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DoubleblessedRN, ADN, RN, EMT-B, EMT-P
223 Posts
I haven't heard much or seen many posts about others' CPNE experiences in Mansfield, so I would love to do the honor of writing about my experience.
First, about the CE's: All three times I tested there, almost all of the CE's were nice. They are not out to fail you (or fail-happy as one friend said) and they don't ask trick questions or try to set you up to fail. Only one CE I dealt with seemed a little snooty...her face was either stern or expressionless, and had a monotone voice.
The hospital has a VERY small peds unit, which is also combined with an adult med-surg. I believe there are only 3 or maybe 4 pediatric rooms, which are private. All times that I tested there (and two other friends who tested there at other dates also told me) nobody was assigned a pediatric. One person was almost assigned a 13 year old with cellulitis to the face, but s/he was to be transferred to a higher equipped hospital ASAP, (the CE was not aware of it until that day) so the CE had to reassign the student an adult substitute. It could still happen, but the chance of getting a ped is slim.
Most, if not all students, were assigned pretty easy areas of care, the very common, usual ones. Nothing complicated added on. (like measuring abdominal girth, hourly intake and output, drainage and specimen collection)
I was lucky and had very easy assigned areas of care and it was very easy to diagnose and write care plans for my patients.
PCS 1
66 year old female admitted for intractable left arm pain, not cardiac related. Hx of HTN and diverticulitis. Assigned areas of care were: Abdmonial Assessment, Neuro Assessment, I&O, Meds (Celebrex, SC Lovenox, and 2 antihypertensives) Under Mobility I was to reposition.
Nursing dx:
Acute Pain RT musculoskeletal impairment AEB pt stating 4 on 0-10 pain scale.
Goal: pt will state pain rating of 3 or less on 0-10 pain scale
Intervention 1: assess pain rating
Int 2: medicate pt per orders.
Risk for Injury RT pt receiving opoid analgesics
Goal: pt will be injury free during PCS
Int 1: keep side rails up x2
Int 2: provide footwear for pt if pt gets out of bed.
I performed the Abd and Neuro Assessments after Caring and Fluids and vitals. I medicated the patient (the staff nurse also gave the pt oxycontin at the same time) then went outside the door to chart and give the meds some time to work. Upon reentering the room, the pt rated the pain as a 3. She had already repositioned herself and declined repositioning. I measured I&O and was outta there. Simple enough.
PCS 2
This pt was an 87 y/o male admitted for pneumonia who had recently underwent a hernia repair and had ileus. Assigned areas of care were: Abd assessment, Peripherovascular assessment to lower ext only, Resp Mgmt w/ deep breathing, coughing, and incentive spirometer, I&O. I was to reposition under mobility.
Dx 1: Ineffective Airway Clearance RT retained secretions AEB abnormal lung sounds
Goal: pt will demonstrate effective cough
Int 1: Assess lung sounds
Int 2: Instruct pt to deep breathe, cough and use incentive spirometer
dx 2: Risk for Injury related to prolonged bedrest
Goal: pt will be injury free during PCS
Int1: Keep side rails up
Int 2: Keep bed at lowest level
I performed the assigned areas of care in the order listed above after caring, fluids and vitals. Upon leaving the room, I repositioned the pt to high fowlers, as the lunch trays were going around but got outta there before his tray arrived! During vitals, I was assigned apical pulse. I had one h*** of a time hearing it because he had such loud rhonchi, so I decided to check it again after resp mgmt. After resp mgmt, rhonchi was still loud, plus the pt had a hx of A-fib, so the irregular pulse made it even more difficult. During evaluation, I asked my CE if I could check the pulse one more time. She said if my reading was different than hers, she would call the CA. After submitting it, the CE came to tell me I had passed, so obviously I had nearly the same reading. (she said that she herself had great difficulty hearing the apical pulse, and if my reading was much different than hers, she would call the CA and ask if we could substitute it for a radial pulse. She said sometimes under circumstances like those that has been done or it has sometimes been overlooked. I was surprised about that.) Two down.
PCS 3
This was a 62 y/o male admitted for dehyration and hypokalemia. HX included alcoholism and cardiac with a pacemaker. Assigned areas of care included Neuro assmt., Periph. Assmt., Abd Assmt., Resp mgmt w/ deep breathing and coughing, I&O, and repositioning under Mobility.
Dx 1: Activity Intolerance RT muscle weakness secondary to hypokalemia AEB pt complaining of weakness on exertion
Goal: pt will maintain normal skin color and temperature with activity
Int 1: Reposition patient
Int 2: Assess pt response to repositioning and resp mgmt measures
Dx 2: Risk for Injury RT general weakness
Goal: pt will be injury free during PCS
Int 1: Keep side rails up x2
Int 2: Keep call light within pt reach
I also performed assigned areas of care in the order above after caring, fluids and vitals. Nothing out of the ordinary with this patient.
I can't even describe the feeling I had when I was told I passed! (I had the same CA as I had the first time I tested there.) I was the first one out of there. If only they were all as easy as this one. Third time is a charm!