A failure for the Order of Nurses

As if we didn’t already have enough health recruitment problems, the Order of Nurses of Quebec has decided to make its admission exam much more difficult.

The success rate for the exam to become a nurse is dropping in an astonishing and worrying way. In three years, it went from about 90% to 50%. In the midst of a labor shortage.

For 10 years, this is the first time that the results of an examination by a professional order have been so catastrophic.

The Order blames training during the pandemic. And says he can’t compromise in the name of protecting the public.

The Independent Professional Admissions Commissioner reviewed the September 2022 exam, where only 45% of students achieved a passing grade. His report is devastating: the exam is unreliable, the pass mark was raised by 4 percentage points without sufficient reason, and 500 more future nurses should have passed.

The College rejected Commissioner André Gariépy’s report and now says the pass mark should have been even higher. You must not lack nerve!

And that’s not all: the Order wants to replace its exam in 2024 with an even more difficult American exam, designed for nurses who have received a university education. However, 80% of candidates for the exam have just completed their DEC in nursing. Several topics on the US exam (eg, long-term care, critical care, palliative care, rehabilitation) are only part of university training.

The Order took this controversial decision when it has been asking Quebec City for a year to impose the baccalaureate as a gateway to the nursing profession, as is the case in the rest of Canada and in the United States. United. The Legault government said no.

Despite everything, the Order wants to impose a university-level exam, if the Office des professions allows it.

The Board should deny this request.

It’s not about leveling the training down. This is a question of fairness.

If you don’t require a bachelor’s degree to become a nurse, you can’t require a CEGEP graduate to pass an essentially university exam to obtain her professional title.

Now, what do we do with the candidates who failed the last two dusty exams?¹

It is possible that the pandemic cohorts are weaker, as the Order suggests. “In nursing, distance learning doesn’t work very well. For the past three years, we have had to review our training [pour les nouvelles infirmières]. There is a difference in the level of preparation to work,” says Valérie Pelletier, director of nursing at CHU Sainte-Justine.

But in 2021, the College also changed the way it calculates the pass mark. This decision is contested, in particular by Commissioner André Gariépy. We won’t go into the technical details, but the Order has raised the pass mark by approximately 4 percentage points (from 49.9% to 53.8% for September 2022). Without these 4 points, about 500 more students would have passed. Admittedly, 70% of those students who took the exam again in March passed it. Bravo for their perseverance! But the situation remains unfair for the 30% that would have passed with the old calculation.

In the short term, the Office des professions must force the Order to return to its old method of calculation. He has the power to do it.

In the long term, the problem is broader: we end up with an Order convinced of holding the truth, determined that the baccalaureate becomes the only gateway to the profession, and which does not seem to understand the magnitude of the problem.

This alarming failure rate is not just that of female students.

It is also the failure of the Order, which accompanies the candidates badly. Particularly those trained abroad (success rate in September 2022: 15%!), which the Order must nevertheless prepare for the exam.

It is the failure of educational institutions.

This is the failure of the health sector, where each hospital prepares its candidates for the exam in isolation, instead of sharing its best practices.

Faced with such a critical situation, the community must stick together to find solutions. It seems like the opposite is happening.

In the short term, the Order must abandon its American examination project and review its method of calculation. But the most important thing is that he changes his attitude.

That he proposes realistic solutions, rather than giving lessons from the top of his ivory tower.