Why so many fail out of our program?

I'm not sure why so many are failing at your school,however, at my school, I can sum up the problem with one thought Care Plans. Yuck! It seems to me ,from a second semester frame of mind,that the way they are taught is a huge waste of time. I spend too much of my time typing instead of learning clinical skills either from the textbook or in the clinic. Unfortunately, I'm a very slow typist. I've learned much more from the book and clinic than I will ever learn from doing care plans.

The thing about care plans (which I used to hate btw) is that they really do teach you to think critically and to know what to do for your patient and why. You can train just about anyone to do clinical skills, but not everyone that can perform a skill knows why they are doing it. Patients and family members can learn injections, suctioning trachs, administering feedings, caring for wounds, so on and so forth.... so why do they need nurses around?

I get really frustrated when I have to spend hours doing prep work and writing care plans for my patients before I even see them and then find out that half of my care plan may not fit because the patient isn't in the condition I expected them to be in. But after spending hours and hours focusing on what I need to do for someone in renal failure, CHF, COPD, Cirrhosis, etc I have really learned some valuable information. When I get to clinical and maybe the patient is better off than I thought they were and I don't need to use all the interventions I had decided on I can adjust my care plan. Next time I have a patient with similar problems My mind immediately starts going to the information I gathered last time that is now thoroughly stuck in my brain and I don't have to work so hard in knowing what to look for and do to care for my patient.

I don't know if I am talking in circles, but I hope I made a little bit of sense to you in explaining why careplans are such a necessary evil

Our school did have a consultant come in and do a free seminar on test taking- I went- and maybe about 45 other students. We have 158 in the class. So if those other 100 or so students didn't take advantage of what the school is providing them...

I don't think all schools do this, but ours did- they also have a nursing "life savers" group- four tutors just for nursing- an open skills lab that you can go to and practice almost anytime-

They also had a stress workshop (a couple of them) and an organization workshop.

I don't love all my instructors- but the school is trying to retain students. It's a community college.

I think that most programs run the same way......all tests are geared toward getting students prepared to take and pass the NCLEX test. You can be an A student straight through all your pre-reqs, but that doesn't come into play in nursing if you can't figure out how to drill down and find the best correct answer. Some students can figure it out and some never seem to get the hang of it......I have someone in my class right now, who after 2 failed attempts in the program, is now finally passing. She said things just started "clicking" this time.

I don't think instructors deliberately make the questions difficult so they can fail people. These are the same types of questions that are going to be on the boards and everyone needs to get used to seeing these type of questions.

I know I hear how hard nursing school is I know because Im in it. Yeah it is hard yeah theres a lot of work but do nursing schools really need to fail out or "weed out" so many students. In our class only 11 out of 29 students are passing. Why is this normal?

No, it's not normal.

The reason why things work this way is because it is a business. In most schools you have to take most of your GE classes before they allow you to take your nursing classes. Usually, there are 5 tests during the semester for each nursing class, but some schools will fail you if your average grade is below "C" after the first two exams. This way they get your money and solve the problem of clinical faculty shortage, because they can not accommodate so many students in one class.

So you paid for you GE classes, you paid for your nursing class, they got your money, dropped you from the class, and there is no problem with clinical faculty shortage.

Umm? They may be a necessary evil. I understand the importance of what care plans are trying to teach,however,there has got to be a better way to teach such evil. I spend more time doing the process than learning what is in the care plan.

Many people cannot get the thought that NCLEX questions are all about priortizing and making sure you know disease process AND what you should do or tell your clients. Not everyone can get the fact that openness and allowing clients to express all their thoughts helps to clarify actual problems....you can't worry about everyone else, you have enough stress to just pass your own classes!

Why so many people fail out of nursing school...ITS NURSING SCHOOL! (hint: its hard)

Honestly though...I would venture to say that is what the number one reason is.

Why so many people fail out of nursing school...ITS NURSING SCHOOL! (hint: its hard)

Honestly though...I would venture to say that is what the number one reason is.

What are you talking about? Did anybody understand anything?

Nursing school asks tough exam questions because nursing is a problem solving profession with lives on the line.

After nursing school, we will experience the following:

A patients sutured abdominal incision is going to split open before your eyes. What do you do?

A patient is standing in the hall, and then topples. The loudest sound is when his skull smacks the tile. What do you do?

A patient starts crying because she has a terminal illness and her children don't come visit her. What do you do?

We really are going to have to calculate drug dosages. All the time. If we get it wrong, we might lose our license, or kill someone and go to jail.

A patient is going to vomit feces. What do you do?

A million other things that I would never, ever even consider possible are going to happen. What will I do?

In every case, there will be a right thing to do, and a million wrong things to do, and everyone around us will expect us to know the difference. The test questions are driving me crazy, but I really, really want to make the right choices when it's just me and my patients.

What are you talking about? Did anybody understand anything?

She stated pretty clearly that nursing school is difficult and that's why some people fail out of it! There is a reason that high GPAs and HESI scores are required for selection. At least at my school!

There are multiple reasons why. A few, if you will:

1. Most schools are rated on their NCLEX passing standards for graduates. In that case, anybody that doesn't actually graduate, doesn't count. There IS no incentive to reduce attrition.

2. Many programs use arbitrary admission standards, including the worst of all: lotteries for admission. The result is the need to resolve issues after matriculation, at the worst possible time as far as preserving seats.

3. Many instructors view themselves as gatekeepers to nursing, tasked with a florence-like devotion to weed out undesirables. Since there is no penalty for doing so, the result is high attrition.

Average nursing school attrition is 20-40% with some programs reporting routine attrition as high as 70%.

California did a study on this, and I'll find the link later. When schools actually TRY to reduce attrition, they can get attrition down to 10% with 6% being unavoidable attrition (students drop for personal reasons not related to the program or their academic standing) and 4% related to school related issues.

The solution is that, in addition to scoring programs on the basis of NCLEX pass rates, programs should be graded on attrition.

Programs that keep attrition under 10% should be rated as excellent. Programs that keep attrition under 12% as good. Programs that keep attrition under 20% as acceptable. Programs that allow over 20% attrition should be placed on probation.

Bottom line: a program that allows greater than 20% attrition is not the result of a failure of students but of a failure of the program, itself.

Rating programs based on attrition would force programs to front load success: they would be more interested in only accepting students already proven TO BE nursing material

Rating programs would force schools to carefully look at each individual drop: no more instructors bias about who is nursing material. Wasting precious program seats is NOT the right place to determine nursing material - the admissions process IS.

Rating programs would bring more minority candidates into nursing. A MAJOR consideration of whether to pursue a long term goal is the viability of attaining that goal. Arbitrary attrition could and SHOULD make most candidates wary about success. Many candidates feel that, given a chance, they WILL be successful. What about candidates concerned that attrition might not be completely arbitrary? It CERTAINLY isn't out of reach to suggest that some programs just do not care who gets dropped so long as the almighty NCLEX pass rate is maintained. Knowing that getting TO the front door creates a high probability of getting to the finish line might invite more diverse applicants to attempt to knock on the front door of nursing.

The answer to your question is arbitrary attrition is allowed because it isn't penalized. The solution is to penalize it, or, more to the point, to grade the programs based on attrition.

I'll say this again: 20% attrition should be viewed as an utter failure of a nursing program itself. That program should be placed on academic probation and heads should roll until it stops failing its students, and its communities.

~faith,

Timothy.

This is what I said, in another thread.

California study regarding nursing school attrition:

http://www.ucop.edu/cprc/documents/nursingprograms.pdf

~faith,

Timothy.