Mediocrity in the Nursing Profession
The Crisis of Mediocrity in Nursing Education and Its Impact on Patient Safety
Mediocrity is plaguing our society. We are living in an era where low effort is not just tolerated, it’s celebrated. It is in every sector of our society. The most concerning part is how competence and accountability are frowned upon and considered unachievable. Mediocrity is a disease and its effects are debilitating and damaging. The more prevalent mediocrity becomes, it dominates and the harder mediocrity can be recognized. Delbert Hickman states that “the price of excellence is discipline. The cost of mediocrity is disappointment.”
Mediocrity is defined as accepting average performance, the bare minimum possible or completing a job just to get it done rather than striving for excellence. Enforcing standards and attempting to pull people out of their comfort zone are viewed as having too high of standards. Mediocrity stifles creativity, innovation, dismisses excellence and presents significant challenges. Mediocrity is destroying the workplace, innovation, customer service and creativity.
The healthcare system is no different. Mediocrity in nursing is becoming pervasive and it begins with educational institutions. College professors have become caretakers of the emotional and personal challenges that students bring into the nursing program. This diverts the attention of the professor from teaching to attending to the students with mental illnesses, emotional and personal challenges and basic knowledge deficiencies from pre-nursing courses. Many students are not properly prepared from their pre-nursing courses to take on challenges of the core nursing curriculum. Many nursing schools have adopted the belief that the “student is always right.” This stems from the fear of losing the student and the revenue that follows. Colleges place the professor in the position of being counselor, parent, and teacher without the support. Professors are reluctant to hold students to high standards for fear that students will complain to administration that the professor is too difficult or not teaching properly.
Many professors have not practiced for years in the hospital system and are not as proficient or up to date in new medical devices, or changes within the healthcare system. Colleges also fail in educator recruitment. There is a shortage of nursing professors due to low wages and there is a failure to recruit the best and the brightest due to these low wages. Other problems such as ineffective teaching, low academic standards, and disengagement, has a profound negative impact on student outcomes, fostering a cycle of low achievement and reduced institutional value. A trend towards easier passable classes and lower standards, driven by a desire to avoid student complaints or to maintain enrollment numbers is driving academics. Many universities treat students as consumers rather than learners, pressuring faculty to boost grades and evaluations, which lowers standards. These educational deficiencies affect critical judgments in the clinical environment and ultimately result in negative patient outcomes. Accelerated pre-licensure programs involve a 12–18-month intense program with tremendous knowledge crammed into these programs. There are significant drawbacks to these programs that hinders long-term retention, deep understanding and ultimately critical thinking. Technical skills for practical work accomplishments are also lacking. The situation points to a need to address the gap between theoretical focus and practical engagements. Addressing the nursing education challenge helps address the transition implications at work, thereby improving patient outcomes.
Errors require interventions through improving education. There is a need to focus on the academic considerations. Many nursing schools have reduced nursing education requirements or watered-down standards. The situation arises from the economic perspectives of these institutions. Retaining students for profits becomes a guide for determining the right students. Underperforming in the courses then becomes part of the training process. There exists no commitment to addressing the concern until it transitions into the workforce or low NCLEX pass rates. Proprietary schools most often are not accredited through the Accreditation Commission for Education in Nursing (ACEN) or Commission on Collegiate Nursing Education (CCNE). Students from unaccredited schools may face challenges with credit transfers, may have lower NCLEX pass rates, and may face difficulty finding employers.
Focusing on passing is a concern that causes the gap between practical work and theoretical work (Collares, 2025). Concentrating on performing better on exams can affect learners' critical thinking. The situation is common when practical engagements are infrequent or inadequate. There are many nursing schools in cities with limited adequate clinical resources. These schools are vying for the clinical sites. Some nursing schools are forced to train in inadequate clinical sites such as nursing homes and assisted living facilities due to lack of clinical sites. Learners from these situations find it hard to develop critical thinking for complex conditions. Patient outcomes are worsening due to poor judgment among the nurses. These challenges in the education sector require interventions.
There are fixes to this mediocrity at the college level. State boards of nursing enforcing accreditation standards within a specified time period through ACEN or CCNE or face closure of the nursing program. Shorten probationary times for nursing programs with low NCLEX pass rates with no extensions. This will force nursing programs to filter out low-performing students. Use of Work-Integrated Learning (WIL) Management tools used by nursing schools to manage quality clinical placement sites. Students not attending quality clinical sites as evidenced through the WIL will not be allowed to sit for boards. This will prevent use of nursing homes, assisted living sites and the overuse of simulation centers. Increase the pay for nursing professors to attract the best that enforce excellence. Requiring professors to work 12-hours a month in a hospital to maintain skills and hospital experience. Nursing schools reducing cohorts to prevent overloading hospitals with students and ensuring quality clinical sites are available.
Aligning with these requirements increase the chances of achieving patient safety, instilling clinical judgment, knowledge and adequate clinical sites is the first step in reducing mediocrity in the nursing profession. Nursing schools have the role of ensuring they recruit qualified educators through adequate remuneration. There must be a deliberate commitment to providing comprehensive quality education and filtering out those students not meeting quality standards rather than reducing academic standards to meet the student.
References
Collares, C. F. (2025). Decalogue for ensuring mediocrity of health care professions students and patient unsafety. Medical Education 60(1):19–24. https://doi.org/10.1111/medu.15677
