The editorial answers you | What if nurses no longer had an Order exam?

Do you have questions about our editorials? Questions about hot topics in the news? Each week, the editorial team responds to readers of The Press.

You are obviously referring to the last exam of the Ordre des nurses du Québec, which generated a lot of reactions because of the very high failure rate.

The failure rate was 48% in September 2022 for CEGEP nursing graduates, compared to an average of 18% over the previous four years. Including CEGEP and university graduates, the failure rate was 43% on the September 2022 exam (for candidates on the first attempt).

The Order of Nurses puts this huge gap on the back of the context of studies in times of a pandemic, when students believe that the exam was too difficult. The College is convinced that was not the case. “It’s been the same type of exam since 2018,” says its president, Luc Mathieu.

Who is right ? The Commissioner for Admission to Professions is carrying out an investigation to find out what happened. He is due to report his findings in the next few months, but it is the Order that has the last word. Meanwhile, most of the students who failed in September were able to try their luck again last week.

Interesting clue: the pass rate also decreased last year on the bar exam for future lawyers (from 86% in 2020-2021 to 76% in 2021-2022), but not as markedly as among nurses.

Well, that doesn’t answer your question…

Here is your answer: without College review, there would have been 1,468 additional new nurses available in 2022.

In 2022, 43% of the 3,442 graduating nurses (CEGEP and university) who took the exam for the first time failed it (there are two exams a year, in March and September). This means that 1,468 nurses had to delay their official full-time entry into the labor market because they failed the exam.

That said, the candidates have three chances to pass it. Many will eventually pass and practice as nurses.

Could these 1,468 additional nurses have made up for the entire labor shortage in the health network? No. According to Quebec, there is a shortage of 4,513 full-time nurses in the public network (58,723 positions are filled). About 8% of nursing positions in the public network are not filled.

In proportion to its population, Quebec (ratio of 7.7 nurses per 1,000 inhabitants) has more nurses than the other Canadian provinces (ratio of 7.02).

Should we abolish the examination of the professional order and only require a DEC or a baccalaureate in nursing, as your question suggests? In our view, that would be pushing the envelope too far. Even in times of labor shortage. Even if it turned out that the exam last September was too difficult.

“Our mandate is to ensure that our members have the knowledge required to practice safely in the health network,” says Luc Mathieu, President of the Order.

If you think the September 2022 exam was too difficult for graduating CEGEP students, you may not have seen it yet: the College plans to make it more difficult over the next few years.

The current exam only assesses the knowledge acquired in CEGEP. Knowledge taught only at university (eg critical care such as emergency, intensive care, trauma) is excluded. The Order wants to change that. “As a professional order, it is embarrassing and worrying. [L’examen ne devrait pas être élaboré] based on a study program, but on the knowledge expected in the health network, as is the case elsewhere in Canada and the United States,” says Mr. Mathieu.

Our little finger tells us that this is not the last time we hear about the degree of difficulty of the exam of the Order of Nurses.