I am a proud New York City EMS Paramedic preparing to enter the Excelsior nursing program.
As a professional in an urban EMS system, I've worked side by side with registered nurses under austere conditions for many years. I consider nurses to be my peers, and I have enjoyed a good rapport and a sense of mutual respect in the context of our professional relationship. The vast majority of nurses I have worked with recognize that health professionals -- paramedics and others -- can and do maintain valuable clinical experience and skills.
However, there is always a small minority of divisive individuals in healthcare and academia who are blind elitists. These are the ones who summarily conclude that if you were not a codified student of a particular discipline, you know nothing. Frankly, I think there needs to be a more nuanced and respectful analysis on the part of those few who think that the clinical experience of other health care providers outside of their own scope of practice amounts to nothing.
Excelsior College attempts to address this problem by recognizing that paramedics like myself, as well as LPNs, PAs, MDs and others, tend to acquire clinical skills that are reasonably compatible with nursing. Excelsior provides a bridge for those providers to fill in any gaps and cross over into nursing in the same way that nurses have demanded a bridge to cross into the paramedic's domain (as PHRN) without having to go through the extensive paramedic training programs and EMS internship.
The two states that summarily reject Excelsior grads do so because they believe the program provides insufficient clinical training compared to traditional programs. This ignores the fact that all students are required to be licensed healthcare providers with clinical experience from the outset. The typical paramedic working in the field has patient care experience that, frankly, meets or exceeds that of most nursing students, and it is probably fair to say the same is true of many other experienced clinicians.
I would argue that the minority powers-that-be who do not see this logic have probably failed miserably in their responsibility to be discerning in their judgment. The fact that there are Excelsior nurses practicing in all fifty states in supervisory positions is proof that the paradigm works. The bureaucrats from the two states who have placed restrictions on latter-day graduates and marked them with an unfair stigma will hopefully retire soon and make way for leaders who can think outside of the box.
Paramedics, LPNs, PAs, and MDs who wish to bridge into nursing require respect. Excelsior grads are experienced clinicians that have consistently excelled in national-level clinical and didactic nursing examinations, and they deserve to be universally and unequivocally recognized as registered nurses!
Thank You! :) Well, I'm not worried about memorizing. Luckily for me, I have that as a strength. Plus, I'm EXTREMELY visual. That has always been easy for me.
What makes me nervous is the fact that I heard that part of the test is on real patients. From what I'm thinking, they throw you out on to the hospital floor, etc. I have NEVER worked as a nurse and my clinical rotations, during nursing school, were less than sterling. We truly didn't get a lot of hands on experience. My school was SUPER disorganized and a new program...so we missed out on a lot, IMO.
From what I know, the first day is dolls and dummies...the rest is real, live, human beings! Does anyone know how many hours you can expect to be there? I heard this is a 2.5 day ordeal and that makes me shiver. It's the ONLY thing I'm incredibly stressing, as far as this program goes. There are still way too many pluses to pass it up, though.
Don't forget WA state.... they do accept Excelsior for LPN's only NOT paramedics (LPN's must go thru a 200 hour preceptorship in WA before they can proceed). Even if you have extensive (say 15 years) of experience, have all your clinical hours documented (yup... all of them), get your RN then go to a university to get your BSN, or MSN for that matter, test, work for a while then test in, work and endorse... any scenario with Paramedic attached, they don't want.
I will say that I felt similarly prior to completing my BSN in a traditional university. I too worked with RN's (flight program), with the same procedures, protocols and responsibilities. Nursing clinicals are different than medic clinicals. I wouldn't discount that part of the education at all. Paramedic clinicals focus more on individual skill sets and individual assessments, while nursing clinicals focus less on individual skills and more on pt assessment as a whole, then the prioritization of patients, looking forward to tomorrow and the next day as far as their treatment and therapies. Paramedic vs nursing prioritization is a bit different... though I miss the 'all of you involved in this accident- walk over here' -- fantastic!! they are all greens!! The good news is as a medic you can easily work full time and still get fantastic grades as there are many similarities and the physiology is the same.... :) (If you can swing the shifts I had a set schedule so it worked great)
Best of luck to you with your career goals, but before you invest in Excelsior, be sure to contact the states you may work in to make sure they take Excelsior Paramedic-RN's....
:yeahthat: as a regents graduate (now excelsior) i could not agree more! when i was in orientation with traditional college nursing grads we were told that we would have 6-8 full weeks of orientation. i was done with orientation within 2 weeks as it was clear to them that i only needed to learn their computer system and nursing protocols.
i believe that those who critisize excelsior think that our diploma's are more or less handed to us. that we are not taking "real" classes and that they should not count as such and that hard work is not required to get our degree simply because we do not sit in a classroom.
i took an a&p textbook and studied it from cover to cover for 6 full months (at least 2 hrs a day, 5 days a week) before taking my test and i made an a, and the same for microbiology. it was not easy. ethics was worse than both a&p and micro combined.
as far as the clinicals that are required by excelsior, the student is required to be able to perform at the level as a new graduate nurse. many lpn's fail cpne because they perform at the level of a seasoned nurse. i failed my first cpne clinical because i cleaned up a mentally challenged adult who was lying in dried feces. my assignment was to perform as a graduate nurse. i was watched closely by a msn level nurse who was making note that i washed my hands, accessed lung sounds correctly, gave the meds correctly, used the 5 r's, documented everything correctly, knew how to write a care plan for the patient, left the 2 top side rails up when walking away from the patient, i was able to answer questions about the patients history as received in report. this msn felt that a newly graduated nurse would not have taken it upon herself to clean this patient up. my next patient i was failed because the care plan didn't say anything about an apical pulse and when i had trouble feeling the radial pulse i automatically did an apical pulse. this was a different msn and she failed me for doing an apical pulse feeling that a new grad would not have thought it through and would have gone for help with the pulse.
i know this is old, but just wanted to say that as a nursing student, i would have been failed if i left a patient in their own feces....no matter my assignment.
I work with Excelsior trained nurses and they are awesome nurses. It takes a special person to be able to take a textbook, be self-motivated to study it on their own, no assignments, no deadlines and when they felt ready to take a test and pass it they did. They studied as much as those who went to traditional nursing school. Having been LPN's they didn't need actual clinicals but did need to prove that they could function as a newly graduated nurse starting orientation on the floor. It's far easier for me to orient a Excelsior graduate than a traditional nursing school graduate.
I think it's a wonderful program. I don't think I could be self motivated enough to finish. I understand less than 10% of those who start the program actually finish it and that Excelsior grads have a high NCLEX passing rate.
I'm not understanding California's point of view. You can go to nursing school in California but not finish your actual college education so you can sit for the NCLEX without actually having an ASN. Yet if an Excelsior RN who has been practicing for 10 years in another state moves to California they cannot work as an RN or an LPN unless they go back and repeat the NCLEX-PN. That just seems backwards to me.
I know this is old, but just wanted to say that as a nursing student, i would have been failed if I left a patient in their own feces....no matter my assignment.
Maybe I read over it to fast, but where did the poster state that they left the person in feces?
Also, I'm very shocked one would be failed for taking an apical pulse.
Maybe I read over it to fast, but where did the poster state that they left the person in feces?
Also, I'm very shocked one would be failed for taking an apical pulse.
Huh? I didn't say they did leave a patient soiled. Here's the quote:
I failed my first CPNE clinical because I cleaned up a mentally challenged adult who was lying in dried feces. My assignment was to perform as a graduate nurse. I was watched closely by a MSN level nurse who was making note that I washed my hands, accessed lung sounds correctly, gave the meds correctly, used the 5 R's, documented everything correctly, knew how to write a care plan for the patient, left the 2 top side rails up when walking away from the patient, I was able to answer questions about the patients history as received in report. This MSN felt that a newly graduated nurse would not have taken it upon herself to clean this patient up.
My point was that this adjudicator thought that a graduate nurse would leave a patient in feces. I was saying that I'm not even a graduate nurse yet (nursing student) but if I left a patient in a soiled bed, I would have failed that clinical day for sure.
maybe i read over it to fast, but where did the poster state that they left the person in feces? also, i'm very shocked one would be failed for taking an apical pulse.
as far as the clinicals that are required by excelsior, the student is required to be able to perform at the level as a new graduate nurse. many lpn's fail cpne because they perform at the level of a seasoned nurse. i failed my first cpne clinical because i cleaned up a mentally challenged adult who was lying in dried feces. my assignment was to perform as a graduate nurse. i was watched closely by a msn level nurse who was making note that i washed my hands, accessed lung sounds correctly, gave the meds correctly, used the 5 r's, documented everything correctly, knew how to write a care plan for the patient, left the 2 top side rails up when walking away from the patient, i was able to answer questions about the patients history as received in report. this msn felt that a newly graduated nurse would not have taken it upon herself to clean this patient up. my next patient i was failed because the care plan didn't say anything about an apical pulse and when i had trouble feeling the radial pulse i automatically did an apical pulse. this was a different msn and she failed me for doing an apical pulse feeling that a new grad would not have thought it through and would have gone for help with the pulse.
i did read it here. perhaps you should try contacting the op. she seems to have 1,000's of posts here on an and is probably still around? best of luck with your studies!
No, she is no longer participating on this website. Regardless, my advice is this: ignore the stories from the past. Go forward and make your weekend your own. There are stories about everything if you listen long enough.
They advise people not to talk to the others in their group who are going through the CPNE test to avoid psyching yourself out with other people's stories. You only need positive suggestions. War stories abound. When you finish the test, pass or fail, you will have stories to contribute too. But you don't want to be responsible for getting someone else off on the wrong track, so don't let yourself stray either. Keep your eye on the prize.
StrawberryBanana
99 Posts
Thank You! :) Well, I'm not worried about memorizing. Luckily for me, I have that as a strength. Plus, I'm EXTREMELY visual. That has always been easy for me.
What makes me nervous is the fact that I heard that part of the test is on real patients. From what I'm thinking, they throw you out on to the hospital floor, etc. I have NEVER worked as a nurse and my clinical rotations, during nursing school, were less than sterling. We truly didn't get a lot of hands on experience. My school was SUPER disorganized and a new program...so we missed out on a lot, IMO.
From what I know, the first day is dolls and dummies...the rest is real, live, human beings! Does anyone know how many hours you can expect to be there? I heard this is a 2.5 day ordeal and that makes me shiver. It's the ONLY thing I'm incredibly stressing, as far as this program goes. There are still way too many pluses to pass it up, though.