ENPC

I just re-verified my ENPC. There are online modules you need to take, these should be assigned by the course instructor. You will need a book for class (along with some printed supplements), some systems will provide these but others will require you to buy it.

Read the entire book. It isn't that long and is helpful especially for those who don't have good peds emergency experience. There are some parts that are not correct (both online and in the book) but you will need that information to pass the test.

Memorise the pediatric nursing process (it is very similar to the trauma nursing process in TNCC), you will need it to pass the skills exam.

If you read the book and pay attention in class ENPC is a breeze, if you don't you will probably fail.

@PeakRN

Im in the process of finishing up the book. what should i expect from the skills course? Is there something i should focus on?

1 hour ago, lanaholler said:

@PeakRN

Im in the process of finishing up the book. what should i expect from the skills course? Is there something i should focus on?

Follow the pediatric nursing process. Make sure that you hit all of the double star criteria in order.

1 hour ago, Pixie.RN said:

@PeakRN - how did you feel about the new course format?

I have some mixed feelings. I do appreciate that we are no longer doing death by powerpoint. I found the online simulation patients to be very creepy and overall they had a pretty poor flow. I'm not sure how I feel about people being able to take the test from home, on one side I appreciate that there is less pressure, but I also think that there should be some baseline knowledge that clinicians should have and not need to reference. If you have a sick kid in the trauma room or in triage you aren't going to have time to reference a book about what to do. I get that test anxiety is very difficult for some people, but I also need to know that the test taker can perform when they have a critically ill child in front of them and that is more stressful than any test.

I think that a lot of classes (whether it be ENPC, TNCC, ACLS, PALS, NRP, NIHSS, and so on) try to teach a very basic level of information that is largely aimed at the low volume or novice clinician. The longer you spend in that specialty the more those entry level rules don't apply, or aren't really the best treatment consideration for the patient.

I also think there were quite a few errors in the class. For example if you have a hemodynamically unstable infant with a heart rate of 260 they need to be converted prior to a 12 lead. Also you typically are not going to be able to differentiate any re-entry pathway on a heart rate of 260 beats per minute, even if you slow down the timing from international standard. Either an IV and adenosine or cardioversion are far more appropriate than 12 lead acquisition and expert consultation (and if your ER doc needs to consult on giving adenosine in SVT to an otherwise healthy infant they should probably just retire now).

Also in the atraumatic limp/tumor lysis case, you need those tumors to have a mechanism of releasing their cytotoxins/inflammatory mediators to present that series of symptoms. A new diagnosis of leukemia can show the symptoms that are presented in that case study and tumor lysis syndrome does need to be considered when starting chemotherapy or radiation, but isn't really a consideration on the initial diagnosis. Therapy also should have included aggressive fluid managment, as any period of time can cause permanent kidney damage in that nephrotoxic state. It isn't uncommon for us to be running 3x maintenance or even start CRRT to preserve kidney function, although typically I haven't needed the latter in kids with an initial white cell count of less than 300 thousand.