Student Not Eligible for NCLEX

[Nurse Beth]

Dear Nurse Beth,

My daughter graduated with a BSN. Transcript shows degree awarded. However, she didn’t make the school's required minimum on the HESI. Now the school has decided to administer ANOTHER test in a month, which will interfere with her job offer. At what point does something give and the school no longer hold the control to hold not releasing graduates to sit for the NCLEX?

---

Dear Daughter Held Back,

Most nursing schools require their students to pass the HESI exam prior to graduation. The HESI exam is a valid predictor of the student's ability to successfully pass the NCLEX.

The HESI exam consists of 150 questions and is designed to test critical thinking and application.

Nursing schools have the right to hold students to conditions of successful completion of the nursing program. Students who do not successfully meet requirements of completion are not eligible for the NCLEX.

The best thing for your daughter to do is prepare to successfully pass the test.

A BSN has no value to employers without an RN behind it.

Her job offer is certainly contingent on her passing the NCLEX, and the first step towards passing the NCLEX is passing the required exit exam. At some hospitals, the applicant's exit exam scores are looked at along with their GPA when hiring.

In other words, although you could choose to fight and appeal the school's decision, your energy is better spent on encouraging and helping your daughter pass. There are a lot of helpful study aids out there.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

[Jory, MSN, APRN, CNM]

12 hours ago, TriciaJ said:

Yes, the part that mystifies me is that the school awarded her a degree but then got in the way of her taking the licensing exam. If they need to see likelihood of her passing the NCLEX, shouldn't they ascertain that before conferring the degree?

My school administered NLN exams as a condition of graduating from the program. It would have seemed a dirty deal if they let us graduate and then prevent us taking the licensing exam.

What they do is award the degree (cuts down on lawsuits), but refuse to complete the paperwork to allow the student to register for the exam.

Schools are legally permitted to include the HESI as a condition for graduation...BUT in this particular case, it was added after the student had already started the major courses of the nursing program. Students incorrectly believe that schools can just blindly change requirements on a whim--they can't. This is why "satisfactory academic progress" and staying enrolled is important. You fall under the catalog for degree requirements OF WHEN YOU STARTED. This prevents schools from creating an unfair hardship on the student that can cost the student money.

The school will generally count on your ignorance of not knowing this...but if you protest it enough, they'll remove the additional requirements.

My school in my RN-BSN program tried to tack on an additional class right before we started our last term. A few of us got together, sought legal advice, and paid an attorney to send a letter to the school informing them the school catalog is in essence, a contract. What "could not be negotiated" per the Dean of Nursing and fell on deaf ears of the President, magically went away.

A simple search online, if you dig deep enough, will demonstrate students usually win those cases. But again, it only applies if you are CURRENTLY in the program.

[TriciaJ, RN]

Yikes. I thought it was dirty pool when they let a student get to almost the end of the program and then decide they weren't going to cut it. But to give you your degree and then kibosh your ability to use it? Unbelievable.

[twinsmom788]

Considering I am an advanced practice nurse, I think I know this. But I appreciate your insight. But you are just as wrong as you can be with your assessment.

Have you worked in licensure? Or on the BON...just saying, because you say that you are an Advanced Practice Nurse...really doesn't make you an authority on any of this. It is a different world.

Does your state require you to retain your RN license as well as your Advanced Practice situation. Do you know? I've seen many NPs come before the board because they did not know that or care about it.

[Jory, MSN, APRN, CNM]

On 6/16/2019 at 11:21 PM, twinsmom788 said:

Considering I am an advanced practice nurse, I think I know this. But I appreciate your insight. But you are just as wrong as you can be with your assessment.

Have you worked in licensure? Or on the BON...just saying, because you say that you are an Advanced Practice Nurse...really doesn't make you an authority on any of this. It is a different world.

Does your state require you to retain your RN license as well as your Advanced Practice situation. Do you know? I've seen many NPs come before the board because they did not know that or care about it.

If you work in nursing long enough you learn how entities work. I don't need to work on the BON either. You want to know why? Because the laws/policies that regulate the BON are public information and available for anyone to read. Do you know where to find yours? Because I know where to find mine and frankly, it isn't too hard to find them in any other state either.

ALL STATES require you to retain your RN license as well as your APRN.

By the way it's not "NPs" the proper collective term is APRN.

[Hoosier_RN, MSN]

I'm wondering if this school was having issues and maybe this was an action plan required by the state BoN...it happened at a local nursing school a few years ago and a few threatened lawsuits and got nowhere, because the BoN holds the power, and can close the school down or put on probation, meaning no degree or license. At least how it was explained back then

[TheDudeWithTheBigDog, ADN, RN]

On 6/16/2019 at 2:51 PM, BrentRN said:

Nursing schools are not manipulating statistics.

That's exactly what they're doing. By only letting the people they feel are likely to pass take the NCLEX, it shows a higher success rate, because they didn't allow the one's they thought would fail take it. If the school is as good as they claim, they should be able to confidently let EVERY graduate take the test, regardless of their score on a standardized test... Because that's what you're paying for. If people can graduate without being ready to take the NCLEX after a little studying on their own, they were ripped off by their school. By the time they graduate, they need to be ready to test and be eligible. If they're too likely to fail repeatedly, then they shouldn't have been able to pass their classes to graduate... Ofc, though, that's another statistic they make sure to manipulate: completion rate.

Basically, they make it easier to pass and harder to test, so that they can have a high graduation rate, and a high NCLEX pass rate.

[caliotter3]

2 minutes ago, tonyl1234 said:

That's exactly what they're doing. By only letting the people they feel are likely to pass take the NCLEX, it shows a higher success rate, because they didn't allow the one's they thought would fail take it. If the school is as good as they claim, they should be able to confidently let EVERY graduate take the test, regardless of their score on a standardized test... Because that's what you're paying for. If people can graduate without being ready to take the NCLEX after a little studying on their own, they were ripped off by their school. By the time they graduate, they need to be ready to test and be eligible. If they're too likely to fail repeatedly, then they shouldn't have been able to pass their classes to graduate.

I most likely have never read anything on this site that I have agreed with more strongly than this post. Of course, nursing schools are manipulating the statistics when they refuse to allow all graduates to take the NCLEX. Common sense.

[BrentRN, PhD]

A few commenters feel that requiring graduates to take an exit exam is "manipulating statistics". I think I understand what they are getting at because they feel a passing rate should not be affected by an exit exam requirement. Based on the many statistics courses I have taken I don't think that qualifies as statistical manipulation. Statistical manipulation means altering your data or presentation of the data to show it in more favorable or misleading light. Manipulation of a passing rate is actually not possible because the data is provided by the State BON not the school. The state just reports the passing rate of candidates as they take the exam.

I have taught thousands of nursing students at three different nursing programs over a 30 year period. Nursing schools face a great challenge of setting a floor for what is acceptable minimal level of mastery. A school can set a bar very high and only allow the very top scorers to graduate but then the school will criticized for high attrition. They could also set the bar very low and then have angry graduates who are incapable of passing the NCLEX or getting a nursing job. Finding that sweet spot is very challenging. Just one problem is that you have different faculty creating different exams of different difficulty levels but all are using the same cut score.

When you have to stick to the cut score you get issues where someone gets to pass by a rounding error along with a better grade on one paper. The student would be better served by repeating the course but rarely choose that option. They then get to the next semester and continue to struggle but either fail or just make it. Remember that in all groups somebody has to be below average by definition.

Nursing curricula are not designed just to pass NCLEX. The exam is just a minimal demonstration of safety using a testing methodology that cannot be fully duplicated by any nursing school (Computer Adaptive Testing). Exit exams are just an attempt to prepare a student for a type of testing they may never have experienced. For example, teacher prepared exams are still done on paper where the whole exam is given to the student at once. A computerized test only lets the student see one question at a time. The ATI, HESI, Kaplan and the like are simulating that testing method. That seems like a reasonable and responsible thing for students to experience before going to the NCLEX.

In an ideal world all graduates should walk out of school and pass without an exit exam. The national average for first time test takers without test preparation is around 85%. Some preparation for the exam can put the passing rate above 90%. While some folks in this discussion see that requirement as a disservice, my experience is that students have thanked us for being sure they are ready. Another issue is that I have had students in the past take the exam without studying "just so I could see what it was like". My fellow faculty and I were aghast at that view because so much rides on first-time passing rates.

To summarize, I don't think an exit exam is a "manipulation". It is just a preparatory requirement right along with passing all your other requirement from Art to Physiology.

[TheDudeWithTheBigDog, ADN, RN]

On 7/1/2019 at 6:58 PM, BrentRN said:

To summarize, I don't think an exit exam is a "manipulation". It is just a preparatory requirement right along with passing all your other requirement from Art to Physiology.

But it's a requirement to be able to test. It limits the people testing to only the ones who score above the school's arbitrary number. It's creating biased statistics. It doesn't have to be limited to only the top scorers graduate. Why not hold the teachers accountable for TEACHING their classes? If the teachers do their job, the students should be graduating ready to schedule their test. If you can't grasp a basic understanding of nursing, you should have failed a class in there somewhere and shouldn't have graduated yet.

Exit standardized tests are used so that the school can be easy enough to pass and have a high graduation rate, while limiting who gets to actually test to have a high NCLEX pass rate. It's manipulating the data to make the school look better than it really is. You really think it's coincidence that so many of the top nursing schools don't have these tests, yet your degree mills and less reputable schools almost all require exit exams?

[ThePrincessBride, MSN, RN, NP]

I graduated almost five years ago and my program required us to pass something similar to the HESI. It was very accurate for me as I passed and it gave me a 99 percent chance of the NCLEX the first time. I passed it with 75 questions, no re-dos.

If your daughter can't pass the HESI, I would be worried about facing the NCLEX.

[Jory, MSN, APRN, CNM]

On 7/26/2019 at 5:43 PM, ThePrincessBride said:

I graduated almost five years ago and my program required us to pass something similar to the HESI. It was very accurate for me as I passed and it gave me a 99 percent chance of the NCLEX the first time. I passed it with 75 questions, no re-dos.

If your daughter can't pass the HESI, I would be worried about facing the NCLEX.

You wouldn't think it was accurate if you had a 4.0 GPA, failed the HESI (let's say it was an evaluation tool at your school and a pass wasn't required) and you still passed with 75 questions.

Like the previous poster said...most top programs don't have exit exams at all...there is a reason for that.

[NICU Guy, BSN, RN]

On 7/3/2019 at 2:07 PM, tonyl1234 said:

It limits the people testing to only the ones who score above the school's arbitrary number. It's creating biased statistics. It doesn't have to be limited to only the top scorers graduate.

The same can be said about NCLEX. Only people that pass NCLEX are those above an arbitrary number. Why are only the people that score above the arbitrary number get to be nurses?

On 7/3/2019 at 2:07 PM, tonyl1234 said:

Why not hold the teachers accountable for TEACHING their classes? If the teachers do their job, the students should be graduating ready to schedule their test

That is the purpose of the standardized tests. It gives the instructors a benchmark. Would you want a school that thought they were preparing their students for NCLEX and have a majority of them fail? If a majority of the students are failing the standardized tests, then the school needs to look at how their instructors teach.

On 7/3/2019 at 2:07 PM, tonyl1234 said:

Exit standardized tests are used so that the school can be easy enough to pass and have a high graduation rate, while limiting who gets to actually test to have a high NCLEX pass rate.

Exit exams show your probability to pass NCLEX. If you did poorly on an exit exam, you either didn't try or are not prepared for NCLEX. Schools want to limit the number of graduates that take NCLEX to those that are likely to pass NCLEX. You want to catch the ones that will not pass NCLEX and give them additional instruction before they pay for NCLEX and BON fees.