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Wednesday, Jul 18, 2018
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Nursing students in state programs struggle to pass licensing exam

For six years, state lawmakers have worked to graduate more nursing students in Florida in anticipation of a statewide shortage as the workforce ages. More nursing schools have opened their doors and the number of graduates has slowly increased each year.

Yet a new report from a state watchdog agency says the effort has a downside: Many of those students aren’t qualified to work in area hospitals.

Graduates from more than one-third of Florida’s nursing programs struggled to pass the standard licensing exam last school year — a number that has grown with the number of nursing schools in the state.

The passing rates for students taking the National Council Licensure Examination, needed to practice nursing, failed to meet the national average at 105 of Florida’s 366 nursing program, according to a new study of data from calendar year 2014 by the Office of Program Policy Analysis and Government Accountability.

Seven of those schools were in the Tampa Bay area.

“We need more resources for nursing education if we’re to develop the strong nurses you want taking care of you and your family, and to do that resources have to be directed towards successful programs that produce graduates who pass their exams,” said Dianne Morrison-Beedy, dean of the USF College of Nursing.

“We’ve still got a ways to go,” she said.

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If a school’s passing rate falls more than 10 percentage points below the national average for two consecutive years, the program has to submit a plan to increase its passing rate within the year or it will be closed. If the school shows progress and meets a majority of the goals outlined in their improvement plan, it can get an extra year to increase the passing rate.

At Southeastern College’s licensed practical nursing program, in Clearwater and Tampa, 10 out of 17 students passed the exam, a rate of 59 percent, and at the college’s associate’s degree program in St. Petersburg, 21 of 50 students passed, or 42 percent.

The college’s Clearwater campus has stopped enrolling students and is in a “trainout” through the state Department of Education until its current students finish their coursework, Southeastern Colleges President Rhonda Fuller in an email to the Tribune.

A trainout comes when a school is preparing to shut its doors but still has students who first need to finish the program.

“The pass rates of the other Southeastern College campuses are evidence of the college’s ongoing commitment to preparing future nurses,” Fuller said in the email. “We strive for similar and higher results with each cohort of current and new students, at all campuses.”

Four of seven students, about 57 percent, passed the exam in the licensed practical nursing program at Rasmussen College in Tampa. Passing rates for students seeking a two-year degree in nursing were 69 percent (9 out of 13) at Christian International College in Largo, 67 percent (8 out of 12) at Ultimate Medical Academy in Tampa and Clearwater, 60 percent (6 out of 10) at Schiller International University in Largo and 43 percent (18 out of 42) at Breckinridge School of Nursing and Health Sciences at ITT Tech in Tampa.

The Breckinridge School is working to implement a new academic improvement plan, said Nicole Elam, a vice president with school owner ITT Educational Services. Schools across the nation have seen a decline in scores, she said.

“Our students are always made aware when any actions affecting a campus program are in review by state agencies,” Elam said in an email to the Tribune. “The national average for scores has declined at colleges all across the country so our nursing faculty are not in a vacuum when it comes to working on improving National Council Licensure Examination (NCLEX) scores of our students.”

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Christian International College graduated its final RN class in January 2015 and is no longer offering nursing programs, college administrator Joseph Murray said in an email to the Tribune.

“During our operation we were approved by the Florida Board of Nursing and Licensed by the Commission for Independent Education to offer Practical Nursing and Registered Nursing Programs,” Murray said in the email. “We have enjoyed a wonderful working relationship with the Commission and met all required regulations and mandates during our operation.”

Locally, passing rates for students seeking a four-year degree in nursing fell below the state’s threshold at only one school — South University in Tampa, where 44 of 75 students passed the test for a rate of 59 percent.

Officials from the Ultimate Medical Academy declined to comment for this story, and those at Rasmussen, Schiller International University, and South University did not respond to requests for interviews.

Most of the programs where students struggled to earn their license didn’t offer a four-year degree as USF, which recorded an 87 percent passing rate among its 186 graduates with a bachelor’s degree in nursing. USF’s program, though, is highly selective, Morrison-Beedy said. The College of Nursing’s acceptance rate is about 40 percent.

A majority of nursing programs formed in the last six years, when legislators made a number of statutory changes to increase the number of nursing programs in the state, and have yet to earn an academic accreditation. A new law will require all programs to earn accreditation — a form of quality assurance that educational standards are met — by July 1, 2019.

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The increase in nursing programs was meant to address a shortage of practicing nurses in the state. More than 15,000 nursing jobs went unfilled in Florida during 2012, according to the Florida Center for Nursing at the University of Central Florida. By 2025, the center anticipates a 20 percent growth in the nursing industry, creating a need for about a half-million registered nurses in Florida as the current workforce ages out.

Yet as of June 2015, 45 of those 105 programs that failed to meet the national exam average were placed on probation by the state and 13 closed.

There are 366 nursing programs in the state, 251 of which were approved within the last six years, according to the report from the Office of Program Policy Analysis and Government Accountability. The number of students who graduate from nursing programs each year has grown from about 11,600 in 2009 to about 16,000 last school year.

“The answer to the nursing shortage isn’t just having more slots open across a variety of programs, both stellar and those with challenges,” Morrison-Beedy said. “It’s about funding programs that produce graduates that are reliable and pass exams. It’s not just the input, it’s the output ... and the proof is in the pudding.”

The University of Tampa had the highest results of any bachelors of nursing program in the state. For the third year in a row, all 46 nursing graduates from the University of Tampa passed the exam on their first try, said Cathy Kessenich, director of the department of nursing. The University of Florida’s passing rate was 90 percent and the University of Central Florida’s passing rate was 98 percent.

Their success is partially due to the university’s ability to retain dedicated faculty, willing to work for less than they’d make in nursing, and pick high-quality students for admission, Kessenich said — other hurdles facing Florida’s nursing programs.

“You can certainly make way more money as a nurse practitioner,” she said, “so our faculty really love teaching and are dedicated to helping our students’ succeed.”

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