With 29 newly graduated nursing students preparing to take the NCLEX exam, Constance Bushey, MSN, MEd, RN, director of the Beebe School of Nursing in Lewes, DE, didn't want to put undue pressure on them by going on about how well her students historically do on the licensure exam. So, let's just say Beebe students' pass rate is consistently high.
Instead of making the May 19 grads nervous about living up to expectations, Bushey and her colleagues prefer to share why students who complete the Beebe diploma program are so well-prepared for the NCLEX.
According to Virginia Rickards, MEd, BSN, RN, CCRN, keeping students firmly grounded in the "why" of everything they do builds the foundation for critical-thinking skills.
"I think our clinical and theory correlation is a big component of our success," she said. "We strongly emphasize rationale and critical thinking in the classroom and the clinical area, and we give them scenarios in the classroom and talk about the situations."
CLINICAL MOBILITY: Graduate nurses Brooke Crane (left) and Julie Hudecheck use Beebe Medical Center's eletronic medical record. Students have the advantage of hands-on learning with technology implemented at the medical center, of which the Beebe School of Nursing is a part.
FACING THE FUTURE: Working together toward the future of nursing are graduate nurses Julie Hudecheck, (front row, left) Brooke Crane, Heather Showell and Amanda Burns. Standing are graduate nurse Michael Screpesi (left) and faculty members Tracy K. Bell, MS, RN, CMSRN, CNE, and Karen Pickard, MSN, APRN-BC, CNE.
Diploma to BSN & Beyond
"We are firm believers there needs to be multiple entries into nursing practice," Bushey said. "Diploma education is one of those key entries that really can be built upon, and I think we all look to foster that educational mobility for obtaining a BSN in time."
Nina B. Hazzard, MS, RN, curriculum coordinator, said Beebe School of Nursing's combination of diploma education and clinical experience leaves students well-prepared to advance their education.
"We've had a formal agreement with Wilmington University [based in New Castle, DE] since 1998, but we've always had an association with other universities for students to progress with their BSN. We now also have a formal agreement with the University of Delaware [in Newark]," Hazzard said.
Faculty members initiate focused conversations with students as they near graduation about the degree they plan to pursue and where. The goal is to make sure students understand the importance of a commitment to lifelong learning.
Faculty in the Driver's Seat
Students complete the majority of their clinical experiences at Beebe Medical Center. They visit Dover Behavioral Health System in Dover, DE, for their psychiatric component and also complete observational experiences at local providers' offices.
"Our clinical experiences are all facilitated by faculty here at Beebe, so we know what has been taught in theory and are able to directly relate it to their clinical experiences in the hospital," said Terri L. Wyatt, MSN, MS, RNC-LRN. "[Since] we're current on what goes on at Beebe Medical Center, we're also current on Joint Commission requirements. From the minute students start, we teach the National Patient Safety Goals, and we incorporate that during our clinical rotations.
"In their senior year, we also incorporate chart audits and safety surveys," Wyatt continued. "By the time our students become practicing nurses, our hope [is these things] are ingrained in them so they will be the best [nurses] they can be."
Hazzard noted students even participated in Beebe Medical Center's most recent Joint Commission survey. "The students were asked questions by the surveyor and answered without hesitation," she said.
Changing Tech & Times
With the School of Nursing celebrating its 90th anniversary, faculty have a well-honed strategy for keeping students abreast of the most recent developments in patient care and technology.
"As a department of Beebe Medical Center, we're intimately involved in the strategic planning process," Bushey explained. "We participate in developing and planning initiatives, and have the unique benefit of an excellent relationship with patient care services. The School of Nursing is included when Beebe Medical Center is implementing something new to ensure we offer that same education, and we work through some of the details of the strategy for implementation."
"We also receive monthly updates like statistics related to quality measures, financial reports and patient satisfaction reports, so we have current knowledge about what is happening at the medical center," Hazzard said. An annual meeting with nursing leadership at the medical center provides another opportunity to share what's new in the hospital that can afford novel clinical experiences for the students. "Any new technology that is available at Beebe Medical Center, we have the opportunity to know about that and we incorporate it into our curriculum so the students are exposed to it," Hazzard said.
EDUCATION LEADERS: Constance Bushey, MSN, MEd, RN, director of Beebe School of Nursing, and Nina B. Hazzard, MS, RN, curriculum coordinator.
The most recent example is the students' opportunity to work with the electronic medical record (EMR) Beebe Medical Center is implementing. As the hospital converts from paper charting to the EMR, faculty was involved in identifying training needs and incorporating them into the curriculum.
"We used the EMR every week in clinical, and students complete scenarios in the classroom before clinical," said Karen L. Pickard, MSN, APRN, BC, CNE. In the same vein, students also have access to state-of-the-art IV pumps, as well as opportunities to shadow the nurse practitioner on a rapid response team and have an up-close observation of open-heart surgery.
NCLEX & Nursing Success
As students gain the knowledge to provide excellent patient care over their 2 years at Beebe, they also are building the ability to apply that information in a valuable way to the all-important exam that will provide entry into autonomous nursing practice.
"Part of [test preparation] is to review good study habits," Rickards said. "We get students who can't seem to put their electronics away to focus. So we go over some testing strategies, study habits, things to help them be more successful with retaining the information." The school's testing committee reviews exams to see what kind of categories the questions cover - knowledge-based, comprehension, application analysis - and instructors strive to have as many application-level questions in their final exams as possible.
"We build that in over the course of the curriculum," Rickards continued. "By the end of the curriculum, more than 50 percent of the final exam questions are application level."
While not a new addition to the curriculum, the school's web-based proficiency testing has been a boon for student accomplishment in grasping concepts. "We mandate completing the scenarios with a grade of 80 percent," Wyatt said.
If the student doesn't achieve 80 percent on the first try, they may repeat the test during the semester until they achieve that grade. "That has offered the students an opportunity to test and/or affirm their knowledge. For students who have tended to be weaker with theory, it has been a wonderful way to enhance retention of information and, I think, has also contributed to their NCLEX success."
Since statistics show students who take the NCLEX within 30 days of graduation have a 90 percent pass rate, Beebe strongly encourages each class to do so after completing a proven review course.
In the meantime, 29 recent grads prepare to test their way into nursing practice, and Beebe School of Nursing prepares for an expansion that will enable the school to double the student body. While faculty members are excited for the upcoming changes, there's a constant that ensures competent classes again and again.
"The curriculum is dynamic and changes over time, and great leadership facilitates that change," Wyatt concluded.
Barbara Mercer is managing editor at ADVANCE.