ISU VS. Excelsior

caliotter3 · Apr 22, 2009

All the above is fancy language for "display that you are capable of doing the tasks required of a nurse".

chaxanmom · Apr 22, 2009

I'm an ISU student and while it has its issues like any school, I really think it is a valuable program and it's my preference over Excelsior. That being said, at the moment I can only recommend it with a "but". We just got a letter stating that there is a new $300 fee being added this fall for clinical courses. This is to improve the sim labs, hire new clinical professors, etc. The letter doesn't clarify if distance students have to pay it but we have to pay other fees such as the technology fee that only benefits on campus students. I called the dean's office but haven't heard back yet so I'll update when I do. If indeed this fee will be charged to distance students then I'm not recommending the program until they come up with a fair fee structure for distance students. The other fees have been around $60. $300 per clinical course for something that doesn't benefit off campus students is where I draw the line. That adds up to about $1800 for nothing. Not cool.

Editorial Team / Moderator · Apr 22, 2009

I'm not sure that I'm getting a full picture of what the three days entails--like, solve problems involving measurement, calculation, reasoning, analysis and synthesis"--what exactly are they talking about? A written dose calc test? Are they asking about a physical stamina test with the 'physical exertion' bit?
If anyone who has been there could tell me exactly what they're talking about with some examples, I'd love to hear it. I'm not the best navigator on the computer and maybe I have missed something they have stated somewhere on their site?

The Clinical Performance in Nursing Exam (CPNE) is a challenging 2.5-day clinical exam. Students travel to regional test sites (hospitals) to take the CPNE. The first day consists of four lab stations that are performed on mannequins -- calculating and administering an IM or SQ injection (you'll get one or the other, you don't know which), calculating and performing an IV push, IV piggyback (calculating and setting a gravity drip), and changing a wound dressing with perfect aseptic technique. If you fail any of these lab stations, you can repeat them one time (before being sent home with a failure) the next day, after you take care of your patients.

The next day, students have two Patient Care Situations (PCSs), with real patients who have agreed to participate. Over the course of the weekend, you'll have a minimum of two adult patients and one pediatric patient. You have 2.5 hours to formulate a careplan with two nursing diagnoses (one can be a risk diagnosis, the other must be actual), carry out your selected interventions related to your careplan goals while also performing selected and required areas of care, and then documenting the whole thing without missing a critical element. You are not asked to do anything invasive -- no starting IVs, no IV push meds, for example -- just basic assessment and basic management. It's a test of basic skills, time management, and prioritization. Your patient isn't in a bubble during those 2.5 hours -- docs will come in, family members, PT, x-ray, etc., so time management really is a factor.

Overriding and required areas of care include demonstrating caring, ensuring physical safety at all times, not placing the patient in emotional jeopardy, evaluating mobility, checking a set of vitals to include manual BPs that must be within a small amount of what the clinical examiner gets (you're using a double-headed teaching stethoscope for BPs, apical pulses, lung sounds, etc.), and fluid management (checking IV sites, infusing fluids, etc.).

Assigned areas of care (most students get 3 or 4 of these assigned) include things like peripheral vascular assessments, neuro assessments, abd assessments, respiratory assessment, respiratory management, O2 management, comfort management, pain management, skin assessment, musculoskeletal management, specimen collection, irrigation, enteral feeding, wound management, medication management, and patient teaching. After all that, everything has to be documented perfectly, and students evaluate the effectiveness of their careplans in writing and choose a priority nursing diagnosis, supported by a rationale.

As I said, you'll have a minimum of two adult patients and one pediatric patient. You can fail one adult and one ped, and repeat those once each before you're sent home without that coveted "pass." In your documentation, if you exclude anything from that area of care that Excelsior designates as a critical element, it's a point of failure. If at any time you place the patient in emotional or physical jeopardy, you fail.

The CPNE can be extremely stressful -- you're in an unfamiliar place (for most of us, anyway) being watched like a hawk by a straight-faced clinical examiner. The key is being super-prepared by the time your date rolls around.

Hope that helps give you some idea of what the CPNE entails. I think the worst part for me was having to wear white scrubs. Ugh.

With all that being said ... if you have an opportunity to go directly to a BSN, I'd take it. I'm an EC grad and yes, a CPNE survivor! :) While it was a wonderful way for me to become an RN, the reality is that in today's economic/hiring climate, employers seem to be wanting RNs with BSNs. The hospital closest to me is now only offering new grad spots to BSN-prepared GNs.

ivanh3 · Apr 22, 2009

i am thinking about going back and getting my rn. i have looked into excelsior alot and the clinicals scare the poo out of me. i have for the last 4 yrs worked in an office behind a desk. i have not been in a hospital in years so the thougth of it scares me. i do however like the idea of the self paced and i love the idea of paying as i go so i do not have to take out student loans.
i have just started researching lsu at the suggestion of a co-worker. i like the idea of having a preceptor who is an rn i think i could learn alot.
i still have to look at the cost of each program, the amount of time it takes to complete and which of my pre-requs will transfer over.
what are your opinions on the two?

i think you should go to a traditional school or at least a school with a significant clinical component that covers the lifespan. i am not sure how much "pre desk job" experience you have, but being out of the game for 4 years is a long time. if you have lots of patient care experience, doing clinicals would help refresh your skills, and if you have little experience followed by 4 years of desk time then you really need to do some clinicals. this would benefit your patients, your peers, and of course your patients.

you have to remember that right now in this climate employers are raising the bar for new hires. you would be putting much undue pressure on yourself to show up at a job as a new grad rn with little or no recent patient care experience.

ivan

chaxanmom · Apr 22, 2009

I agree with Ivan. I took 10 years off to be at home with my kids so there's no way I would do Excelsior. I found out after the fact that it wasn't approved in Maryland but I knew I needed the clinical component. ISU requires 500 clinical hours and it is one on one with a preceptor so it's really great experience. Now if we can only get this matter of the clinical fee straightened out I can start recommending it again. :/

Editorial Team / Moderator · Apr 22, 2009

Now if we can only get this matter of the clinical fee straightened out I can start recommending it again. :/

That is ridiculous, to charge online students for something that doesn't benefit them! I hope they change that.

chaxanmom · Apr 22, 2009

That is ridiculous, to charge online students for something that doesn't benefit them! I hope they change that.

Well, I'm still trying to find out if that's the case or not. I left a nastygram on the dean's voicemail the other day so I'm trying to calm myself a little before calling again. They are probably screening calls after that. Haha! :coollook:

mrsM121 · Apr 23, 2009

The Clinical Performance in Nursing Exam (CPNE) is a challenging 2.5-day clinical exam. Students travel to regional test sites (hospitals) to take the CPNE. The first day consists of four lab stations that are performed on mannequins -- calculating and administering an IM or SQ injection (you'll get one or the other, you don't know which), calculating and performing an IV push, IV piggyback (calculating and setting a gravity drip), and changing a wound dressing with perfect aseptic technique. If you fail any of these lab stations, you can repeat them one time (before being sent home with a failure) the next day, after you take care of your patients.
The next day, students have two Patient Care Situations (PCSs), with real patients who have agreed to participate. Over the course of the weekend, you'll have a minimum of two adult patients and one pediatric patient. You have 2.5 hours to formulate a careplan with two nursing diagnoses (one can be a risk diagnosis, the other must be actual), carry out your selected interventions related to your careplan goals while also performing selected and required areas of care, and then documenting the whole thing without missing a critical element. You are not asked to do anything invasive -- no starting IVs, no IV push meds, for example -- just basic assessment and basic management. It's a test of basic skills, time management, and prioritization. Your patient isn't in a bubble during those 2.5 hours -- docs will come in, family members, PT, x-ray, etc., so time management really is a factor.
Overriding and required areas of care include demonstrating caring, ensuring physical safety at all times, not placing the patient in emotional jeopardy, evaluating mobility, checking a set of vitals to include manual BPs that must be within a small amount of what the clinical examiner gets (you're using a double-headed teaching stethoscope for BPs, apical pulses, lung sounds, etc.), and fluid management (checking IV sites, infusing fluids, etc.).
Assigned areas of care (most students get 3 or 4 of these assigned) include things like peripheral vascular assessments, neuro assessments, abd assessments, respiratory assessment, respiratory management, O2 management, comfort management, pain management, skin assessment, musculoskeletal management, specimen collection, irrigation, enteral feeding, wound management, medication management, and patient teaching. After all that, everything has to be documented perfectly, and students evaluate the effectiveness of their careplans in writing and choose a priority nursing diagnosis, supported by a rationale.
As I said, you'll have a minimum of two adult patients and one pediatric patient. You can fail one adult and one ped, and repeat those once each before you're sent home without that coveted "pass." In your documentation, if you exclude anything from that area of care that Excelsior designates as a critical element, it's a point of failure. If at any time you place the patient in emotional or physical jeopardy, you fail.
The CPNE can be extremely stressful -- you're in an unfamiliar place (for most of us, anyway) being watched like a hawk by a straight-faced clinical examiner. The key is being super-prepared by the time your date rolls around.
Hope that helps give you some idea of what the CPNE entails. I think the worst part for me was having to wear white scrubs. Ugh.
With all that being said ... if you have an opportunity to go directly to a BSN, I'd take it. I'm an EC grad and yes, a CPNE survivor! :) While it was a wonderful way for me to become an RN, the reality is that in today's economic/hiring climate, employers seem to be wanting RNs with BSNs. The hospital closest to me is now only offering new grad spots to BSN-prepared GNs.

WOW! Awesome answer! It certainly does seem like a lot and I appreciate your answering and taking the time to explalin so much.

Editorial Team / Moderator · Apr 23, 2009

WOW! Awesome answer! It certainly does seem like a lot and I appreciate your answering and taking the time to explalin so much.

It is a lot. It has to be! :) I think some students might have gone the traditional route if they had really known what the CPNE entailed ... it gets downplayed as a "2.5 day skills check-off," and that is certainly misleading.

dialysisnurseLC · Apr 2, 2011

Hi mrs lunah! i am considering Excelsior and i also looked at The college network (which i am not going to do) the college network advisor did make it seem like it was just a clinical skills check off...before ur CPNE how did u prepare?? did u use the excelsior cpne study guides..or do some preparation at ur home hospital??

thanks in advance

Editorial Team / Moderator · Apr 2, 2011

I posted a CPNE description here: https://allnurses.com/distance-learning-nursing/isu-vs-excelsior-386245-page2.html#post3582285

There are workshops and other resources available for preparation.

dialysisnurseLC · Apr 2, 2011

thanks very much!