Why are Hospitals so darn mean when someone fails the NCLEX?

humglum, BSN, RN · Apr 1, 2005

Well, unfortunately, they have to take her patients and reduce her pay. I'm not sure why they would advertise the fact that she failed state boards... that's adding insult to injury, IMO.

When I graduated, my state didn't recognize the role of GN, so I didn't have my first nursing job until I was licensed. There was someone who started orientation with me, though, and had yet to take boards... she was started as a CNA. She stayed in that role as she failed the NCLEX three times. The last I heard, she had to take a CNA-related course in order to keep that position.

They couldn't only cut her pay by $3.00 because then she'd be paid far more than other CNAs for performing the same job. A person cannot function as a nurse if he or she is not licensed as one.

Roland · Apr 1, 2005

Why coudn't she do the same things that she did as a grad nurse? All I'm saying is give her at least one more chance to pass the test before turning her life upside down. Also, I find it ironic that we are constantly preached to about patient confidentiality while at the same time it is collectively "spit upon" in the case of co-workers, and employees. Even a student nurse can do more than a CNA especially one that has been "checked off" on various advanced skills which she has. I could even see cutting the pay to $15.00/hr. I'm sure she will be able to focus on her next exam now that her life has been turned upside down. That damm test is stupid anyway. Why can't they test "basic concepts" in a straightforward manner like almost every other professional licensing examination. For example I have taken and passed State Licensing examinations in Real Estate Sales, Appraisal, Fire Fighting I&II, EMT-B, CPR ect. In all of those cases I was asked things that I should definitiely know if I was awake in class and did the readings. Furthermore, the questions were very straightforward with no "word game" or multiple correct/almost correct answers. When did nurses collectively buy into the "critical thinking" psychobabble, pandered by MENSA happy, MIT psychometric fixated geeks?

Well, unfortunately, they have to take her patients and reduce her pay. I'm not sure why they would advertise the fact that she failed state boards... that's adding insult to injury, IMO.
When I graduated, my state didn't recognize the role of GN, so I didn't have my first nursing job until I was licensed. There was someone who started orientation with me, though, and had yet to take boards... she was started as a CNA. She stayed in that role as she failed the NCLEX three times. The last I heard, she had to take a CNA-related course in order to keep that position.
They couldn't only cut her pay by $3.00 because then she'd be paid far more than other CNAs for performing the same job. A person cannot function as a nurse if he or she is not licensed as one.

z's playa · Apr 1, 2005

I think it's ridiculous for them to advertise her failure of the NCLEX. I've said it before and I'll say it again. Nursing as a profession seems to have a problem with sticking together like say medicine (doctors)...sorry guys but I think it's true. Nursing seems to encourage hanging out a colleague to dry. As a nursing student I am a bit leery about even completing my degree. It's bad enough that the public and the gov't thinks not too highly of health care and its nurses...do I really need to have to watch my back every minute with my so called colleagues too? Sad.

Honestly...if a nurse needs support after failing the test...she can bloody well ask for it! :angryfire :angryfire

wow am I upset.

BittyBabyGrower, MSN, RN · Apr 1, 2005

While I don't agree with the advertising, the rest, well, that is what happens. You aren't licensed and you know the consequences of not passing board, I know that sounds harsh, but is the real world . You can't pay someone the same wages when they aren't doing the same job. Many hospitals won't even take GN's anymore and use them in an RN role.

caroladybelle, BSN, RN · Apr 1, 2005

I don't agree with the public posting of the name.

However, it is a "privilege" have GN status, not a right. Many places will not afford you the GN status at all because it puts the facility at risk. As such, you have to pass at the first opportunity.

I have also seen cases, where the GN presented the slip that showed that s/he had signed up to do the NCLEX....but then never took the test. The manager kept asking for the results. After several weeks, the lie was found out. They stopped letting anyone work as a GN, after that due to the legal ramifications of permitting this person worrk as a GN when legally was not permitted to. I have also known GNs to know that they failed but to deny that the results were back...to gain some work time.

Marie_LPN, RN, LPN, RN · Apr 1, 2005

I don't agree with the name being in the newsletter, but i'm really not seeing a problem with any of the rest.

Even a student nurse can do more than a CNA especially one that has been "checked off" on various advanced skills which she has. I could even see cutting the pay to $15.00/hr.

She's no longer a student nurse, she is unlicensed, so i didn't see the point of that statement.

When did nurses collectively buy into the "critical thinking" psychobabble, pandered by MENSA happy, MIT psychometric fixated geeks?

Namecalling doesn't help anything.

Tweety, BSN, RN · Apr 1, 2005

Steps 1 and 2 are appropriate. (Although, you would think they would be more oganized as to try and find out a person status before their shift. So I don't think that was handled in the best manner either.)

But I totally disagree with sharing what is a private thing with the rest of the hospital. Sounds more like a humiliation tactic rather than a supportive one. I wonder how long they have been doing it and why someone hasn't gone ballistic on them. It's almost slanderous imo. Wrong.

I hope she passes NCLEX soon and finds a better place to work.

USA987, MSN, RN, NP · Apr 1, 2005

I agree with the consensus of the above posters. I don't understand the need to publish her name. The rest of the actions are appropriate.

Home Health Columnist / Guide · Apr 1, 2005

students need to realize the practice of nursing and medicine is serious business as the actions one takes or doesn't take may cost someone their life or cause significant harm.

i'm sure she will be able to focus on her next exam now that her life has been turned upside down. that damm test is stupid anyway. why can't they test "basic concepts" in a straightforward manner like almost every other professional licensing examination

people come in all shapes and sizes. what works with one individual may have the opposite effect on another person. that's why medications, nursing actions and care plans are individualized. one standardized widget approach does not work in healthcare, especially when an individual's "free will" comes into play.

with all the focus on pretesting in nursing programs and teaching nclex style questions, i question why new graduates don't understand that focussing on taking the nclex is imperative.

furthermore, the questions were very straightforward with no "word game" or multiple correct/almost correct answers. when did nurses collectively buy into the "critical thinking" psychobabble

nursing education began to change in the 1960's as science and healthcare devices developed. critical thinking was a minor part of my lpn program in 1977 and major part of bsn program 80-82. instead of focus on "how" to do things, focus was on "why" things are done and when to deviate from usual practice due to person's unique needs.

first position paper on nursing education:

[color=#b22222]education for those who work in nursing should take place in institutions of learning within the general system of education. professional nursing practice is constant evaluation of the practice itself. it provides an opportunity for increased self-awareness and personal and professional fulfillment. it is asking questions and seeking answers--the research that adds to the body of theoretical knowledge. it is using this knowledge to improve services to patients and service programs to people. it is collaborating with those in other disciplines in research, in planning, and in implementing care. further, it is transmitting the ever-expanding body of knowledge in nursing to those within the profession and outside of it.

"such practice requires knowledge and skill of high order, theory oriented rather than technique oriented. it requires education which can only be obtained through a rigorous course of study in colleges and universities....

position paper on education for nursing," ajn (december 1965),

[/url]

[color=#003d84]clinical nursing practice

[color=#b22222]"the emphasis at the ana convention meeting may 14-18 in detroit michigan will be on clinical aspects of nursing practice. for the first time, in addition to the general and section meetings, 74 clinical papers will be presented by nurses during convention week at 21 clinical sessions...topics at these clinical sessions focus on clinical nursing problems, use of research in nursing, and technical innovations and new scientific knowledge to improve patient care."

"ana convention week preview," ajn (may 1962), p. 80

http://nursingworld.org/centenn/cent1960.htm

1970's focus [color=#003d84]nurses: patient advocates in a developing health care industry

saw the introduction of nurse practitioners and clinical nurse specialist as the need for access to heatthcare grew. by 1980's healthcare as a business was established: nursing care in a booming marketplace especially with advent of "drg's" diagnosis related groups as means to classify healthcare and minimize healthcare costs.

since the business model been introduced to healthcare controlling costs has been the chief imperative in hospitals. when executives abandoned the focus on educating the workforce in the mid-late 80's , support to new grauates from all health disciplines except medicine all but dried up. demotion from new nursing grad to cna after failing one licensing exam became the norm along with cut in pay. some facilites even terminated employment. mentoring became almost none existent with the result deskilling of employees by the late 80's as experienced staff deserted hospitals for expanding outside healthcare jobs. now pendulum been shifting back over past 3-5 years to reestablish hospital based nurse educator positions.

lesson learned: important as new grads to ask what will happen to employment if nclex not passed on first try. choose an employer with mentoring, strong education focus and longest orientation program.

Nurse Ratched, RN · Apr 1, 2005

The only reason I can think of for listing the names is that other staff can be aware of the change in status and not assign duties assuming licensure or GN status. It would take the person out of the position of having to say, "I can't do (whatever thing) that I've been doing as I failed my boards. Weak, I know, but it's the only logic I can think of.

The rest of it is just business, unfortunately. They can't have someone practicing knowing that they haven't met the requirements to do so.

suzanne4, RN · Apr 1, 2005

The hospital offers the GN a position on the merit system that they will pass the Boards. Unfortunately, if they do not, they are removed from the position. This actually has nothing to do with the hospital, but the state that issues the license. The permit to work as a Graduate Nurse is null and void if the student doesn't pass.

This is one of the reasons that I suggest that the student take his or her boards before beginning their training. Remember that the hospital doesn't just put the nurse on the floor running, but invests in an orientation for them with a preceptor. There are also costs involved to the facilitity. There are actually quite a few hospitals that will no longer hire GNs because of this reason.