CPNE: Opinions and Discussion

  1. Who has had to retake the CPNE, did you feel that it placed too much emphasis on benign considerations and not enough emphasis on what may be more important aspecs and skills of ACTUAL nursing.....I'm starting this thread for others "frank" opinions about the CPNE, as I have to believe that there are others with similar experiences and opinions as me. I have been working in healthcare since 1988 (at the age of 18, I'm 35 now), in Emergency mostly. I became an EMT in 1987, and then a PARAMEDIC in 1992. Full time E/R for 3 years, then as a Paramedic/Fire Fighter in a moderately large city's 911 system for another 7 years (all the while additionally working about 20-30 hrs a week PRN in Emergency Rooms) my experience also entails worked in Cardiac Cath. Labs, Telemetry floors, and O/R.. . . . . My point is that in all that time, I have become very comfortable and confident in my abilities and skills to render COMPETENT and quality care to the pt.s I've cared for. The CPNE is the last component of the program I have yet to complete. I have had to retake the CPNE twice, and I accept partial responsibility for some of the reasons why, and others reasons I will never agree with. I feel there are elements that are designated as "Critical" that should not be, and other elements and skills that I was astonished to learn are "not even present" in the evaluation. I understand that some form of practical evaluation of students must occur prior to releasing them into the field, I am simply voicing my observations of the CPNE and it's flaws.
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  2. 10 Comments

  3. by   Spazzy Nurse
    Stinky, you should've heard me ranting and raving a while back, saying the EXACT same stuff that you are saying now! I'm sure there are many, many EC students who would give you a high-5 and say "right on!!"

    BUT. Let me tell you guys something that no one told me when I was in your positions. I am glad no one told me this, because I most likely would've laughed my butt off at them and told them to move on with their NCLEX studies and get out of my face. :chuckle

    Being that I have gone through it I will say this--- something that it took me a long time to figure out........ I think the CPNE is right on. I figured this out just prior to taking it, which I think actually helped me pass.

    Yes, you're right, it doesn't concentrate on skills as much as it could. But do you know why? Because during the CPNE we are to perform as brand spankin' new graduate nurses. Learning skills comes with experience, and we're not supposed to perform skilled nursing procedures like we are experienced. But here is what we ARE supposed to be able to do..... this is what the CPNE is all about.
    It tests our mind. It tests our will to follow to rules we might not understand or agree with, and it tests our ability to frequently adapt to change. Why? Because that's how a life in nursing is. Yep--- they take your a$$ out for forgetting to wash your hands, not gloving before taking an oral temp, and laying dirty linens on the floor. Some of these things seem petty, but nosocomial infections rage through hospitals and healthcare facilities because of behaviors such as this. They are no-mercy when it comes to infection control, which is how any school of nursing should be.
    Slip up and forget to count something little, like a measly 50CCs in your intake? 50CCs could mean an pt. who is NPO vomiting from anesthesia and aspirating, causing pneumonia and eventual death. That 50CCs could be a very big deal.
    Forget to chart something minor, like that the left pupil was just more sluggish than the right?slightly ? There goes your real world elderly hospital pt. who fell and got back into bed without any staff knowing about..... dying due to a head injury that no one knew about because someone forgot to chart a tiny little detail.

    Ok, these are probably stupid examples, but this is how I see it. I talked to a few other people who were also hit with the realization of what the CPNE is trying to do. It hit them either during their preparation or after they were done. I'm not saying that everyone comes to this realization--- I'm sure there are some people out there who will forever think that it's a whole bunch of bull and they're sorry they ever put themselves into the position they're in. But this is my view on it, and I hope you guys will at least think about it.......it's a whole lot easier to go through this with a positive outlook on it all, rather than a negative one.

  4. by   thelmamedic
    I am taking the CPNE the end of July and would appreciate any pointers you have regarding the testing process and what to look for or watch out for. Help please! I have a similar background of pre-hospital and now FT ER and am worried I might be a little too sure of my skills on the job compared to the testing focus.
  5. by   thelmamedic
    Can you offer any input on specific areas I should concentrate on for my CPNE? I am getting the impression from studying that it's more about details and the personal side of nursing (caring, comfort) that are focused upon along with the prevention of spreading disease. Is that your take on it?
  6. by   Boston-RN
    There was a similar debate but not so much about the CPNE itself. I have to say that it seems a little harder for people with EMT/Paramedic/extensive backgrounds to adapt to the CPNE than it is for new grad LPNS simply because of what has already been mentioned. SKILLS are not focused on in nursing school. Skills are not what makes a good nurse a good nurse. Heck I never put in a foley, an IV or done a bunch of things until I actually graduated.

    They reinforce the fundamentals which seem to be brushed off in the "real world". The NCLEX, just like the CPNE is based on book theory. Go through any JAHCO or State survey and it's just like going through the CPNE....details details but there's a reason for it.
  7. by   Pixie.RN
    I have a better understanding of why the CPNE is the way it is now that I've worked with some new-grad RNs in the ER where I'm a tech ... I was surprised to find out that skills really aren't taught in nursing school because you learn them when you go to work! So they're learning to do IVs and Foleys and NG tubes now. They keep telling me I know more than they do, but I just have some technical skills that they don't. A couple of them were LPNs, so they have more skills than an average new grad. So that's changed my expectation of the CPNE experience a little bit ... for the better, I think. As a medic, I just have to put my brain into a slightly different headspace.
  8. by   emsrn969
    I have been a prehospital EMT, an ED Tech, an LPN, and now an ED RN, after graduating from Excelsior. The CPNE is a daunting weekend and one of the most stressful things I've ever completed. I would rather castrate myself without anesthesia than do it again, but would not trade the experience of it for anything. I now train the grads from the local nursing program and I am generally disappointed with their lack of clinical skills. Their NCLEX pass rates are poor in comparison and we've had students that had never even touched a patient before their rotation with us. Wow sorry for the tangent.

    The CPNE is more than just an exam of basic clinical knowledge. It tests your attention to detail, some more useless than others, but exacting details. The pass rate in the ~67% range should be evidence of how difficult it is and add to the stress as well. 100% on all critical areas or you fail. No traditional nursing program could fulfill that or they would lose students faster than they already do.

    The mindset from medic to CPNE RN is one of monotony. Forget about saving the life, but remember the ABCs. Remember to make the sure the bed is locked and wear gloves all the time. Walking into the station and saying "BSI" won't cut it this time. Wash your hands so much they hurt by the end of the weekend. Practice sterile fields which tend to be a trip-up on medics.

    Most important of all: Relax and breathe.

    Best of luck.
  9. by   Oromtiti
    The CPNE is more than just an exam of basic clinical knowledge. It tests your attention to detail, some more useless than others, but exacting details. The pass rate in the ~67% range should be evidence of how difficult it is and add to the stress as well. 100% on all critical areas or you fail. No traditional nursing program could fulfill that or they would lose students faster than they already do.
    Best of luck.[/quote]
    My CPNE is in the middle of August. I am nervouse. What steps did you take when you get into the patients room.
    Wash hand, intro self and instructor, id patient, check iv fluid &rate, glove check site. Then did you wash your hands to don another gloves for oral temp? or you didn't need to don glove for temp?If you have to give meds do you take the med with you first or after intro you go back and get it?
    Let me know how you guys who passed did it!!
    Last edit by Oromtiti on Jul 7, '07
  10. by   Oromtiti
    My CPNE is in the middle of August. I am nervouse. What steps did you take when you get into the patients room.
    Wash hand, intro self and instructor, id patient, check iv fluid &rate, glove check site. Then did you wash your hands to don another gloves for oral temp? or you didn't need to don glove for temp?If you have to give meds do you take the med with you first or after intro you go back and get it?
    Let me know how you guys who passed did it!!
    Last edit by Oromtiti on Jul 7, '07
  11. by   strengthcouragewisdm
    I am employed at Grady Hosp in Atlantat GA, and the CPNE is usually administerd on my unit. The CA is a Clinical Manager also at Grady. I am not prepared for the cpne yet, however I will be paying close attention to the exam next time they are on our unit.
  12. by   Lorie P.
    Quote from strengthcouragewisdm
    i am employed at grady hosp in atlantat ga, and the cpne is usually administerd on my unit. the ca is a clinical manager also at grady. i am not prepared for the cpne yet, however i will be paying close attention to the exam next time they are on our unit.

    when you do observe the next cpne, could you please share your thoughts?
    thanks so much!

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