Prepare Nurses to Pass NCLEX, or Prepare Nurses for Real World?

[Hoosier_RN]

On 7/28/2020 at 5:42 PM, KatieMI said:

I do not know how schools nowadays let out nurses who literally do not know ABCDs of pathology and pharma and how these nurses successfully pass NCLEX in droves and get employed without having the slightest idea of what they are playing with.

Oh, bother....

Schools teach to the NCLEX because of the all important pass rates needed to stay in business. Students don't get the same education that I got 30ish years ago, that taught me to learn in depth and develop the critical thinking skills needed to adequately care for patients once I left school and got my license. Nowadays, they depend on facilities to fill in the blanks, which is proving to be detrimental to nurses, as well as patients. Not all residencies are good, and not all new nurses get the training and support that they need. I don’t blame nursing instructors, per se, they are hired to teach a class by the model the school wishes. I blame the schools that take these students money and leave many of them grossly under prepared.

[meanmaryjean, DNP, RN]

3 minutes ago, londonflo said:

Was it a fat envelope or a thin one! LOL

Now I'm having a flashback! ?

[Wuzzie]

1 minute ago, meanmaryjean said:

Now I'm having a flashback! ?

Me too! ?

[guest1008832]

9 hours ago, JKL33 said:

I'm not trying to be mean but sometimes I think schools/instructors are a little too fascinated with the thought of Bloom's Taxonomy and the idea that for all of these goofy questions there is some nonsense right answer according to higher ordered thinking...

Finally....someone who gets it! (Standing Ovation).

[guest1008832]

8 hours ago, londonflo said:

I think Bruse has illustrated some of the current thinking of a student along those lines.

(Look, I'm famous now...I was mentioned in a blog not directed directly to me!)

Many states do not allow students to begin their practice on a permit; instead they cannot be hired until they are licensed. Test questions like SATA, rank ordering etc. can test multiple related things in one question. And of course, there is a great demand for a determination of competence "now" on today's consumer.

I will admit, PA is one of those states that will allow GN's to practice prior to sitting for the NCLEX. I was offered a job at a local hospital in the ER, I was beyond tempted because it was what I went to school for. However, I simply wanted to wait until I passed the test so I didn't become confused based on "textbook" practice vs. "real world" bad habits. It was just personal choice. After I tested in January 2020 and failed, the PA BON sent me my failure notice along with a pleasant "STOP WORKING NOW NOTICE" in the mail claiming the permit I applied for (which cost $65.00) in addition to the standard ($75.00 application fee to test) was being REVOKED! The permit had a 1-yr. expiration date on it and nowhere on the application, the PA BON site or any other resource was I ever informed if I failed the NCLEX, the permit would be REVOKED! So, if I was banking on keeping the ER job, I needed to pass the NCLEX and if I would have left my former employer as a Paramedic, I highly doubt I would have just gotten my job back.

So let's assume you leave your job, take a GN position and fail the NCLEX. Who is responsible for the failure? You? NCSBN? Your school? Your professors? Who would now pay my bills after no longer being allowed to continue working in the capacity of GN and must wait 45-days just to retest? Unemployment Compensation? Should they pay my bills? WHO? (And I don't mean to shout...just trying to make a stern point).

The fact of the matter is, I made a very intelligent decision not to take the GN position in the ER banking on passing the NCLEX. I would have lost my job, my car, my home and dignity all at the same time. I almost forgot to mention the $23K in student loans I have to repay.

Bruse

[Susie2310]

On 8/11/2020 at 1:07 PM, llg said:

Nurses do not practice medicine. The NCLEX has nothing to do with medicine - or EMT practice. It is about professional nursing practice and nothing else.

If you feel unprepared to do well on the NCLEX because you don't feel you have sufficient knowledge about being a Charge Nurse, etc., then you should study that sort of content before you take the test again. Now you know what your weak spot is. Apparently, all of your EMT experience did not prepare you for those aspects of the nursing role. In most areas of the country, even Associate Degree prepared nurses are expected to be the Charge Nurse sometimes and to have a basic knowledge of being a team leader, make staffing decisions, participate in policy development, etc.

Over 80% of all newly graduated nurses with an Associates Degree pass the NCLEX on their first attempt. They pass it by learning the nursing content -- and not relying on any past experience they may have in other disciplines. You seem like a bright enough guy. I'm sure you can pass the exam too if you just focus on opening yourself to learning new things -- and "letting go" of old knowledge from different fields to carry you through this new field.

...and "thank you" for standing up to Excelsior. I think there are a lot of poor quality schools out there that should be either closed or forced to upgrade. They take students' money and don't provide them with a good education. I am sorry that happened to you. Had you gone to a more traditional program that did a better job of teaching the nursing content, you might have been an RN by now.

I've bolded the part of your post I am referring to. I'm not sure why you found it necessary to use the phrase: "In most areas of the country even associate degree nurses . . ." Why not just say: "In most areas of the country, associate degree nurses . . .?" You are well educated, so you know that your choice of words conveys meaning. In this case, your words conveyed to me disdain for the abilities of Associate Degree Nurses. No doubt you will post back and say that you intended no such thing and offer a reason for your choice of words; however, this is how you are coming across to some of us.

Associate Degree Nurses used (I can't speak for the current situation as I don't have full information) to be very well prepared to take care of patients. Many of the students were older, some were on their second careers, and many already had bachelors degrees or other special training, so they brought a lot of life experience, sense, and wisdom, to these programs. Students graduated very well prepared to start jobs providing actual bedside patient care in hospitals, and they didn't need long orientations or residencies. Yes, ADN nurses learn about leadership also; we were expected to lead a team when I was a student. ADN nurses are Charge nurses and are involved in policy decisions etc. You appear to be trying hard to suggest that ADN education has had it's day and that this type of degree/nursing education is no longer sufficient in today's workplace, which is untrue. My experience has been that ADN prepared nurses are the nurses who actually know how to and are able to provide patient care to real live patients in hospitals and other settings in the community.

[londonflo]

2 hours ago, subee said:

Bruse: What was the pass rate in your class? You would have better standing for a lawsuit if your class's pass rate was out of line with other schools'. There are multiple posts on this forum from nurses that had to take the exam more than 2 times.

The latest set of stats for First Time takers in Pennsylvania is for October 2018 to September 2019 and were very good. 7901 were tested, 7238 passed for a pass rate of 91.61%. 82 schools were listed as graduating at least one class during that period. 5 schools had pass rates below the minimum pass rate of 80%. The National pass rate for first time test takers was 88.07%. I am assuming the pass rates for first time test takers for October 2019 to September 2020 will be reported in about 2 months.

Bruse Do these stats jive with what was published by your school? How many graduates were in your class? That can sometimes skew a school's results.

2 hours ago, subee said:

I have made the assumption that this school is even accredited.

Subee I am assuming the school was accredited by ACEN because Bruse mentioned that with regard to EC.

[guest1008832]

2 hours ago, subee said:

Bruse: What was the pass rate in your class? You would have better standing for a lawsuit if your class's pass rate was out of line with other schools'. There are multiple posts on this forum from nurses that had to take the exam more than 2 times. I have made the assumption that this school is even accredited. And what was the pass rate for your state? If the majority of takers failed, that would give your argument more credence.

Wuzzie,

I have no idea of what the pass rate is at my school. The school was based in Coral Springs, FL. I live in PA. So, I'm taking NCLEX-RN in PA. Interestingly, all of those students who took the test in FL, have passed from my class. The school had a great reputation but the nursing program closed shortly after my class so it could provide a higher level of education for a BSN program.

Unfortunately, the NCSBN is not breaking down pass/fail rates per state. They are only providing National statistics. Sadly, after reviewing the pass/fail rates of the document provided below, there is a significant problem with the pass rates of this test. Pay attention to the time period of Oct. - Dec. 2019 with a 72.5% pass rate for Associate Degree students. What is most troubling are the numbers for the "repeat" test takers and the overall percentage of failures. Only during one period btwn July - Sept. 2019 did the pass rate exceed 50%. Atrocious and disturbing. Now if someone can find a breakdown by individual states, that would be interesting to see, because I thought this was a National test. If one state is doing poorly do you blame the student...the state...or the school? And remember, I came from a FL nursing program after transferring credits from an on-line non-brick & mortar school.

Bruse

[londonflo]

48 minutes ago, emtpbruse said:

After I tested in January 2020 and failed, the PA BON sent me my failure notice along with a pleasant "STOP WORKING NOW NOTICE" in the mail claiming the permit I applied for (which cost $65.00) in addition to the standard ($75.00 application fee to test) was being REVOKED! The permit had a 1-yr. expiration date on it and nowhere on the application, the PA BON site or any other resource was I ever informed if I failed the NCLEX, the permit would be REVOKED! S

Here is the location of the regulations in PA (https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Pages/Board-Laws-and-Regulations.aspx#.VTAurP50xRA) which state:

Quote

. § 21.7. Temporary practice permits.

(a) A graduate registered nurse may only practice professional nursing under supervision and if the graduate registered nurse holds a current temporary practice permit. “Supervision” means that a licensed registered nurse is physically present in the area or unit where the graduate registered nurse is practicing. The Board may grant a temporary practice permit to a graduate registered nurse as follows:

(1) A graduate registered nurse who wishes to practice professional nursing shall submit an application for a temporary practice permit for a graduate registered nurse on a form provided by the Board and remit the fee specified in § 21.5 (relating to fees). A temporary practice permit granted under this section is valid for up to 1 year from the date of issuance, unless extended under paragraphs (3) and (4), and immediately expires if the applicant fails the licensing examination.

Did your school not even have you review what a Nurse Practice Act details? I just now read you did NOT go to school in PA.

48 minutes ago, emtpbruse said:

So let's assume you leave your job, take a GN position and fail the NCLEX. Who is responsible for the failure? You? NCSBN? Your school? Your professors? Who would now pay my bills after no longer being allowed to continue working in the capacity of GN and must wait 45-days just to retest? Unemployment Compensation? Should they pay my bills? WHO? (And I don't mean to shout...just trying to make a stern point).

I am glad that you are still able to work as a paramedic as you would be responsible for the failure and know that and are just projecting again. In most states you must work for an employer for a certain period of time to be eligible for Unemployment Compensation. I am sure this information is available on the PA Department of Unemployment Compensation (https://www.uc.pa.gov/Pages/default.aspx) I am just wondering if you yourself felt there was a significant chance of failure. If so, I am glad you paid attention to your instincts.

[guest1008832]

On 8/12/2020 at 4:25 PM, Susie2310 said:

You appear to be trying hard to suggest that ADN education has had it's day and that this type of degree/nursing education is no longer sufficient in today's workplace, which is untrue. My experience has been that ADN prepared nurses are the nurses who actually know how to and are able to provide patient care to real live patients in hospitals and other settings in the community.

Fortunately, I understood the message "llg" was trying to convey. And to piggy-back on your conclusion, I was told by a host of nurses not to apply at several different hospitals here in the Allentown, PA area if I didn't have a BSN degree or if I wanted to work in the ER. The hospital I referenced before in an earlier blog post, who offered me a GN position in the ER, was a Stewart Hospital based in Easton, PA and was recently bought out by a larger hospital system. Nurses here in the PA area have been told...get your BSN or "find a new job!".

The ASN program I attended in FL was closed voluntarily so it could submit the proper documentation to the FL BON to receive BSN level recognition. It was a fully accredited program. My local community college also closed their Associate Degree program. That was a mistake!

However, through all my didactic training and clinical periods, I was never required to be a "charge nurse" or make big decisions pertaining to department budgets, staffing, equipment, Q&A or other pt. care aspects...but I was tested on it! Was that fair? Should a Paralegal be required to take the same Bar Exam a recent law student is required to take after completing law school?

Bruse

Bruse

[guest1008832]

32 minutes ago, londonflo said:

The latest set of stats for First Time takers in Pennsylvania is for October 2018 to September 2019 and were very good. 7901 were tested, 7238 passed for a pass rate of 91.61%. 82 schools were listed as graduating at least one class during that period. 5 schools had pass rates below the minimum pass rate of 80%. The National pass rate for first time test takers was 88.07%. I am assuming the pass rates for first time test takers for October 2019 to September 2020 will be reported in about 2 months.

Bruse Do these stats jive with what was published by your school? How many graduates were in your class? That can sometimes skew a school's results.

Subee I am assuming the school was accredited by ACEN because Bruse mentioned that with regard to EC.

The school I attended in FL was accredited. Where did you find the individual state breakdown of NCLEX testing by chance. Is it on the NCSBN site?

My cohort (or class) had approx. 52 students. Many of them transferred into the school after having sever difficulty at Broward College in Coral Springs, FL.

Bruse

[londonflo]

40 minutes ago, emtpbruse said:

What is most troubling are the numbers for the "repeat" test takers and the overall percentage of failures. Only during one period btwn July - Sept. 2019 did the pass rate exceed 50%.

I believe the national statistic for second time test takers passing is 40% on average and only varies minimally each year. I don't have any references here at home though so don't quote me. I will check further but the numbers cited seem about right.

[macawake, MSN]

1 hour ago, Susie2310 said:

I've bolded the part of your post I am referring to. I'm not sure why you found it necessary to use the phrase: "In most areas of the country even associate degree nurses . . ." Why not just say: "In most areas of the country, associate degree nurses . . .?" You are well educated, so you know that your choice of words conveys meaning. In this case, your words conveyed to me disdain for the abilities of Associate Degree Nurses. No doubt you will post back and say that you intended no such thing and offer a reason for your choice of words; however, this is how you are coming across to some of us.

Associate Degree Nurses used (I can't speak for the current situation as I don't have full information) to be very well prepared to take care of patients. Many of the students were older, some were on their second careers, and many already had bachelors degrees or other special training, so they brought a lot of life experience, sense, and wisdom, to these programs. Students graduated very well prepared to start jobs providing actual bedside patient care in hospitals, and they didn't need long orientations or residencies. Yes, ADN nurses learn about leadership also; we were expected to lead a team when I was a student. ADN nurses are Charge nurses and are involved in policy decisions etc. You appear to be trying hard to suggest that ADN education has had it's day and that this type of degree/nursing education is no longer sufficient in today's workplace, which is untrue. My experience has been that ADN prepared nurses are the nurses who actually know how to and are able to provide patient care to real live patients in hospitals and other settings in the community.

I read the entire thread but since I do my nursing in a non-NCLEX country I’ll stay out of that part of the debate. I just wanted to add my 0.02 regarding the word even. I didn’t read llg’s post as disparaging towards ADN nurses. I assume she read all the posts the poster she responded to had written. Even though she just quoted a partial post, she did respond to several different things that poster had written. One of them was:

”Someone with a BSN is more at an advantage than someone with an ADN/ASN vs a diploma certificate. How is this form of NCLEX testing even remotely fair??? I was asked a host of questions on the NCLEX placing me into the role of ”Charge RN” and needing to make decisions regarding staff, policies and budgets. How is this relevant to my ASN degree? I’m not a nurse manager. I didn’t get exposed to those educational resources.”

To me the wording ”even associate degree nurses” in llg’s response seemed logical considering the above quote. Only llg’s can say what she intended, l’m just sharing what her words conveyed to me. I read them differently than you.