Four nursing-school programs in Kentucky have fallen out of state compliance by failing for the third straight year to have at least 85 percent of their graduates pass the national exam.
Now officials from those schools — Northern Kentucky University, two community colleges and Spencerian College — must go before the Kentucky Board of Nursing this spring and explain how they plan to improve their instruction for one of the few burgeoning careers during this rough economy.
Officials at the four schools under review are pledging that they will bolster their nursing education to avoid the Board of Nursing taking drastic action, such as revoking its approval of the program.
"It will not be tolerated either by the college leadership or by the faculty," said Keith Bird, chancellor of the Kentucky Community and Technical College System.
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Two community colleges, Gateway in Northern Kentucky and the Lees Campus of Hazard Community and Technical College, have had three years in which less than 85 percent of their students passed National Council Licensure Examination for Registered Nurses.
Bird said the college system has replaced the administrators in charge of the nursing programs at both campuses. College officials are taking other steps, such as providing better training for nursing instructors to help students in test preparation, Bird said.
Spencerian College, which offers nursing at its Louisville campus but not in Lexington, has fallen short of the 85 percent level six straight years.
Jan M. Gordon, executive director of Spencerian College, said in a statement that the Kentucky Board of Nursing's expectations might be too stringent. Only two state boards require the 85 percent success rate for first-time exam-takers, she said.
"We feel that while well-intentioned, the KBN is exceeding its authority in disciplining schools for the first-attempt test-taking abilities of its graduates," Gordon said. She said it would be a mistake for the nursing board to move to shut down the out-of-compliance programs.
"It could result in the loss of potentially over 500 registered nurses annually in the commonwealth at a time when our hospitals and nursing homes are facing a historic shortage of nurses," Gordon said. "We support high standards for nursing, but punishing the institution does nothing to improve patient care."
Nathan Goldman, general counsel for the Kentucky Board of Nursing, said no decisions have been made about the fate of the four programs. The board will meet April 23 and 24, at which point members will discuss the next step and will probably invite the colleges to make presentations.
"In general, they'll want to know what changes have the four programs pledged to make over the last two years to improve the pass rate and what seems to be holding them back," Goldman said.
One of the issues affecting NKU's pass rate is that most of the school's best nursing students aren't counted in the figures, said Gail Wells, NKU's provost and vice president of academic affairs.
The college allows its top students to take the national exam after two years so they can start working at area hospitals sooner. The pass rate for those 69 students was 91 percent last year, Wells said.
But the board allows NKU to count only students who take the test for the first time after completing the four-year program. Last year, 78 percent of the 54 students taking it at that point passed.
Programs that fail to meet the 85 percent mark in a year are sent warning letters.
If schools miss the mark two straight years, the board downgrades their status to "conditional" and often demands program changes. Three years could put a program's future in jeopardy.
At NKU, officials heightened expectations for student performance in science courses and implemented peer mentoring, and are limiting those accepted into the program, Wells said. Of the 300 nursing applicants NKU receives each semester, it takes 80, she said, adding that the school also is seeking $45 million for a nursing building to handle high demand.
"Many of our hospitals are actually giving us funding to support faculty and instruction because they need the graduates so badly," she said.