SECOND TIME UP: A Nursing Readmission Procedure that Promotes Student Success Mrs. Nettie Guy Director of Nursing Programs Dr. Bob Shackleford Vice President for Student Development

The Challenge Nursing is a very rigorous curriculum that requires study habits and test-taking skills that are different than those to which many students are accustomed. Students cannot proceed until they attain the required competencies.

The Challenge Therefore, making readmission decisions must preserve the integrity of the program as well as serve the students.

A Little History The previous nursing readmission procedure: Students readmission requests were discussed in a Nursing Department faculty meeting. Students were simply notified of the decision.

A Little History The results of that procedure: Generally, few were readmitted. Students had little confidence in the fairness of the process, and often felt they were blackballed. Readmitted student graduation rates and NCLEX pass rates were unacceptably low.

A New Procedure In April 2005, we began a new nursing readmission procedure in an effort to improve the fairness of the readmission process and facilitate better success rates for readmitted students.

A New Procedure 1. The student writes a letter to the Vice President for Student Development, explaining his/her case and requesting readmission.

A New Procedure 2. The student is granted a hearing before the Allied Health Readmission Committee, made up of four nursing faculty and the Vice President for Student Development.

A New Procedure 3. The Vice President for Student Development begins the hearing by reviewing the students transcript and discussing the students previous experience in the nursing program.

A New Procedure 4. The nursing faculty on the committee question the student about concerns related to his/her experience in the nursing program.

A New Procedure 5. During the hearing, the Vice President for Student Development keeps a checklist of things they discuss.

A New Procedure The checklist includes: (1) Requirements of the readmission policy that apply to all students. (2) Specific things the committee will require of this student, if readmitted, based on his/her individual circumstances.

A New Procedure Specific items on the checklist include: Limiting work hours as much as possible. Utilizing campus resources. Student Success Seminars. Keeping certifications up-to-date: C.N.A., CPR, and TB. Space-availability contingency.

A New Procedure Checklist (continued): Current criminal background check. Limit of one readmission allowed. Courses the committee will require the student to take/audit in preparation for readmission. Practice nursing skills with instructor in the lab. Other requirements.

Typical Reasons for Students Struggles Time management: Required more time than anticipated, complicated by jobs, children, etc.

Typical Reasons for Students Struggles Academic rigor: Much more academically challenging than anticipated.

Typical Reasons for Students Struggles Study Skills/Test- Taking Skills: Requires a different kind of study than that to which the student has been accustomed.

Typical Reasons for Students Struggles Financial problems: Had to work more hours than desired because of personal finances; couldnt afford reliable transportation or a babysitter.

Typical Reasons for Students Struggles Personal Problems: Family problems (i.e., children) Marriage problems (i.e., abuse, divorce) Personal illness (i.e., surgery, chronic illness) Illness/death in the family

Typical Prescriptions Required by the Committee Attendance at one or more Student Success Seminars: Time Management Stress Management Study Skills/Test-Taking Skills Career Planning

Typical Prescriptions Required by the Committee Audit one or more previously- taken nursing courses, or other courses (i.e., math) to help prepare the student to succeed upon re-entry. Practice nursing skills in the lab with the lab instructor.

Results We are now starting to compare our data on the outcomes for readmitted students under the previous readmission policy and the new policy. Note: Because the policy is relatively new, statistical results are very preliminary.

Results for LPN Students There were only two L.P.N. students readmitted in 2003/2004. Both passed their Board Exam on the first try. There have were five L.P.N. students readmitted in 2005/2006. Four passed their Board Exam on the first try and the other has not yet taken her Board Exam.

Results for A.D.N. Students Under the previous readmission policy: There were eight A.D.N. students readmitted in 2003/2004. Of those, three later dropped out and two others graduated but did not pass their A.D.N. Board Exam. Both later passed the L.P.N. Board Exam.

Results for A.D.N. Students Under the previous readmission policy: Five (62.5%) of the eight readmitted students remained in the program until graduation. Three (60%) of the five readmitted students who remained in the program until graduation passed their Board Exam on the first try.

Results for A.D.N. Students Under the previous readmission policy: Only three (37.5%) of the eight students readmitted in under the previous readmission policy graduated and passed their A.D.N. Board Exam on the first try.

Results for A.D.N. Students Under the new policy: In 2005/2006, there were 11 students readmitted. Of those, three later dropped out and one did not pass her Board Exam. Eight (72.7%) of the readmitted students remained in the program until graduation.

Results for A.D.N. Students Under the new policy: Seven (87.5%) of the eight readmitted students who remained in the program until graduation passed their Board Exam on the first try. Seven (63.6%) of the 11 readmitted students graduated and passed their Board Exam on the first try.

Summary of Results for A.D.N. Students Graduation Rates: Old Policy: 62.5% New Policy: 72.5% * In the first two years of the new procedure, compared to the last two years of the old procedure.

Summary of Results for A.D.N. Students NCLEX Pass Rates: Old Policy: 60% New Policy: 87.5% * In the first two years of the new procedure, compared to the last two years of the old procedure.

Summary of Results for A.D.N. Students Graduated and Passed NCLEX on first try: Old Policy: 37.5% New Policy: 63.6% * In the first two years of the new procedure, compared to the last two years of the old procedure.

Our Experience The early results support our hypotheses: (1) A more inclusive nursing readmission policy is more fair to students. (2) A more prescriptive procedure better equips readmitted students to succeed.

Our Experience In our experience, implementing this new readmission procedure was the appropriate decision. The initial indications are that it has already begun to produce the result for which we had hoped – STUDENT SUCCESS!!

Questions?