A lot rides on nursing exam, for students and schools

Soon, Maureen Knell will cross a threshold. She will cease being a college student and become a respected adult.

She insists she is not nervous about this. She is not anxious or scared.

She has been working toward this for many years, and she is full of anticipation.

Passing the nursing exam will be the start of a new life.

"They’ve been preparing us since the first semester," said Knell, 24, who will graduate from Nevada State College in Henderson next month and plans to take the exam in June.

Passing the exam, called the NCLEX, is necessary to get a nursing license in Nevada and everywhere else. This means there would be no point in going to nursing school if you can’t pass the exam.

Having students pass the exam is critical for schools, too. They can’t get full approval from the Nevada State Board of Nursing unless at least 80 percent of their graduates pass the exam on their first try. Full approval is necessary for a school to keep its accreditation.

Students are allowed to take the exam as many as three times before they’re required to take remedial education.

Nevada State, which graduated its first nursing students in 2005, passed the bar last year. The nursing board last month gave the school’s program full approval.

"For the people looking for a program, to see we have both accreditation and full approval, we’ve met the highest standard," said Shirlee Snyder, interim dean of nursing at the college.

Nevada State, which opened in 2002 as a midlevel public school between the universities and the community colleges, had a fairly dismal pass rate until last year. That is generally true of new schools.

But its first-time pass rate rose gradually each year, from 63 percent for its first graduating class in 2005 to 80 percent last year.

Similarly, Touro University’s first graduating class in 2007 had a sub-par first-time pass rate of 57 percent. It also rose to 80 percent last year.

The board is expected to give the private school’s nursing program full approval next month.

When a new nursing school is proposed, the state board gives it provisional approval if it meets requirements. The status allows the school to hire faculty and build facilities, said Debra Scott, executive director of the nursing board.

But "students don’t like the term provisional," said Robyn Nelson, acting nursing director and human services dean for Touro’s Henderson campus.

Having full approval, she said, "is sort of a guarantee to them that we’re not going anywhere. We are here."

Schools are automatically given two years to raise their first-time pass rate to 80 percent. If they do so in that time, as Touro did, they get full approval once an on-site inspection is completed.

But if there’s a delay, as there was at Nevada State, the board will assess the program, see what may be wrong and recommend changes.

Changes were recommended and adopted at Nevada State. They included increasing admission standards.

If a school cannot maintain an 80 percent pass rate, it could lose its full approval. The program will again be evaluated and perhaps changed.

This has happened at the University of Nevada, Las Vegas and the University of Nevada, Reno, and is not uncommon.

If the first-time pass rate falls below 80 percent for two years, the program’s status falls to conditional approval and a consultant probably will be brought in to identify problems.

In theory, a program could lose its approval status completely if graduates don’t measure up. Without that status, accreditation is in danger. Without accreditation, a program would no longer be viable.

Very little of this was a concern for Knell, the soon-to-be graduate.

Though she grew up in Las Vegas, she transferred to Nevada State from out of state for personal reasons, she said. She was drawn to the Henderson school because of its small size. She likes the one-on-one attention available from instructors.

She said she made the right choice.

Contact reporter Richard Lake at rlake @reviewjournal.com or 702-383-0307.

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