The amount of care required by hospitalized patients seems to grow every year, and many nurses in the field question whether recently-graduated nurses are sufficiently prepared to take on the demanding task.

Josephine Nappi, MA, RN, director, nursing professional development for nursing education at Memorial Sloan-Kettering Cancer Center, in New York, NY, agrees there is an added amount of care needed for those who are hospitalized.

“Our patient acuity rises daily, our aged population presents additional challenges, and at the same time knowledge and technology increase exponentially. Individuals new to our profession must translate what they have learned in their basic nursing programs into practice rapidly,” says Nappi.

The National Council of State Boards of Nursing (NCSBN) considers this a major issue and recently raised the passing standard on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to ensure new nurses are sufficiently ready to take on the growing needs of sicker patients.

The higher passing standard was voted on in December 2009 and will go into effect on April 1, 2010. Nurses will be granted a passing grade with a -0.16 as opposed to a -0.21.

Joanie Alston Lovelace, MBA, RN, NHA, resident services administrator at Barclay Friends in West Chester, PA., believes that “a test score does not always reflect the knowledge level of an individual.”

“The new nurses coming out of school today are very ‘book’ smart, however they lack the hands-on experience of the ‘old’ school nurses,” says Lovelace. “There needs to be more clinical time incorporated into the learning process. The new nurses also are not truly prepared for what they will face in a new position. In school, they have maybe three patients to take care of in their last year of school and when they are in the work setting they could have as many as 15.”

Judy Dodge of the Indiana Heart Hospital has mixed feelings about raising the passing standard of the NCLEX. “I do feel that 75 questions doesn’t seem like enough to cover all the processes and diseases that one learns over the course of their education. I realize one cannot cover everything, but it just seems like such a very small sample,” she says.

The higher standard is the result of NCSBN’s regular plans to reevaluate the test and passing standard every three years to ensure both stay current and reflect the care nurses will give their patients.

Lovelace, Nappi, and Dodge believe that changing the passing standard is only part of the solution, and is one of the many steps the nursing profession should take to safeguard the patients.