i just thought i should share my CPNE experience since i got so much help from this site.
I tested in Chambersburg, this past weekend. First time testing.
i was so scared and tense. but i had studied and read that study guide like crazy.
i memorised all critical elements and practiced scenarios in my head and on my teenage son. I watched you tube videos cos i could not afford buying videos. But i attended Tina Logan's workshop and did
careplans with her. i also did the 6 CarePlans on EC website and submitted them to EC.
Friday nite, we were 7. i failed my first lab because i was so nervous and tense. it was
a very easy lab, piggyback. my calcualtion had 15drops per mL, i saw 20 drops per ml. got perfect count with CE, signed MAR. fail, 'why? i calculated and did everything'. she pointed on 15drops on order, then pointed to my 20' 'oops im sorry' 'dont apologise to me, relax'.
i was all nerves. after i failed that, i went out and composed myself and told myself 'i will not let fear control me and all sorts of self talk. i passed the next 3labs with time to spare (2wks before exam i did one hr a day practising labs), passed all PCS sat and sunday.
i had been reading a lot about "the CEs want you to pass, or, know your critical elements'
once yu go thru the planning phase and your CarePlan is accepted, you have to prove you know
what you are doing, by being confident, get report, ask right questions, washing hands, do 20minutes check, and do your areas of care with confidence, your interaction with patient then yes they will give yu a cue here and there.
my very first patient was on 02 3l/m via nc. so my CP was all about impared Gas xchange and activity intolerance. i walked into her room, she is not on 02, she is lying there smiling. after washing hands, intro and id. i asked patient about 02, 'ooh they took it off me'(i had just gotten report 2 mins ago that she is on 02). and now am sweating, thinking "i cant revise my careplans' i was assigned sats, so i checked her sats, 88% and i reached for 02 tube, cleaned canula, turned it on and was about to put canula on patient, telling her 'you need your oxygen your sats are low'
CE coughed out loud and hard, i dropped canula, checked my kardex 'report to primary sats below 92%'.. phew!
Doctors were coming in and out, therapists, primary nurse. i was so confused and in a daze. wanted to do chart something while waiting but didnt know where to start cos had not done any area of care yet. 9 am and have not yet taken vitals for meds with bp parameters. i was sweating and believed that i was failing this one. 915 had my first set of vitals, and told CE i need to get meds, "yu need to declare your BP first'. "i cant declare cos i need to take another' (patient was already eating breakfast with family). CE says 'yu cant take BP now, you have to wait till she is done eating.
i said out loud 'ooh God i need you here right now' i turned my head away and gave her the vitals, she goes 'are you agreeing that this what yu are declaring' i say 'i guess cos, i have no choice', she laughs and says 'BP matches mine, she shows me hers - exact match.
i run to get the 6 meds. right meds, right dose etc, speaking med names out loud and expiry dates, run back to patient's room id, no straw in water pitcher, patient has drunk all juices, small cup i had put for her is in trash. what to do. CE says 'I had put a small cup for you on med cart and thought you would take it'. family member rushes out and brings me cup. 930a patient is swallowing meds..all flows well after that.
next patient, during report i asked which arm they use for BP, the patient was new admit, nurse didnt know but reports patient has iv on left arm, no tubes or anything on other arm. so went in smiling did my 20mins, did one of my area of care, then vitals, very nice friendly patient. i explain all and grab cuff to put on patient. patient stretches arm and as im about to put cuff, she pulls arm away. so i explain again, smiling that i need to do this, she says "ok honey', stretches her arm but pulls it away again as im about to put cuff, she did this several times, there were 4 visitors in room. CE was watching everything, i was getting frustrated and confused and on 5th try, CE very frustrated now goes cos visitors had stopped talking and watching, CE goes 'she is trying to tell you something'. i dropped cuff, Patient is wiggling her elbow, red band on her wrist 'Do not take BP on this arm". phew! patient says 'thats what i was trying to tell you honey, i want you to pass'.
3rd patient, i walk her to Bathroom with walker, get in BR and am assisting her to sit on toilet and explaining i will be outside by the door waiting, she whispers in my ear 'if yu want to count my urine yu better put a collection thing there for me to pee in'.. i looked, it was not there and not in bathroom, i had completely forgotten about it, but had explained it to patient before. CE is sitting in room, im in BR with patient, i cant remember CE name, i couldnt call 'excuse me' cos visitors in the room. i cant walk patient back or leave patient alone in order to go get the 'hat', so i pull call light and someone comes and i request it. during my careplan, i had a diarrhea CP aeb abd cramping, and as i was writing it out, was saying it out loud, goal was patient will be report relief from abd crampling., intervention offer clear liquids, intervention 2, what? oh my what can i use to help patient get relief from abd cramping,, i flipped thru the book several times, got up was thinking, CE says to herself, or am cramping in this chair, let me sit there..
intervention 2: reposition patient.
so, yes you get cues once you prove you know what yu are doing and it becomes easy. out of 7, 2 or 3 of us passed.
the ones who failed, 2 didnt make it through planning phase, they used assessments for interventions and again goals not measurable(so they told me). they had taken same careplan workshop.. another lady didnt know some procedures she was assigned, irrigation of something and hemovac. believe me when you study all those things listed in guide and you know them, it will be easy.. once there, things dont necesarily flow according to your plan. but confidence helps. i did not take any ativan, xanax or anything like. spend time on you tube and stick to nursing/medical and not homemade videos.
by the way, the site i went to does not allow you to pre-cut tape for wound, so yu put abd pad, remove gloves, reach for tape, tear - apply and so on. i had not been told this, but read it 2 days before exam as i was prepping, and i immediately sent email to EC for them to reconfirm this and they did.
reading EPN i got so confused with people talking about using gauze after im injection or after insulin injection, so Thursd befor my exam i sent urgent email to EC and asked them to kol me. they did i asked and was told you do not have to apply anything after injections, you can do quick wipe if you want, but dont rub. but only heparin use 2x2gauze apply light pressure for one minute, do not rub.
i gave IM, ventro. no alc swab, no gauze, no wipe, i was scared tho. pass. the im syringes are different sizes, they have needles already on them and then there are extra needles of different sizes on table. i just picked correct syringe, removed whatever needle was there, picked right size needle and replaced. one student failed cos she did not remove and put correct needle.
my advice is, dont rely on others for infor, its good to share experiences, but clarify things and get infor direct from EC, write down questions on whatever you read and request a call and ask.
Read your study guide. read appendix K cos thats what they will have on them and checking against.. so check your mneumonics against that. one girl told me she didnt read study guide much cos it was confusing (she failed).
All the best to you all.