Nurses’ exam re-sit reveals nurses did not know their onions

Mar 22, 2017 Letters

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Dear Editor,
Now that the results of the nurses’ state final examination are at hand, the resulting picture is even more grave than anticipated. Governmental intervention is imperative as the health of the nation would be in jeopardy otherwise. At stake is much more than the integrity of the nurses.
Last October while 250 nursing students were preparing to take their State Final Exam to become Registered Nurses, word reached the Public Health Ministry stating that the examination had been breached, thereby compromising the process. Thankfully the word reached before the deed was done. Initial investigations by officials of the Ministry indicated that the situation required the intervention of the Police Force
During the fiasco, the Junior Minister of Public Health, Dr. Karen Cummings asserted that, “we need to know that our nurses know their onions” and for that reason a re-sitting of the examination will be conducted, in order to ensure that only the most proficient of the students are allowed to practice in the public health system. She further stated that such a move would also ensure that the nurses who pass the exam will be able to boast of success without controversy overshadowing their respective performance.
Well here we are results in hand, after re-sitting and remitting; only 23 of the 179 candidates secured overall passes. The results clearly show that the General Nursing Council know what they did. The Nursing Council with its chequered past, and now cloud of suspicion, is tasked with setting the State Final Examination, taken by students of the country’s four nursing schools: Georgetown School of Nursing, the Charles Roza School of Nursing, the New Amsterdam School of Nursing and privately-operated St. Joseph Mercy Hospital.
Contrary to the previously expressed belief of the Junior Minister of Public Health, Dr. Karen Cummings, the results further affirm that the nurses in question did not know their onions but their garlic too. After all the public health system in Guyana is currently reeling from a chronic nursing shortage, and if some nurses are helped to reach the goal, by being given exam papers this can be looked upon as a dishonest step towards situational remediation.
On deeper analysis it is evident that there are individuals who are fully aware that the nurses even on completion of training are not up to the required or expected standards. The prevailing situation brings into question, the calibre of prospective nurse trainee, required admission qualifications for both nurse and nursing instructor and above all the nursing curriculum, or who is teaching who, what and how. Has the nursing shortage forced the respective training schools to lower their admission standards and requirements? In some teaching contexts the instructors are expected to get a bell curve of grades to show that they are teaching to meet expectations.
The question of accountability for nursing education also needs to be addressed, because nursing instructors may see their role as simply forwarding and dispensing knowledge, thereby neglecting the need to know how to be great educators. The majority of nursing instructors have never been officially trained as educators. Most have either a Masters’ degree or no graduate degree at all, just the mere nursing background and experience.
They have not undergone any formal training in how to evaluate the learning needs of students, how to develop learning tools to assist nursing students achieve satisfactory program outcomes. In addition they cannot evaluate student performance outside of an exam score, or assist students at the margin develop corrective plans to address unaccounted concepts or content. Therein may lie the crux of the problem. Should the nursing instructors be held accountable for the student outcome? Most certainly! If nurses are held accountable for patient outcomes, then in like manner nurses in educational practice should be held accountable for student outcomes.
From hereon the nursing instructors must be made aware of their responsibilities to create lifelong learners and not just assist nurses to prepare themselves to pass a onetime final nursing examination. The present breach has served its purpose – it has laid bare the flaws of the entire nursing and nursing education system, although some nurses may have previously benefitted from the surreptitious behavior of the Nursing Council. Sad but true, the occurrence of certain in -hospital tragedies may have its roots in the quality of nurses produced by the breach.
The entire nurse training program, nurse selection, nursing curriculum and nursing instructors must be rigidly scrutinized, evaluate and remedial measures put in place as necessary. Those at the General Nursing Council responsible for the breach should be pursued to the full extent of the law, along with all identified accomplices. In actuality the punishment meted out should be severe enough to serve as a deterrent to others. An entirely new body working in conjunction with the Minister and Ministry of Health should be created to overlook the nursing curriculum, the setting of the nursing examination, distribution, collection and tabulation of the results. It is only in so doing that nursing education can have an effect on the ability of the profession to uphold and transmit its core values to provide nurses that make intelligent judgement, thereby keeping patients safe.
Yvonne Sam

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