Reports of possible widespread cheating on a nursing examination have prompted officials in Maryland, Virginia and the District of Columbia to consider withholding licenses from some 3,000 recent graduates of nursing programs in the area.
The standardized multiple choice exam, which all nurses are required to pass before they are allowed to practice as registered nurses, was given last July to 1,500 nurses in Maryland, 1,800 in Virginia, 500 in the District and thousands of others around the country.
A few weeks after the test, officials in New York received allegations that the answers to the exam had been sold in advance for sums ranging from $300 to $2,000 in Chicago, New York, Philadelphia and Detroit.
An investigation by the New York Education Department revealed what one official there terms "an evident breach of security." State officials decided to throw out the test results and delay the licensing of more than 12,000 prospective registered nurses in New York.
Maryland officials yesterday said they have begun their own investigation of the possible cheating and expect the state board of nursing examiners to decide by next Tuesday whether to invalidate the test results. Officials in Virginia and the District said they are waiting for a recommendation early next week by the National Council of State Nursing Boards.
The cheating allegations, meanwhile, have provoked anxious inquiries from nurses in this area who passed the July exam and have since settled into jobs at hospitals.
"This shocked a lot of us," said Stephanie Kalner, a May graduate of Montgomery College's nursing program. "Those of us who have proved ourselves academically and clinically don't want it taken away. It's not fair to implicate all the nurses across the country."
Henry G. Nathan, an official at the Maryland Department of Health and Mental Hygiene, said his agency was checking to see if any nurses taking the test for a second time did "unusually" well on the July exam. "We're looking to see if there are any patterns for groups of people -- from one school, foreign nurses," he added.
New York officials discovered in their probe that many more persons than in the past scored above the passing mark of 350 points. Among those who demonstrated significant gains in the test were some "repeaters" and foreign applicants.
In Virginia, an official at the state board of nursing said authorities "have no reason to believe there were problems or any hanky-panky in Virginia."
In fact, this official said: "We were disappointed with the results. People did worse this year than in the past. Even if they had access to the answers beforehand, it obviously didn't benefit them any."
Robert Lewis, acting director of Washington's Licensing Department, said the department has not received any reports of cheating in the area. However, he said, his department has begun a comparison of test scores based on the irregularities found in New York.
"We're concerned that we're fair to everyone. We're notifying all those who took the test about what's going on and why the licenses are being delayed," Lewis said. The department will wait for the results of the national nursing boards council investigation before deciding whether to grant the licenses, he said.
Representatives of the national council would not comment on the cheating allegations yesterday except to say that the council will discuss the issue at its regular meeting next week.
The nurses licensing test is given every July and February and is the final step to becoming a registered nurse, the highest level of nurse on a hospital staff.
Kalner, who was told two weeks ago that she had passed the July test, said that she and others who graduated with her can continue to work at Holy Cross Hospital in Silver Spring with a temporary license, but with fewer responsibilities and less money.
"The exam makes or breaks you," she said, "that's what all the tension's about. I feel very, very frustrated because I should have gotten my license today.
"I'm 30 years old and I wanted to be a nurse since I was a little girl. This was the high point to me and it's just not fair to take it away," Kalner said.