Evergreen Valley College's 90 percent passing rate on the national nursing exam wasn't good enough for Richettia Walker.

Instead, she came to Modesto Junior College.

"I knew it had an excellent nursing program and that the pass rate is high," she said. "I thought 'the curriculum has to be good' and it actually is."

But nursing students fear such superb programs are compromised because colleges are moving to lottery systems to determine who gets admitted.
With more demand for classes than colleges have room for, some have started determining who gets in with a random drawing. Using a lottery over a ranking system is meant to increase the diversity of nursing students, but some students feel that puts patient health at risk when top students are denied.

Officials need a way to limit the number of applicants because colleges across the state and nation do not have enough room for everyone.

Walker transferred to MJC from San Jose's Evergreen campus three years ago — grabbing one of 75 highly coveted spots that open up each semester.

Some California colleges are turning away 80 percent of would-be nurses. The state average is 40 percent, according to Californians for Patient Care, a nonprofit group advocating health care reform.

MJC denied 44 percent of qualified applicants last semester, and has 119 students on its waiting list.

"I worked really hard and I hate to see the gimme attitude (of entitlement)," said Andriana Woodward, an MJC nursing graduate. "I see students now getting in who couldn't get in years ago under the ranking program. It's rewarding mediocrity. It's not rewarding the people who worked their butts off."

Woodward works in the neuro critical ward at Doctors Medical Center.
MJC's old system ranked students based on their college grade-point average from prerequisite classes, English classes, and core biology classes. Points would be subtracted for any biology classes that needed to be repeated.

Students need to meet a benchmark based on the equation to even qualify for the program.
The formula includes the most effective measures in predicting completion of nursing programs, according to a 2002 study by the Center for Student Success.

The average grade-point average of incoming nursing students for MJC's spring semester is 3.23.

Pushing for a switch
The California Community College chancellor's office is pushing for a switch to the lottery, said Bonnie Costello, director of MJC's nursing program and a veteran nurse. Officials at the state chancellor's office could not be reached for comment last week.
"The lottery is nondiscriminatory once you qualify (for the program)," Costello said. "Some argued that some people were getting disproportionate access without the lottery."
Starting last semester, MJC uses a computer that randomly generates numbers for each student. People who have applied more than once and landed on the waiting list will have their names submitted multiple times to increase their chances, Cos-tello said.
While Walker said she was fortunate to get into MJC's nursing program before the lottery system, she doesn't think it's accurate to base a person's knowledge on a letter grade.
Woodward said a combination of ranking and lottery systems makes the most sense for people who might be bad at taking tests.
Course load is rigorous
If unqualified people get into the nursing program, the rigorous course load and internship should weed them out.
"Nurses are nurturing people, but the faculty have to be hard-edged. They can't let incompe-tency pass," Costello said.
Instructors are top-notch and know how to tutor students, Walker said. They also know when to hold someone back.
But those students who drop out take away seats from more deserving students, some argue.
"My concern is eventually they'll have to lower their standards," Woodward said. "If students are not doing well in the prerequisites, they won't do well in the program."
MJC's limited classroom and lab space restricts the number of students admitted, Costello said. When the new Allied Health facility is eventually built with part of $326 million in Measure E funding, officials hope to expand the number of seats to 100 each semester.
Enrollment also is limited to the number of spots available for students to complete their clinical internships at participating hospitals and doctors' offices, Costello said.
Space limitations hamper state and college efforts to fill nursing spots — 14,000 vacancies alone for registered nurses statewide.
The empty slots translate into 35 vacancies in each California hospital, according to Californians for Patient Care.
Schools trying to fill shortage
MJC's nursing program is among many at colleges across the state that tries to pump out qualified nurses to fill the nursing shortage. Programs also are available at California State University, Stanislaus, Columbia College and the University of Phoenix.
"Most come in because they want to make a difference and nursing is a way to make a difference," Costello said.
Meanwhile, Walker continues her learn-by-doing experience. She works a 7 p.m. to 7 a.m. shift as a nursing student at Memorial Medical Center once a week.
She wants to work in critical care, a speciality that keeps her busy and constantly in motion. The position also sees patients who need lots of care.
When reflecting on why she loves nursing, Walker recalled the family of a patient who thanked her for her care and bedside manner.
"That made me feel real good, made me feel I'm in the right field," Walker said. "Everyday I feel like I'm there for a reason."