We need more nurses. Here's how to train them. | Blake Halladay | TEDxNightingale College

In my very first lecture, in my very first class, on my very first day of nursing school, I was taught one of nursing's most foundational principles, evidence. Evidence-based practice is at the root of everything we do in nursing.

Every intervention, every medication, every treatment must be based on solid evidence that shows that it works and that it's safe. Years later, I transition in my career to start working with the laws and the regulations that govern nursing practice,

specifically nursing education. the very education that taught me just how necessary evidence is. So, imagine my surprise when I found that many of those laws aren't based on any sort of reliable, consistent

evidence at all. In fact, many of them aren't based on anything more than opinion. well-meaning opinion, I'm sure, but opinion nonetheless. So, why does this matter?

Well, it matters because of who it hurts. In the United States, to become a nurse, you have to graduate from nursing school and then pass an exam or pass your boards, as you've probably heard it said. Many licensed professions follow the same process in the US.

So, this makes sense. But here's what doesn't make sense. Nursing is apparently the only major licensed profession in this country that judges the quality of its schools based on how many of their graduates pass that exam on the

very first try. Not whether they pass at all, but whether they pass the first time. In fact, if any of you wanted to become a nurse, the school that you graduated from that taught you

everything you need to know to be a new competent nurse can be totally and completely shut down if too many of you simply need a second try. I have read and studied every single law and every single regulation governing nursing education in this country, 50 states

plus territories. And in my research, there's always two questions that come to mind. First, where is the evidence for this whole first time passing thing?

especially in relation to your ability to pass a highstakes multiplechoice style exam and the quality of the school that you graduated from. And two, well, if we're going to do this whole first time thing, how many is enough?

How many of you have to pass that exam the very first time in order for your school to be determined as good enough? Well, the answer to the first question, I think you already know.

I couldn't find any reliable evidence tying your ability to pass that exam on the very first try and the quality of the school that you graduated from. But it was really the answer to question two that shocked me.

How many is enough? Well, apparently nobody knows. Out of 50 states plus DC, I found 26 different answers to that question. 26 different mathematical calculations used by boards of nursing across

the country to determine if a school is good enough. But here's the kicker. I found that if you have a school and you put it in a state, we'll call this state A, and not enough graduates of that school are passing that

exam on the first try, they're passing it, they're just not passing it the first time for whatever reason. Maybe it's an underserved community, test anxiety, whatever it may be. So now this school here in state A is at

risk of being shut down. If you took that school, the exact same school, same administration, same faculty, picked it up and put it over here in state B, perhaps even right next door to state A, the school could be just fine simply because