EC and LTC

erinp88 · Jul 18, 2007

Lisa,

I am in the same situation as you! I have been an LPN now for almost 6 years, in LTC and now at a local school district training CNA's.

I used to work as an ER tech (now over 6 years ago!). I just applied with EC, because I cannot stand waiting another year to get into a program.

Here is what I am thinking.. After reading several posts regarding the CPNE, it sounds as if they are not judging you on "life saving" techniques, but a lot on the nursing process and infection control.

Luckily, I have friends that work in the acute care setting. I am hoping to spend some days job shadowing them prior to the CPNE to become a little bit more comfortable in the acute care setting and help decrease some of my fears.

I know this doesn't specifically answer your question by any means. I'm very glad that you asked it as I would like to hear from people that have come from LTC and are in Excelsior as well.

Erin

caliotter3 · Jul 18, 2007

Does your LTC facility have a subacute section? My plans when I first started with EC were to practice at work (LTC facility). I was on night shift and I knew that I could have got the RNs to help me over in the subacute section, since I was training in all the sections anyway. We had people with IVs, and some very sick people. All you need to practice are the skills that are being tested on the CPNE. These criteria are pretty basic, no matter what kind of patient you are dealing with. The biggest problem people have are with their nerves. By going through scenarios at work with another nurse standing there with a clipboard, you can try to overcome some of the nervousness. Just my plans at the time. I ended up not working there anymore so don't have that kind of a setting to practice in.

Editorial Team / Moderator · Jul 19, 2007

I work as a tech in an ED, and my manager has already said I can practice at work, and she'd also get me time over in the main hospital (I work in a freestanding ED about 8 miles from our main facility) if I needed more practice. :)

rh39 · Jul 19, 2007

Erin

I am glad to hear of another LTC LPN in EC, on this board you don't hear much in regard to them, but I find it hard to believe there aren't more of us out there. I don't know about the rest of you, but the majority of the LPN's in our area are working in LTC, the hospitals here prefer RN's and it's kinda tough to get in.

Caliotter3,

Unfortunately I work in one of the few nursing homes that could actually be classed as an "old folks home". Our population is very stable, most are 85-100 (one will be 105!), and we don't see much acute care. If we do it's basically, CHF, Pneumonia, and sepsis. That's the plus side to my job, I am familiar with all the residents, their routines and health issues, so if nothing is going on, I can have a peaceful night and get some study time in. It's working for me. I'm considering the pro's and con's of changing jobs (as in the hospital). I can't decide if the extra experience would be worth the added stress of a new job. We all know the outside stress can factor in big time to degree derailment.

I guess the big question is in the end will the hospital have concerns that I went through EC, and have less clinical time? or does it really matter if you graduate and pass your boards? I know it's expected that all new grads will get a significant period with a preceptor. I am a good nurse, attentive to detail, and I give a crap about the ppl I'm taking care of. I'm sure with effort on my part I will be able to adapt to the acute care setting.

I guess the easiest way to settle this in my mind would be to call the 3 local hospitals in my area and ask them this question directly, see what they say. If I do I'll post the response.

Lisa

caliotter3 · Jul 19, 2007

Employers do not denigrate EC grads. They are more interested in your license and work experience, not so much where you went to school. They realize that LPNs that worked in LTC previous to acute care are going to have a different set of skills. Furthermore, the clinical practice in most programs is overrated. My nursing program was very poor in preparing me for clinical practice. I learned how to do my job by working as an LVN and getting info from experienced nurses around me. I felt that my schooling was merely a formality, due to the low level of instruction that I was receiving. Imagine talking about that to a prospective employer. I really have to watch what I say when I interview. Don't obsess that EC will not meet your educational needs. Yes, it would be better to attend a brick and mortar school but sometimes that isn't possible so EC is a viable alternative. Just look at it this way: you'll be picking up skills and experience on the job, once you are licensed.

erinp88 · Jul 19, 2007

Lisa,

The director of the Assisted Living Center at my work went through Excelsior. I don't know her that well nor do I see her often enough to question her about the program. Other than that, I don't know of anyone in my area that has completed Excelsior.

As far as LPN opportunities in my area, it's so limited. Even the physician offices are getting difficult to get into - they want MA's. The LPN program I completed was very "long term care" based. The majority of my clinicals were at a nursing home.

The only reason I enrolled in the LPN program was to bipass the RN waiting list (which was only 2 yrs back then!). I had so much ER experience and never thought I'd work in a nursing home. I don't mind the people I care for, I do mind the incredible load of paperwork and responsibility.

caliotter: Thanks for you advice and additional information. The nursing home system I work for has been increasing their acuity over the past few years. I am familiar with tube feedings, vac dressings and running piggyback IV's. I help teach phlebotomy at my other job, but it's been years since I've done a "live draw." Since I haven't even started NC1, I'm going to try not to worry about this CPNE thing for a while! I can't help that it's there in the back of my mind though!

txspadequeenRN, BSN, RN · Jul 19, 2007

i am a ltc lvn and i am going through ec. i have a wide range of experience though ,but the majority is in sub-acute ltc. don't worry about the cpne until you get there or you will drive yourself crazy.

caliotter3 · Jul 19, 2007

My friend went through EC almost 15 years ago and acted like the CPNE was a breeze. She told me that she went into the test acting like she knew what she was doing, managed to establish a positive relationship (how, I don't know) with the test proctors, and got through it with no problem. Wish I knew her secret. Everybody develops anxiety related to the CPNE. I wish they would come up with a different methodology. Well, good luck to everyone in the program and to those getting ready to start the program.

anticoagulationurse · Jul 19, 2007

My experience as an LPN was some subacute LTC (lots of dressings, injections, IV management, foleys, etc) but mostly outpatient office setting. My clinicals in LPN school were good, some in hospital some in LTC and office. BUT, not once in clinicals in LPN school did I get preceptored by an LPN, all RNs (even the instructors were RNs). THe hospital I work at did not hire any LPNs at the time, so not sure why they even had us there, but anyway, it was a good experience.

I went into the CPNE after not having worked LTC for over a year. I hadn't touched tubes of any kind for that long. I did fine on the CPNE.

I agree, 90% of the skills I have learned in nursing have been OTJ. You don't get proficient at insertiing foleys or whatever during clinicals! You don't get skilled at trauma assessment in clinicals, you get that by working in the ER as a nurse after school. You see where I'm going? If I am correct, I think almost all nursing programs (LPN or RN) used to be OTJ training hospital diploma programs...

You'll want hands on experience with IV pumps and tubes and injections and dressings for the CPNE, so if you are dry in those areas and don't have an opportunity where you work as an LPN, try gettng into a SNF or home health or something... It will help to feel familiar and comfortable with those aspects, especially for the lab stations. If you feel comfortable with tubes, you'll be okay.

rh39 · Jul 19, 2007

Along the same lines as Calliotter3, in regard to clinical experiences being overrated. I had a conversation with one of my former LPN instructors, who has her masters and also was an instructor at a well known RN program in our state. Her statement to me was, "If your going to go to a traditional school because of the clinicals, don't. Your clinical time in the LPN program was far greater than you'd get in an RN program." She encouraged me to go through EC. That was definitely a deciding factor for me.

I have heard of several ppl going through EC, but they are all currently working in the hospital. I agree with clinicals being more of a formality than a learning experience. All I felt it really did was expose me to different environments within the healthcare setting. Most of the time we were left to our own devices, just trying to stay out of the way and stay busy at the same time.

As far as the CPNE, I too have heard both scenarios: I worked with an LPN who made it through the program only to fail the CPNE, she never took it again. The gentleman that I bought my Chancellors guides from said he studied way to much for it. He was also a paramedic, I have a feeling you learn to deal with nerves with some of the situations they see in the field.

I am committed to this course regardless, and I intend to deal with it one step (or exam) at a time. I guess I'm trying to decide if I might need a change of course down the road to ensure all my avenues to future employment remain open, because as an LPN I feel very boxed in. There is no shortage in this area of LPN's, there's actually too many, full time employment is hard to come by.

Thanks to all for the encouragement, one nice thing about this board is it makes me feel less like the Lone Ranger minus Tonto.

Lisa

Editorial Team / Moderator · Jul 19, 2007

The gentleman that I bought my Chancellors guides from said he studied way to much for it. He was also a paramedic, I have a feeling you learn to deal with nerves with some of the situations they see with in the field.

That's true ... and National Registry medics also have a very intimidating skills portion to pass for certification. So in addition to the written part, we also have to successfully pass 12 (I think it's 12, it's been a few years since I tested) practicals stations, including starting IVs, giving IV meds, trauma, intubation (both adult and pediatric), dynamic and static cardiology, and other fun stuff. We have to nail the critical components for each station, or we fail. It was nerve-wracking, to say the least. I've heard from other medics that if you can do National Registry, you can do the CPNE. I'm hoping that's the case! :)