PROVO — Matt Anderson has known he wanted to be a nurse since he was a child.
He was born with a congenital heart defect and always appreciated a good nurse on any of his trips to the hospital or annual cardiology visits.
He wanted to learn "to do the kind of things that people did for me when I was a kid," Anderson said.
"Nursing is an art. It's a science, but it is also an art," he said. "It's learning to care for an individual and to care for them objectively, not judging them for their life choices."
Now in his fourth year of nursing school at BYU, Anderson, 25, says the experience has been invaluable to him.
And while he already works with patients, Anderson has yet to take the National Council Licensure Examination, or NCLEX, developed by the National Council of State Boards of Nursing. He can't sit for the exam until after graduation in December, and he can't get a license to practice until he successfully passes the exam.
Luckily, however, being at BYU gives him some sort of advantage, as the school has the highest passing rate in the state and one of the best in the nation.
The nearly 96 percent passing rate has remained consistent at BYU, even though the board updates the test every three years, making content harder to predict and the up-to-six-hours-long test even more difficult to pass.
"No matter how much they've studied, no matter how much they know, it can find a question they don't know," said Renea Beckstrand, who teaches the NCLEX prep course at BYU.
Beckstrand said the computer testing method used for the examination has the ability to "learn" what each test-taker knows. It is ultimately looking for a 95 percent confidence level that each applicant will be a safe practitioner.
According to a summary of first-time candidates, BYU nursing grads pass at a rate of 16 percent above their peers within the state and 13 percent higher than the national average.
Nationally, more than 45,000 people sit for the exam each quarter, with an average rate of about 89 percent passing.
Beckstrand said BYU professors, and likely those at other schools, make it a point to be "tied in" and aware of the national standards, which increase in intensity each year.
"We tell students, 'You can't mess around with this,'" she said. "And most students will rise to the challenge. They have a healthy respect for it and are not too fearful."
The test offers a possibility of up to 265 of 3,500 available questions, but it can also figure a pass or failure after just 75 questions. No one gets the same test or length of test, and it turns off after it reaches that prediction of safety.
Applicants pay $200 to take the exam. It can be taken multiple times, but with a 45-day interval between each attempt. Some employers hire nurses on condition that they pass the test in a certain time frame, and others won't hire a nurse until they are fully licensed.
Jasmine Burson, 23, of Murray, recently graduated from the nursing program and passed the NCLEX in June. She now works as a nurse in the intensive care unit at Intermountain Medical Center, but she remembers feeling relieved when the test was over.
"I plan on keeping my license up to date so I never have to go through that experience again," Burson said. "The test covers everything you learn in four years of nursing school so you have to think back to all that."
If asked to take the test again today, Burson said she likely wouldn't be ready.
But, as Beckstrand said, students are sometimes too hard on themselves.
"It is always a great surprise that our students do as well as they do," she said. "It's encouraging, and I'm glad they listened and were prepared for the harder exam this year."
Nationally, passing rates declined from close to 90 percent to 83 percent with the board's modification of exam questions taking effect April 1. For nursing students in Utah, the passing rate dropped from 90 percent to 80 percent, but BYU students did not see a drop, maintaining a passing rate of 96 percent.
The national and state trends are common. When the NCLEX has changed in the past, passing rates have almost always dropped.
"I'm so proud of them that they listened and that they took it seriously and rose to the challenge," Beckstrand said. "They absolutely stepped up to the challenge."
Practice tests between each semester of school at BYU, as well as helpful professors and useful study suggestions, Burson said, gave her the edge to finish successfully.
Getting into the program is very competitive, so "everyone there is very focused and determined to do very well," she said. And, thankfully, her hard work has paid off.
Working in the ICU is stressful and difficult at times, Burson said, but also very rewarding.
"The patients are just really sick," she said. "It's a very high-acuity unit. You've got, in a sense, people's lives in your hands at any given moment."
The collaborative team environment and ability to work under pressure was partly what drew her to the unit, she said.
"Nursing is really an expression of my faith," Anderson said, adding that his education, coupled with his beliefs in The Church of Jesus Christ of Latter-day Saints, has been life-changing.
The BYU College of Nursing slogan is "learning the healer's art," and Anderson, of Taylorsville, said he wants to help people heal in all aspects of their lives.
What he's learned, he said, has also helped his family get through the obstacles involved with having a child born with the same congenital heart defect he was born with.
"I have loved my experience at BYU," Anderson said. "I will always remember walking past a staff meeting in which the professors heads were all bowed in prayer and they were praying for us as students and so they could educate us properly. They want to help us be the best nurses we can be."
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