NCLEX: How many times is enough?

Nursing Students NCLEX

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I was thinking about posting this question earlier, but decided not to post until I read a thread dealing with the topic. So what do y'all think? If a person hasn't passed the test by the nth time (you change the "n"), should they give it up because they obviously (in your opinion) haven't learned what they need to learn, therefore, would not be a safe practicing nurse?

I think an interesting question (and the makings of a nice bit of research if it hasn't already been done) would be to investigate the correlation between number of attempts to pass and the "quality" of nursing provided upon passing.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
Well...I appreciate your opinion and I'll think about it more (I always allow that I just have a giant blind spot, as I often do).

My thoughts, in response:

I think its an unproved assumption that limiting the number of tries only allows the competent to make it through. It might be true, as you say, but it might not. I'm just not sure of the evidence that relates NCLEX in fewer tries to ultimate competence on the job.

And...unlimited number of tries would not demean the profession, as far as I can see, because it already is set at unlimited number of tries. Unless you're saying it has already demeaned the profession? I know one can sit an unlimited number of times for the bar (which is also pass/fail) and this fact (as far as I know) does not demean the profession (by itself). I know many atty's who have sat multiple times for the bar, and the mayor of Los Angeles may never have passed (despite multiple attempts, and never any proof he passed). Just interesting side notes, not directly related I realize.

Mostly, I agree. It's not something I feel strongly about and am kind of wishy washy about NCLEX and the number of tries. I did ad the caveat that it really doesn't in all cases measure competency. I'm not a fan of the exam by no means.

I do feel that a national exam coupled with accredited education standards can measure compency to an extent and is probably isn't that bad a system. It could use some tweaking in my opinion but it's probably not a bad system.

I don't mean to insult the good nurses that took six tries either. We demean our profession in many ways, having unlimited number of tries at NCLEX is part of it I feel, not a big component, but part of it.

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Specializes in Medical and general practice now LTC.

Some state BON's will only allow x amount of sitting and failing before they have to take a review/remedial course before sitting the exam again. I believe 3 times is the usual number. Florida off the top of my head is one who requires this and I think if they fail it 4th tie then that's it unless they do nursing school again although not 100% sure on that but am sure they have to do a course if they fail 3 times. Saying that there are other BON/BRN which allow unlimited sittings. Some people are poor test takers and who knows how they did in school. I have also worked with nurses that I wondered how did they pass and even worked with one nurse who was not allowed to hold any keys what so ever and do any drug rounds as she wasn't deemed safe but they still kept her in a job, she was a lovely person but had no common sense at all. We even had to get to the meal trolley before she did because was normal for her to put custard on main meals. Sad really even though it could be hard work on the rest of the trained staff

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Specializes in Physical Rehabilitation, med-surg.

I've known plenty of chitty nurses in my career who passed their boards on the first try. I've also known several who had a terrible time passing but ended up being great nurses.

The NCLEX is what we have, but imho it isn't the greatest.

I recently helped my new-grad cousin study. I would have had a heck of a time passing the test if it was anything like the online review she was using. We spent hours on it, and it was hard as he//! She had a terrible test taking problem, and it took her 4 attempts to pass. She's certainly not dumb, and I think she's made a good nurse.

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I say that because it is SOOO frequently said: "I'd rather have the good clinical person than the one who does well on tests", as if those were the only options. I meant that all too often it's used to say that all those people who do lousy on tests are really just fabulous nurse-to-be's, when in fact there are probably a good number who are also lousy nurse-to-be's.

I was speaking about a general statement used so broadly as to make it sound like the characteristics (good nurse/bad test taker, good test taker/bad nurse) always seem to go together. I think it gets used as a crutch in many cases--as in, "she'd be a great nurse, she just can't take tests" as if that were absolutely the only thing preventing her from being Florence Nightingale's twin.

I didn't mean to start a fuss, just kind of voice a frustration of mine. Sorry if I offended!

You didn't offend. I just don't understand, that's all. I guess I've never heard that before. And my assumption isn't that all nurses who can take tests well are terrible clinically or vice versa. Who would ever say "I would love to have a nurse who can't take tests and is also terrible clinically" or "Man, I hope I don't get a nurse who is smart AND good - that would be terrible!" In the case of the person I know, she IS good, just has test anxiety. That's not to say, nor did I mean to iimply, that all people who have test anxiety would be good RNs.

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On a side not....holy CR@P!! What the heck was the PTT on THIS dude when she was done??

Haha, I have no idea! I know that they were like DUDE - lay COMPLETELY still and DO NOT MOVE!!!!! I know he ended up being fine - can you believe it? No complications! I would wonder whether he would end up with HIT or anything if they tried heparin on him in the future. Luckily it was a stable, younger guy. And thank goodness heparin has such a short half-life!

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Some state BON's will only allow x amount of sitting and failing before they have to take a review/remedial course before sitting the exam again. I believe 3 times is the usual number. Florida off the top of my head is one who requires this and I think if they fail it 4th tie then that's it unless they do nursing school again although not 100% sure on that but am sure they have to do a course if they fail 3 times. Saying that there are other BON/BRN which allow unlimited sittings. Some people are poor test takers and who knows how they did in school. I have also worked with nurses that I wondered how did they pass and even worked with one nurse who was not allowed to hold any keys what so ever and do any drug rounds as she wasn't deemed safe but they still kept her in a job, she was a lovely person but had no common sense at all. We even had to get to the meal trolley before she did because was normal for her to put custard on main meals. Sad really even though it could be hard work on the rest of the trained staff

OMG I just typed a whole long response and then lost the whole thing! Stupid internet! Anyway, what I had said was basically this: I don't know what it's like to have test anxiety. I passed my first try at 75 questions, and was usually one of the first people done taking tests in school. But I think school is different, because you have say 4 tests, a paper, and a clinical score that make up your grade. It would be a lot more stressful if there was one test per class, pass or fail, that's it. And that's how some people view the NCLEX.

I think there should be something more than a review course, but short of having to redo a whole degree program. I like the idea of a writen test/mentor program. If you fail x amount of tmes, take the written test, let someone review it, and then discuss the results wth you. Maybe they would find that you DO have the knowledge. Maybe they would find that you DON'T. Then it would be time to discuss options. But if everyone could pass the test, what would be the point of having one at all? I just feel like sometimes the NCLEX is not that accurate - some people are able to pass and then don't make the best choices when they are a nurse, and some people who have trouble passing end up being fantastic.

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Wow...nice little discussion here. Thank you all for participating. So here are some thoughts.

If the rules say they can take it as many times as they would like, then the authorities must not feel the same way that some people on this board does.

Some state BON's will only allow x amount of sitting and failing before they have to take a review/remedial course before sitting the exam again. I believe 3 times is the usual number.

If I'm not mistaken, in TX, you have 3 tries. If you don't do it by then you have to take it in another state. Perhaps I'm wrong all together or perhaps it's changed since I took it, but I feel fairly certain about this (without taking the time to look it up to be 100% certain)

And, in defense of those who need to take the exam five times or more, let me ask this question: do you assume that if someone fails three times, they are incapable of "improving?"

You make many fair observations. One would think there was some psychometric testing done on the NCLEX, but again, I haven't done the research to see if there is research.

Now, the excerpt I quoted above is what I specifically wanted to respond to. Indeed their ability to take the test can improve. As you mentioned, students can be taught to take this test. However, the other part of that story is that as they continue to prepare for their test (and I believe you have to wait, what....90 days between tests [or has that been shortened]?) their clinical skills continue to drop because they are not using them. Yes they can pick up these skills with good precepting and a supportive hospital, but how much longer would it take for someone who graduated 1+ year ago vs a couple months to get to a level of competency where they could begin to function independently on their floor? I'd think it's reasonable to believe, on average, the more recent new grad would be ready to practice a bit sooner than an "older" new grad. Is this something a hiring manager would take into account? For a mngr who wants to make sure her employees do well (and not just trying to fill a spot with a warm body) will the mngr consider an "older" new grad to be too "high maintenance" to give them a chance (whether they would be in reality or not)? I guess this is a new question that would be best answered in an new thread posed to hiring mngrs, but thought I'd throw it out there.

Unlimited number of tries at NCLEX would just demean the profession and you may as well drop that requirement if you allow people to take it ad nauseum until they can pass.

I wonder how many shots at boards a MD or lawyer or pharmacist is allowed? I know I recall an old saying that I had heard (but was later corrected by an MD as being absolutely incorrect)--Do you know what they call a med student who fails such and such 5 times? Answer--doctor.

Nonetheless, to an extent, in regards to our profession, I really do kinda agree with what you are saying. We are a profession that is continually fighting to improve our image; to prove that we are every bit as important as other members of the health care team; to prove that we are a real profession and we practice via real science, not some fluff pulled out of someone's rear. But if you allow someone test until they pass, which, theoretically could be until the day they die, that does little to improve our image as a group of professionals.

Again, good discussion going on here. I really hesitated to post this because it could have quickly gone to the old RN-BSN or union vs nonunion type of mudslinging that is seen on this board.

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Again, good discussion going on here. I really hesitated to post this because it could have quickly gone to the old RN-BSN or union vs nonunion type of mudslinging that is seen on this board.

Heaven forbid!! It is an interesting discussion...I was a bit surprised to see it moved to the NCLEX forum, as the audience viewing it is more likely (I think) to be overwhelmingly in favor of innumerable tries allowed versus just a few. I thought having it in General for a broader audience to see might have been better. Perspective is everything: when I was preparing for that beast of a test, I'm pretty sure I would have been very much in favor of unlimited attempts! Looking back at it, I'm not of the same opinion. Sorry, guys: I still think at some point, you've gotta cry "UNCLE!" and stop beating a dead NCLEX.

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Specializes in Med surg, Critical Care, LTC.

I made many of these same comments on another thread, nearly identical to this one, and I got flamed big time - and my, and other posts, were deleted.

I agree, three strikes and your out. If you've taken the test once, then you should have a good idea of what it is like, therefore, it should be easier to anticipate it the second round and therefore improve. If that isn't what happens, then perhaps a career change may be in order.

If I failed ACLS and PALS numerous times, I'd be out of a job!

Sorry, but I agree with many of the posters. Perhaps changing her career to radiology tech ( they made more than we do) might be easier, and the majority of the credits would transfer.

Good luck

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uhh.. i think 3 is enough.

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three is enough if you're not really into nursing. like some one just said it's better to take this course than your first choice... totally, a waste of time. but if to be a nurse is your dream, why not try again.. besides, we have trainings before we start to work. i believe that if you have a dream, loved your duty, found it interesting and tried your very best, then i guess success will follow. no matter how many times you took the exam, you'll become not a good nurse but a great nurse. imagine the nurses at the time of florence nightingale, they didnt took the nclex but still we can say they practiced nursing and did great duty..

:D:D

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imagine the nurses at the time of florence nightingale, they didnt took the nclex but still we can say they practiced nursing and did great duty..

:D:D

Your sentiment is lovely, but of course the 'nurse' at the time Nightingale began regulating a nursing practice bore barely a passing resemblance to the nurse of today. Certainly no one would compare what is expected of a nurse today in terms of infection control and outright knowledge to what those good, kind women did. They did the best they could with little to no knowledge of A&P & chemistry and zero understanding of infection control. They functioned for petty compensation and no one would have DREAMED of suing them. My, times have changed! And, so, must our expectations of anyone who desires to be a modern-day nurse.

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