Making the Grade

Making the Grade

From Chicken Soup for the Nurse's Soul Second Dose

Making the Grade

It is not so much our friends’ help that helps us as the confidence of their help.


This was going to be a great group of students—I could tell. I asked each one to introduce herself and tell us why she wanted to learn to be a certified nurse assistant. A few said this would be their first experience in health care, and they weren’t sure what to expect. However, most of the students said this class would be their first step on the way to nursing school.

Marie caught my attention. She was a tall woman. She said she joined the class because she had been a home health aide for so many years; she felt she owed it to herself to achieve certification and earn the salary she thought she deserved. Later in the semester she confided to me that she wanted certification for her own self-esteem— she was tired of her family’s constant teasing and criticism. She told me that they repeatedly called her “dumb” and said she would never amount to anything.

For the first two weeks Marie shone. She participated in class discussions and described techniques that could only have come from experience and creativity; these methods of patient care were certainly not in any textbooks. She sailed through the clinical labs. With no need to practice bed baths or patient positioning, Marie would share her experience with classmates who were learning these tasks for the first time. Everyone in the class warmed to her and appreciated her kind and friendly disposition. So I was shocked when I administered the first written test and she failed—badly.

I spoke to Marie privately. She claimed she was just nervous and would try harder. But she failed the next two tests.

I approached Tanya, our admissions counselor, for advice. “I wondered how long it would take you to ask. Marie can’t read very well. That’s why she’s not passing the tests even though she knows the material. Plus, Marie has no self-confidence in her abilities and talks herself out of succeeding. It would really be wonderful if you could find a way to help her earn her certification. She really has so much to offer, and passing the certification exam might help her believe it.”

Of course, certification was important to all the students, but Marie was a gentle, knowledgeable caregiver who really needed—and deserved—to pass. How could I get her through the state exam? Her clinical demonstration would be a breeze, but the written exam would stop her cold. Then I remembered something from my original school orientation and inquired, “Doesn’t the state give an oral version of the exam in some cases?”

Tanya said they did.

“Then I’m going to ask Marie if she wants to try that testing format. I’ll read the next exam to her and see what happens. If she’s willing to pay the additional fee for the oral exam, that might make a difference.”

What about the rest of my students? Certainly they would need to be monitored during the test. If I read aloud they might be distracted. I had no answer then, and by the time of their next exam I was still seeking a solution. So with Marie’s permission I posed the question to my students. Their response was immediate and unanimous. They glanced at each other, then stood up and changed their seats so no one would be sitting next to another student. One student beamed at me and said, “Go ahead, Mrs. Malkin. Just sit out in the hall with Marie. You can watch us from there and see that we aren’t talking to each other. We really want to know if we understand this material. You can trust us.”

And I did. I peeked into the classroom between the questions I read to Marie. Tanya also passed the classroom from time to time to see what we had worked out. All of the students were as good as their word. Marie scored over 80 percent on that first oral test, and on the rest of the tests that semester. She developed a comfort level with that testing style and continued to excel in her clinical work. By the time the students went to a local nursing home for their bedside experience, everyone wanted to pair off with Marie. We all delighted in her newfound confidence.

The day of the state exam I was as nervous as the students. Although I was not scheduled to work, I came in anyway “to straighten up,” fussing around my classroom, rearranging shelves, and refolding linen while I waited for the students to finish. One by one they filtered into the room with certificates, hugs, and smiles. I congratulated all of them. Although they could have left upon completion of their exams, everyone remained on the pretense of helping me until we’d heard the entire class’s results.

They were so relieved the exam was over they started talking nonstop. There was so much noise and chatter that we didn’t notice when Marie appeared, standing quietly in the doorway. There was no expression on her face and my heart dropped. As the students began noticing her, the room slowly became silent. When Marie knew she had our complete attention she broke into a huge grin, strode into the room flourishing her certificate, and swept me up in an enormous bear hug.

Everyone cheered, and I could hardly breathe! She put me down and held her certificate in the air. “Look at this! Look at me! I’m going to carry this with me for the rest of my life, and if anyone ever tells me I’m nothing, why, I’ll just pull this out and show them that I am really something!”

Susan Fae Malkin

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