Date of Award

Spring 2016

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

VandeVusse, Leona

Second Advisor

Haglund, Kristin

Third Advisor

Schroeter, Kathryn


In the past decade, there has been little research conducted regarding individuals’ stories about not initially being successful on the nursing licensure examination (NCLEX-RN). An unsuccessful licensure examination attempt may affect the individual personally and profoundly in ways that could influence their future success. Learning from registered nurses’ experiences may contribute to developing new strategies to promote graduate nurses’ initial success, which could help alleviate the nursing shortage. The purpose of this research study was to explore, using a narrative method, the experiences of registered nurses who were not initially successful the NCLEX-RN, then subsequently passed. Personal Construct Theory (PCT) was used to guide this study. PCT is used to explain how individuals make sense of critical events in their lives. A purposive sample was used for sample recruitment. Fifteen participants were individually interviewed one-time. Data analyses were conducted using both manual and electronic coding, through multiple phases of thematic identification. Rigor was ensured by meeting quality criteria for qualitative research, such as using field notes and careful auditing. Four major themes were identified: (a) pressures all-around, (b) the stigma of being unsuccessful, (c) correcting the problem, and (d) the ultimate learning experience. Participants identified internal and external pressures that prevented them from being successful on their first attempt. They also expressed awareness of a stigma with being unsuccessful; therefore they chose to maintain privacy about their initial results. After a period of time, participants prepared to retake the NCLEX-RN by engaging in positive self-talk, focusing on content, practicing licensure examination style questions, taking commercial preparation courses, and revising test-taking strategies, among others. After successfully passing the NCLEX-RN, the participants wanted to share with graduate nurses what they had learned from their experiences. Following their initial unsuccessful NCLEX-RN result, participants were deeply affected, but with help and support of family, friends, nursing instructors, and managers, they were able to move forward, change their approaches, and become licensed nurses. Participants also expressed that the processes they undertook toward ultimate success on the licensure examination enabled them to be “better nurses” due to increased sensitivity to others who were encountering challenges.