Back in 1999, the State of California realized it was facing a critical nursing shortage. The crisis was the result of several factors, including an aging population, a generation of nurses on the verge of retirement, and poor working conditions. So in 2002, Governor Gray Davis launched an ambitious plan to address the shortfall, which included funding to increase the state's capacity to educate nurses at community colleges. One of the recipients, Oakland's Merritt College, succeeded in increasing its enrollment, but its retention rate just nosedived.
As of October 14, just 43 out of an initial 100 students remain in the first year's class. Students say that while high dropout rates among the notoriously stressful nursing programs isn't uncommon — 19 percent is the statewide community college attrition rate from 2000 to 2007, according to a report by the California Board of Registered Nursing — this high rate is extraordinary. And they say fault lies with the instructors and disorganization of the program.
"We're not asking for the college to lower their standards, but to provide the assistance that we need to pass the exams," said Jyotsana Francis, 40, one of several students who dropped out of the program because she was failing. "The exams aren't congruent with the lectures. ... All they do is point fingers and say to study harder."
Francis is one of 59 nursing students who recently signed a letter asking for changes to the program at Merritt, which is not related to the nursing program at Oakland's private Samuel Merritt College. Chief among their complaints is that the college doesn't offer adequate resources for the students to succeed. Lectures allegedly weren't targeted toward test preparation, and lab time often consisted of watching videos instead of practicing on equipment. In addition, they complained, their textbook contained inaccurate and contradictory information — which led to incorrect answers on tests.
About thirty to forty students formally presented their complaints to instructors, department heads, and college Chancellor Elihu Harris in early October, requesting tutors and asking to postpone a test that would cement their fate. But those meetings proved unfruitful, according to several students. "Elihu even said, 'Yeah, you should be teaching more toward the test,' but no one said, 'OK, we'll do that,'" said one student, who wished to remain anonymous. "So as far as I know, there's no plan to implement any of our suggestions." Instructors told the students they needed to study harder and to attend office hours that "literally none of us knew" existed, according to the student.
Jeff Heyman, a spokesman for the Peralta Community College District, to which Merritt belongs, said the college is looking into several options to help the students, such as allowing them to retake a test, but that nothing has been finalized. "A number of students did not pass the exams and we're very concerned about that and trying to figure out what happened," he said. "It's very unusual. Merritt is one of the best nursing programs in the Bay Area."
The massive failure rate comes at a time when Merritt is supposed to be increasing its enrollment and retention. According to records supplied by the California Community Colleges' chancellor's office, Merritt received $334,742 for enrollment growth and capacity building, and $98,872 for assessment, remediation, and retention for the 2007-08 school year. That includes offering tutoring and case management to at-risk students, purchasing lab equipment, making minor upgrades to buildings, or offering another assessment test after enrollment. Merritt succeeded in increasing its enrollment. One hundred students attended the first day of class this year, compared to 88 last year.
Heyman said the funds went toward equipment and materials used for retention, such as "computer-assisted dolls" that are used as stand-ins for live patients. But students say their labs are severely lacking in proper equipment. "The thermometers don't work," said Katherine, one of the failing students who dropped out and only wanted to be identified by her first name. "We're supposed to have suctioning tubes. That doesn't work. It's poorly supplied. You go there and they don't have this, they don't have that."
Several students said the program set them up for failure from the very beginning. Francis said that on the first day of class, instructors told them to "look to your left and look to your right. Two of you aren't going to be here" by the end of the two-year program.
Instructors made students sign a contract in the beginning of the semester to agree to withdraw from the program if they scored under a 75 percent average after the first three tests. The teachers assured them they'd have the opportunity to review their tests and see what they did wrong. But instead, they simply read through the answers quickly without providing time for questions or review, according to another student who dropped the program after failing the first test and wished to remain anonymous.
"Since we've been complaining it's been getting worse," Katherine said. "They play a lot off of our anxiety. Especially with the second test, they knew that we were nervous that this test was gonna break us. They would say comments like, 'For those of you who make it.' It was never once 'You can do this. We're here to help. Let's do a test review.' They never did a test review."
Studying didn't appear to help much, because their textbook contains wrong and misleading information, students say. "This book has so many errors it's not funny," said Katherine. "You can answer a question in the answer review and you check the correct answers in the back of the book and it literally tells you the wrong answer is right, several times." In one example, she said, "umbilicus," a synonym for navel, is referred to as "love handles." Also, the book says testicular exams can be performed before and after a shower or bath. The test made clear only one answer was correct. On the second exam, there was also a typo: carbon "monoxide" was the answer, but the option said "dioxide." "They said you should have known that was the right answer," Katherine said.
For many students, failure comes at a high price. Some made enormous sacrifices to attend the program. Many are mothers trying to enter or get back into the workforce. In Francis' case, she left her husband as a result. "I gave up my marriage for this program," she said. "I gave up spending time with my kids. My parents had to move in with me. ... They told us things have to be put aside to meet our goals. If you have issues with a relationship, just put it aside. ... Where did that get me?"
Katherine said many students suffered mental stress: "A lot of people complained about headaches. I know one girl who got sick in class — she had to have an ambulance come. ... In my opinion, she was having an anxiety attack."
In a statement released by Chancellor Harris, several explanations were offered as to the discrepancy in retention rates between this year and last, including the fact that GPA requirements were lowered this year because of new state criteria. In addition, fewer students attended a special program to help prepare them for classes because they couldn't afford it. The statement basically blamed the students. "Students struggled to read and digest, or comprehend the text book then apply it to exam taking through a critical thinking process," it stated.
While Merritt, like many community colleges, typically does not attract top-tier students, the students say they were up to the task, especially after completing their prerequisites. Katherine said students regularly met for study groups at Barnes & Noble, where nursing students from other programs also study. "A lot of students leave at 6 or 7 and we leave at 11," she said. "They look less stressed out. From talking to other students, they feel the same way. It's not supposed to be like this. We got gypped."
In any case, according to the state's own standards, the students of Merritt's 2010 nursing program appeared qualified to complete the program. As part of its retention and enrollment project, the state requires nursing students to take an assessment test, in order to predetermine which students were academically fit enough and thus more likely to graduate. All of Merritt's first-year nursing class passed the test.
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