Just thought I'd share with ya'll that I took my CPNE at AMC this weekend and PASSED with no lab or PCS retakes. It wasn't easy but neither was it the nightmare that I had feared. Maybe it's different at other sites - Albany being Excelsior's main site - but I found the CA and CE's to be very realistic in their assessments. They were looking to see if we could be safe and competent new RN's, and not looking to fail us on minutiae. None of my CE's were even interested in things like if I looked away from my meds after preparing them. I suppose if I'd WALKED away from them it would have mattered, sure, but basically I just got the feeling that if they saw we were prepared, they wanted to give us every chance to pass.
Only one of the CE's seemed very stern and a stickler for the rules. I won't mention her name but she tried to fail me at the IV push station for not ID-ing the patient immediately before pushing the med. She said "I have to talk to the CA for a moment". They came back together and the CA said, "unfortunately you didn't ID your patient." I said, "I did the ID right after I drew up the flushes and the med." The CE then said "yes but you didn't do it immediately before you pushed it" at which point the CA broke in and said, "oh that's a pass. Just as long as you did it." The CE then tried to debate it a bit with the CA but the CA cut her off pretty abruptly and told me I could move on. I guess she didn't want a disagreement happening in front of a student, so I just said, "thank you very much" and moved outta there. Later, that CE apologized to me but she seemed irritated so I was glad that I didn't have her on my PCS rotations the next day. Not that I think she would have consciously tried to torpedo me, but I was worried that subconsciously she'd be looking for any reason to fail me because she had been overturned by the CA in the lab.
Anyway, that was the only snag. The next day my first PCS (adult) was a train wreck post-surgery patient with multiple problems. But the CE was very helpful with everything. It's hard to describe. She didn't give me hints but she was really understanding that there was so much going on - so many drains and tubes and suction plus a really talkative patient, etc., that I didn't get flustered at all. Even when the primary nurse came in and knocked over one of my crushed meds (destined for the NG tube) and the patient's ice-chip cup (there went I/O!). The CE just eliminated that med from my kardex and helped me ballpark the I/O.
My second PCS (child) was a very pleasant 11 year old girl post appendectomy. She was about to be discharged. The CE for this one was very quiet but was definitely interested in me just busting out the few assignments and getting out of there so the patient could go home. Everything went perfectly (although I had to revise my care plan later because she never did have acute pain) and I was done.
Next day was a patient with several problems on the vascular surgery ward. This CE was extremely helpful and very relaxed. Again a pass with no problems. And it was over.
All in all, definitely a nerve-wracking experience, but at least for this site there was no sense of the CE's trying to catch me out and fail me on the smallest detail. I think being prepared helps them relax and focus on what really matters - delivering safe and effective patient care. So know your critical elements and you'll do fine!
