New to ER and getting CEN?

miss81, BSN, RN · Jul 2, 2011

Here in Canada we have to have a accumulate 3900 hrs in our specialty area before we can apply to write the certification exam. Is there some requirement like this that you must meet before you can become certified?

raskol · Jul 2, 2011

I would suggest working towards TNCC first. I want to get CEN, CTRN, CFRN certification and all the nurses I highly respect encouraged me to wait until I have more experience in those specialities. I did get TNCC a week after I passed my boards and made some good impressions/connections through that.

Esme12, ASN, BSN, RN · Jul 2, 2011

You should wait for your best chance at passing the exam. It really does test practical knowledge of emergency nursing.......What is the advantage of rushing through??? Really what's the rush??

In order to be eligible to take the Certified Emergency Nurse Exam, one must have a current, unrestricted nursing license or nursing certificate that is equivalent to a Registered Nurse in the United States. It is also recommended, though not required ( I think it should be required), to have at least two years of experience as an emergency room nurse in the United States.

Check out this site

http://www.testprepreview.com/cen_test_breakdown.htm

delilas · Jul 2, 2011

I agree with raskol - go for TNCC. CEN is an expensive and difficult test to go for with only a couple months of experience under your belt. TNCC teaches you great skills in addition to the certification.

Although its not required, CEN recommends two years of emergency nursing before attempting the test (so similar to Canada's requirement of 3900 hours).

While no one can predict your 'chance' of passing, I really do agree with your coworkers; give it some time. In critical care areas like EDs, we were told in our fellowship it takes at least a year to be truly comfortable and prepared to handle whatever walks in the door. Give yourself at least that much time before you dive headfirst into making it your specialty.

murphyle, BSN, RN · Jul 2, 2011

I'm a new grad (ASD-BSN) who started straight in Emergency, and wrote the CEN exam at just shy of a year's experience chronological (I pick up a ton of OT, so it was more like 1.25 years FTE - still early by BCEN's rubric). I passed on the first try, and passed well (142/150). It can be done, but there are a good many things you'll want to do to give yourself the best possible chance of success.

* Classroom work and certs. I had all of the Big Four (ACLS, PALS, TNCC and ENPC) before writing the CEN. At the absolute bleeding minimum you'll want TNCC and ENPC - the question format and course content is very similar to what you'll see on the CEN. I'd also recommend that you attend any lectures, lunch-n-learn events, or conferences in your area. The broader knowledge base you have, the better. (CEN content has been described by several people on this board as "Trivial Pursuit: Emergency Nursing Edition," and they're not wrong.)

* Study. I purchased the ENA test review book (five full exams with answers and rationales, plus two online practice exams), and studied the daylights out of it. I'd do twenty or twenty-five questions a morning after work, went through the entire book that way, and then did the two practice exams the week before writing the official exam. Learning the rationales will help you far, far more than memorizing the answers.

* Learn your weaknesses. In my case, I knew orthopedics was my downfall, as nurses hardly ever handle ortho in my department (splinting, casting and the like is overwhelmingly done by techs). I asked to be assigned to Minor Care for a few nights to immerse myself in ortho. Conversely, I had a good handle on cardiac and HEENT already, so didn't need to spend quite as much time there.

* Talk to the "resource people" in your department. Every ED has people who are absolute geniuses at certain things - and not all of them may be RNs. For example, we have an ex-SICU nurse who knows vents, drips and invasive access in her sleep, a respiratory therapist who's a COPD maven and has the best ears for auscultation in the hospital, a doc who's an ortho whiz, and so on. Find those people in your department and ask them (politely!) to walk you through some of the stuff you're unsure of.

I'd also agree with the previous posters to give yourself some time in the ED before attempting CEN. At the two-month mark I may or may not have remembered to put the Zoll pads on a coding patient. (Okay, maybe not quite that bad, but you get the idea. ) Some of the toughest questions on the CEN, I answered right not because of study, but because I'd seen those things and cared for those patients in the Department. At least get your certs and get somewhere closer to 9 months, if not a year, before you consider having a crack at the exam. And at that point... let us know how it goes!

Best of luck to you, and please don't hesitate to ask if there's anything else I can help you with. :nurse:

Editorial Team / Moderator · Jul 3, 2011

There is nothing wrong with starting to study for the CEN -- it will only make you a more knowledgeable ED RN. :) I took my CEN (and passed well) with only 10 months of experience as an ED RN, but I had already been a paramedic for almost 6 years and had 3+ years of experience as an ER tech. Good luck, and I hope you're enjoying your ED experience thus far.

Medic/Nurse, BSN, RN · Jul 3, 2011

I took and passed in September after passing NCLEX in April of that year.

I had been a medic for 9 years and had taken ENPC and TNCC.

I had been an ACLS and PALS instructor for years. I had been actively teaching ConEd topics for years as well.

I don't think I was special, just different.

I think you should give it time - sure, exam prep makes you a better nurse IMHO, but unless you have taken ALCS and PALS for the second time, and taken TNCC and ENPC - you are cheating yourself.

Focus on being a good ED nurse - you are just starting (less than 2 years as a nurse and I get excitement and the desire to "get it done", but do you really think a few months equals a level of mastery that board certification implies? I think that experience is essential to being successful. Many ???'s are patient management - not rote memory - and that favors experience. The is nothing better that experience. You need the foundation (ACLS, PALS, ENPC, TNCC, critical care classes) after than you gotta do some time in the trenches.

How will you handle a 27 yo female G3P2 32 weeks gestation that was unrestrained passenger in lateral impact MVC with 10" passenger compartment intrusion on opposite side that is that was initially unresponsive at the scene but was walking round on EMS arrival. She arrives to the ED on LSB/C-collar, refused IV access and monitor and VS and is now tearfully c/o neck pain and low back pain. What do you do first?

Not busting on you and that is a tough one - but, it is still what is waiting on you in ED practice.

Take the time know what you don't know. You will get there - just one step at a time.

Mark Boswell is an APRN on here and he a is great resource. Prior medic, RN and now ED advanced practice RN - so he knows all the angles. He has written an excellent review manual and does regional prep courses. You may be able to PM him at mboswell and get a lot of good info. He has the exam and the process down and works with this often. I just have to retest this September to recert - so I haven't been too involved with it for 4 years - and I understand that it has changed a bit. Contact Mark for more recent info.

No rush - this is a marathon - not a sprint. You are new and careful about positioning yourself as an expert RN in emergency care. Which is what I think the board certification does in some ways. IF something goes all to h#)) - you may be held to the standard of the Certified Emergency Nurse, regardless of your limited experience.

Also, even if you study a bunch - imagine how crushing failing the CEN would be at this point. I have a dear friend that is a great RN, ED director, lots of experience, is an instructor in most everything and I reviewed with her before the test - I would have bet anything that she would pass with flying colors - she failed. We reviewed her experience and I think she "drew" the most difficult questions imaginable - it was bad. I had went with her and shopped and waited while she tested - expecting that we would be celebrating shortly. It was a big disappointment (though she passed second attempt). I think your energy is best spent working hard and finding out what you don't know. Dazzle them with your CEN on your nametag and on the wall in a year or so - report back and share your what is sure to be your future success. I do really admire your focus - and goal setting will set you apart from many other ED nurses alone.

Good Luck

:angel:

mwboswell · Jul 3, 2011

Couple of thoughts....

1) Nothing says you can't try it now. There is no time requirement before writing the CEN exam. The suggested 2 years is just an approximate amount of time that the "average" ED RN will have a chance to experience/see most of the diversity of ED practice, with a reasonable chance of success on the CEN exam. Obviously, depending on your facility/job you may need longer/shorter time to see "most" ED type patient scenarios.

(Interesting side note: I wish someone would do some reasearch and see what the "best" correlation between time in practice and exam score is)

2) I HIGHLY recommend doing one of the "official" ENA practice exams. Use it as a self-assessment tool.

Passing score on the CEN is 73%. If you take a practice test, then look at the scores you got on each section. If you get 75% or better, you are good on that section. Less than 75% = you need to spend most of your time on that section reviewing. Over 80%, you are good to go.

Let this be the START of your studying/review. Identify your strengths and weaknesses and focus on increasing your weaker areas.

Let step #2 be the way you decide when your'e ready to test.

3) Even if you have quite a bit of study/review to do to beef up your scores on those subsections, you will be benefitting as you'll be learning about ED practice along the way.

4) Network with your peers and see what worked for them. Probably the BEST methodology would be for an educator to lead an entire department, over about a 2-3 month period, full of inservices, informal group sesessions and repeat practice exams. You would also reap the benefts of a group study effort and support.

Bottom line - you need to make an objective assessent of your readiness; and I think the best way is using an official ENA practice exam then take it from there.

mwboswell · Jul 3, 2011

I agree with raskol - go for TNCC. CEN is an expensive and difficult test to go for with only a couple months of experience under your belt. TNCC teaches you great skills in addition to the certification.

The CEN exam isn't really expensive. the "base price" is $360, you can get that down to $200 with group and ENA discounts. AND if you pass, you don't have to spend that money again for 4 years. TNCC is actually more expensive on the average. The overall "average" TNCC class price is $200-275. You may find some cheaper but, not many. Two days of continuing education for $200-$250 is pretty appropriate and farir.

raskol · Jul 4, 2011

The CEN exam isn't really expensive. the "base price" is $360, you can get that down to $200 with group and ENA discounts. AND if you pass, you don't have to spend that money again for 4 years. TNCC is actually more expensive on the average. The overall "average" TNCC class price is $200-275. You may find some cheaper but, not many. Two days of continuing education for $200-$250 is pretty appropriate and farir.

I took TNCC free from my hospital. I don't even work in the ED, I'm on a cardiac step-down floor. My hospital has many faults but they do strongly advocate for nursing education.

bbie17 · Jul 5, 2011

Thank you so much everyone, for taking the time to give me advice. I'm very inspired after reading all of you guy's comment. All the advices were great! I will take everyone's advice and take it one step at a time. I will take my TNCC and ENPC first, then review gradually for the CEN. I was rushing to get the CEN because I really wanted to get trained in the trauma area. At my ER, only RN's with CEN can work in trauma. It's been 2 months in the ER for me and I love it! I'm so eager to learn about everything and I take every opportunity to sneak in the trauma area and watch. Hopefully, one day soon I'll play a role in that room. Thank you all again!!