Clarification appended: This story has been updated to reflect that Florida saw a decline in out-of-state students taking the nursing exam in 2024, though not necessarily a decline in out-of-state enrollment.
Florida ranked last nationally for nursing exam pass rates in 2024, according to a new report from the Florida Center for Nursing.
First-time pass rates for registered nurses in Florida stood at 84.9% in 2024, falling short of the national average of 91.16%. The pass rate for the state’s practical nursing exam (80.78%) was also significantly below the national average of 88.38%.
Other Southern states like Texas, South Carolina and Tennessee have overall pass rates of over 90%.
Despite the statewide shortfall, nine nursing programs in the state university system had National Council Licensure Examination, or NCLEX, pass rates above the national average. Florida Gulf Coast University had a 100% pass rate, while 98% of nursing students at the University of Florida passed the exam.
Shakira Henderson, the dean of the UF College of Nursing, said there are multiple factors that contribute to the school’s high pass rates. Targeted NCLEX preparation, rigorous coursework and proximity to UF Health Shands Hospital are some of the factors to success, Henderson said.
UF’s nursing program relies on state funding through programs like PIPELINE and LINE, designed to combat the statewide nursing shortage. The PIPELINE and LINE programs are critical for resources like NCLEX preparation programs and supporting high-quality faculty, Henderson said.
Florida is expected to have a shortage of 56,369 nurses by 2037, primarily due to an aging workforce population, according to preliminary FCN data presented at a Feb. 12 Senate Appropriations Subcommittee on Higher Education meeting. The majority of the deficit lies with the supply of practical nurses, a profession predicted to have a 45% vacancy rate by 2037.
“Nurses can make much higher salaries than in a nursing school,” Henderson said. “And that’s a constant balancing act and a constant struggle.”
The National Council Licensure Examination is the nationwide exam students must pass to become registered nurses. Florida has underperformed in the Licensure Examination over the past decade with 2020 pass rates for the NCLEX-RN more than 25% below the national average. This comes amid a statewide shortage of practical nurses, which is only expected to worsen over the next decade.
Florida’s low success rate can’t be attributed to any one factor, said Jason Bartos, Florida Center for Nursing assistant director of communications. However, accredited programs, which are recognized by a specialized agency, often perform better than non-accredited ones.
“Everyone in the state really is looking at the NCLEX rate,” Bartos said. “There’s been a lot of focus on what has caused success in certain areas and how that can be replicated to other programs or across the state.”
The Florida Center for Nursing report also showed Florida is narrowing the performance gap. Pass rates for the National Council Licensure Examination for registered nurses and practical nurses have improved since 2023, and the Florida Center for Nursing also reported improved retention rates for practical nursing programs.
Florida saw a large drop in out-of-state student test-takers in 2024, Bartos said, though it's unclear whether this is correlated with the improvement in pass rates.
Willa Fuller, the executive director of the Florida Nurses Association, said Florida’s last place rankings can be traced back to 2009 statutory changes. In an attempt to address a staggering nurses shortage, the state legislature reduced the amount of oversight held by the Florida Board of Nursing, making it easier for nursing programs to gain approval. As a result, Florida experienced a boom in private for-profit nursing programs.
“Not all schools were of the best quality, and that was when the pass rates began to slide downwards,” Fuller said.
Students taking the registered nurse exam at private for-profit programs performed almost 10 percentage points lower than students at public or nonprofit programs in 2024, according to the FCN report.
Florida has experienced a sharp decline in test-takers at private for-profit programs since 2021, which coincides with a rising pass rate at those institutions.
Florida has started closing the performance gap thanks to stricter state regulations in recent years, Fuller said. In 2023, the Florida legislature mandated registered nursing programs obtain accreditation before getting approval. The Florida Board of Nursing’s greater oversight over schools and firmer accreditation standards is encouraging, Fuller said.
Fuller said the Florida Nurses Association hopes more oversight will be returned to the Florida Board of Nursing in the future.
“The reason they exist is to protect the public, and you protect the public by making sure the schools are putting out a quality product and safe practitioners,” Fuller said.
Abby Outtrim, an 18-year-old UF student, said she hears discussions of the nursing shortage in her pre-nursing program. The NCLEX is known among students for being a stress-inducing exam, Outtrim said, but she feels prepared through UF’s nursing program to succeed in the field.
“[Nursing] requires a lot of you, not only mentally, but emotionally and physically,” Outtrim said. “Those are all factors that you kind of need some practice with in nursing school in order to perfect your techniques and increase your performance.”
The Florida Center for Nursing will provide an in-depth presentation on the findings of the report during its Education Symposium, which will be held in Gainesville on March 7. The UF College of Nursing is co-hosting the event.
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