The Lived Experience of Graduate Nurses with Multiple NCLEX-RN® Failure

Purpose: This qualitative study sought to understand the phenomenon of graduate nurses (GN) who have failed the NCLEX-RN^® multiple times. With each successive failure, the GNs chances of passing the NCLEX-RN^® decrease. The GNs who fail initially and continue to fail, cannot work as Registered Nurses (RN). As the American population ages and the nursing workforce ages, the need for RNs increases. An aging nursing workforce may lead to a RN shortage in the future. Understanding the lived experience of the GNs who have failed the NCLEX-RN^® multiple times could assist with supplying RNs to meet the demand.

Methods: A qualitative study which used Hermeneutical phenomenology as influenced by Heidegger (Heidegger, 1927/1962) was conducted to attempt to understand the phenomenon.  The method will be referred to as HHP. Phenomenology describes carefully all that is hidden in any act of consciousness. Hermeneutics is analyzing of interview content. HHP analyzes the participants’’ stories of their everyday lives as part of the phenomenon being studied. To gain understanding of the phenomenon, nine participants were interviewed and their stories were analyzed using Hermeneutical analysis. 

Results: Three significant themes were identified. The themes identified included blaming, being alone and needing support, and questioning. The themes revealed in this study suggest a need for assistance. After failing the NCLEX-RN^®, the GNs felt abandoned and alone. They blamed not only themselves but the nursing program and nursing faculty members. They believed that they were not prepared sufficiently to be successful on the NCLEX-RN^®. Some of the participants believed that the nursing faculty and nursing program failed to identify and address needs of the at-risk student during the nursing program. The participants questioned what to do after the initial failure and each successive failure. The themes all suggest a need for guidance before and after the failure.

Conclusion: Implications and conclusions discussed included careful implementation and use of standardized testing packages (STP) by nursing programs, the need for pre-graduation identification of at-risk students and assistance, and the need for post-graduation assistance for the GNs who fail the NCLEX-RN^®. The GNs who fail the NCLEX-RN^® may need assistance to become successful. Only after successfully completing the NCLEX-RN^® can these GNs become part of the professional nursing workforce.