Every graduate nurse dreads taking the NCLEX – the state board exam required to obtain a license to practice in the United States. This test is used to measure the minimum skill and knowledge needed for safe and effective practice by an entry level nurse. Previously “entry level” was defined as a nurse having no more than six months of experience, but has been redefined. The entry level designation is now a nurse that has no more than 12 months of experience.
Each profession evaluates the length of time that a newly licensed person displays entry level characteristics. Nursing is no exception, and though no method has been developed to use across professions, the NCSBN (The National Council of State Boards of Nursing) collects data to determine how long the new nurse requires additional support and training. Research has established that newly licensed nurses are more likely to commit errors in practice and require more support during the entry level period.
Every three years, the NCSBN conducts practice analyses to look at entry level practice. With the data obtained from these studies, the NCLEX test plans are developed. Analysis of data from a nine year period indicated that due to changes in healthcare setting, there was a need for a reevaluation of the defining characteristics of an entry level period.
This analysis included a nurse focus group that consisted of 35 RNs and LVNs who, divided into four groups, were part of a facilitated discussion regarding entry level nurse practice, patient population and today’s practice setting. They were asked to answer the question of how long a nurse must practice before entry-level characteristics began to dissipate. The answers ranged from 6 weeks to 24 months, with the average answer for the RN’s being 12.19 months and the average answer for the LVN’s being 13.4 months. Using these findings, the current entry level practice environment and today’s client population, the NCSBN board of directors approved the revision of the entry level period from no more than six months to no more than 12 months. This will be implemented at the beginning of the next NCLEX practice analysis cycle.
Practically, this means that health care facilities will consider nurses entry level for the first year of their career, which may translate into a delayed increase in salary. While this will not be great news for new nurses, the longer entry level designation has benefits for nursing across the board. It means that the standard is raised, and indeed the list of standards may be amended related to this change, resulting in a longer period of support, preceptorship and on-the-job learning for entry level nurses.
About the Author
Sarah Heroman is an RN, BSN who has found her niche as a school nurse in Texas. With almost 20 years of experience, Sarah is still passionate about the nursing field and enjoys mentoring and helping nurses continue to find the joy in their careers. She believes that a good nurse is able to combine the science and the art of nursing and find fulfillment in providing the best care for their patients.