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Graduating from nursing school and passing the National Council Licensure Examination (NCLEX) are two of the highest hurdles any nurse would believe that they have to get over. Succeeding the NCLEX however simply means that one is minimally qualified to provide safe and effective care to patients. In 2010, the Institute of Medicine (IOM), along with The Robert Wood Johnson Foundation (RWJF) completed a two year report addressing concerns on the future of healthcare pertaining to nursing education, practice and leadership in regards to the demanding increase for public healthcare. The IOM Report suggests that changes need to be made that will affect education of health care providers, how primary care is to be distributed and the impact on nurses as leaders in their profession.

With consideration that an additional year must be allowed for pre-requisite courses that must be completed before entering a program, it can take people anywhere from 3 to 5 years to obtain a degree in nursing. At this point students are able to take the NCLEX, which is a standard universal exam. With a known shortage of educators, the graduation rate of new nurses is less than what will be required. “More nurses are needed to replace the ones that are retiring, and many of those hold advanced degrees” (IOM Report, 2010, p. 126). With this being said, nurses will need to seriously consider the challenge of furthering their education very soon after becoming registered nurses. When considering that higher educated nurses are in more demand it should not be discounted that current education and testing levels need to be revised. As stated in the IOM Report, the current testing guidelines for nurses may need to be reconditioned and the “focus on the NCLEX exam will need to shift” (2010, p. 168). The change in the NCLEX would be to ascertain the ability of future nurses to perform at a higher

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