CPNE. St.Mary's April 24-26

[Suzanneyoulike]

Ask any questions you have. I'll be happy to answer them! Here it is...

Day 1- The first time I was up here(August 2008) I passed all of my labs with no repeats. This time I actually did WORSE on the labs.

I failed to roll my NPH insulin. Weird, because I do it every night at work. So SC/IM was a fail. I also failed the wound station. The ABD was huge and I didn't realize it was folded in half when I put it on the wound. I could see the blue stripe, so I thought I was good. Not so much.

I was obviously upset with myself when I left the hospital. This was not a good start and I was not looking forward to Saturday. There was always a chance that I could ace my PCSs and STILL FAIL my labs and the end of the day. I questioned my decision to even try the CPNE a second time. Maybe this exam was a little too intense for me and a traditional school would suit my personality a little better...NO. I had to pull it together!! I had a careplan to write and a CPNE to pass!

Time to utilize the Xanax prescription that I got JUST FOR THE CPNE.

Day 2- 2/yo little girl s/p tonsillectomy. Comfort, Vitals with apical, Resp. Ass., ABD Ass., IV fluids running, Siderails x2, OOBx1 with supervision, Full liquids, I&O, continuous O2 sats, Pain level. I used Anxiety r/t hospitalization(or something like that) as my primary diagnosis since she was no longer in pain. I know that kids don't like hospitals and I figured I'd be able to get her to tell me that she would rather be home. I would give her a teddy bear and vocalize my understanding. I believe I used Risk for Injury or Risk for Falls for my second diagnosis. Risk for injury is a good one to use when you are already assigned to have the siderails up. And you always have to put the bed in the lowest position before you leave the patient's room, so that's your second intervention. I remember that one of my Anxiety interventions was also pediatric comfort intervention. Overlapping interventions to keep myself from getting flustered was part of my gameplan.

I had a written a page long list for every single thing that would be doing or saying when I got into the room during planning phase. This was KEY!!!!! I remember how nervous I got during my first CPNE and how I let it effect my organization. I had to remind myself that as long as I kept organized, I'd have plenty of time to complete everything I needed to do. I was sure to include my twenty minute check and my interventions on my "grid" as well as everything that was assigned on my kardex. I washed my hands upon entering the room, before leaving, and every time I took my gloves off.

I went into the room and rocked it out. I marked everything off my list as I did it. I took deep breaths PRN and I double checked my kardex and my careplan before I left the room just to make sure I didn't leave anything out. I think the parents and told the girl goodbye.

I turned in my finished careplan along with my documentation. Pass. This is just the confidence that I needed.

My second patient was an older woman with a Right femur fracture. She wasn't a good candidate for surgery, so I was confident about using Pain as my primary diagnosis. Risk for Injury was my second diagnosis. I had trouble assessing her lungs and her apical pulse d/t her apnea/snoring and the fact that she was slightly demented and wouldn't stop talking or cooperate with any deep breathing. Her respiratory rate was also alarmingly low, so the nurse had to be notified. She was obese and I had to have the CE assist me with repositioning her to assess the wound on her coccyx. I was sweating by the time I left the room. It was an exhausting PCS...but I passed!!!

I had to redo the two lab stations I had failed the previous day. I figured they would give me another SC injection to do. Instead they gave me some IM meds to mix and give. Pass. I also redid the wound. I thought everything went pretty darn good and then...I had to step out of the room. I was only out there for about 1 minute when the CA came out and said, "You were right." I can't be positive what he was referring to, but the CE examining me looked a little concerned when I didn't check the arm band on the wounded arm. That is the one station where you don't have to ID or sign...I'm thinking she hadn't tested anyone on that station before. I'm just glad my heart started beating again.

Day 3- I had the "one more patient" mentality. I knew that even though the majority of the exam was over, failing this one patient would shake my confidence and possibly screw up the entire CPNE. Failure was not an option.

Nice guy. s/p prostatectomy. Multiple open wounds on abdomen from recent surgeries. V/S, Sats, Pain level, Resp. Mgmt, TCDB, ISx5, ABD Ass., Medications, Comfort, Amb in hallway x1, INT, I&O(foley). Very cooperative guy. Very straight forward assessments. Impaired Comfort and Risk for Injury. I didn't have to do any interventions outside of the things I was to do as part of my assignment. Documented with very little time left d/t a slight equipment malfunction in the room. The CE added time to make up for the equipment flub, but I became very nervous...I also was sweating the fact that I didn't even get into the room in time to give the medication. I had to change the order of my "grid" to accommodate. I documented and I passed!

The CA and the CEs at St. Mary's are all so nice. They were nice the first time I went too. I changed some things in my personal life in between CPNEs and I think that made a huge difference in my general attitude and outlook for the exam. I had great support waiting for me at home and I also took someone who would support me while I was there. I would like to thank everyone that has taken the time to post CPNE experiences on allnurses.com. I have learned A LOT from these boards.

I still have the NCLEX and the little matter of the Georgia BON to deal with.......but I passed.

[caliotter3]

Good for you! You have probably gone through the worst part of your career, now the NCLEX is only a date with a computer. Good luck on the NCLEX and on the start of your new career.

[DebanamRN, MSN, RN]

wow! give yourself a great big pat on the back!:anpom::anpom:contrats!

[NC Girl BSN]

:ancong!: on your CPNE success!!!!!

[Raggedy Ann]

Congrats! Got all teary eyed reading your accomplishment. Your hard work and dedication has paid off. YAY for you! Traci

P.S. Thanks for sharing your experience with us future testers.

[FeFe23 RN]

Huge accomplishment!!! Congratulations!!!!!!

[rnlately]

Congrats Suzanne. As I draw nearer to completion of the required studies I am becoming increasingly nervous. Reading experiences such as yours helps me to understand that this is a very attainable goal. Hope all goes well with you and the board (fellow Georgian here) and keep us posted as to the outcome.

[Suzanneyoulike]

Congrats Suzanne. As I draw nearer to completion of the required studies I am becoming increasingly nervous. Reading experiences such as yours helps me to understand that this is a very attainable goal. Hope all goes well with you and the board (fellow Georgian here) and keep us posted as to the outcome.

Thanks.

You'll do fine as long as you keep organized and don't let you stress take over. Good luck to you.

[RNandRRT]

Congratulations!

I thank YOU for sharing your story. It's easy to pass and go on with your life, but you took the time to share with us and it's very appreciated.

I have put in my application for CPNE and am currently waiting for a date. Every time I read one of these stories I get so nervous and excited.

Good luck on your next step, NCLEX!

[Suzanneyoulike]

Congratulations!

I thank YOU for sharing your story. It's easy to pass and go on with your life, but you took the time to share with us and it's very appreciated.

I have put in my application for CPNE and am currently waiting for a date. Every time I read one of these stories I get so nervous and excited.

Good luck on your next step, NCLEX!

Thanks and good luck!