CNAs have to demonstrate their skills. Pilots have to demonstrate their skills. Same with cosmetologists.
Why don't nurses?
What the rationale behind not including a demonstration of basic skills as part of the licensure process?
Are you in favor of a demonstration or not? Why?
A professor of mine once said that the reason why the board exam does not include demonstrated skills is 1. to streamline the process and 2. one can reasonably assume that the applicant becomes competent during the clinical hours a LVN or RN student has to complete under a supervision of a nursing professor.
Well, ideally, yes but....
So what do you think?
P. S. I am a pretty new Allnurses poster so I apologize if this has been discussed ad nauseam.
The NCLEX is not a test that measures whether or not you have the clinical skills to be a nurse; you'll get that evaluation when you go to work and you have to pass and have documented that you met all of the institution's clinical competencies. Many hospitals will even have written and demonstration tests during an orientation/internship.
The NCLEX is a test that measures the safety of your decision-making. It's is a test to protect the public, not to measure your skill. Sure, it will ask you important questions to evaluate your risk of harming a patient while performing skills, but they don't care if you can follow steps 1-10 exactly, as long as you can do it safely. It's a judgement test, not a skill test. They want to know if you can identify the patient who is most in trouble, or the medicine that carries the most risk-potential. If they ask a question about skills, it's more to hone in on where the risk is and what your judgement would be as a nurse in a situation where your decision will have an impact on that risk somehow.
I have often wondered though, why it's not something they do as an exit exam from nursing school. My school has a beautiful, top of the line simulation lab. We often use it during clinical rotations, at least once or twice, to simulate high-risk scenarios or common clinical skills. I even wrote a paper on how I think part of the exit exam from the program should be passing an individual simulated scenario.
Well I graduated as an ADN able to do most of the basic skills, thankfully. Because no one was going to teach me in the real world these days. But I guess if you'd have to choose, you might want a graduate nurse who had never done a foley insertion but knew the steps by heart, the reasons you might need a foley inserted, the possible effects of said foley, what to look for before, after and during the procedure, the reason why sterile technique was so crucial, how often the foley should be changed, etc. A skill like foley insertion can be learned easily by most people with enough repetition and a good instructor. But if you don't understand all the other things that go along with the skill and can't consider the implications critically, you are missing the main point of nursing. That is what I think they are attempting to test with the NCLEX. Whether they are doing so successfully or not is up for debate.
Well said JenniferSews.
I was not merely "trained" in technical skills but rather, as stated above, I was educated in disease process, rationale of interventions, how to think critically and problem solve etc. My professors were fond of hammering home that distinction and for myself personally, to this day, I cringe when the word training is used to describe my education.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I am an instructor in my hospital's Critical Care Nurse Residency program. 3 or 4 years ago who had a group of residents that included 4 graduates of a direct entry masters program. During one class where it was explained that as ICU nurses they would be expected to maintain IV acess on all their patients themselves. One of the direct entry masters grads asked when they would be instructed on how to insert IVs and draw blood? I told them that was a very basic nursing skill and we expected that they learned that in nursing school so we would not be including instruction on starting IVs in the program. All 4 grads where upset by this as they had been told in their program that they would either learn these skills on the job, or the hospital would have. an IV team and there was no need for them to learn IV skills. I told them that they would need to learn basic skills on their own time as the residency was not budgeted for that.
I should point out that the ADN & BSN residents all claimed to have been instructed in IV insertion and all had done so on fake arms and most had several attempts on real patients.
I am an instructor in my hospital's Critical Care Nurse Residency program. 3 or 4 years ago who had a group of residents that included 4 graduates of a direct entry masters program. During one class where it was explained that as ICU nurses they would be expected to maintain IV acess on all their patients themselves. One of the direct entry masters grads asked when they would be instructed on how to insert IVs and draw blood? I told them that was a very basic nursing skill and we expected that they learned that in nursing school so we would not be including instruction on starting IVs in the program. All 4 grads where upset by this as they had been told in their program that they would either learn these skills on the job, or the hospital would have. an IV team and there was no need for them to learn IV skills. I told them that they would need to learn basic skills on their own time as the residency was not budgeted for that.
I should point out that the ADN & BSN residents all claimed to have been instructed in IV insertion and all had done so on fake arms and most had several attempts on real patients.
I keep hearing that students ask about gaining skills and practicing them (ADN and BSN as well), and being told they won't have to worry about it. Really pathetic. Direct entry is a scary thing imo.... who wants someone who hasn't DONE the job???
The NCLEX is not a test that measures whether or not you have the clinical skills to be a nurse; you'll get that evaluation when you go to work and you have to pass and have documented that you met all of the institution's clinical competencies. Many hospitals will even have written and demonstration tests during an orientation/internship.
The NCLEX is a test that measures the safety of your decision-making. It's is a test to protect the public, not to measure your skill. Sure, it will ask you important questions to evaluate your risk of harming a patient while performing skills, but they don't care if you can follow steps 1-10 exactly, as long as you can do it safely. It's a judgement test, not a skill test. They want to know if you can identify the patient who is most in trouble, or the medicine that carries the most risk-potential. If they ask a question about skills, it's more to hone in on where the risk is and what your judgement would be as a nurse in a situation where your decision will have an impact on that risk somehow.
I have often wondered though, why it's not something they do as an exit exam from nursing school. My school has a beautiful, top of the line simulation lab. We often use it during clinical rotations, at least once or twice, to simulate high-risk scenarios or common clinical skills. I even wrote a paper on how I think part of the exit exam from the program should be passing an individual simulated scenario.[/QUOTE]
We had to do this at the end of each rotation. Either in the lab, on each other, or on select patients in clinicals. 1983-1985.....
I have taking my nclex twice and failed I am trying to stay positive is there any ideas, you guys can give me I used the saunders book its helpful but I need more. What other book can I use to prep for the nclex pn?
Well the answer is that NCLEX isn't meant to test proficiency as a nurse- it's meant to test whether or not you can be trained. Period. You just don't learn even a 10th of what you need to know in nursing while in nursing school. It's really on-the-job training where you those skills. And each facility has their own policies and equipment.
Specializes in LTC, CPR instructor, First aid instructor..
I don't know why they don't, but I am glad they don't...
My state exam for EMT-B included several skill stations, plus the written test, plus a 6 week wait for results. It was an ALL day affair, and required many examiners, and I tested in a rural county. I remember it as far more stressful than the NCLEX-RN.
Ditto. I was an EMT for 18 years, 15 of them in NYS and the rest in PA. I noticed though that the PA one was easier. I don't know why.
Specializes in LTC, CPR instructor, First aid instructor..
I thought the NCLEX was a breeze compared to the written EMT exams. They were the same type--multiple choice, but you had to know what to do in an emergency including what equipment to carry with you, what wasn't an emergency, what was an emergency, how to triage, how to be a leader in a triage situation, complete head - to - toe assessments; both primary and secondary, how to calm patients and family, being calm yourself in an emergency situation, etc., and when I tested, you had to pass the 5 skills stations in order to be able to qualify for the written exam. I loved it. The NCLEX is mostly theory. For instance if an individual presented with signs and symptoms of a certain illness, what diagnostic tests would be ordered, what types of meds would be ordered, etc.
IMO there are alot of unsafe nurses out there. Having a clinical component to the NCLEX would definately weed out the undesirables. The CNAs have to demonstrate to the state their basic nursing skills and why wouldn't the LVN/RN have to? They need to have basic nursing skills. I'm all for a clinical component. But again, this is my opinion.
I thought the NCLEX was a breeze compared to the written EMT exams. They were the same type--multiple choice, but you had to know what to do in an emergency including what equipment to carry with you, what wasn't an emergency, what was an emergency, how to triage, how to be a leader in a triage situation, complete head - to - toe assessments; both primary and secondary, how to calm patients and family, being calm yourself in an emergency situation, etc., and when I tested, you had to pass the 5 skills stations in order to be able to qualify for the written exam. I loved it. The NCLEX is mostly theory. For instance if an individual presented with signs and symptoms of a certain illness, what diagnostic tests would be ordered, what types of meds would be ordered, etc.
I remember having to do one-person CPR with a BVM on a mannequin that had a meter (whatever ya call it) on it. The examiners could see how effective my compressions were, but I couldn't. I want to say it lasted like 15 minutes - at least it felt like it. I remember the whole time I was thinking "wouldn't I have a partner in the field?!?, or at least a cop or someone to help?!?"
No prep either for the scenarios - when it was your turn you walked in the room and found out what you had to demo.
nurseygurlie
49 Posts
The NCLEX is not a test that measures whether or not you have the clinical skills to be a nurse; you'll get that evaluation when you go to work and you have to pass and have documented that you met all of the institution's clinical competencies. Many hospitals will even have written and demonstration tests during an orientation/internship.
The NCLEX is a test that measures the safety of your decision-making. It's is a test to protect the public, not to measure your skill. Sure, it will ask you important questions to evaluate your risk of harming a patient while performing skills, but they don't care if you can follow steps 1-10 exactly, as long as you can do it safely. It's a judgement test, not a skill test. They want to know if you can identify the patient who is most in trouble, or the medicine that carries the most risk-potential. If they ask a question about skills, it's more to hone in on where the risk is and what your judgement would be as a nurse in a situation where your decision will have an impact on that risk somehow.
I have often wondered though, why it's not something they do as an exit exam from nursing school. My school has a beautiful, top of the line simulation lab. We often use it during clinical rotations, at least once or twice, to simulate high-risk scenarios or common clinical skills. I even wrote a paper on how I think part of the exit exam from the program should be passing an individual simulated scenario.