As nurse educators we have a duty and responsibility to protect the public from students who have demonstrated an inability to be safe in practice.

Based on my own observations as a nurse educator, as well as hearing the concerns of nurse educators from other parts of the country where I have been asked to speak, some nurse educators are feeling the squeeze either from nursing department leadership or from administration to LOWER THE BAR of academic excellence so that students can be successfully retained in programs of nursing.

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Whether the motivation for this ongoing emphasis of “student success” is philosophical or financially motivated due to tuition reimbursements, I believe that when nurse educators have a choice between patient safety and student success, our guiding principle to be patient advocates as a professional nurse must not be compromised, therefore patient safety must continue to be our top priority!

I want to make one thing very clear. I am for student success! As a nurse educator, I give 110% to promote the learning of my students. I willingly choose to do what is needed to guide and develop their learning to translate skills and knowledge to the bedside. My numerous clinical handouts that are posted on my website and my tireless work to situate clinical reasoning in both the classroom and clinical settings are a testimony to this.

The following quote has guided me as a nurse educator, and has relevance to this current struggle in nursing education:

No student will RISE to LOW expectations

This statement testifies to the need to have a HIGH but realistic bar of what is needed in every aspect or our programs so that students are able to successfully translate their knowledge to the bedside. In other words the end point of nursing education is NOT directly about the STUDENT, but the safety of the PATIENTS they will care for in practice once they graduate.

An example of this principle is Del Bueno’s work that identifed that 2/3 of new graduate nurses were unable to recognize a basic change of status because of inappropriate use of NANDA taxonomy (1). By de-emphasizing NANDA in academia, the correlation of improved patient outcomes would be the end result.

What Bar Prevails in Your Program?

Does your department sacrifice academic excellence and lower the bar so that students who are marginal or unsafe can be successfully retained?

Some examples of lowering the bar that I have seen as a nurse educator include students whose clinical difficulties were minimized by departmental leadership so that they could be retained in the program.

I also had an English as second language (ESL) student who had a thick accent. Though I could understand her, as I watched her interact with her patient, it was clear that the patient could not so I addressed my observations and concern with the student.

These concerns were also minimized by departmental leadership when the student accused me of being prejudiced because no other faculty had raised this concern. Though patient safety related to communication should have been obvious, when race was interjected into the equation, patient safety no longer was preminent, but the rights of the student and their perceptions.

Some Student’s Need More Time

Nursing is a difficult major. Some student’s require more time to be successful. Therefore failure at any level can be a new beginning that can lead to student success! By retaining a struggling student, this may actually not serve the needs of the student and their needed learning in the long run.

As a gender minority in the profession, I readily recognize the need for both gender and ethnic diversity in nursing. It is clearly documented in the literature that both men and ESL students have higher than average failure to complete nursing education rates.

What both men and ethnic minorities require is needed support to be successful. For ESL students, their greatest need is support to overcome the language barriers that hinder their success.

But despite the need and desire to facilitate diversity, if a student is CURRENTLY unable to meet standards of safety related to skills or communication, nurse educators are also student advocates. It is often in the student’s best interest to give them TIME to make a current weakness a strength. Therefore, allowing a student to drop or to fail, if done in a supportive manner, can best serve the student in the long term development as a nurse!

I have witnessed struggling students who failed, come back the following semester stronger, better prepared and literal rock stars! The failure, when done in a supportive way, allowed them to reflect, strengthen their weaknesses and were the better as a result.

In Closing…

I understand the squeeze that many of you experience in nursing education. Administration wants retention at all costs, especially when $$$ is at stake. BUT, it is also the responsibility of nurse educators to EDUCATE administration how nursing is different than other majors because of patient safety if unsafe students are allowed to continue.

Though there are battles that are not worth fighting in academia, this battle must be addressed head on. If a department is united, it has great power. Unite to hold a high bar that will prepare your students for professional practice, and provide needed support for those not able to currently make it over the top!

Comment Question:

What bar prevails in your program? What have you done to provide support to students who are unable to be successfully retained?

Comment below & let the conversation begin!

References

1. Del Bueno, D. (2005). “A Crisis in Critical Thinking,” Nursing Education Perspectives, 26(5), 278-282.