CPNE,....Anyone have any neg. experiences

  1. I am finished with the Assc. program, with the exception of completing the CPNE, which I have Frustratingly taken twice now, has anyone else "breezed" through the program, like myself, only now to be "hitting a brickwall" with the CPNE? Oh, and so you dont think I am of average intelligence and drive, a little background. I have been an EMT/Paramedic for approx. 18 years, 7 of those as a Paid Fire Fighter/Paramedic in a 911 system ( one of the best in Texas )(My medical director said my pt. care is "some of the best hes seen") , "Top" of my class in EMT program, "A" average in Paramedic Program, In Top "5" of my Fire Academy, extensive E/R experience (including level 2 trauma centers). Most of my academic endevours have come easy to me, its the CPNE's focus on trivial issues, that have tripped me up and frustrated me so.
    Last edit by StinkyMcStinker on Feb 8, '03
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  2. 46 Comments

  3. by   Rock
    You must study the "Critical Elements" in order to
    pass the clinicals.

    Wash your hands - failure

    Greet patient - failure

    Check wristband - failure, etc. etc.

    Study critical elements. You can't pass without
    them.
  4. by   medroomromance
    I know not washing your hands and checking the wrist band would be a failure.What I want to know is do they check if you do it everytime or when you do it once you get checked off for that skill and cannot be failed after that.We all know that somethings you do everytime all the time like washing your hands but if your pt has meds at 7,9,12 ect and you know it is the same pt do they make you check everytime,do they watch you pull the meds?It would be nice if we actually could do like we do in school but anyone here that works medsurg knows when you have 8 pts to pass meds then change a dressing then DC a foley or NG tube ,calling the DR. because the med order reads 1.2mg instead of 1.2g or 1200mg(If I had a dime for everytime that happened)ect what shortcuts are taken to save time.
    If someone could who has actually taken the clinical test could give us a brief rundown of how it works that would be great.

    Disclaimer:I do not advocate taking shortcuts that could be dangerous,I make my decisions depending on the PT,use commonsense.
    Last edit by medroomromance on Feb 8, '03
  5. by   angelbear
    Great question I too would appreciate a run down of how it goes.
  6. by   kavi
    In one of the other threads here, someone recommended this study group. I just joined it, but I noticed quite a bit about CPNE in their archives.

    http://groups.yahoo.com/group/rnstudygroup/

    Also, when I first started with Excelsior I went into their student discussion board and read alot of what people said about the CPNE. The gist seemed to be to memorize their guide, and get plenty of practice elsewhere so you go in totally confident.

    I think they are almost 'extra' strict and tough in their grading to overcome that "nurse by mail" attitude so many of their graduates have gotten. They want to make sure to have a good reputation with any nurse they graduate.

    I know there are some Dr.'s offices and small clinics that will let you work as Med. Asst. to sharpen your habits in the little details that seem to mean so much to them.

    I'm a long way from CPNE, but that is the part that scares me the most.
    Good luck!
    Last edit by kavi on Feb 9, '03
  7. by   Agnus
    Last edit by Agnus on Feb 9, '03
  8. by   Rock
    Handwashing is the key.

    When I worked in a dermatology ward, we had to do
    treatments to the entire ward, 20-25 patients. We
    rounded up ambulatory patients and brought them
    to the treatment room, the remainder were treated
    at the bedside.
    I had to wash my hands between each treatement,
    i.e. forty (40) or more times per shift.

    Handwashing is the key. Follow the CRITICAL Elements
    guide that they will send you before you appear at
    the clinical site.

    Follow Critical Elements !!!!!!
  9. by   debRNo1
    I passed the cpne in Albany NY in 2001. I passed without repeating a lab or a PCS (pt care situation) I was very well prepared for this exam............

    I think you can only take it 3 times and Id be interested in knowing exactly what they failed you for ??? But anyhow you shouldnt make the same mistakes next time. Were care plans a problem being an EMT ?? Curious cause a friend of mine failed the first time and passed the second.

    I used mneumonics to memorize the CE's (critical elements) I also used the "grid" and wrote it on the back of the PCS form (which is perfectly acceptable) I checked off the things I had done and put things in red that were important. Use it later on to
    document....have it on disk if needed.

    Put aside EVERYTHING you ever knew and do things by the book
    thats their book the study guide and know those CE's backward and foward

    I have alot of stuff I saved and anyone interested in advice or guidence can please email me and Ill help if I can. I also have my cpne experience that I wrote up to share with my study partners, reading the experiences of others was a great help in what to expect. I was still scared to death but you need to control the fright and stress and just do what you gotta do and get the heck out.........

    Join a study group too one already posted and here are 2 more

    http://groups.yahoo.com/group/RCSNstudyctr
    http://groups.yahoo.com/group/regent...gdisteducation

    You cannot forget ONE critical element or you fail. Some areas of care are required and some are assigned.

    I would check the pts ID band each and every time I gave meds during the cpne. PS only gave ONE med during the exam and had nobody on IV fluids just pure LUCK It doesnt hurt to go a little over board and be over cautious- just listen VERY carefully for hints from the instructors, they WILL give you hints verbally ASK questions and if they cant answer it they will tell you. No harm no foul but ask anyway if you arent sure of something.

    my email is debRNo1@aol.com

    good luck in your CPNE adventures........

    deb
  10. by   CindyJRN
    [QUOTE]Originally posted by debRNo1
    [B]
    I used mneumonics to memorize the CE's (critical elements) I also used the "grid" and wrote it on the back of the PCS form (which is perfectly acceptable) I checked off the things I had done and put things in red that were important. Use it later on to
    document....have it on disk if needed.

    What Deb said is exactly what helped me. Read some of those CPNE archives, as well. When a member of the study group took the CPNE he or she would come back and post a detailed description of the experience. I learned about the "grid" and used it to pass!! Are there any rumors out there about what sites NOT to go to? Back when I went, there were a couple of places deemed "harder". The site I went to, Grady Memorial in downtown Atlanta, Georgia, was "known" for being tough. I had a really good weekend. The head of the Southern Region even stopped by on Saturday and met us. In the spring of 2000, the Dallas site was closed for a while to be "revamped." Anyone heard anything else, lately?
  11. by   debRNo1
    My weekend saved from former study buddy and Chipkalee's site................ #1 PREPARATION

    MY CPNE EXPERIENCE
    I'm glad to have remembered details to share, I always felt that the experiences posted really helped me know what to expect. _

    I did attend a workshop in Albany in March. _I thought the workshop was informative. _After the workshop everything seemed to click for me so I am glad I went. _It's an added expense but a good investment nevertheless !

    How did I study ? I began with mnemonics and the areas of care, first I memorized the mnemonic, _and then the area of care and ALL that went with it. You NEED to memorize these areas of care so that it will come to you under stressful times. _Writing was my way, I wrote the CE's out by hand day after day. _It's so boring and repetitious but it's a MUST to have all areas fully memorized before testing. _I was still writing them towards the end just to be sure I hadn't forgot any critical elements. _If mnemonics wont work for you find another way maybe_keywords, letters or numbers. Areas MUST be memorized. An organizational tool of some kind will contribute to success during cpne !

    I read the SG, reread the SG, I did all the review questions and I looked up anything/everything I needed to along the way. _I copied info and put it right into my SG under the area of care. _I practiced assessments at work using CE's as guidelines. I did a math review and got that all-straight in my brain. _I set up a lab at home and did the labs over and over until it was automatic to me. I did save care plans till the end I feel that CP's come easier when you KNOW the care areas first. Towards the end I was fortunate enough to find some wonderful study partners/friends who I practiced with, we did practice pcs's , we did _grids, documentation, nurses notes, and careplans. _We reviewed the ENTIRE SG before I left and I was ready to pass !!! _Thank you.......((you two))

    The grid is gold and I am convinced that when they see the grid they know you are organized and back off, they feel more comfortable when you are organized. _More than one instructor picked up my grid and looked at it. _I had anything and everything on there. I used red for "important' things and crossed it off as I went. __At a glance I knew what I did and what I had left to do. While charting I referred to it to be sure I had documented correctly. __I attended the chats on epn and I was forever pestering the nurse educators with my sometimes silly questions !!! _Of course this site was a lifesaver while trying to conquer this hurdle !!! _Looking back it was all so BIG and overwhelming at first, then it got smaller and easier as I went along. _Alot of hard work and persistence really paid off for me. _Last but not least, _you must control your stress, _find a way and use it to help you stay calm during the exam.

    Study hard, practice, and prepare and YOU CAN DO IT too

    Fear of the unknown is the worst fear of all. _I feel I benefited greatly from reading the experiences of others and at times felt like I was there with them. _I never thought I would remember details but I wrote stuff down as I went as a way of taking my mind off what was coming my way next _during the
    weekend. _Stress management is ESSENTIAL for this exam, _and I know you have heard this before but KNOW the CE's, _know them backwards, forwards and inside out and upside down. __Go in with a positive attitude, _have a mind set for passing and be confident. Use of the grid or another organizational tool is also essential. __Take deep breaths and say to yourself ____________
    I CAN DO THIS !!!! _______________
    Because you can................. ______

    more to follow

    deb
  12. by   debRNo1
    originally posted by debrno1
    my weekend saved from former study buddy and chipkalee's site................
    day 1 .stress,orientation and labs
    me, hubby and son leave for albany (which is a 3 hour ride) @ 9:30 am. _traffic is a problem from the get go. _there was traffic and construction for the entire ride, _it took 5 hours to reach hotel in albany !!!! stress management began on the nys thruway in heavy traffic and massive construction !!! _we arrived at quality inn @ 230pm, _check in, bring bags to rm, unpack, i changed and we went off in search of st peters hosp. which is a 10 min ride from there. __albany is full of one ways streets and one wrong turn will put you somewhere else. _we saw the blue h sign and followed the arrows to the hosp. _i never got to eat so i had a donout and cup of coffee, _they dropped me off and i went to the lobby to wait. _i paced around for a while and saw what i thought had to be other students......i approached them and sat down we made small talk and one girl said "i'm not passing this thing" _yikes !!!! _no negativity around me please ! _some were not using the grid or mnemonics from what they said, _i kept breathing and being positive despite the negativity surrounding me !!!! _i'm not one to feed into this kind of thing !!!! _i'm passing this thing- my mind is made up and that's that !!!

    now there are 6 of us and here comes the ca.....she's smiling and seems so nice and perky ! not the robot from the video at all. _she's says "follow me" and we all do. _she's pointing out the cafeteria, elevators and whatnot as we go. _we go in elevator, _we go thru halls, _down steps, up steps, _thru more halls till we reach the room for orientation. _it's a big room and all the labs are set up in there. _we sit down and she offers us the ladies room some go.... i don't. the negative girl says i'm going to pass out.................i say take a db !!!! _another ( who failed) is saying mobility is not a required area and arguing about it "that's not what i was told " _oh brother, here we go there's one in every group, i'm thinking breath !!!! __we begin orientation fill out papers and do finger prints and all that jazz. _it seems to be a relaxed feeling not rigid and stressful like the video at all. _now its time to draw straws for rotation patterns and labs. _it was like catching the bouquet @ a wedding, _we gathered around ca and made a mad grab @ these index cards. _i got the last one , i was slow to grab, _oh ok........peds first thank you ( now i can write cp and look up all on baby) _that's what i had hoped for-so i'm ok with all this so far. _but-i'm going to the floor first then will do my labs. the ce's come and intro themselves ok some look nice and some look not so nice !! _oh please let me get the nice ones, the ones who are smiling and look friendly _!!!!

    ok here we go, _ce for pcs #1 is nice to me, (thank you god! ) more halls more elevators........ she reminds me to ask anything and if she can't answer she will tell me. she also tells me if i turn my back with sr down on the baby she's failing me ___ok i can live with that i'm thinking !!!! _shows me around the floor and ill never remember what she's saying !!! _get the chart and she leaves me alone for a while. _there's nothing in the chart, __just admitted, _the best is she's in for r/o seizures !!!! _oh lord i'm getting a 5 mo old with seizures, i'm trying not to think about it too much. __got those labs to do.... ill go back to hotel and look everything up. _we head back down to the room with the labs.

    labs
    during orientation look and touch everything open the gloves try them on, open the dsgs too, _draw up some meds if you want, _all the mars were in a binder at each station i peeked in there too. they were there, _so look !!! get comfortable with the equipment.....now's your only chance............feel the model for the landmarks in case of an im. all pb's were 50cc's...... i get pb first and who is my ce, the guy from the video, _you know the one who fails the student @ pb lab !!!! _oh that voice it's starting to freak me out !!! i cant really look at him, _i go into auto pilot and begin, cant remember med but 50cc in 20min gtt10............25 gtts min ok double check it yes it is 25, _that's 6 gtts in 15 sec. its right and i begin............at one point he turned his back what is he doing shuffling papers ?__no refocus on me not him........i'm doing it like i did 100 times in my dr for weeks. _wait now he's sitting in a chair 10 feet away !! _i'm ready for you to count i say......he's says no ! _what ? my heart stops and the sweat is pouring off me now, _my drops are on the money am i failing what did i do ????? what did i not do ??? he says i counted with you- you got it !!!! i sign the mar and he says you pass !!!!! __breath !!!
    #2 _ivp is next....... this one worried me-as much as i practiced @ home i felt least comfortable with this one, _read the mar, _now hes sitting just inches from me ! _i'm looking for the dilutant....i look again and again, _what.... no dilutant ?? _where the heck is it ?? _its not there, _straight med and flushes. _lasix 40 mg over 2 mins. _1 cc ns flush before and after. _vial is 10 mg/ml, _there is no other lasix so that's is it, _4 cc _there were 3 cc + 10 cc syringes. _so 4 cc in 2 mins= 0.5 cc q 15 sec. _that's nice i thought !!! _not a funny # to deal with........i can do this !! _no.. he does not want to see my calc ? _i tell him what i'm doing and hand him syringes he just glances and gives them back. _i do it fine and i'm done sign the mar and he's says congrats you pass.....now clean that mess you made !!!! _i listen to him and clean up my mess !!! _he's ok i'm thinking and he's my ce for pcs #3 !!!! _thank you
    (he's a good actor in that video !!!!!)
    #3 _wound easy stay sterile .....pass it too !!! _he says you're on a roll !!!! _now i'm almost done i don't want these labs hanging over my head tomorrow. _
    #4 _sc/im
    i get humalog 10 u sc, _the vial says 100 u/ml. _ok so now i'm trying to make a calc out of it somehow i'm trying different #s.......what the heck am i doing ???? breath and refocus.......... 10 u sc __crap !!!! _i'm losing it now with my ce for pcs #1 watching me !!! __i'm sweating sooo bad at this point, i think and breath and scratch out what ever it was i was trying to do with those numbers !!! _draw up 10 u.............id, _give it sign mar done you pass she says.............
    ________________________________ __wow __holy cow i did it !!!!!!!!!!!!
    _____________________________________
    i'm glad to have it done now back to hotel to write my cp. _ risk for injury of course (baby) and that will be my priority too unless something else comes up overnight. _ok risk for injury rt maturational age will not experience injury keep sr's up and secure with mom or staff when oob ( pcs form said hold ad lib under oob/mobility) _that's done. _can't think of actual cp...nothing works need aeb, need some kind of sx for the cp....... what to do ? tried a few nothing worked, anxiety fear dunno>>>>>>>> call a sb who passed in march at home we debate, discuss and decide on either altered g+d rt separation or infant behavior disorganized rt seizures ?????? i turn the lights off @ 2 am and get up @ 5 am............still not happy with this cp !!!!

    i wake up @ 5 am had two clocks set just in case !!!! _i brought my fav coffee and make a pot in the room _( bring things to make you happy and coffee does make me happy) _i am soooo tired did i even sleep ??? __nah _i shower, get dressed and take out that freaking _cp, _i don't like it at all....... why cant i come up with one ? i did 100 cp's for practice...........crap....... i looked thru that book page by page and nothing fit for actual !!!! well got to go to hosp wake these guys up and we go............... i go to cafeteria the 5 others are there already i'm never late, get coffee and now the ce's come, dump the coffee and we split up and go with our ce's to the unit

    drumroll please...........................
  13. by   Spazzy Nurse
    Sorry to butt in during Deb's drum-roll!

    Stinky, there is one key to passing the CPNE...... play the game. I have no doubt that you are an excellent Paramedic, but there are excellent nurses out there who have difficulty passing this thing too. I'm sure you already know this, but you really have to play by the rules. Period.
    Yes, a lot of the rules/procedures are considered trivial, and I didn't understand why EC does things how they do it until after I took my CPNE..... adaptation and compliance. Frequently nurses have to adapt to different situations in the blink of an eye, and they have about 2 seconds to make decisions and take action. Sometimes these situations are not ideal and not how we think it should be done, but in the real world, that's just how we have to do things sometimes. (I'm not talking about complying with situations we find unethical here.) In the real world we have to play by the rules because that's how things work. I think that is why the CPNE is how it is.

    Sure, people fail by not washing their hands, dropping a pen and picking it up off the dirth floor, etc. but these instances are rare. I have read a zillion CPNE experiences and I have never seen these little things fail someone. The main reason is usually poor stress management, which leads to incorrect BP readings, forgetting to document certain needed info., memory lapses on the critical elements, etc. By the way..... as a paramedic, you have one big thing going for you..... you are most likely able to handle stress better than many (most?) nurses. As I'm sure you know, stress management is KEY to this CPNE monster.

    You should really check out rnstudygroup if you haven't already. It's a fabulous board with wonderful people and fantastic experiences and advice/tips to read. I know of at least one other frequent poster on the site who will be taking it for her 3rd (and God willing LAST) time, so you're certainly not alone.

    Have you attended a workshop? I think that would be a great thing for you to do if you can. I went to one put on by EC and I am so glad I did. It'd give you a chance to find out exactly what the problem is and what you can do about it. You can talk to EC staff and get some advice right from the horse's mouth, so to speak.


    My CPNE is still (slightly ) fresh in my mind, and I would be happy to talk to you if you ever want to. I posted my little story on rnstudygroup when I got home, and I can send it to you if you want to read it some time. It's always fun to read what other people went through and their views on it all.

    Now that you've done it and done it twice, take that frustration/stress and use it as adrenaline to nail this thing!!!



  14. by   kavi
    I can't wait for Deb's 'drumroll' story.

    But I am a little concerned about one thing. When you 'fail' the CPNE, don't they tell you why? So that you can 'overcome' that failing before you try it again.

    If they don't, that kind of scares me. Alot.

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