PASSING THE CPNE: tips from my experience - page 10

well, i thought this thread might stick around a bit longer if the title was more obvious. so, i am posting my cpne experience here instead of "anticoag nurse passed the cpne"... i'll start with... Read More

  1. by   hospicenurse2008
    I'm new to allnurses.com. The information you provided is very helpful. I'm trying to figure out how to send you a personal request for the documents you are willing to share. Please send me a message. thank you!
  2. by   Pixie.RN
    Quote from hospicenurse2008
    I'm trying to figure out how to send you a personal request for the documents you are willing to share. Please send me a message. thank you!
    You can't use the private messaging (PM) system until you have 15 posts to your credit. So join in some discussions, and you'll be able to PM in no time!

    Welcome to Allnurses!
  3. by   farmgirl
    I've felt like a dip half the night trying to figure out why I can't seem to find the IM component. Didn't know I was too new :smackingf
  4. by   pielęgniarka
    I wanted to post a few things that got me through the CPNE successfully: the following paragraphs are taken from a previous post of mine from after I PASSED!

    Tips: Make up a mad scientist lab in your basement. Get the skills kit and practice the sim labs until you can do them without looking at a list. Then have someone observe you while you do it and them hold a checklist to critique you. My husband works in construction and he was my "silent observer". It's much harder with an audience. Make a dummy out of old clothes. And hook it up to an IV. It may scare visitors to your house but-- practice PCS dialog and go through all the AOC motions with this dummy until it's second nature. The CE's do watch you closely to make sure you're not aucultating over bone for lung sounds or AP so learn those landmarks.

    Get a calculations book and practice figuring out IV pushes, and IV gtt/min rates, and IV ml/hr pump rates, and mixing med formulas. Get comfortable with math!

    I don't work with IV's currently. And I was really nervous about doing this during the CPNE. An occasional picc line but they've all been like one way valves, so I didn't even have to aspirate or anything. All my studying and rehearsals walked me right on through the PCS's with IVPB's or saline locks. I knew exactly what steps I had to perform and the CE programmed the pump based on what I told her to do.

    I bought a little hand held voice recorder and recorded myself doing PCS dialog. I submitted care plans and narrative notes to the EC advisors and recorded their responses and advice and encouragment. I recorded my mnemonics. I recorded normal ranges for VS and the sizes of needles to pick out for IM and subQ. I recorded myself walking though dosage calculations. I would put an ear piece in while doing dishes and listen to me. I would play it in my car. During my lunch break at work. I am SO SICK of listening to myself! But it all became second nature and the CPNE ended up being doable. I watched cpnex.blogspot. I went to allnurses.com. I had help from Lisa Arends. This EPN was invaluable. Also get all the information you can from your EC advisors as that is the final word. Use your phone calls to them.

    Also, all my nursing dx interventions were taken off the Kardex. Every single one. For whatever dx they fit into: SR up x2. Ambulate to BR x1. Transfer to chair x1. Respiratory assessment assigned I would put Assess lung sounds or even Reposition x1. So on and so forth. Ensure call light within reach, etc. Instruct on deep breathing. That sort of stuff.

    I didn't get to get report from the pts primary nurse, not once! All the info I got from my CE. I didn't get to report off either, the primaries are so busy. The CE takes control of report so you don't have to in that case.

    I practiced manual BP's at work and Apical pulses like crazy to get back in the game, it paid off.

    ALSO, I totally don't believe any posts about the students that fail the whole thing because they dropped a pen on the floor and then picked it up or put their papers on the pts bedside table or something like that. I think instances of that sort are just the straw that broke the camels (or CE's) back. There must have been plenty of little things leading up to that failure. There was a time when one of the 15 pens or pencils fell out of my pocket, the CE swooped in and picked it up with a paper towel, set it by the sink so I could "gel" it off later. You can bet my asepsis was top notch after that warning. There was one time I forgot to close the door and was about to start an assessment and the CE dove over and stated "I'll just close this door here." You can bet my privacy measures were over the top and obviously stated after that! There was one time when I set my papers on the foot of the pts bed and I went ohhh crap and looked at the CE, she said thats fine just put them back in your pocket. The CE's are incredibly professional and smart. Treat them with respect and they will do the same for you.

    Sara
  5. by   shopgirl_2008
    Quote from anticoagulationurse
    well, i thought this thread might stick around a bit longer if the title was more obvious. so, i am posting my cpne experience here instead of "anticoag nurse passed the cpne"... i'll start with general tips from my experience: i also have a very long journal recollection type thing (4 typed pages of my pcs experiences and a long 2 page recall of my sim labs). i really think they are too lengthy to post here, so if you would like, pm me and i will email them and please feel free to keep and pass on to others in the future.

    (moderator note: in keeping with the terms of service, do not post your email addresses on this thread or in the body of any allnurses.com post. to pm, click on the name of the member, then select 'send a private message to...')

    cpne tips
    • arrive at the location the day before and practice driving or bussing or getting yourself to the hospital.
    • bring music that 1) pumps you up, 2) relaxes you and makes you happy. i did not bring music and really wished i had. it would have added to my feeling of having some sort of choices and autonomy, and would have helped distract me.
    • if you are traveling 3 time zones away like i did, consider practicing a week in advance getting up at "0230". i traveled from west to east coast and the time zone thing really messed me up badly. i was already a frazzled mess, let alone lack of sleep!
    • bring bath salts and a tea-light candle to relax by.
    • bring a small item that reminds you of home.
    • come with a loved one. i thought i would be fine on my own but i was a wreck. it really would have helped having my husband along to hold me, coach me, and be around to listen to and distract me.
    • trust your mnemonics. do not stray from your grid. keep your grid in viewable distance the entire time. i failed one pcs because i had no-where to set my grid but the windowsill and didn’t look at it during respiratory management. i missed a critical element (coughing) i knew in my head (had a nagging feeling), but would have caught it if my grid were in sight! check critical elements off as you complete them.
    • do the implementation phase in phases. leave the room for 15-20 minutes at least once to catch up on planning, thinking and documenting as you go.
    • document on your grid as you go along and transfer to your pcs recording form later. group patient care activities, and remember assessments and managements don’t all have to be linear. do bits and pieces as opportunities present.
    • feed the patient questions that relate to your nursing dx. example: for impaired comfort, ask the patient if they are stiff, sore or feeling grimy, etc. for impaired physical mobility, ask if they feel off balance when they walk or stand, or weakness, etc. get them to tell you what nursing dx is appropriate to them.
    • doing vitals twice is not necessary when you use machines for bp or spo2 or temp. this is according to my ce’s.
    • don’t spend a lot of time in the planning phase. just pick some sort of reasonable nursing dx and interventions quickly. you will have limited knowledge of the patient and you will probably have to revise any nursing dx and interventions anyway. do your thing in implementation and then allow what you’ve already done to direct you in choosing a priority dx and interventions during the evaluation phase.
    • when you have a question about anything, ask the ce. the worst they can do is say they cannot answer the question or, maybe give you a partial answer that guides you in the right direction.
    • be attuned to your ce’s body language. they may inadvertently cue you into things you are missing!
    • if during implementation, the ce interrupts and asks, “have you completed the critical elements for blah blah assessment/management?” immediately say, “no, i would like to review my papers.” then, think madly and try to figure out why they asked you that. if they ask this, it may mean you are about to fail and you may have a chance to correct your mistake if you can figure out what you missed. they will not ask you this question if you are doing everything correctly.
    • during evaluation and documentation, check your grid against your pcs recording form at least 3 times before turning in. make yourself a system for marking off your grid as you go and then as you document. one student my weekend failed a pcs for not documenting pain of 0, even though the ce and the student both knew she assessed the patient’s pain at least 5 times during implementation. if it is not documented, it wasn’t done.
    • mark a line on the cup the patient is using if there is liquid in it, at the beginning of the implementation phase. this will help you accurately measure intake later.
    • bring the mar into the room with you to document when you give meds. saves time.
    • keep a whole bunch of gloves in your pocket. glove whenever you have doubt (touching washcloth, foley bag tubing, tray, etc.) even if you wouldn’t in real life. be sure to remove gloves if contaminated before touching something else in room, such as the curtain or bathroom doorknob, or your pen.
    • in planning phase, don’t spend too much time with the kardex or the chart. you will learn so much more directly from the patient and it will save you time. you can always look something up later if needed. you don’t need to know everything about the patient.
    • smile at your ce, they really want you to succeed if you have any business succeeding.
    observations from my cpne

    all patients:
    were very friendly and talkative, which is time consuming.
    intake and output
    spo2


    i was not assigned:
    neuro assessment
    musculoskeletal management
    pain management
    weight
    abdominal girth (although all pcs’s had abdominal assessment!)
    oxygen management
    wound management
    peripheral vascular assessment
    anticoag,
    it would be awesome if you could send me what ever you have!!! i will be taking the cpne in jan. in albany, feeling overwhemed but determined-
    thank you thank you in advance
  6. by   kobepuppy
    hello, my name is amber (lpn). i will be taking my clinicals in ohio soon. i was wondering if you are still willing to email me your typed exp. i am really nervous and hope it might help. wish me luck and thanks.



    moderator note. please do not post email addresses in posts as per terms of service
    Last edit by Silverdragon102 on Nov 19, '08 : Reason: TOS
  7. by   ougreene
    your tips really did help, i am glad that you posted them. thank you very much!
    g:d (soon to be rn)
  8. by   SarahMcD
    Would you please send the tips to me?

    Thanks, Sarah
  9. by   SuesquatchRN
    The OP no longer posts on the site.
  10. by   bjbabs24
    Thanks, I had done the pm to her several times for the tips but no reply.
    If anyone out there did receive her "package" of email files could someone forward them to me???
    I would really appreciate it!!
    THANKS!
    BJ
  11. by   kdsharp
    I would love to hear from people who passed the CPNE without doing a workshop. I just don't have the time or money, and I'm scheduled in Ohio 3/20-3/22. Looking over the study guide, it doesn't seem that difficult to me, but I don't want to be over-confident, because I work on a floor, and I'm scared I'll be one of those with too many bad habits to overcome. Words of advice, anyone?
  12. by   SuesquatchRN
    Quote from kdsharp
    I would love to hear from people who passed the CPNE without doing a workshop. I just don't have the time or money, and I'm scheduled in Ohio 3/20-3/22. Looking over the study guide, it doesn't seem that difficult to me, but I don't want to be over-confident, because I work on a floor, and I'm scared I'll be one of those with too many bad habits to overcome. Words of advice, anyone?
    Post this as its own thread.
  13. by   preciosa76
    you mention you have some notes you could e-mail. Would it be possible to have these sent. I'm new to this site, so not sure how that works.

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