High Fail Rate for new Grads on Boards

[jerry Rn]

I work in East Texas and have noticed a alarming trend, our new grads are failing their state boards at a alarming rate (60 % from our local junior college). Moreover, all these new grads that were hired as GNs cannot be fired to make room for nurses that have passed their boards for a least 3 months ( when they retest).

Is this trend national or local in nature? Also, as a preceptor I have noticed that many of our new grads are competent in clinical skills ,but have no idea of what is going on with their patients (disease process). Can I get some feed back and possible suggestions on what can be done to fix this problem?

Thanks Jerry RN, BSN

[live4today, RN]

Mattsmom, you hit the nail on the head, I'd say. "Budget" is the word, and the name of the game. Of course they would have to find something "wrong" with a seasoned nurse. Otherwise, they'd have to hire her/him, and pay them well! :chuckle

[J_W, DNP, APRN, CNS]

Mattsmom81-

I to took the old paper/pencil test over 2 days, now it is computer adaptive. Meaning it chooses your next question based on how you answered the previous one. It might start you out with question of middle difficulty, you get it right, then it gives you a little harder question, you get it wrong it gives you an easier question. I do have issues with todays GN only having to get 75 questions at the minimum, and the max is 265. The paper pencil test I took was 360 questions. But the NCSBN have developed the NCLEX and it has proven validity and reliability, so I don't think they will be going back to the paper-pencil test.

I agree the CCRN was harder than the NCLEX, then I took the CCNS test and it was just as hard or harder than the CCRN.

[mattsmom81]

Howdy, fellow Texan and thanks for explaining that new test, JWRN, I've heard students saying " it turned off at 80" and I wondered about that....sounds a bit like an ACLS logarithm!

Is the CCNS the neuro critical care exam? I bet that is a doozy...I do my AACN CEU's religiously as I hope to NEVER take that CCRN exam again! Ha!

I hear that many students today are purchasing NCLEX review books and attending 'pass the NCLEX' seminars... preparing themselves to pass just in case their schools miss the mark. Sounds like a good plan and I would do the same. Hope we don't swing the pendulum back and forth between clinical skills and academics--we gotta find some middle ground.

When I was in school, I thought it was awful when I heard through the grapevine that one of my competitor schools failed 20%--now I read 60% here and wonder what's going on! I think all pass/fail rates of nursing schools should be public record in order to show accountability to the public and to the students. I'll check the Texas BON site for that data.

You GO, student nurses we need more proactivity! I was one who took responsibility for my own learning too and it always worked for me (and I STILL go to every critical care update and interesting seminar I can hunt down!) I love 'em, there's always some new info for me to 'ruminate' on...heehee..:)

.

[nilepoc]

Would this have anything to do with the structure of the program, and the state standards for education.

I am currently applying for a lisence in Washington DC, and on the app it states that "If your primary lisence is from Texas, California, or (can't rmember), don't count on obtaining a lisence in DC. The educational standards of these states is not up to our standards." So how different can those programs be?

Craig

[Peeps Mcarthur]

So, a lot of talk about the supposed 60% fail rate of some school but none of it from the person that originally posted the thread.

How could a curicculum fall within state guidelines to even be taught and then have 60% of the graduates fail?

Did I miss Jerry's response to questions about where he got his information? I see plenty of response from everybody else.

April fools day is just around the corner ya know.

Brandy,

Unless somebody happens to have a "Beautiful Mind" they'll be using a calculator like the rest of us.

Good luck on your boards.

Brad

[BrandyBSN]

i LOVED that movie :) no matter what math class i take, I will still consider myself a "math moron". Thank God calculus has nothing to do with drug calculations!

BrandyBSN

[el]

I agree with Charles. We are in a very tough spot as preceptors and or educators. I have been precepting new grads for years. I have noticed a recent trend that is frightening. I don't know if their motivation to become a nurse is different, or if due to our need for nurses, and the low enrollment rate schools are "lowering the bar". I have had FANTASTIC NEW GRADS, but recently I have had some really scarey ones. Example, one of my new grads wanted to give narcan to help relax a patient for MRI, scarey enough, but when I said no, and instructed her to look up narcan and tell me what it was used for, never did.....I waited that whole shift, and then the next day, and then asked her again, and she still didn't know. I don't know what bothered me more, that she thought to give a med without being clear on it's use, or had no desire to learn from it. I have been to my unit manager, and to our clinical education department for help. They are under pressure to get these nurses on the floor due to the shortage, so they ask that I continue on with people that I will never believe to be safe in practice. It isn't only knowledge that they lack, it is the desire for knowledge. I had a new grad that had the wrong iv fluid up, I questioned her, and the answer was that it was hung the shift before. I explained that once you have report, it is your responsibility, so YOU have the wrong ivf up. Talk about falling on deaf ears, she just insisted that it was up from last shift. I think back to my preceptorship, and how I cried sometimes because it was so hard, now I think I am glad I cried, because at least I understood my responsibility, and took it serious. I have recently precepted new grads that argue with me about doing something, or purposely don't do what I tell them has to be done. Now I am the most patient of people, and I have alot of trouble dealing with the fact that I can't teach them, I feel it is my failure as much if not more than theirs. But then I think, I can't teach the desire to be a nurse, or the desire to give quality nursing care. It is a big change for me, in the past, I always knew that the new grads I precepted would be fine eventually. Now as I said, I have experienced some that I won't clear to be on their own. I have never considered that precepting a new grad could end up with me in court some day until recently. I am sick over it. Lastly, I will say again I have precepted some of the greatest new grads ever, but have noted a trend recently that must be "fall-out" from the shortage of nurses.

[mattsmom81]

I can relate to everything in your post (as one who has also precepted for 25 years) . Very well said, EL. :)

I am encountering attitudes in new grads / young nurses I've never seen before too and it is unbelievable to me. The most bothersome are those who want to do a Spock-like brain meld on the experienced staff, and openly defy you when you suggest they do some research themselves and come back with pertinent questions. They want to be handed the title 'experienced nurse' on a silver platter. (almost like attending lecture in school, they wait to be 'given' all pertinent knowledge by another!) These types are such a drain on us....many tell us flippantly "I'm only here in the ICU for my year's experience, THEN I'm going to anesthesia school and THEN I'm going to ...bla bla bla." I guess they're not called the 'entitled' generation for nothing, eh? LOL!

And of course, not all new grads are this way but like Charles and EL I too have noticed a trend. Has the 'dumbing down' of our profession begun in the wake of the nursing shortage? I surely hope not.....

[live4today, RN]

The way SOME young people think about WORK and MONEY today has a lot to do with their upbringing as well as their exposure to worldly trends. Which is another reason I started the thread about "Cross-Generational changes, etc." If this generation behaves and looks at life as if "the world owes them....", what are their children going to do to society? Scary thought, if you ask me. :chuckle

When I worked as a CNA Clinical Instructor in 1994, my students were of various ages, and it was always the twenty-somethings who always seemed to come across as the "What does the world owe them instead of what they could do for the world mentality".

After many attempts to get one young CNA student to see the seriousness of her role in patient care, she consistently thought that because her mother was a RN, she already had it down pat as how to care for patients. Well, as much as I hated to do what I ended up doing, I had to fail her in my clinical rotation because I just couldn't see letting her loose with a CNA certificate to perform patient care with a "the world owes me, I don't owe the world" attitude as her attitude was reflected in the sloppiness of how she performed in the clinical area.

She may have made the grades in the didactic portion of the classes, but she failed everytime in the clinical setting. She was going to do things HER WAY, or nobody's way. Hmmmm, wonder what Miss Know-it-all is doing today? Did she repeat the classes, or did she enroll in nursing school like she said she MIGHT! Scary thought!

[Stargazer]

These types are such a drain on us....many tell us flippantly "I'm only here in the ICU for my year's experience, THEN I'm going to anesthesia school and THEN I'm going to ...bla bla bla."

mattsmom, please feel free to remind these types that lazy, careless, dangerously negligent nurses make lazy, careless, dangerously negligent CRNAs/NPs as well. The difference is that independent practitioners like CRNAs make MUCH more attractive targets for litigation.

[J_W, DNP, APRN, CNS]

Mattsmom81---The CCNS exam is an advanced practice certification exam for Clinical Nurse Specialist in Acute and Critical care nursing. Like the CCRN there are three exams to choose from- Adult, Pedi, and Neonatal. I took the adult one. It was pretty hard, it focuses on the roles of the CNS, along with the pathophysiology stuff, too.

I know three people that just took the NCLEX here in TX. One from BSN program, and two from Diploma program. All three passed it. The BSN student only had 75 questions, the two diploma students had 105 questions each. I know here in TX the pass rates of all TX nursing programs are located on the BNE website (http://www.bne.state.tx.us).

[mattsmom81]

Thank you, JWRN! :) I'm always interested in hearing the whys and hows of education paths nurses choose.

A coworker of mine obtained this credential and now runs a critical care internship program at a large hospital here in Fort Worth...are you doing something similar? Or?