PASSING THE CPNE: tips from my experience

Well, I thought this thread might stick around a bit longer if the title was more obvious. So, I am posting my CPNE experience here instead of "Anticoag nurse passed the CPNE"... I'll start with general tips from my experience: I also have a very long journal recollection type thing (4 typed pages of my PCS experiences and a long 2 page recall of my sim labs). I really think they are too lengthy to post here, so if you would like, PM me and I will email them and please feel free to keep and pass on to others in the future.

CPNE Tips

• Arrive to the location the day before and practice driving or bussing or getting yourself to the hospital.
• Bring Music that 1) pumps you up, 2) relaxes you and makes you happy. I did not bring music and really wished I had. It would have added to my feeling of having some sort of choices and autonomy, and would have helped distract me.
• If you are traveling 3 time zones away like I did, consider practicing a week in advance getting up at "0230". I traveled from West to East Coast and the time zone thing really messed me up badly. I was already a frazzled mess, let alone lack of sleep!
• Bring bath salts and a tea-light candle to relax by.
• Bring a small item that reminds you of home.
• Come with a loved one. I thought I would be fine on my own but I was a wreck. It really would have helped having my husband along to hold me, coach me, and be around to listen to and distract me.
• TRUST your mnemonics. Do not stray form your grid. Keep your grid in viewable distance the entire time. I FAILED one PCS because I had no-where to set my grid but the windowsill and didn’t look at it during Respiratory Management. I missed a Critical Element (coughing) I knew in my head (had a nagging feeling), but would have caught it if my grid were in sight! Check Critical Elements off as you complete them.
• Do the Implementation Phase in phases. Leave the room for 15-20 minutes at least once to catch up on planning, thinking and documenting as you go.
• Document on your grid as you go along and transfer to your PCS recording form later. Group Patient care activities, and remember Assessments and Managements don’t all have to be linear. Do bits and pieces as opportunities present.
• Feed the patient questions that relate to your Nursing Dx. Example: For Impaired Comfort, ask the patient if they are stiff, sore or feeling grimy, etc. For Impaired Physical Mobility, ask if they feel off balance when they walk or stand, or weakness, etc. Get them to tell you what Nursing Dx is appropriate to them.
• Doing Vitals twice is not necessary when you use machines for BP or SPO2 or Temp. This is according to my CE’s.
• Don’t spend a lot of time in the planning phase. Just pick some sort of reasonable Nursing Dx and Interventions quickly. You will have limited knowledge of the patient and you will probably have to revise any Nursing Dx and interventions anyway. Do your thing in Implementation and THEN allow what you’ve already done to direct you in choosing a priority Dx and Interventions during the Evaluation Phase.
• When you have a question about anything, ASK THE CE. The worst they can do is say they cannot answer the question or, maybe give you a partial answer that guides you in the right direction.
• Be attuned to your CE’s body language. They may inadvertently cue you into things you are missing!
• If during Implementation, the CE interrupts and asks, “Have you completed the Critical Elements for blah blah assessment/management?” Immediately say, “No, I would like to review my papers.” Then, think madly and try to figure out why they asked you that. If they ask this, it may mean you are about to fail and you may have a chance to correct your mistake if you can figure out what you missed. They will NOT ask you this question if you are doing everything correctly.
• During Evaluation and Documentation, check your grid against your PCS recording form at least 3 times before turning in. Make yourself a system for marking off your grid as you go and then as you document. One student my weekend failed a PCS for not documenting pain of 0, even though the CE and the student both knew she assessed the patient’s pain at least 5 times during Implementation. If it is not documented, it wasn’t done.
• Mark a line on the cup the patient is using if there is liquid in it, at the beginning of the Implementation Phase. This will help you accurately measure intake later.
• Bring the MAR into the room with you to document when you give meds. Saves time.
• Keep a whole bunch of gloves in your pocket. Glove whenever you have doubt (touching washcloth, foley bag tubing, tray, etc.) even if you wouldn’t in real life. Be sure to remove gloves if contaminated before touching something else in room, such as the curtain or bathroom doorknob, or your pen.
• In Planning Phase, don’t spend too much time with the Kardex or the chart. You will learn so much more directly from the patient and it will save you time. You can always look something up later if needed. You don’t need to know everything bout the patient.
• Smile at your CE, they really want you to succeed if you have any business succeeding.

Observations from my CPNE
All patients:
Were very friendly and talkative, which is time consuming.
Intake and Output
SPO2


I was not assigned:
Neuro Assessment
Musculoskeletal Management
Pain Management
Weight
Abdominal Girth (although all PCS’s had abdominal Assessment!)
Oxygen Management
Wound Management
Peripheral Vascular Assessment