NCLEX- how many attempts is too many?

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Inspired by another thread I saw, just wondering what people's thoughts are: Should there be a limit on attempts? Why or why not? Personally I feel that if you can't pass it by the second time, some serious re-evaluations should be made

I have a feeling that this is going to be a heated discussion.

I do believe that there should be a limit on the number of attempts allowed. I think that three attempts should be the maximum. I think that it's a reasonable compromise between allowing for factors that can affect a person's performance

on a single day while still maintaining the integrity of the license.

The NCLEX as far as I understand tests critical nursing judgment and is used to determine if a nurse is safe to practise at a beginner/novice level. Since the majority of nurse graduates pass it on their first attempt, to me it's a huge red flag if someone fails it five or eight times. There has to be some vital parts of the nursing process that the graduate simply does not grasp. It can't be blamed on nerves or being a poor test taker. Sometimes, something's simply aren't meant to be.

For those who think that an unlimited number of attempts should be allowed, would you really be comfortable being cared for or having a loved one being cared for by a nurse who's struggled so, with the very basic/beginner level of nursing?

What about a pilot who's taken a test twenty times in a simulator after completing his/her training and crashed every single time. Then they magically pass on the twenty-first attempt. Would you be comfortable getting on a flight piloted by this individual?

What about the police officer to be who's failed time and time again on the range and even managed to shoot his/her instructor in the leg on one or two occasions. Now s/he miraculously passes the gun proficiency test on the umpteenth attempt, should he or she be allowed to be carrying a gun, policing the community? Would you feel safe?

Sometimes, somethings aren't meant to be. There's no shame in that, it is what it is.

In my opinion we owe it to our patients to maintain high standards in our profession. Part of the standard should be the ability to pass a basic entry-level test. If the stress of taking a test is too much, how well equipped is one to handle the stress, challenges and responsibility/accountability of a nursing job? They are infinitely more demanding than a mere multiple choice exam.

One last thought.. I really question the quality of a program that allowed a person who goes on to fail the NCLEX 5+ times, to graduate.

Exactly. Not everyone is a "winner". Not everyone is meant to "do anything they want to do for a living".

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Specializes in Nurse Leader specializing in Labor & Delivery.

And whenever I hear "I'm a poor test taker" I think of the Daniel Tosh bit.

Don't you love it when people in school are like, "I'm a bad test taker"? You mean, you're stupid. Oh, you struggle with that part where we find out what you know? Oh. No, no, I can totally relate. See, because I'm a brilliant painter, minus my God-awful brushstrokes. Oh, how the masterpiece is crystal up here[points to head], but once paint hits canvas, I develop Parkinson's.
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Specializes in OR, Nursing Professional Development.
... considering some people say they have extreme test anxiety. I studied like my life depended on it and passed on the first try, but I don't want to judge others too harshly

If someone can't take and pass a test in multiple tries based on test anxiety, how will he/she function in a life-threatening emergent scenario? This is why I can't buy the test anxiety excuse for more than the first, maybe second attempt.

I think it should be three attempts, required intensive remediation, and if unable to pass the first time after remediation, then it's over. Not everyone who wants to be a nurse can or should be a nurse. If one can't pass a basic competency exam in three tries followed by intense remediation and a fourth try, I don't want to be the one working with them or in their care.

Letting pretty much anyone attend and graduate nursing school (predatory for-profit schools, I'm looking at you), the relatively low entrance requirements (I work with some awesome diploma and ADN grads, but reality is that everyone is requiring higher degrees and while nursing should grandfather in those already licensed, we need to get on board), the constant bickering about degrees (how many ADN vs BSN debates are on even just this site), and the unlimited attempts to pass the basic competency exam contributes to part of why nursing isn't seen as a profession to be respected by those in power (the CEOs who see us as a disposable and easily replaceable workforce).

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In Michigan:

You must complete the NCLEX within 12 months of your first attempt at the test. If you fail the test, you will have to wait for 45 days before you can retake the test. You will typically be able to test up to 3 times per year. If you fail the test 3 times, you will have to complete an educational program that is acceptable to the board before you are approved to take the test up to 3 times more. You will have a total of 6 attempts at the test.

I'm not sure if "educational program" means go back to nursing school, or some sort of refresher course.

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Why should someome have 3 attempts before being required to take remediation? Why isn't 2 enough? The first time we can get a pass for untimely illness, realizing what kind of study and prep is needed or obtaining test anxiety counseling, what is the reason for allowing a 3rd attempt? I think a 2nd is plenty before going back for more education.

I'm not familiar with the modern NCLEX content, do you all think it is a good gauge of competency?

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Specializes in OR, Nursing Professional Development.
Why should someome have 3 attempts before being required to take remediation? Why isn't 2 enough?

I think there is going to be a lot of pushback from the people who benefit from the unlimited chances: those who can continue taking the exam (the graduates who fail multiple times), the BON who profits from the multiple applications, and PearsonVue, who also profits from the multiple times. A slightly more generous but still allowing for a fair amount of profit would probably be a lot more palatable to those groups, plus a three-strikes and remediation would be congruent with Canada, who also (as of 2015) tests using NCLEX. Either way, a limit becoming reality in the US is probably nothing more than a dream.

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Specializes in Nurse Leader specializing in Labor & Delivery.
Why should someome have 3 attempts before being required to take remediation? Why isn't 2 enough?

You realize that we're naval-gazing here, right? It doesn't really matter if it's 2 or 3 or 12, because our opinions are not going to change NCLEX policy.

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Specializes in Med-Surg, NICU.

This really isn't as big of an issue as some people make it out to be. About 85% of people pass the NCLEX on their first try and about 50% pass on their second attempt. So that leaves about 7.5% who take more than two times to pass.

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Specializes in Management, Med/Surg, Clinical Trainer.
Just to add a different perspective physicians have 6 attempts to pass each step of the USMLE. The pass rate for US trained physician on each step is higher than the NCLEX.

That is scary!

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You realize that we're naval-gazing here, right? It doesn't really matter if it's 2 or 3 or 12, because our opinions are not going to change NCLEX policy.

Well now that you've pointed that out, yes :-)

Make it a rhetorical question..

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Specializes in Management, Med/Surg, Clinical Trainer.

I'm not familiar with the modern NCLEX content, do you all think it is a good gauge of competency?

I do not know if it is a good gauge of competency, however nursing schools in general test to this test. So in theory if they did well in school and the school taught to the test....the new nurse should pass the test.

At my school at the end of each semester we had to have a NCLEX practice test on that section of nursing.

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I agree with your sentiment about finding peace with the idea of letting those who completed nursing school have the opportunity to test until they pass. There is a documentary that features a man in California who graduated law school and works as a paralegal. Every year he attends a bar preparation course and sits for the bar exam and fails. He has done this since the 80's! The test has his number!!! And many states give medical school graduates 10 years to take their board exams!

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