you find out from the answer key was actually the correct answer?

And we have probably all chosen to forget the NCLEX questions that were just rediculous because they strayed so far from reality.

I remember a lot of questions going something like this:

Your patient is hemorrhaging from every pore of his body. The nurse should:

a) call for help

b) continue to breath, blink, circulate blood, and call for help

c) call for help before any subsequent blinking, breathing, or movement of blood

d) call for a pastoral consult as the patient is so obviously about to croak.

Not saying we don't need NCLEX, just trying to provide a reality check.

LOL !!!:rotfl:

[austin heart, BSN, RN]

Actually, in the my state of graduation, in 1994, per the Board: a Graduate Nurse was only a "graduate nurse" until the NCLEX was taken at the earliest opportunity and must be passed, otherwise they legally lost the title graduate nurse.

If you either didn't take the first possible NCLEX test post graduation, or didn't pass, you lost the legal right to use that title.

This may vary state to state, but has been the rule of the BON in some places.

QUOTE]

This is the way it is in Texas too.

[steelcityrn, RN]

Why would a hospital publish the results of anyones nxclex results, be it pass or fail? This crosses the line as far as i am concerned. Whats next, maybe publish the next time a piece of equiptment fails a test, or how about the next spread of infections from unsterile procedures. Come on, the more I think about it, it seems like the hospitals way of showing you to the door...

[tridil2000, MSN, RN]

Why coudn't she do the same things that she did as a grad nurse? All I'm saying is give her at least one more chance to pass the test before turning her life upside down. Also, I find it ironic that we are constantly preached to about patient confidentiality while at the same time it is collectively "spit upon" in the case of co-workers, and employees. Even a student nurse can do more than a CNA especially one that has been "checked off" on various advanced skills which she has. I could even see cutting the pay to $15.00/hr. I'm sure she will be able to focus on her next exam now that her life has been turned upside down. That damm test is stupid anyway. Why can't they test "basic concepts" in a straightforward manner like almost every other professional licensing examination. For example I have taken and passed State Licensing examinations in Real Estate Sales, Appraisal, Fire Fighting I&II, EMT-B, CPR ect. In all of those cases I was asked things that I should definitiely know if I was awake in class and did the readings. Furthermore, the questions were very straightforward with no "word game" or multiple correct/almost correct answers. When did nurses collectively buy into the "critical thinking" psychobabble, pandered by MENSA happy, MIT psychometric fixated geeks?

OH MY GOD!!

[mariedoreen]

By the way the facility in question is a magnet hospital and is considered one of the very best in the area.

Oh so it gets even better! They're expunging your reputation in one of the best hospitals in the area! Then I would definitely leave, I'm sure they'll have many more to take my place, and my parting line would still be... Since you love printing personal information for all to see here's my resignation, you can put it next to my now successful NCLEX results. Thanks for paying for all that training and good bye!

And to those blasting the OP about the NCLEX, he's got a point. The questions are often ambiguous and extremely annoying in their inability to simply ask a straight question about what we know. But...

...on the flip side, I am one of those who has now bought into the critical thinking psychobabble Marxist nursing bs (were those your exact words??) as well... because, nursing is problem solving. You go to work and you're given a set of data and told to make sense of it. You have to know how to think critically: how to attack the problem and sort the data effectively in order to solve your patient's problem. In addition to testing our knowledge base, NCLEX questions (as much as we hate it) are also testing our ability to work that process.