Nursing Safety and Passing NCLEX

[Leno182]

Is it reasonable to call someone unsafe if they took several years to pass the NCLEX?

[Rose_Queen, BSN, MSN, RN]

Someone who hasn't passed NCLEX has failed to demonstrate that he or she is capable of meeting the minimum competency to practice as a nurse. Repeated failures over a span of several years leads one to question whether said individual will be able to meet that minimum competency without repeating a nursing program. I'd say that saying someone who can't demonstrate minimum competency is not safe to practice is fair.

[Leno182]

No I understand that. But I'm saying someone who passed on the second time but only procrastinated due to fear...

[Double-Helix, BSN, RN]

I don't think you can make that generalization. At the time of passing NCLEX, that applicant has demonstrated the same level of competency as any other person who passed the exam. Whether it took 1 attempt or 7 attempts, the minimum competency has been met for both candidates.

Passing the NCLEX is what determines that someone has the minimum level of knowledge necessary to practice as a nurse. It is a less valuable indicator of actual nursing practice. One nurse might be easily able to retain facts and answer test questions, but has a poor ability to apply that information to clinical practice. Another person may have needed many attempts or even refresher courses to pass the eventually NCLEX. This may be due to knowing English as a second language, a sub-par nursing education, or personal issues at the time of the initial attempts. However, this person may have better critical thinking and practical skills.

Whether or not one is a "safe" nurse depends on many factors. The most important factor is whether or not the nurse is willing to admit that they have a lot to learn, take steps to verify information before carrying out tasks, and seek advice and support when needed. I'm much more afraid of an over-confident new grad who passed NCLEX on the first try and thinks they know it all than I am of a nurse who took the NCLEX multiple times but understands the importance of questioning their own practice.

[Leno182]

I totally agree, my issue with this was a nurse tearing down a new nurse by publicly saying that this person was "unsafe" because it had been several years before they passed it on the second attempt...I felt this was very inappropriate as well as hurtful to the new nurse who was so proud of finally becoming an RN. I figured if the board of nursing had any concerns they would have never allowed said nurse to even take the exam without meeting further requirements. We should be supporting each other not tearing each other down!

[la_chica_suerte85, BSN, RN]

No I understand that. But I'm saying someone who passed on the second time but only procrastinated due to fear...

No, because they passed and that means they meet the minimum competency to practice safely as a brand new nurse. Anything else surrounding the circumstances of when they took and passed the test is not relevant to the fact that they possess an LPN/RN license.

[la_chica_suerte85, BSN, RN]

I totally agree, my issue with this was a nurse tearing down a new nurse by publicly saying that this person was "unsafe" because it had been several years before they passed it on the second attempt...I felt this was very inappropriate as well as hurtful to the new nurse who was so proud of finally becoming an RN. I figured if the board of nursing had any concerns they would have never allowed said nurse to even take the exam without meeting further requirements. We should be supporting each other not tearing each other down!

People are entitled to be opinionated about certain things but that doesn't mean they are correct in their opinions. The person who said that is mistaken about what it means to possess a license. If the new nurse was inherently unsafe in their actual work (i.e. not asking questions, pushing forward without thinking things through, not appearing to care about doing a good job, etc.), then they might have a leg to stand on but, otherwise, they just make themselves look like an ass for saying something like that.

[Double-Helix, BSN, RN]

I totally agree, my issue with this was a nurse tearing down a new nurse by publicly saying that this person was "unsafe" because it had been several years before they passed it on the second attempt...I felt this was very inappropriate as well as hurtful to the new nurse who was so proud of finally becoming an RN. I figured if the board of nursing had any concerns they would have never allowed said nurse to even take the exam without meeting further requirements. We should be supporting each other not tearing each other down!

I sincerely hope that if you ever witness a coworker "tearing down" another, publicly or otherwise, you step up and say something. This is workplace violence and, especially in the eyes of the nurse being bullied, silence is agreement.

[RNNPICU, BSN, RN]

Passing the NCLEX does not automatically mean someone is safe, just that they have met the minimum competency to practice. I can see a few scenarios

1. Person graduates from a good nursing school, had family issues, or personal issues, hadn't prepared for the NCLEX and decided to wait until a better point in life. A few years later, life is better and now passes after preparing.

2. A person graduates from nursing school and is struggling with the NCLEX, doesn't have a game plan, just retakes and hopes for the best, repeatedly doing so but not making any changes or thinks about the why.

3. A person graduates from nursing school and immediately signs up to take the NCLEX, doesn't prepare or prepare sufficiently and fails. Becomes demoralized and waits a year or so to retake, and then retakes an passes.

In all three of these scenarios there is a gap in years from graduation to NCLEX passing. The all reached that minimum competency to practice. The unsafe practice would come into play during orientation and if they failed to prove they could practice safely.

Passing the NCLEX is the first milestone post graduating from nursing school and gives that person the license to practice.

[brownbook]

A nurse is a good nurse based on her assessment of patients physical and emotional needs, and what she does with the information gathered from the assessments.

A nurse is a good nurse based on knowing the parameters for vital signs, and common drug dosages, and knows when to look a drug up or ask for help if she doesn't know.

A nurse is safe who is not afraid to say "I don't know," instead of muddling through.

A nurse is an unsafe if they think publicly tearing down another nurse is appropriate behavior. I wouldn't trust a nurse who displays such egregious bullying behavior with my or my families care irregardless of their IQ, nursing school grades, or NCLEX score.

[nurse2033, MSN, RN]

I say no, you can't infer that they are not safe. I believe safety is an affective skill, and test taking a cognitive skill. School prepares you for the latter more than the former.