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!
Hi, First of all I want to say congrats again!!! I will be traveling to AMC in one month. I was curious how you planned/studied and do you think I should take a support person? I'm traveling 7 hours to albany. Right now I'm memorizing the CE with mneumonics, I set a lab up in my bedroom so I can practice the labs, I read a little on the care plans. Do you have any study advice for me? I would apreciate your help since you did so well! I couldn't imagine the relief you feel now!!! Thanks! Laura:)
Thanks for sharing, i wrote a question reguarding Abany this morning. I have found a lot of negative complaits re: the CPNE and it was starting to really make me anxious about the whole thing. congrats and thanks for this
Sorry I didn't get back to you earlier, I didn't see your post. You must be about ready to head to Albany by now.
To belatedly answer your questions: it sounds like you're doing everything you can. I never did set up a lab to practice the skills. I took a workshop so I knew how the skills lab would go, but basically just learned the critical elements and the "nursing way" and fell back on my experience as a medic for the IV Push, IV Med, and IM/SQ stations. The wound packing was new to me so that I DID practice (ordered a wound and practiced over and over).
Don't stress about care plans, just follow the guidelines in the Study Guide and you have your Mosby's right there with you in the CPNE, so just go with simple and straightforward and don't try anything fancy. In my CPNE I worked backward on my care plans: i.e., I looked at the assignments I was given (pain management, respiratory management, etc.), and then picked nursing diagnosis that had these assignments as part of their nursing actions. When you do it that way you get a double benefit: your assignments tell you what nursing diagnoses the patient should have, and you don't make any extra work for yourself - your care plan actions are already assigned to you. If you pick a nursing diagnosis outside your assignments, then you'll be basically assigning yourself extra management because you have to complete the nursing actions appropriate for that diagnosis as well as what's already been assigned.
When in doubt, Acute Pain and Risk for Injury will usually work for all patients.
One important key point: make SURE that everything you write in the "Outcome/Goal" section and then again in the Evaluation phase "response" is patient centered. In other words, how the patient responded/should respond. For example: "patient will report a decrease in pain during PCS" and "patient reported a decrease in pain during PCS" NOT anything the nurse did. Nursing actions (what you did/plan to do) goes in the appropriately labeled area, but NOT in the patient goals and patient response area. Always write those from the perspective of the patient. And remember that anything you do management-wise needs to have the patient's response charted. If you repositioned them, did comfort care, respiratory management...any action you take, be sure to chart how they responded. They're big on that.
Memorize those mnemonics and set your grid up and let them see you do it. It'll show that you're prepared and help them (and you!) relax a bit. Good luck!
Thank you so much for sharing. I wasn't really that worried about the whole thing until I started reading all of the horrible things online. I have started all of the online conferences, and then I will be going to the workshop in albany at the end of March. Thank you for taking the time to share your story. It just made me feel better to hear what you had to say about your experience.
Thank you so much for sharing. I wasn't really that worried about the whole thing until I started reading all of the horrible things online. I have started all of the online conferences, and then I will be going to the workshop in albany at the end of March. Thank you for taking the time to share your story. It just made me feel better to hear what you had to say about your experience.
People who fail seem to be more prolific writers than those who pass. You will always read horrible things about the CPNE, but the key is to go in there and make the experience your own. I know that's tough -- right after I got to Mansfield for my CPNE in 2008, I read some horrible post about it on the EPN. Someone said something like, "No one can pass there, it's terrible, blah blah blah." I thought I was going to hurl, seriously. But I went in determined to have my own experience, and I did. It's important to filter out the noise, you know? :)
I just got off the phone with Excelsior faculty. They absolutely recommend using a grid and find students who don't use them have time management issues. Organization is key!
Thank you Equusz for detailing how you prepared! The wound is continuing to get lots of use! I hope it has good vibes on it!
You will always read horrible things about the CPNE, but the key is to go in there and make the experience your own. I know that's tough -- right after I got to Mansfield for my CPNE in 2008, I read some horrible post about it on the EPN. Someone said something like, "No one can pass there, it's terrible, blah blah blah." I thought I was going to hurl, seriously. But I went in determined to have my own experience, and I did. It's important to filter out the noise, you know? :)
dunnfamily
4 Posts
Hi, First of all I want to say congrats again!!! I will be traveling to AMC in one month. I was curious how you planned/studied and do you think I should take a support person? I'm traveling 7 hours to albany. Right now I'm memorizing the CE with mneumonics, I set a lab up in my bedroom so I can practice the labs, I read a little on the care plans. Do you have any study advice for me? I would apreciate your help since you did so well! I couldn't imagine the relief you feel now!!! Thanks! Laura:)