How to fail at CPNE

Baloney Amputation, BSN, LPN, RN · Jun 4, 2008

From my reading of things, it appears that it is mostly either nerves OR unpreparedness to carry out the critical elements that are the culprits in most failures. For the ones that have failures due to nerves, the second time around appears to be a breeze. They are still quite nervous, but that aspect of the unknown is gone. I don't actually think it's a component of skills so much, unless it is causing the student to be nervous. I have no figures on this, BTW. Good luck!

What are some common ways to fail out of the CPNE? While their pass rate is like 60%, what is the pass rate for LPNs who are already working in the field? I imagine the high failure rate is due to the population that has not had the chance to work on their skills daily? Does any one have figures on this, and what are common ways to fail?
Thank you,
Sharon

Editorial Team / Moderator · Jun 4, 2008

While their pass rate is like 60%, what is the pass rate for LPNs who are already working in the field?

Actually, Sharon, what I heard recently from an LPN who did her RN through EC is that seasoned LPNs often have a more difficult time with the CPNE because they have so many years of experience! It's not easy for an LPN with 30 years of experience, for example, to turn it down a notch and be a "first day new grad." But it can be done. :)

Common things I hear that cause failures: forgetting to ID the patient before a medication or just upon entering the room seems to be at the top of the list, followed by forgetting to wash hands. Running out of time is also a problem. It comes down to being organized and going in with practice and a plan of attack. :)

Melinurse · Jun 10, 2008

From what I see, asepsis is a big reason for failures and incorrect I&Os. Time management is another I've been hearing alot about. But, forgetting to wash your hands is number one according to my co-workers and from what I've seen. ( I work at a test site ) :eek: It seems so easy, but people seem to forget their Standard Precautions. Usually, it is our own stress that gets us all in the end. Know your stuff but DON'T NEGLECT YOUR STRESS MANAGEMENT!

txspadequeenRN, BSN, RN · Jun 10, 2008

this is the main reason i considered not doing ec... real world nursing is nothing like what you learn in nursing school or learn from a textbook. i'm not even sure i can place a foley without entering from the back of the patient or getting in the bed with the patient anymore (work with elderly). so over the next several months i will be working to retrain myself.

actually, sharon, what i heard recently from an lpn who did her rn through ec is that seasoned lpns often have a more difficult time with the cpne because they have so many years of experience! it's not easy for an lpn with 30 years of experience, for example, to turn it down a notch and be a "first day new grad." but it can be done. :)
common things i hear that cause failures: forgetting to id the patient before a medication or just upon entering the room seems to be at the top of the list, followed by forgetting to wash hands. running out of time is also a problem. it comes down to being organized and going in with practice and a plan of attack. :)

NC Girl BSN · Jun 10, 2008

Just recently heard that alot of people are failing the wound lab and IV labs.

Mudwoman · Jun 16, 2008

The CPNE is "best practice". That means that you must perform skills in the way they should be performed based on a really good skills book. Many a nurse knows that real world and a skills book are not always compatible. Long time nurses get into habits and habits are hard to change.

Here are some of the failure points.

Vital signs. Most basic of skills, yet many fail on this. Can't pump the B/P cuff up more than 20-30 mhz above the highest base line systolic of the patient. Go 32 and you fail. If you must repump, you must let out the pump all the way and wait for at least 1-2 minutes. How many times have you been taking a manual B/P and you start to let off the pressure bulb and you aren't quite sure of the first beat and you repump up the cuff a little. Fail. You only get 2 tries on a B/P per patient. Must be accurate with what your CE gets.

Not washing your hands.

Not ID'ing the patient. In the real world, we don't walk into the room 20 times a day and every time we walk in, we look at the ID band and ask the patient to tell us their name and date of birth, but on the CPNE you have to because that is "best practice". We are not in the habit of doing it and it is easy to forget.

I can't begin to tell you how many have failed on counting heart rates.

In the CPNE, you have 20 minutes once you enter the patient's room to do certain checks. You would be surprised how many forget this. You have to check the IV site, IV fluids, skin turgor, pain level etc. Many go in, forget to ID the patient, forgot to wash their hands, looked at the fluids and IV site, but then forgot to check the skin turgor.

Respiratory Management is another high fail area. You must do an assessment prior to doing the management and then you must do another assessment when you are done. Seems lots of students forget either the beginning assessment or the one after.

Lots of students just don't get the care plan and the evaluation phase. You don't have a lot of time, so this area of care requires that you really understand what you are expected to do and get it done. You need to be able to evaluated what you need to do for the patient you are assigned, and do the care plan in less than 20 minutes. Do your assigned duties in about 45 minutes and then do the charting and evaluation phase in about 25 minutes.

Lots of students simply forget to do one of the assigned areas of care. They don't look at their mneumonics because of nerves or whatever. They walk out of the patient's room and think they are done and then realize they forgot to do some little something like reassessing the lungs after doing respiratory management or something.

Charlee

Editorial Team / Moderator · Jun 16, 2008

Yup ... I failed for not ID'ing a patient using two forms yesterday morning. It was stupid, but I was rushing because it should have been my last PCS! I was more focused on the finish line than what I was doing, and it almost cost me the whole enchilada. I slowed down for the last one and aced it. :)

I agree with the careplanning -- the longest I spent in careplanning/grid prep was 30 minutes. I had an hour to do my evaluation phase for every successful PCS. The time in the room really isn't too long.

jkeys100 · Jun 16, 2008

The most anxiety provoking time of my life. After studying so hard, passing all the tests, it came down to just those few moments in the patients room with the CE. I knew it was do or die. I do think that those who haven't been nurses have a big advantage. I can understand why Excelsior is so stringent. Their reputation is on the line related to the students they turn out as RN's. I have never run into anyone who said anything negative about going through Excelsior (Regents for me). More the opposite. Wow you must be very self motivated, self disiplined, very smart, able to pass the CPNE. Wow. For me it was all a great experience. When I went you could also go if you were a CNA, which of course, they have changed. Many were able to take advantage of the opportunity. I have worked with some RN's who were previously CNA's and I don't see any difference working with them or the RN who went to traditional school. Although I agree with their decision to stop accepting CNA's into the program.