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High Failure Rate On Exam Could Add To Shortage, Officials Say

September 27, 1988

LOUISVILLE, Ky. (AP) _ Health industry officials fear that the high failure rate of people who took the national nursing exam in July foretells a worsening in an already serious nursing shortage.

″We’re in a real bind,″ said Bill Massie, chief operating officer of the University of Kentucky’s Albert B. Chandler Medical Center, where 29 of 73 nursing graduates hired over the summer failed the test.

Nursing-school graduates can work as registered nurses until their test results arrive, but those who fail lose their positions.

Nationally, 16.4 percent of individuals who took the two-day exam for the first time in July failed, said Carolyn Yocom, director of research services for the National Council of State Boards of Nursing, which prepares the exam.

Partly because of changes in the test and the way it is scored, that is the highest failure rate since the council started the exam in 1982, she said. Last year, only 9 percent of first-time test takers failed, and in previous years the failure rate ranged from 8 percent to 12 percent, Yocom said.

The failure rate increased in all 50 states, she said. In Kentucky, then failure rate was about 20 percent of first-time test takers, up from 10 prcemt last year, said Patricia Calico, president of the Kentucky Board of Nursing.

″This just exacerbates the (shortage) problem,″ said Michael Rush, vice president for member services of the Kentucky Hospital Association. A survey it did in 1987 found that one in 10 registered-nurse positions in Kentucky hospitals was unfilled.

The UK Medical Center has closed three intensive-care-unit beds because it didn’t have enough nurses, Massie said.

Carolyn A. Williams, dean of the University of Kentucky School of Nursing, said she worries that the bad results will scare young people away from a nursing career.

This year’s test has been changed to cover new subjects because of the changing skills and knowledge required of entry-level nurses, Yocom said.

Also, the number of correct answers needed to pass the test was increased, but by fewer than 10 out of the total of 300 questions asked, she said. The Chicago-based council won’t reveal how many correct answers are needed to pass the test.

Yocom said the council expected the failure rate to increase, but not by as much as it did, and said changes in the exam accounted for only half the increase.

She theorized that increasing opportunities for women in other professions, night and weekend hours in many health-care settings, and non-competitive salaries have prompted fewer top-quality people to enter nursing.

The Kentucky Board of Nursing has asked the national council to offer the exam three times a year instead of the current two so nurses can get into the work force more quickly. The next scheduled exam is in February, and by the time those results come out the nurses who failed in July but pass in February will not be able to start work as registered nurses until about April.

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