I'm so happy to have found this wonderful nursing community. I'm not really sure where this question belongs. I am an LPN with six years experience. I can't seem to be able to pass the CPNE. I get extremely nervous and start shaking and I'm a complete mess. I have taken it twice and it's my last chance. Bad luck seems to follow me around. The first time I took it my fiance accidentally broke his leg as he took me in to my first day. It was upstate NY and he slipped on the ice. SO, I had to ship him off to the ER as I did my CPNE in the same hospital. Passed all the lab stations. Ran out of time on my first cps when they gave me a chatty patient then my second PCS my careplan was not measurable. Second time around in Georgia, I failed the lab stations, I ripped four different pairs of gloves while attempting to do my wound station six months pregnant with raynauds in a freezing room. I shook so bad. Failed at it both times. Passed my PCS's though.
I don't know what to do anymore. I know my stuff. I just can't seem to calm down. It's not like I can afford to keep throwing all this money out. I'm the primary bread winner in my house and its so hard for me to even come up with money. I have one more chance and I cannot blow it. All I need is my CPNE and Microbiology. Any advice would help. This time around should be easier because one I am not worried about loosing my job because they would not give me the weekend off and two because I'm not pregnant :) I've been to the workshops and my care plans are strong. I'm currently working nights in hospice so I get a lot of down time to study. Any advice would be so appreciated. Thanks so much =D
First of all change your mindset. I dislike the title of this thread because you CAN pass the cpne. You have to decide before you arrive that you will pass. "I'll go and see what happens" won't cut it. I had some of the wackiest things happen during my weekend. I was on my 3rd pt and STILL no bp cuff available for my manual requirement, a pt that would not stop talking during resp assess, a new CE who stopped me in the middle of my pcs and pulled me out to fail me (challenged her and won) you name it. I just decided to pass and it made the difference. I saw students taking xanax, inderal, and rescue remedy spray to get over their nerves but we passed and that is what counts. You have to believe in yourself though or no amount of advice will help you. It is a monster but it is doable. I'm rooting for you. :)
Hey just curious, what happened when the CE pulled you out to fail you, and you challenged it? What was she trying to fail you for? and what was your argument? Thanks in advance :)
Specializes in Primary, Geriatrics, Neuro, MS, Hospice.
Thanks so much everyone for your positive feedback. I don't know anyone who has finished the excelsior program and its so nice to know I'm not alone in this. I truly appreciate the time you took to help me. I am going to take my time and not worry so much. Everytime I take it I seem to have so much pressure to pass (i.e baby coming, closing on house, difficulties at work) this time I'm gonna do it for me. :heartbeat No more excuses. I can do this:cool:
good luck nurseymom. i hope the third time is the charm. you may want to try xanax. i took it for my cpne and it helped (although i was still shaking a little bit but i was calmer).
seems like you already know what to do to pass but you just need help with managing your nerves. have you tried some breathing techniques? try to read as much cpne journals as you can on the epn and you may learn a few things from previous testers that will help you pass.
show confidence even if you are not confident during the whole ordeal. sometimes if the ce knows you know your stuff, she will help you pass.
Hey just curious, what happened when the CE pulled you out to fail you, and you challenged it? What was she trying to fail you for? and what was your argument? Thanks in advance :)
I'm not sure if I can discuss it because of the academic honest /confidentiality policy.
Thanks Lunah :) My assignment required me to do cough/deep breathe AND incentive spirometry. I did the IS and listened to the pts lungs and before I could move on to the C&DB she stopped me and pulled me out. She asked if I knew why and I said no which was the truth. She said "you were also assigned C&DB and you moved on to the assessment phase(listening to lungs) before you completed it. I gave her my best HUH? expression and CONFIDENTLY stated "how am I supposed to document the effectiveness of the resp hygiene exercises if I don't assess between them. How will my documentation show what worked to clear the lungs?" She looked confused and shook her head no. I asked for the CE/CI (can't remember) and he came down and I told him the same thing and stood my ground like I was POSITIVE that I was right. He pulled her out of the room and when they returned he said you can continue and we will add 10 minutes to your time. I actually lost about 30 min with the whole ordeal and I almost failed for time. I bolded some words because you HAVE TO convince them that you know what you are talking about. I think if I would have waivered they woukld have failed me. It wasn't in the guidelines that way but it made perfect sense and I was certain it was best for the patient. Hope this helps someone.
Thanks Lunah :) My assignment required me to do cough/deep breathe AND incentive spirometry. I did the IS and listened to the pts lungs and before I could move on to the C&DB she stopped me and pulled me out. She asked if I knew why and I said no which was the truth. She said "you were also assigned C&DB and you moved on to the assessment phase(listening to lungs) before you completed it. I gave her my best HUH? expression and CONFIDENTLY stated "how am I supposed to document the effectiveness of the resp hygiene exercises if I don't assess between them. How will my documentation show what worked to clear the lungs?" She looked confused and shook her head no. I asked for the CE/CI (can't remember) and he came down and I told him the same thing and stood my ground like I was POSITIVE that I was right. He pulled her out of the room and when they returned he said you can continue and we will add 10 minutes to your time. I actually lost about 30 min with the whole ordeal and I almost failed for time. I bolded some words because you HAVE TO convince them that you know what you are talking about. I think if I would have waivered they woukld have failed me. It wasn't in the guidelines that way but it made perfect sense and I was certain it was best for the patient. Hope this helps someone.
Good for you! It sounds like you had a good point and thank you for sharing :)
Your issue sounds purely a lack of CONFIDENCE when it comes to the CPNE. It also sounds like you have very sound clinical judgement and you have to be intelligent to have gotten this far. I am going to suggest something that will almost guarantee you will pass your last time but it isn't cheap. You have already been to workshops, another isn't going to help(IMHO). However, to make you BELIEVE that you are the nurse that you truly are you need a confidence boost. Do yourself a HUGE favor, invest in yourself.....go to an ANTHONY ROBBINS seminar. He is an amazing motivator. At the end of his seminars he has everyone convinced they can walk on a bed of hot coals and those who attempt it succeed. Please have confidence in yourself. The only other thing I would offer is checking out hypnosis sites and purchasing three downloads. One.....confidence Two...relaxation and Three.... beating fear of failure. Good Luck!
Am testing in 4 weeks @Mansfield, I know--I should be studying!!! Re:Xanax, have taken on occasion, usually cut tab in half (has helped with insomnia). Am afraid may cause me to be "loopy". For anyone who used this to help calm nerves, what time did you take it? Maybe I can try taking it a few times before CPNE to "get used to it". I just don't want to be too relaxed. Can't believe that one weekend of our lives can make me babble about xanax!
Am testing in 4 weeks @Mansfield, I know--I should be studying!!! Re:Xanax, have taken on occasion, usually cut tab in half (has helped with insomnia). Am afraid may cause me to be "loopy". For anyone who used this to help calm nerves, what time did you take it? Maybe I can try taking it a few times before CPNE to "get used to it". I just don't want to be too relaxed. Can't believe that one weekend of our lives can make me babble about xanax!
Thanks for any input. Cindy
It is "absolutely" essential that you try Xanax several times prior to using it for CPNE. Don't forget that each person may respond differently to the same medication. You do not want to take this on the MOST IMPORTANT day in your studies without knowing how your body will respond to this medication. Remember as nurses these are teaching we will also be giving to our patients therefore remember to practice what you preach. Try experimenting at taking it home different times to see when you achieve best results and if you really need it.
I'm not sure I'd recommend Xanax before the CPNE- Sometimes the adrenaline and sharpness you get from nerves can be a good thing- Just know your stuff backwards and forwards. Something else that helps- when you are going through that monster 3 ring binder to prep for it- imagine/picture in your mind exactly what you will do from the moment you walk into a patient's room. The difficult part is remembering to stay aware of EVERYTHING you do and say, as well as chart. The best way to deal with it is to drill untill you have all of the requirements down cold-Then act (even if you don't feel it) confidant in your ability to do it. In my experience, the examiners were very nice, and while they were professional, they weren't out to "get you", and really tried to give you the benefit of the doubt.
If you mess up one section, regroup, relax, and don't let it get to you. When I did the practice lab (meds & treatments) I was so nervous I mixed insulins backwards- A stupid thing that I've done correctly thousands of times, but I let my nerves overtake my concentration. I had to go back the next day and retake that one part, but that was the only thing I messed up. It is torture- by the third day you feel like a train wreck- when I finished my last patient care scenario and she came back from marking my nursing notes and told me I passed, I LITERALLY burst into tears at the nursing station- and trust me, that isn't something I'm prone to do. It's horrible, but it is passable. Another suggestion is to make yourself as comfortable with the testing site as possible. I actually took it at the hospital I had been working in- it reduces your anxiety if you know where you are going, where everything is, how to work the beds/IV pumps, ect. The student boards through Excelsior are also very good- everyone is in the same boat, and people post scenario that you can use to study from. Let us know how it works out.
Hello! I just took the CPNE and passed(!) the first time in Racine, Wisconsin. I highly reccommend this location, the instructors WANT you to pass. I hope this will help you and others that read this. First of all, you are your own worst enemy, it is your fear that is failing you not you. I have been an LPN for 23 years, I am a very organized, efficient and an anal person, I plan my patient care so I walk as few steps as possible and won't wear the patient out either. HOWEVER, none of it mattered! Because I failed 3 of the 4 labs right off the bat, things I have done 15 times a day for 23 years! It's because I NEVER had someone staring at me with a clipboard in their hands scrutinizing my every move! I was shaking so bad I could not get the drip rate on the IVPB, I looked like I was having a seizure standing up! I failed the other stations because of the shaking and my mind went cloudy. Now that you have been through this twice you know what to expect, the element of surprise is gone. I finally got a grip on myself and passed them all the second time, I did fail one patient care situation because I left out ONE sentence in my rational- Oxygen is a basic physiological need-OK down to business, lets help you pass this. This is how I passed: I ignored the instructor! You have to be assertive and they tell you to be! Some of the insrtuctors walked slow, took their time logging on to the computer for vital etc... finally I started to say "ok lets get going I'm ready, we gotta move, time is of the essence. Look at your patient care assignment kardex, for each area of care memorize two basic care plans that fit that area of care, for instance- Mobility, pt uses a walker or needs assistance- Risk for impaired skin integrity R/T mobility deficit, pt will maintain intact skin integrity, nurse will assist pt to ambulate to door with walker, nurse will encourage pt to change position frequently- DONE. Keep your care plan as simple as possible, you need to spend most of your time with the patient. Plan 15 minutes with care plan, 5 minutes writing baseline vitals and pain level next to the ones you have to take and other notes move fast, 5 minutes writing your grid, practice writing your grid for all areas of care until you can do it in 5 minutes. OK, I finally took control of the situation heres what I did : she handed me my pt kardex I scanned it, found my areas of assigned care, in pencil I wrote a number next to each one, fluid management #1, vital signs #2, I added pain assessment to the vital signs, it is the 5th vital sign, you will ALWAYS be asigned fluid management and vital signs and pain, oxygen management # 3, respirtory assessment #4, peripheral vascular assesment #5, mobility #6, comfort management #7, I then went to the blank pages in the back of the booklet and wrote my critical elements in the exact same order, if you are assigned meds they are usually due at 0900, you can do them at 0830, by the time you are done with fluid and vitals its usually time for meds which works out perfect because you have their blood pressure if you are giving a bp med, I don't assign a number to meds, although you could always make it the 3rd thing you will do. This is why I do this- Ok from the top- I wash my hands before I enter the patients room(there are sinks right outside every patients room, and all the patient rooms are private, no room mate) I knock on the door even if its open, I introduce myself, I tell them I am a nursing student with excelsior and my instructor will be observing my assesments, I then thank the patient for allowing me to take care of them, I pick up the pts wrist while looking at their name band I ask them to tell me their name and date of birth, DO NOT start any element without identifying them! You could have walked into the wrong room! while looking at my kardex I tell them I will be assessing their IV taking their vitals, listenting to their lungs, checking the pulses in their feet, and helping them to walk to the door or hall or whatever and that I hae some medicatons for them, just be brief, and I say is this ok with you? I haven't had one pt say no. Now heres where the organization comes in to play, if you have fluid hanging get this element done AND charted right away, then do the vitals, ask them what their pain is ( if they need meds tell their nurse quickly, don't proceed until you address this) then perform the critical element for oxygen management, then proceed to respiratory assessment, then peripheral vascular assessment, give meds if you need to , breakfast tray may have showed up, while the pt is eating breakfast CHART or give them thier meds, also if you reposition the pt to sit up better for breakfast that is a comfort measure, one down 2 to go. I always save mobility for last, watch the pt so when they are done with breakfast you ASK for the measuring device so you can chart their intake, now I ask the pt to take a walk with me, then they go to the chair or back to bed, before they sit down STRAIGHTEN their linen, this is a comfort measure, 2 down one to go, I then offer to help set them up to brush their teeth comfort measur # 3 DONE, REASSES THIER PAIN IF YOU HAD TO MEDICATE THEM, tell the pt you are going to take a moment to review your assignment to make sure you didn't forget anything, scan your kardex, if you feel confident that you performed every area you were assigned tell the instructor you would like to go chart, compare your charting to your critical elements. Do you see the organized way to move through your assigned areas of care? Do all assessments that require the pt to stay in bed in first, work from the top of their head to the tips of their toes, dont perform an abdominal assessment BEFORE you perform the respiratory assesment, they are already probably sitting up in bed and you would have to lie them down to do the abdomen and sit them back up to do the repiratory, to many steps. REMEBER, wash your hands before you enter the room, after that gel as many time as you want, wash your hands when you leave the room, and you can go back and do something you forgot unless it is like a hep lock flush, if you flush before you aspirate its over. I know this was lengthy but I hope you gleened something from it and I wish you blessings on your next try, I HIGHLY reccommend Racine, wisconsin. arrived as an LPN left as an RN
I don't know anyone who has finished the excelsior program and its so nice to know I'm not alone in this. I truly appreciate the time you took to help me. I am going to take my time and not worry so much. Everytime I take it I seem to have so much pressure to pass (i.e baby coming, closing on house, difficulties at work) this time I'm gonna do it for me. :heartbeat No more excuses. I can do this:cool:
N1colina
222 Posts
Hey just curious, what happened when the CE pulled you out to fail you, and you challenged it? What was she trying to fail you for? and what was your argument? Thanks in advance :)