Finally ready to talk about my CPNE experience 3/25/2011

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Specializes in Telemetry.

Okay, so it's taken me several weeks to get over my CPNE PTSD and finally write about my experience. Please don't discount the reality of the PTSD you may experience when you are done. I had nightmares and depression for 2 solid weeks after the test even though I passed. For the past year, I imagined how I would act after passing my CPNE. From jumping up on the nurses station, to dancing at my graduation party....I had all the scenarios mapped out in my head. Nothing prepared me for how I felt afterward. I came home from the CPNE and got into bed and slept the entire day and night. I tossed and turned and had nightmares about my PCS's, Excelsior finding something I didn't document and revoking my PASS status, you name it....if it was horrible, I dreamt it. I walked around like a zombie for the first week, because I didn't know what to do with myself. I had spent the week before locked in my room practicing over and over for 8 or more hours a day. I wanted to be happy and excited, but I just wasn't. The following week was a bit better, the nightmares became less frequent, but I still had this overwhelming feeling of dread that this just wasn't real and somehow my pass would now be a fail. This week I feel fine, I feel proud and excited. I want to go out and celebrate and I am able to talk about my experience, because I KNOW it's real and I KNOW that Excelsior ISN'T going to call me and tell me I really failed! :rolleyes:

So now for my story:

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I LOVE IT!:lol2:

Thanks for sharing! Congrats woman! Relax now, and let the good feeling soak it! You did it!

Veni, vidi, vici

:yeah:

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Specializes in Telemetry.

Day one:

Got to York Hospital about an hour before I needed to be there and just read over my mnemonics for my skill stations. I just closed my eyes and pictured myself doing them over and over. Finally the other students began to arrive, and I was happy to forget about my mnemonics for awhile and just enjoy their company. The other 5 students were so nice and one girl, Theresa, became my new best friend pretty quickly! She was so nice and it was wonderful to have someone as a support system. (We ended up emailing each other and texting from home every night during the CPNE!) It felt great to have someone who UNDERSTOOD what I was going through.

Okay so, the CA arrives in the lobby and takes us to a large meeting room and goes over all the excelsior paperwork. We are all super nervous and we all ask a ton of questions about the simplest little details, just because no one wants to make any mistakes! It was kind of funny and the CA finally just looked at us and told us to relax! She was amazingly laid back and really set the tone for my entire CPNE. I will say this first and foremost, these people are NOT there to fail you! No matter what you have heard or read, please know this....THEY WANT YOU TO DO WELL!!! I Know this to be true, so stop reading all the negative crap out there and if you take nothing else out of what I have to say, take my advice on this....they want you to pass!

Next, we met the CE's and four people are selected to begin the skills stations, and myself and another student are asked to wait outside. (Forgot to mention we had ample time to examine each station and check everything out. Do yourself a favor and open packages, try on gloves, open needles, read what SIZE needles they have and literally tear that room apart! Don't leave any stone untouched...this is YOUR CPNE, make the most of this time!) You are given 4 sheets of paper each in a different color representing the different skills stations...these are the EXACT papers that are in your study guide, so if you haven't done so already, get to know them VERY well. So my first skill station was IV push, I wrote out my mnemonic on the side of the paper first. I wrote out the entire word for each step, and then continued. I read out the MAR, picked my meds and did the math. I honestly don't remember what the drug was, only that I had to push it over two minutes. I thought I may have contaminated one of my flushes, so I through that one in the sharps and redrew it. I pushed my med over the two minutes using the twist method and then flushed...DONE! Lot's of time to spare. The CE looks at me and says "Did you complete all the critical elements?" And I look at her like she has two heads and say..."NO". OMG....what??? LOL....I didn't understand what she was asking me, and she said, "Well finish whatever you want to finish then", and I say, "I'm done". OMG... seriously, one of the most embarrassing moments of my life!! I think I just lost my mind for several minutes or something, but she just smiled at me and said "YOU PASSED"!

Next up, IM/SUB Q station. I got IM and I forgot to add air to my second vial and it just sucked up all my med!! :eek: LOL....I just looked at the CE and said, I'm starting over and I did, passed!

Secondary IV medication came next. There were at least 10 different med bags on the table and they had laminated ID cards attached to them telling you what the med was supposed to be. After I ID'd the med I took off the card because it was in my way and the CE just smiled at me. Counted my gtts, in 15 second increments, then 30, then 60 and then with the CE....PASS!

Okay here's where it gets interesting. The wound station! I practiced the wound station at home over and over until my fingers were ice cold prunes, so I KNEW I had this in the bag! But, at home I practice on my nice, LARGE, dining room table. Now, I'm standing in front of a little fold up table that has tons of crap all over it! Gloves in all sizes, boxes of 4x4's, gloves....EVERYTHING! There was no room to work and several people before me failed. Okay, so now the NYer in my goes into full swing. I look at that CE and tell her, "I'm dragging a chair over here and when the timer starts, EVERYTHING but what I need is going on that chair!" She just laughed and said "Go for it!" The timer started and cool as a cucumber I dumped that mess onto the chair. I have my own method of packing that I call "the wonton" and I slapped my little wonton into that wound, unfolded it's four corners, covered it up and done! PASS!

Let me stop here to give you some backround on how I studied for the stations. I have a learning disability in math, and having someone WATCH me do math is pretty much my biggest nightmare come true. So, I knew I needed to leave myself lot's of time to do the math and check it several times. My plan from the beginning was to get my time down on the skill stations to where I could do them at least twice in the time allowed. I seriously became a ninja at these skill stations. For 3 weeks I did those stations over :nurse:f I failed any of them it would ruin the rest of my weekend and I didn't want anything hanging over my head. I went in there like I was going into battle, I was taking NO prisoners! You MUST take control over your CPNE, this is another huge piece of advice. Be confident, and ask for what you want. There was NO way I was going to fail my wound station because THEIR table was overloaded with supplies! I brought my OWN sterile gloves and enough extra's for my fellow students. Those were a life saver because the gloves they had sucked. If something is in your way, rip it off, like I ripped off that label! Don't be timid.

Next up....PCS's....

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I'm reading hunny so keep them coming!!!!

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Specializes in Telemetry.

(After the skill station you are paired up with the CE you will be having the next day and that CE takes you to the floor you will be working on and goes over the kardex with you. By this time it was after 8pm and I had a 45 minute drive ahead of me, so I didn't ask a lot of questions, I just wanted to get home and do my careplan and go to sleep!)

Day two:

PCS #1 Pt. is on a cardiac monitor and in with exacerbation of CHF, AFIB (cardioverted the day before and is now in a sinus rhythm), is on a lasix and heparin gtt.

I took Sheri Taylor's in person and online workshop and If I had to pick one I would go with the online workshop because I watched those careplan videos over and over until I could bang out a careplan in 5 minutes that I KNEW would not need to be revised afterwards. I knew to look at whatever I was assigned and base my careplan on that. Submitted my paperwork and PCS officially starts. I do the handwash, ID my pt., ....yadda yadda.....20 minute checks....done. On to my vitals....here's where it all starts to go bad! I am assigned to check an apical pulse. So let me begin by saying this woman was, to put it mildly, morbidly obese and had giant pendulous breasts. I know my anatomy and I KNOW where the apex of the heart is, but as I stood there SEARCHING for this woman's apical pulse (as the CE stares at me with the other end of the stethescope in her ears) I just kept thinking, "I'm going to fail because this woman has giant breasts!" So I basically molest this woman for about 5 minutes, lifting and pushing her giant breast around trying desperately to hear a pulse and all I hear are these loud bowel sounds! lol....I wanted to die. I look at the CE and I say...."I want to invoke clinical decision making". OMG....did those words seriously come out of my mouth? ( I could honestly hear my heart beating in my ears. My hands were shaking and I thought I was going to pass out. You honestly can't imagine what this CPNE is like unless you have been through it. The stress level is beyond anything I have ever felt in my life.) We walk outside the room and I tell the CE that I can't find her apical pulse and she looks at me like I'm the biggest moron in the world and say's "You can't find an APICAL pulse???" So now my NY backround comes back in full swing and I look at her and say, "NO, I can't find it but I can go over the anatomy and tell you exactly WHERE the apex of the heart is and where you SHOULD be able to hear it!" "I feel like I am causing emotional jeopardy to this patient by feeling her up like we are on our first date!, I'd be surprised if anyone can find an apical pulse on this woman!" "She is on telemetry, can't we use the pulse rate that is on the monitor?" She looked at me and said, "Well, let's see if ANYONE can find it!" LOL....omg....I wanted to run out of there! So we go back in with the double stethescope and she tries to find the apical pulse and thank you sweet Jesus, it took her about 5 full minutes before she found it, but it was really hard to hear so she just looked at me and winked and said, "continue your PCS!" I finished up my stuff and tore out of that room like a bat out of hell! I finished up my paperwork with 3 minutes to spare and when she asked me if I had completed all the critical elements, I swear I felt like I was handing over my firstborn! 20 minutes later....PASS!!! OMG....I nearly fainted from the stress!

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Specializes in Telemetry.

(You are supposed to have 20 minutes between your PCS's, but because my first one was such a disaster and we ended up talking afterwards....the CE told me "I can SEE you know your stuff and you KNOW what you're doing, but if you don't get your nerves under control....YOU ARE GOING TO FAIL!!" OMG...seriously?? Get my nerves under control?? Tell me how to do that please? I just missed failing over someone's giant breasts! Sure, I'm going to now figure out a way to calm down! LOL!:rolleyes: )

PCS #2

I only got to sit with my fellow students for about 8 minutes before my next instructor walked in to get me. We start walking to my next assignment and on the way she says to me.... "You are going to love your next assignment....he's a 10 month old little sweetie!" My legs almost gave out on me! To say that I didn't study peds, is an understatment. I DIDN'T study peds period!! I knew about checking the fontanel....that's it! So many people told me that they got peds substitutes, I tried to forget about the possibility of getting one myself! Here's another piece of advice.....STUDY PEDS!!! LOL....what a mess! Anyway, this way my next assignment...

10 month old little boy, with respiratory infection and asthma. I was assigned, respiratory management, skin assessment, vitals, meds, SUCTIONING WITH BULB SYRINGE!!! (kill me.) I think I blanked everything out after that!

So I write out my care plan in about 5 minutes and hand it in, because I KNOW I'm failing this and want to get on to my next patient as soon as possible. (p.s. let me just say I am 45 with 3 children of my own, but the thought of taking care of someone else's sick baby terrifies me, and I can't stand to see children hurt.) I go in after washing my hands and immediately ID my patient. I check his little fontanel right off the bat! He's absolutely adorable and the mom is as nice as can be. I'm assigned apical rate AGAIN and AGAIN I can hardly count it because it's going so fast and I can hardly hear it because his lungs are so junky and wheezy!! I tell the CE that I will be listening and counting his Apical pulse several more times because of his junky lung sounds, I also tell her that he sounds like he's tight and needs a treatment and maybe I'll be able to hear his heart better after a treatment. (seriously, just buying time till I can figure out how I'm going to count an accurate pulse on this squirming, wheezing, mucus filled nightmare!) I literally fly by the seat of my pants through the whole PCS and actually get my heart rate reading when I steal a quick look at the heartrate while checking his O2 sat! I'm in this to win it, and I'm not going down without a fight! I suction the little critters nose after doing my management and reassess like a good CPNE'er! I literally run out of the room and do my paperwork.....PASS! What the hell??? Did I seriously, just wing that? OMG....I need to be nominated for an OSCAR at least!

Day over....one more to go!

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Specializes in Telemetry.

(Woke up and told myself to stop acting like a nervous idiot and to start acting like the confident nurse I am at work. I promised myself that this last PCS (hopefully) was going to be me, being me! I was going to remember who I was and go in there and snatch that CPNE right out of Excelsiors hands!)

PCS #3 30 something woman in with bilateral PE's, DVT's. On heparin gtt. I'm assigned to do Peripheral vascular assessment, ambulate, ice pack....and I swear I can't remember anything else. Honestly, I have so many blank spots about this whole weekend. I am so amazed at how people remember all the details!

Not much to say about this one, I did what I was assigned to do. I felt very confident and acted like a totally different person than the blundering idiot I had been for the past two days. I laughed with my patient, we went for a walk, it was great. I did my charting, handed it in and sat and waited. And then it hit me....I thought about everything I had overcome to get to this point. I have been an LPN for 15 years because I knew I'd never be able to get past the math requirements in college. I thought I'd die if anyone ever found out I had a learning disability. I don't know when it happened or what happened to change my mind, but one day I just decided I was going to get officially tested and get the documentation I needed for my community college, so I could get the accommodations I needed. $1000 dollars later I got my official diagnosis and my accommodations. I went to tutoring EVERY single day during my math and Chemistry classes and passed!

I sat there waiting and all of this came rushing back to me and right there, right then I just started crying. I mean the type of crying you do when someone dies! OMG... I think I had just had it and all that stress just overwhelmed me. I got up and went to find a rest room and cleaned myself up a bit, but by then my eyes were swollen and red and there was nothing I could do. I walked back to where I was told to wait and the CE just looked at me and said, "why are you crying, you're going home!" LOL....I lost it! I just balled my brains out and she was so nice! We walked back to the room where they did the skills testing and my new bestie, Theresa, was standing there...she had passed too! We hugged like we had known each other our whole lives! I went in and the CA congratulated me and gave me my paperwork. We talked for a bit and then I tore out of there before they could change their minds!!!

I know this is long, but I feel so much better after telling my story. This test is totally doable, but please know going in that it is by far the most stressful experience you will ever have. BE PREPARED!! Know your stuff inside and out and be able to defend your actions. Fight for yourself, this is YOUR CPNE! If anyone has any questions please email me, I'd be happy to help anyone get through this. :)

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Specializes in Telemetry.
I'm reading hunny so keep them coming!!!!

Thank you. :heartbeat

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Specializes in GI, Outpatient Surgery.

WOW- what a great write up/ experience! I have 2 LS tests left and I am scared to death of the CPNE!! I hear its doable but the idea of it is- ugh!- killer! I am so happy for your for passing and you poured your heart and soul into it! Congrats to you!! I really appreciate you writing this!!

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Specializes in LTC, Clinic, Med/Surg, Ortho.

I just copied and pasted all that onto a word document to print and read later.. lol

I may be messaging you for info. Thanks so much

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Specializes in Telemetry.
WOW- what a great write up/ experience! I have 2 LS tests left and I am scared to death of the CPNE!! I hear its doable but the idea of it is- ugh!- killer! I am so happy for your for passing and you poured your heart and soul into it! Congrats to you!! I really appreciate you writing this!!

Thanks so much! It's good you're scared, this way you will study nice and hard and be super prepared!! I was terrified and let me tell you I studied my ass off! I only studied for about 3 weeks but I did it every day like it was an 8 hour job! I knew that CPNE inside and out and I could do those assessments in my sleep! You'll do great, email me when you get your date and I'll try to help in any way I can. :)

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Specializes in Acute, Adult Gerontology.

I have enjoyed reading this, wow!, I am currently waiting for my FCCA, to come will be writing it 20 - 29th of this month, i hope to get there soon, i am yet to send in my CPNE application. I think i shall get the sheri taylor online too. but thanks for posting this and congratulations.

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