With a new director of the nursing program, a drastic increase in test scores and a variety of newly revised courses, the Keene State College nursing program is proving to be stronger than ever before.
Nursing Program Director Dr. Patricia Shinn temporarily arrived at KSC as a consultant back in December, when Dean of Professional and Graduate Studies Dr. Karrie Kalich called her and asked if she could help KSC’s nursing program develop a systematic evaluation plan, which would later be sent to the Board of Nursing in January of 2017. On May 30 of this year, however, Shinn arrived at her new home on Appian Way for good, determined to get the program back on track.
Shinn said since she’s started working with the program in May, she’s been getting to know faculty and gaining insight as to what they have all seen as problems within the program, as well as those that still remain. “There have been a lot of changes with the nursing program, but we haven’t seen all those changes come through yet in graduates, so we’re really excited with this senior class that’s on board because they’re the first class to have all of the changes, particularly the admission requirements that were put on the year before last,” Shinn said.
In terms of admission requirements, in order to be accepted into the program, applicants must have a 3.4 GPA overall, a 3.2 GPA in their preparatory science courses (chemistry, anatomy and physiology I & II and microbiology), a passing score on the math proficiency exam for nurses and a score of proficient or above on the Test of Essential Academic Skills (TEAS) which is accessed on the ATI Nursing Education website.
The seniors that graduated from the program in May of 2017 had experienced some of the changes, such as courses that were changed or differing credits being given here and there, but they didn’t have the admission requirements that the current seniors have now. According to Shinn, that’s why it’s so exciting that the 2017 seniors are doing as well as they are on the National Council Licensure Examination (NCLEX), which costs anywhere between $300 and $400 to take each time.
Of the 32 seniors that graduated from the KSC nursing program in 2017, Shinn said 30 have taken the exam, six failed on their first attempt and the remaining 24 students passed. Of the six failures, three retook it and passed the second time. As of August 30, there were only two students remaining who needed to take the NCLEX exam.
Currently, the May 2017 nursing graduates are at an 80 percent pass rate on the NCLEX, a drastic improvement after the 48.28 percent pass rate in 2014.
In the first year of the program (2013), just nine nursing students graduated and only one failed in their first NCLEX attempt; this started the program off with a 77.79 percent pass rate in their first year.
In year two (2014), the program reached their lowest point: a 48.28 percent pass rate. Shinn said the reasoning behind this was a drastic jump in enrollment during the 2014 year. “The faculty tell me what really happened was, all of a sudden, they had 40 students compared to nine [in 2013] and no more extra faculty full time. I mean, they had to have added some adjunct clinical [faculty members] because we are restricted to eight students to one faculty in a clinical setting, and so they [the faculty] feel that’s why it went down to a 48.28 percent pass, but at that, but I’m sure the Board of Nursing in 2014 was saying, ‘Hold it here, this is not okay. Less than half of your students passed,’” Shinn explained.
In 2015, the rate increased to a 62.16 percent. Considering the state average passing rate is between 87-88 percent and the national average is between 85-88 percent, Shinn said concern from the Board of Nursing kept growing.
In 2016, the percentage improved by less than four tenths to a 62.5 percent which, according to Shinn, really was not enough. “At this point the Board of Nursing is saying, “Hmmm, you know, you guys are on probation and you’d better be doing something fantastic here,’ and that’s what the college did. The college paid for this and paid for that and did a lot of things to try and help get that group really ready for their licensing exam,” Shinn said.
With the 2017 passing rate currently hovering at 80 percent after revising courses and curriculum, the KSC nursing program is finally starting to see progress and improvement.
Shinn has high expectations for those seniors planning on graduating in May of 2018. Will these strict GPA requirements they were required to stick to be staying the same? Dr. Shinn said for now, they will be.
“Until we really know that we’re out of hot water and, again, that will be this May ’18 group, you know, I’d love to see them in the 90 percents, so if that is the case, then we might look at being able to back down some on those requirements, but for right now we’re sticking to them,” Shinn said.
In the end of February 2018, the department will be reevaluated for their accreditation, meaning they must write a self-study, which is about a 90-page document, and an appendices. Then, the Board of Nursing will visit the campus in the middle of April and, if everything goes well, Shinn said the accreditation should be extended for the full length of time (approximately 10 years).
In terms of the program’s probationary status, on Sept. 21, KSC Interim President Dr. Melinda Treadwell, Provost William Seigh, Dean Kalich and Shinn will be meeting with the Board of Nursing. Shinn said although they would have liked to see the NCLEX exam scores at 87 percent, they’re not quite there yet, but an improvement has been made and she doesn’t believe they would reward the program by closing it completely.
“I know they [the Board of Nursing] are on our side. I really do know that they want us to succeed and I think they feel very comfortable that I’m now here with this program because they know me and I know how to do this…. I don’t realize how much I really do know and how much I have to bring to the program. I’m here to get this program on really solid ground and keep it there,” Shinn said.
Senior nursing students are also beginning to see new and improved changes within the program. Senior Amy Orsini said the first week has felt really positive and she hopes the rest of the year continues in the same way. “In the beginning, I think with any new program we…weren’t really sure what to expect with the new program. We thought it’d be a little bit uncertain, we were kind of concerned but so far this year, I can already see so many big changes that have already happened in the program, like really positive changes. I feel like the communication between the director and the professors has been really great this semester and I feel like the new director is even going above and beyond to help us,” said Orsini.
Revised Curriculum & Faculty Changes
After hearing feedback from faculty members, graduated seniors and current students, Shinn said the department members are working on “little things.”
Assistant Professor of Nursing Carolynn Ernst said the nursing program is at a much better place than it was a couple years ago. “We have all have been involved in that restructuring, we all have brought our own experiences with our previous classes in the first few years… and felt like we had a good handle on the things we thought were working and not working. So we were moving forward with redesigning classes, redesigning when courses were offered, adding courses, shifting our credit hours around and feeling really good about the forward movement we’ve been making,” Ernst said.
One small step taken in order to restructure the program has been strengthening the Medical Surgical Nursing classes, or MedSurge for short. In the proposed plan, Shinn said when students come into the program their junior year, they will take a fundamentals class, which would act as their “basic” MedSurge. Following that semester, they will take MedSurge I, II and III, which really strengthens that component of the program.
In addition to building up the MedSurge portion of nursing, Shinn said the department has brought on a new MedSurge faculty member, as well as a full time Simulation Lab Coordinator.
“It [the Simulation Lab] is never open because our faculty are in class or at clinical and they’re not even on campus sometimes, so those doors are shut and locked. So now, we’re going to have somebody there all the time and students can drop in and if they don’t feel comfortable, you know, if you have a patient tomorrow that’s going to have a urinary catheter that they need put in or flushed or whatever, you can come in and practice it before you go into clinical,” Shinn said.
Additionally, the nursing faculty are working to redesign the course load for students during their junior and senior years in the program and have added a focused and dedicated two-credit NCLEX preparation and review course, according to Ernst.
When redesigning the course load, rather than having one semester with a 14-credit course load, one with an 18-credit course load, as they do right now, Shinn said there is going to be a consistent 16 credits in each of these semesters, making it more user-friendly for students, as well as ensuring they aren’t overloading or underloading students credit-wise.
As if Nursing Program Director Shinn didn’t have enough on her plate, she’s also agreed to do some teaching this semester, which, she said, she’s very excited about. “I haven’t done this much lecturing in quite a while because I’ve been a director….I had agreed to teach one class a semester, but now I’m teaching two, a clinical component and the classroom simulation component of the clinical, and there’s one I want to teach next semester, so…I might do that anyway,” Shinn said.
Goals of the Future
For the future of the program, Shinn said she doesn’t just want to see high pass rates on the NCLEX exam, but she wants to see high retention rates within the program as well. Nationwide, nursing retention is about 60 percent, said Shinn, and the lowest retention Keene State has seen was this past year’s graduating class at a 79 percent. Every other graduating class has had between an 80 and 90 percent retention rate each year.
“Keene has good retention. That may have been part of the problem with the boards [the NCLEX] is that they were retaining students that weren’t able to pass the boards. We just have to marry those two [passing rates and retention rates] and keep students in that we mentor them the way they need to be mentored so they pass the boards, and I think we’re getting there. The faculty are so dedicated to helping this program produce quality professional nurses and I’m really excited to a part of that because I think that we’re desperate for nurses and it’s not going to ease up anytime soon,” Shinn said.
As scores continue to rise, Ernst said she has high hopes for the future of the program. “I see the scores continuing to rise, students are doing much better on the NCLEX, we’re doing really well right now, which I feel really good about, and I think it’s only going to improve and the program is going to be stronger. The faculty are strong and will continue to be strong. We’re a very committed, dedicated faculty and I feel like the college and the community are very committed to our program which feels wonderful,” Ernst said.
Although Director Shinn isn’t planning on leaving Keene State anytime soon, she said one of her long-term goals before she leaves would be to see a graduate program in nursing education. “The area needs it desperately…I can’t produce anymore nurses if I don’t have faculty and you have to have your master’s degree for that…all of us colleges are hurting because we pull from a very small pool of master’s-prepared nurses and it’s scary. You know a good nurse in the hospital is not necessarily a good educator. A good educator is not necessarily a good practice nurse, but when you get the two together in the right combination like I see in these faculty here, [it works].”
All in all, Shinn said she hopes to be at Keene State for quite a while, for her and her husband just bought a house in Swanzey, about five minutes from campus. “I do not want to change jobs again, I really hope that I’ve found my home.”