Hope this helps someone-ask me anything you want-couldn't have done it without reading other journals and all the post on here, Excelsior and Facebook-Thank You all!!
Here is how I prepared and passed the CPNE - I always learned something from reading other post so thought I would give it a try! Sorry for how long it is-so much to tell.
I decided early on from reading so many other post I was going to do Sheri Taylor’s online and in person workshop. My husband and I talked about it and I said I could end up spending around $800 but if I passed my first time so worth it. As my husband said spend $800 more and pass or risk failing and spending 3-4 thousand more when you add up CPNE cost, travel and food plus time off work. Actually I think I spent close to $1000 but again so worth it when you hear those wonderful words “You Passed”.
First I bought the skills kit including the wound from Excelsior and read everything I could about CPNE on Excelsior, Facebook and AllNurses.com couldn’t have done it without the info from all of them.
I got my CD from Excelsior and took it to Office Depot and had it printed off for $60. I had it bound in 2 different books and one or the other went everywhere with me to work to read on breaks and lunch, my bedtime reading at night and next to my chair to read in the evening. When I signed up for Sheri’s I bought her study guide for the discounted price offered when you sign up-so worth the money!! It is a condensed I think around 90 page version of Excelsior’s 500 pages. I read Excelsior’s 4 times through by the time I went and read Sheri’s over and over so many times almost memorized it!
Sheri said in one of her post on Facebook don’t try to tackle it all at once break it down. So I started with the mnemonics from Sheri’s book which I really liked and wrote The name of the AOC on one Card and the Mnemonic for it on the other and then taped 2 sets on my bathroom mirror and 3 sets on my bathtub wall so I saw them all the time and as I got them memorized I put up a new set. I used Flashcardexchange.com and loaded them on my laptop and Iphone so they went everywhere with me. Even made a set on a spiral bound index cards that I kept with me for work. While learning these I started getting 2 care plans a week from Sheri and she can tell you I was awful at first-haven’t written a care plan in over 30 years, trust me it was bad at first! As I got them back I printed them out with the corrections I made and put them in plastic sleeves and in a binder, I studied these all the time. I watched her videos daily and then started to set up my labs next. I put a bullatin board on my wall with the steps for each station on it. I got a swim noodle and cut it in pieces, I taped two together for a thigh for my IM, took another piece and drew a circle for the navel on it for sub-q, cut another one in half length wise so it would sit flat on my desk and put the IV in it and taped it down then took a glove and filled with kerlix and put the other end of IV in it and taped to the end of the tube for my IV push. I used one more piece to be my practice arm for IV med-no tubing hooked to it just laying on the table. On each one of these I put a piece of tape with name, birthdate and Medical record # to get myself in the habit of IDing pt each time. I practiced at least one lab a day and on days off practiced them all 3-5 times each except for the wound which I packed 10-20 times every day on my 3 days off a week. I work 4 ten hour days and have an hour drive each way so most days this 53 yr old lady just came home and crashed - learned if I tried to do this tired I just messed up and became aggravated with myself.
After a while it just all started clicking and before I knew it time to head to Utica-Nerves and all!! My husband went with me because I really needed his support after all he has been with me every step of the way and my biggest cheerleader.
On friday I passed all four labs but have to say when I went to the first one IV push station she said her little spiel and I just stared at the table for about 5 seconds thinking what do I do!!! Then I heard Greg say “Mar-Med-Math” and off I went, I was shocked when I finished and she said pass and my time was 6 minutes!! Great confidence booster, next was IM-the CA shows you the labs and gives you 15 min to look around and she pointed out that all the syringes have 1 1/2” needles but there are 1” needles on the table if you feel you need them-hint hint. I got IM and chose my syringe and put that 1 inch needle next to the leg to remind me to switch it once meds were drawn up-also wrote Aspirate on my alcohol swab so when I tore it open it was what I saw. Again a Pass-6 minutes again and my confidence was growing. Next up IV med-got 25 drops and I felt like I was taking FOREVER to get the drops right, got it right on 25 and counted for a full minute and when she came over and we counted it started slowing down but still 23 and a pass-she said good job under 10 min-Wow I couldn’t believe it. Next my one I dreaded the most Wound- the wound was on the left where she was sitting at the end of the table and I ask if I could move it to the right since I am right handed and had always practiced that way and she said sure-got all my supplies out and opened put on my gloves and removed the old dressing, then deep breath and put on my sterile gloves perfectly and went to reach for my 4x4’s and my stomach dropped I forgot to dump saline on them so off with the gloves and poured the saline and put on another pair - started packing the wound and she got up and looked as I started pulling each part to the edges she turned to sit down and I finished and as she looked down at her paper I reached over and grabbed that 4x4 and slapped it on there-she looked up and just smiled-another pass!!!
Got my kardex for my peds substitute and headed to the floor for orientation and to look at the chart, went back to the room and wrote my care plan turned in the next morning and took her about 5 minutes and said you passed the planning stage-Thanks Sheri!!!! I had a skin assessment, reposition and meds. I think I did Impaired skin integrity-he was from a nursing home and had 5 pressure wounds and my other Nanda was impaired bed mobility since he was no help and a reposition x2. I ask when I went in each room where is my clean space and layed my grid out and followed it word for word-checking off each mnemonic as I went. When done I charted the same way using the grid and crossing off each letter of my mnemonics-Pass! My second PCS same way wrote my care plan in 5 minutes and double checked it - she looked at it and said you passed the planning phase and off we went - I was in and out of the room in 30 min. did my charting and another Pass!! For this one I had PVA of lower, O2 management with teaching of O2-she was admitted with O2 sats of 65% and didn’t like wearing her O2-gave her a hand out I ask Primary Nurse for and went really smoothly. Still didn’t sleep much that night and didn’t eat much either. My nerves were awful this weekend-only slept 4 hours each night and couldn’t eat more than 4-5 bites at a meal. On sunday morning my nerves finally got the best of me and I made a really stupid mistake. She said here is your chart and the night nurse was in there trying to finish her charting and said hey don’t go too far with that-not very happy about us taking the chart. I only had skin assessment and mobility-struggled finding care plan and started to panic plus wanted to get the chart back to the nurse and forgot to ask the CE for a report. She had said I will be your primary nurse just let me know when you want report but I was so worried about getting the chart back to the night nurse I forgot to ask. She had cancer but had denied any pain at all for the 3 days she was there so I used Impaired Mobility and this is where I screwed up - I put my outcome as - The patient will ambulate to door and back to bed (assigned) and then for The nurse will I put - encourage patient to sit on side of bed and dangle legs-good and The nurse will ambulate patient to door and back to bed-Exact same wording as Outcome!!! I even read it 3 times and didn’t see it I was rushing since I was running out of planning time. She came back in with CA and I knew I was in trouble - they put it in front of me and pointed it out and ask what I should have put and I said Encourage and they said yes that was your only mistake on this plus the CE said if you would have ask me for report I would have told you she was in pain today-crap!! They are so nice they really want you to pass the CE apologized all the way down in the elevator and said I really wanted to erase that word for you but I just couldn’t. I told her don’t apologize I have only myself to blame. I had to sit in the cafeteria for 2 hours to wait for another CE and the whole time I could hear Sheri in my head saying “What were you thinking I have told you over and over you cannot use the same thing for intervention and outcome”-really I heard that Georgia accent in my head!!!! I also read that Mosby’s book and found 3 other Nanda labels I could have used. Got my next PCS and wrote out the care plan in 10 min went in the room for 30 and charted for 45 min-I charted every move and breath he took-LOL!! She was only gone 8 min trust me I timed her and came back and said lets go down-I ask is it good or bad? She smiled and said good-soooo happy. When we were in the elevator she ask is this your last one or do you have more-we never get told.
The CE’s and CA were all so nice and really do want you to pass!! My first one said to me in the elevator “really take a deep breath you will get through trust me not as bad as you think it will be.” The one who had to fail me was sitting down with the CA when I walked in she was the first one to say to me So??? I said I passed and she put her head down on the table and said thank god-I felt so bad earlier. I said to her again it was all my fault. The CA got up and hugged me and said “Why did you make yourself work so hard today?” Got my paper and walked as fast as I could out of there before they changed their minds and came to take it back. Such a wonderful feeling and so proud of myself! Go into this prepared know how to write a care plan and grid in 20 min or less - you have 30 but goes by so fast. Know your critical elements like the back of your hand. Know them so well you only have to write out the first letter of the mnemonic, leaving room for notes in your grid if anything is abnormal, I wrote abnormal in red so it stood out when I charted. Practice charting-I memorized Sheri’s documentation she had in her workbook and used it in the documentation class I took at Excelsior and got all Great and Excellent comments. Sorry this so long-hope it helps and Good Luck!!!