HESI is Wrong ! Let's File Suit

[gasguy1960]

i go to school in montgomery co. texas and have done okay in the nursing program making mainly bs through out the course, but i am not good at taking nursing test. comming from a trade background i have found that when i look at the rationals to the questions i miss it is usually that i thought of things in a common sense way not a test way. that said i have suffered through and i am suppose to graduate in may and then comes hesi. i took the test monday, march 26 and missed passing by 53 points. i can take the test again on 4/27 but i don't like my chances any better at passing it then either, i just don't test well or i at least don't nursing test well. what gives collages the right to keep you from taking the boards if you have completed 2yrs of their bs? isn't the hesi about keeping the pass rate on the first try numbers up for the college? so they look good. i have decided even if i pass the hesi i am going to retain a lawyer and sue the college for it's practice and i think that if they are going to use hesi that they should just factor it into your grade and not ruin your life over one stinking test. i would like to hear some of your options on whether or not ya'll think we should bring a national class action lawsuit to stop this madness. some students in ca. sued and won the right to sit for the board even though they didn't pass hesi and i believe that we deserve that right too. (

[gasguy1960]

Thanks for your comment navynurse06. Fact is I have maintained a B avg. in this arm pit of a program so I have done okay. My wife has been a nurse for 20 yrs and they never had to take HESI at all and she barely passed the boards on the first try. Also she will tell you that no employer has ever ask her what she made on the boards or what her GPA was, only if she had a license or not. I agree with you HESI and test like it should be a training aid and not a termination tool. (

[Sheri257]

Whatever happened with those girls? Did they get to graduate?

Hey, I'm editing this post instead of re-posting....here is their update from December 2006..

http://www.napavalleyregister.com/articles/2006/12/16/news/local/iq_3733219.txt

It's important to remember that the only reason those girls were allowed to graduate despite failing the ATI was ...

It's wasn't formally approved as part of the cirriculum by the community colleges board. If it had been approved (and I think it is now) then, they probably wouldn't have had a case.

They basically were able to challenge this based on a technicality.

:typing

[gasguy1960]

thanks for your comment rn2b86. a teacher told me once when i voiced my opinion that if i didn't like the way nursing school was run " then change it" and i swear pass or fail it will be my life's mission to change at least this aspect of nursing for the good of all to come. would you be willing to sign a petition?

[Sheri257]

Schools use HESI and other exams because studies have shown it does improve NCLEX pass rates. And, for better or worse, schools live and die by NCLEX pass rates.

In the Napa California case, that school's pass rate was barely above 70 percent. They were in danger of losing their accreditation with the BRN where, the school goes on probation when the pass rate falls below 70 percent.

The other reason schools use these tests is: the NCLEX pass rate overall has fallen in recent years. There was a time when the average pass rate nationwide was in the '90s. Not anymore.

When the national pass rate dropped into the low '80s, what turned it around was these exit exams. The pass rate didn't get back up into the '90s but, at least it got into the high '80s once these exit exams became the norm.

So I do think these exit exams are here to stay. If the BON's think it's a good idea then usually the courts agree with them. Generally, the trend is to toughen standards, not lessen them.

:typing

[Jolie, BSN]

Generally, the trend is to toughen standards, not lessen them.

:typing

I don't think anyone has a problem with toughening standards. But the time to do that begins with the admissions process and continues throughout the entire nursing curriculum. Introducing a "capstone" exam administered in a manner inconsistent with its stated purpose is not the answer, especially when the college has happily accepted the student's tuition money for 2-4 years, granted passing grades in coursework, and ultimately prevents the candidate from receiving a degree and sitting for NCLEX.

[Sheri257]

I don't think anyone has a problem with toughening standards. But the time to do that begins with the admissions process and continues throughout the entire nursing curriculum. Introducing a "capstone" exam administered in a manner inconsistent with its stated purpose is not the answer, especially when the college has happily accepted the student's tuition money for 2-4 years, granted passing grades in coursework, and ultimately prevents the candidate from receiving a degree and sitting for NCLEX.

Despite the Napa Valley case, my school (which is also a CC in California) is using these exams more extensively than they did before.

The list of unfair things in nursing school is a mile long. It doesn't seem to matter much how unfair it is. As long as it's approved by the board of nursing and the college system, they're probably going to use it.

They are the gatekeepers and you can complain about it but ... I really don't see this going away anytime soon.

:typing

[morte, LPN, LVN]

The problem is that schools are only accountable for the percentage of their graduates that pass NCLEX.

As such, they bear no penalty for not letting those pass that don't also pass whatever extra requirement, such as HESI that they impose.

It is a failsafe protection of the programs to ensure that they keep their NCLEX passing standards high.

I propose the programs ALSO be evaluated based upon the amount of attrition they allow.

About 6-10% of attrition is beyond their control. Some students drop for a variety of personal reasons. Several programs that concentrated heavily on reducing attrition were able to hold attrition to 10% without serious impact on NCLEX passing standards.

Most programs, however, allow an unreasonable 20-40% attrition rate and a few programs have attrition rates as high as 70%.

Unacceptable, but not currently unreasonable as the programs have no penalty for failing a student, only a penalty for NCLEX failures on students they allow to pass.

I would propose that, in order to get a good rating, in ADDITION to the current NCLEX pass standards, programs be required to keep attrition down to less than 12%. Programs that allow attrition to go beyond 20% should be put on probation.

This would do 3 things:

1. It would place the burden on programs to divine who exactly is nursing material in the ADMISSIONS process, and not after the fact. The programs would have to change their philosophy from nursing school itself being the place to divine 'who is nursing material' to having an obligation to get through their programs students that they've predetermined, in the admission process, to BE nursing material.

2. HESI and other tests would, of necessity be de-emphasized because the programs would have to ensure competent training along the way in order to cut down on attrition. Poorer performing students would have to be identified and aided much earlier in the process. In short, it would make programs accountable for the material they teach.

Failing a large group of students based on an exit exam identifies the failure of the program to teach and not necessarily of students to learn. This is especially true in that these students received passing grades.

3. It would also severely reduce students being paralyzed by fear of arbitrary dismissal, and that would aid the learning environment.

~faith,

Timothy.

timothy, many a time i have sat here, reading your posts, and disagreed....this time, i would like to shake your hand, slap you on the back, whatever....until you "hit them were it hurts" this will go on....i sometimes think that some of the attrition is built in, so that the upper level classes are smaller.....obviously the lottery system needs to go byby, and students need to have one on one evaluation in the admission process...but as long as it doesnt cost the schools anything., it will continue

[Sheri257]

HESI and other tests would, of necessity be de-emphasized because the programs would have to ensure competent training along the way in order to cut down on attrition. Poorer performing students would have to be identified and aided much earlier in the process. In short, it would make programs accountable for the material they teach.

Failing a large group of students based on an exit exam identifies the failure of the program to teach and not necessarily of students to learn. This is especially true in that these students received passing grades.

~faith,

Timothy.

While I agree with this to some extent, I also don't think it's that simple. The board of nursing, at least in my state, requires nursing programs to teach a hellava lot more material than what shows up on the NCLEX because, as a nurse, you need to know a lot more material than just what shows up on the NCLEX.

So while there are certainly failures in teaching, the instructors also kind of have their hands tied behind their backs. They've got to get through a ton of cirriculum mandated material and ... while a lot of it is relevant to the NCLEX, a substantial portion of it is not.

To be honest, the students who failed the NCLEX in my class were also the students who didn't study for it, plain and simple. The students who always studied and prepared had no problem.

I really can't totally fault the instructors. There are certainly things they could have done much better but, the students have some responsibility also.

:typing

[ZASHAGALKA, RN]

While I agree with this to some extent, I also don't think it's that simple. The board of nursing, at least in my state, requires nursing programs to teach a hellava lot more material than what shows up on the NCLEX because, as a nurse, you need to know a lot more material than just what shows up on the NCLEX.

So while there are certainly failures in teaching, the instructors also kind of have their hands tied behind their backs. They've got to get through a ton of cirriculum mandated material and ... while a lot of it is relevant to the NCLEX, a substantial portion of it is not.

To be honest, the students who failed the NCLEX in my class were also the students who didn't study for it, plain and simple. The students who always studied and prepared had no problem.

I really can't totally fault the instructors. There are certainly things they could have done much better but, the students have some responsibility also.

:typing

While I also agree with you to some extent that this isn't cut and dried, there are a few issues at play.

1. Many of those failing these exit exams have done well in their programs. WHY the disparity in passing grades and passing the exit exam? The programs might have MORE to teach than simply this material, but certainly ALL of this material is important, as well.

2. The students you complain about would have a much more difficult time even getting INTO nursing school if the admissions process is where we vested who is 'nursing material', and NOT during the programs. Currently, that vetting process is done more and more (exacerbated by issues such as lotteries) within the programs and done so because the programs bear no real penalty for doing so.

3. In addition to making students waste valuable time getting to the finish line but not being allowed to cross, this philosophy of no penalty attrition causes upwards of 10,000 seats in programs to be wasted nationwide each year. THOSE seats should be considered vital to bringing new nurses on-line.

Instead, they are viewed as completely expendable.

Simply put, 20-40% attrition is and should be considered a failure of the PROGRAMS.

~faith,

Timothy.

[Sheri257]

The students you complain about would have a much more difficult time even getting INTO nursing school if the admissions process is where we vested who is 'nursing material', and NOT during the programs.

My school did try to tighten up the admission standards but, the higher ups wouldn't let them. I remember they spent a lot of money trying to make it happen but, to no avail.

I don't know all of the details but, I do know that they tried.

:typing

[gonzo1, ASN, RN]

There is no doubt in my mind that nursing education and admission needs a huge overhaul. I got through fine, but am appalled at some of the things I saw.

First, they let students in with a 2.0 grade average and then the students find out that the grading scale is completely different ie: 100-94 is an A, 94 to 86 is a B and 80 to 86 is a C, a student who has been maintaining a 2.0 most likely can't make the move to the higher standard.

Since I tutored students after I graduated I saw several students who flunked first semester and retook it, then flunked second and retook it, then flunked third and retook it, then flunked fourth and retook it. Their 2 year program turned into a four year program. A couple of the students did go on and pass the NCLEX but what was the college thinking allowing the students to retake every semester? I believe this is a terrrible disservice to students.

The other thing is that I saw teachers that allowed students to turn in papers that were supposed to be typed, in pencil, all sorts of unbelievable crap.

The teachers seemed to demand very little accountability from the students. And it is true when the students come out they can't even begin to function on the floors unless they were CNAs or something similar previously. And are they ever shocked at having 6 patients.

Nursing education really, seriously needs to be revamped, with much more emphasis on clinical time and I see no need for the HESI at all.

Good luck with your quest to get rid of it.

[Jolie, BSN]

My school did try to tighten up the admission standards but, the higher ups wouldn't let them. I remember they spent a lot of money trying to make it happen but, to no avail.

I don't know all of the details but, I do know that they tried.

:typing

I believe you mentioned that you attended a community college program. The inability to tighten admission standards, or the unwillingness of administrators to do so is a problem in many community college nursing programs. The basic philosophy of community colleges is to accept everyone who wishes to advance their education, including those who wouldn't qualify for study in the university setting. This "open-door" philosophy of the community college is in direct opposition to the push for elevating admission standards to the nursing program. My guess is that the director of the nursing program wanted to tighten admission standards for nursing students, and was over-ruled by the community college administrators who believe that everyone who meets basic criteria should have the opportunity to "try" nursing. (Admission based on ranking of qualifications vs lottery admission.) Problem is that many of those with borderline qualifications who "try" nursing drop out along the way, taking up space that could have gone to better-qualified candidates who would have had a better chance of success. The community college administrators don't see that as a problem though, because they have a long list of alternates waiting to snatch up those now-vacant seats, and don't lose a cent of tuition money.

I attended a program that had different admission standards for different groups of students. Causasian females, who comprise the majority of nurses, were required to have a minimum 3.3 GPA in pre-requisites for admission to the nursing program. Males and persons of color were admitted with a 2.8 GPA. Although the ultimate goal of increasing minority representation in nursing was admirable, it didn't work. The attrition rate among those admitted with a 2.8 GPA was much higher than those admitted with a 3.3 GPA. That certainly does not indicate that males and persons of color are less capable of becoming nurses than white women, but it does indicate that higher admission standards translate into higher graduation rates, and in the case of my class, a 96% NCLEX pass rate.