excelsior cpne

abgstat · Nov 3, 2005

I'm sorry to hear that you were unsuccessful this first time. I failed my first attempt because of #1: nerves, #2: not enough sleep the night before, and most important #3: I did not take a few seconds to think before I acted. Did you fail because of the labs or PCSs or both? I know why I passed the second time......I was so mad at myself for making such stupid, expensive mistakes I went back with the attitude that "this is my exam, I can do this, I will not become rattled and I will not rush".

hsieh · Nov 3, 2005

i failed my 2 pcs on sat and failed a repeat lab on sat. i was just so nervous. i'm going to read dr. phil mcgraw book on life strategies and maybe that will help me find out why i have such self destructive anxiety. i restest in a while. i'm definetly getting a grip on myself and getting a better attitude. any other advice out there?

pedinurse05 · Nov 3, 2005

i failed my first cpne. due to nerves i believe. does anybody know anybody who failed it all three times? what do you do then? i'm reading dr. phil mcgraw books to try to figure out why i'm so nervous i flub up. any other suggestions out there?

A few tips of mine are...

--Leave the day before so you have time to get settled and find the test hospital site.

--Eat well.... I tried to eat lowfat foods like sandwiches, soup, fruit, etc.

--Take a companion with you for support.

--Take relaxing music and candles with you.

--Get prepared before hand with everything you need for that evening or day clinical.

--Say to yourself, "I can do this!!!"

--Avoid unnecessary stress before and after the exam.

--Don't take young children with you...leave them with a family member or friend that you trust.

--Above all go with the attitude that you don't know everything and are a STUDENT!

--Watch for small signs that may clue you in to double or recheck something. The CE may be trying to clue you in prior to calling a FAIL.

--Avoid negative students. One guy in my group was failing and kept trying to make several negative comments...avoid this. His mistakes were valid. He did not prepare well...I knew I prepared well and would have to test according to the CPNE guidlines. Lift your spirits and don't let anyone drag them down!!!! You own this exam so take it and make it a success!

Good luck and best wishes!

Missy

abgstat · Nov 4, 2005

Great tips from Missy!

Do try to get there on Thursday -- you'll have time to locate the hospital, time to settle in, and even time on Friday morning to call EC if you have any last minute questions.

Don't go in with any other attitude than, "yes, I am a student nurse.....evaluate me!" Be confident!! As long as you KNOW THE CRITICAL ELEMENTS, do them and document them, you will pass.

Do listen to the CE -- they might by giving you hints as to things you need to do.

As far as taking a support person, eating certain foods......I suppose that's more a personal choice. I chose to travel alone so I could concentrate. I tried the "good diet" the first time, it didn't work for me. I needed my usual bacon breakfast sandwich :) And I stayed on my regular sleep schedule the second time, which helped me get enough sleep Friday night (though I guess this would be difficult to do if you don't work day shift). Anyway, I think just trying to stick to your regular routine as much as possible would help. And do take your pillow with you......those hotel pillows can be most uncomfortable!!

And Missy was so right about avoiding/tuning out a negative person! I've seen this in both of my cpnes, and it is really best to just forget about them...they fail because they are not prepared and have an attitude!!

Best of luck! AB

BBFRN, BSN, PhD · Nov 4, 2005

One thing that helped me pass (first try), was to ask around at the EPN and the Yahoo groups to see who else was testing with me. We got to know each other a bit beforehand, and some of us got together and studied/practiced as a group in our hotel rooms. We were all very supportive of each other, and this helped knock down some of the anxiety for sure.

pedinurse05 · Nov 4, 2005

One thing that helped me pass (first try), was to ask around at the EPN and the Yahoo groups to see who else was testing with me. We got to know each other a bit beforehand, and some of us got together and studied/practiced as a group in our hotel rooms. We were all very supportive of each other, and this helped knock down some of the anxiety for sure.

Great idea! I passed first try with no repeats, but didn't know anyone else I tested with until after the CPNE. I think what helped me pass first try also was reading stories of others on alittlesarcasm.com Other students can offer support!

county162 · Nov 5, 2005

I also too got very nervous when taking the cpne, but here is why I believed I passed:

1. I was well prepared and that made me feel confident

2. I went on the website http://www.mindtools.com to help me with my nervousness( greatest help of all )

3. The night before I took an Ambien so that I was assured that I would get a good nights rest

4. I thought about what I was doing before acting upon it and took my time during both the stations and pcs's

Good luck to you, I hope this helped

DutchgirlRN, ASN, RN · Nov 5, 2005

i failed my first cpne. due to nerves i believe. does anybody know anybody who failed it all three times? what do you do then? i'm reading dr. phil mcgraw books to try to figure out why i'm so nervous i flub up. any other suggestions out there?

I feel for you. Been there done that. It is so devasting to fail CPNE. I was an LPN for 26 years and just knew there was no way to fail. I knew my meumonics like my own name. I do believe the location has something to do with it also. I went to two different sites in Atlanta and the experiences were like day and night. The CE's at the first site were hateful and not at all concerned with anything but getting off from work early. At the second site they were very pleasant, helpful, supportive and anxious for us to pass. I made up this plan for myself after failing and once I passed I came home and wrote it all down so I would never forget it and be able to help out someone else in the same boat so here it is. I was complimented by the testers on how organized I was. I call it my organizational plan to pass CPNE. P.S. I took 1 mg of Ativan on Saturday the second go round!

Here's my advice having been through CPNE twice...........Accounts of PCS's ended up not helping me at all what made the difference was

"organization". Between my first and second CPNE I did not study at

all, what I did was organize. OKAY.......First.......grab your

Carpenito's, a highlighter, and some sticky tabs to mark your pages.

(I passed my marked Carpenito's on to a student who had failed

once before and had failed two PCS's on Saturday, so I can't give you the page numbers). She was a complete stranger to me. I had already passed, I recognized her from Friday night, she was in a restaurant crying and had to go back on Sunday and pass all three. The CE said it had never been done before but she should do it anyway just for the practice. We sat there and went over my plan for hours. I prayed for her and Hallejah the next day she called me on my cell while I was driving home She had passed. All three on Sunday, the first time it had ever been done at that site! Here's the plan:

1. In the front of the book where the pages are

marked with Roman

Numerals, I think around page XXXViii , about 3/4 of

the way down the

page find and highlight these words:

"if not managed now will deter progress to achieve

outcomes"

This is your "rationale for choice as a priority

nursing diagnosis"

for all three of your PCS no matter what dx you use!!!

Now put a

sticky tab on that page so you can flip to it fast

during your

evaluation phase.

2. Go to the section for Infection. Find and

highlight this

phrase: related to a site for organism invasion

secondary to presence

of an.... then highlight "an invasive line",

"surgical trauma"

etc..... Then find and highlight "be free from

nosocomial

infectious processes during hospitalization" Your

interventions then

would be things that you do anyway 1. meticulous

handwashing and 2

aseptic technique. Now put your sticky tab on this

section. So when

you put it together it goes: Risk for Infection

related to a site

for organism invasion secondary to presence of an

invasive line. Or

you could use related to surgical incision, wound or

whatever applies

best.

3. Go to the section for Injury. Find and highlight

this phase:

related to unfamiliar hospital enviroment. Pick an

outcome and

highlight it and for interventions use things you'll

do anyway such

as bed down, side rails up X 4. Call light at reach.

4. Go to section for Altered Comfort and find and

highlight this

phrase: related to tissue trauma and reflex muscle

spasms secondary

to surgery or "whatever" applies. Find and highlight

the outcome of

your choice. I used the patient will relate relief

after

satisfactory relief measure as evidenced by a pain

level of 3 on a 0-

10 scale. Highlight your choice of interventions. I

used Promote

relaxation with a back rub and Provide pt. with

optimal pain relief

medication, return in 30 minutes to assure

effectiveness. Remember

you can only highlight in book. DO NOT write anything

in book.

5. Now the other areas to mark with sticky page tabs

are Anxiety,

Altered Nutrition, and Impaied Physical Mobility. I'm

sorry I can't

tell you what to highlight in these sections because I

can't remember

but you guy's are smart or you wouldn't have gotten

this far!! Mark

yourself a related to, an outcome, and generic type

interventions.

These 2 Risk for sections, Infection & Injury and 4

Actual Dx

sections: Comfort, Anxiety, Nutrition and Impaired

physical

mobility should help you cover 99% of any PCS

situation. And since

your pages are tabbed and phrase highlighted you can

get to them

fast, if you need another dx you'll just have to do

your best.

This is really important!!!! Everything that is

required within the

first 20 minutes is to be recorded on the "PCS

Recording Form" so

when you go into the patient's room your priority

should be to get

everything filled out on that "PCS Recording Form"

even if it's only

marking N/A. EVERY line on that page has to have

something on it.

Now for more organization! In your planning phase,

turn your

booklet over to the blank page, draw a line down the

middle of the

page. Actually more off to the right. On the left side

write down

each assigned area including Mobility and Fluid

Management and list

each critical element. On the right side write at the

top of the

page "Safety" and write down side rails up X 4 and

whatever else is

assigned. Then draw a line and title the next square

"Supplies"

write down there a list of any supplies that you will

need. Draw a

line and title the next square

"meds" and write down the meds and what time they

are due.

The next square will be vitals signs and make a note

as to what you

have to do such as axillary temp, apical pulse

etc.......

Then have a miscellaneous section. Now go back to the

assignment

kardex and highlight each and everything that has been

written down

and make sure you have it on your planning phase page.

When you go

in the room and have finished the PCS Recording Form

turn the booklet

over and start doing everything you have written and

cross off each

item as you do it. Now you are taking a "open book

test!!" My CE's

were blown away by my planning page.

Finally, you now have to remember things like to wash

your hands,

make sure have the rails up anytime you leave the

room, sign the MAR

as you give the meds so you won't forget, Ask the

patient about

level of pain on a 0-10 scale both initially and when

asking as a

reassessment. You'll fail if you reassess and just ask

a number.

Clarify to the pt you are asking for a number on a

0-10 scale.

If O2 is running but you are not assigned Oxygen

Management you will

not be expected to do the CE's but you do have to

chart that the O2

is running and being maintained under other

considerations which is

the last section in the nursing notes.

For the section continue plan I used this for each

PCS:

"requires on going management gradually decreasing as"

So it looks like this: Acute Pain requires on going

management

gradually decreasing as less pain medication is needed

and level of

pain decreases. You just start with your diagnosis

and end with

whatever is appropriate.

Well this is my story and I'm sticking to it! This is

what got me

through with no repeats and with far less anxiety than

the first

time!!!!!! Practice making your planning page over

and over so

you'll be able to do it out of habit. I took about 30

minutes to do

each planning phase during the PCS. That 30 minutes

was the key to

success!!!!! Finally have faith in yourself and have

everyone put

you on their prayer list.

This was Dec 2000. Please don't e-mail me to ask an additional questions. I do not remember anything. It's like having a baby, once the pain is over you only remember the good stuff.

yvonnemuse, BSN, RN · Nov 8, 2005

wow, I just printed your post! I will use these tips for sure. I am TERRIFIED of the CPNE, but in my heart I KNOW it is doable and that the most difficult thing to tame is my own mind!

Nascar nurse, ASN, RN · Nov 8, 2005

I passed the CPNE first try with no repeats. I did not take any workshops or anything like that. I commited those critical elements to memory all the way to my toes. I practiced listening to apicals on my cat nightly(cat did not appreciate this & got expericence w/ difficult patient too!,) put dressing after dressing on my kids, had an IV line hanging in my kitchen (outdated saline that my facilities pharm. was generous enough to give me) and practiced drip rates nightly during dishes (had my 11 year old daughter doing them with me as a contest :) as to who could get closer to whatever predetermined number we dreamed up that day). Got to Racine with one of the WORST colds of my life - practically overdosed myself with cold/cough medicine to hide my symptoms, which then induced diarrhea - back to a local pharm at 6am for more medicine to plug up EVERY end :rotfl:. At this point I felt so dang bad I just wanted to go home. Not sure if it was the medicine, the acutual cold itself, or just the months of cramming all the memorization into my brain, but when I left Racine, I felt like I had just acted in play. They said all the lines {outlined in the study guide}, I responded with all my lines and it just went so smooth. The one thing that really helped me most, is when they gave me my assignment, I immediately wrote down all the critial element steps on the paper so I wouldn't forget anything as I went. I crossed them off as I did them and double checked before turning anything in. I thought the ladies up in Racine were great too. They were all so kind and seemed to really want us all to pass. Good luck to any of you that are taking this exam. It will be an experience that you will never forget, BUT once you get thru it you will have an overwhelming confidence in yourself.

DutchgirlRN, ASN, RN · Nov 9, 2005

wow, I just printed your post! I will use these tips for sure. I am TERRIFIED of the CPNE, but in my heart I KNOW it is doable and that the most difficult thing to tame is my own mind!

You are so right and you are most welcome. Good Luck