Passed CPNE @ Albany Medical Center

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I spent the weekend in Albany taking the CPNE! I was successful and obtained my 'GN' status!! I have pasted my Journal below for everyone to read, hope it helps!! Sorry it's so long. :nurse:

Well it all began on Thursday evening (August 18, 2011) when my husband and I drove to Albany, NY. After our 2 and a half hour drive from Connecticut we arrived at the Hilton Garden Inn and checked into our room. I looked out the window and the front entrance of Albany Medical Center was literally staring me in the face! I couldn’t believe that this weekend had finally arrived after 3 months of studying and preparing…where did the time go? After getting settled in, we decided to go get some dinner and then come back to the room and relax. I slept in a little on Friday and when I woke up we got some breakfast and I did a run through of all my labs. Then spent the rest of the day relaxing and waiting for 4:30 to come around when we had to meet the CA in the main lobby of the hospital. All 6 of us had arrived early and sat there anxiously waiting. The CA arrived to scoop us all up. We then followed her up to our ‘hub’ for the weekend. We found our name tags and sat around the table and then realized that this was actually happening. The CA began reading to us and then we were greeted with a huge BOOM of Thunder, which just freaked us out even more. We had some papers to sign and then the CA passed around a few index cards and told us to randomly pick one and this would determine which group we would be in for the weekend and the order of our PCS’s. I picked the card for the first group and my PCS assignment was Adult, Pediatric, Adult! Wahoo I was so excited to have this order. After this the CA took us into the rooms where the labs were set up and she went through each lab station with us. Then she gave us approximately 15 minutes to get hands on with the lab materials. Then we were led back into the ‘hub’ room and were introduced to all of the CE’s. Then the CA had us split up into our groups. My group, group 1 was going to go up to our units and get our patient assignment while group 2 started the lab simulation. I was brought up to the cardio-thoracic floor which was on the 8th floor of the hospital. Received my PCS packet and was told that my patient was a woman who had cardiac surgery and she was on ‘sternal precautions’ and couldn’t push or pull with her arms. I had 15 minutes to look through the chart and compile information I needed to put together my care plan later that evening back at the hotel. After getting oriented to the unit and getting my patient information I was brought back down to the ‘hub’ to start my labs. First station, IV Push….eeek, this one worried me a little. But I went through all the motions and had to push 2 ml’s over 1 minute! I was nervous that I would have to push a small amount over a longer period of time and was glad that I didn’t have to. I said that I was finished and the CE read that dreaded question…”have you completed all the critical elements?” I double checked everything and I said yes! She said congratulations, you have passed this station. Wahoo, one down! Next was the wound station. Went through all the motions, got a little nervous when I was packing the wound and the CE got up out of her chair and watched every move I made. Finished taping my dressing, cleaned up my mess and another pass! Okay, next was IM/SubQ injection…I was thrilled to get an Insulin injection. I got a little flustered with my calculations, but was just psyching myself out….I made sure to roll my NPH and drew up the Insulin R first and then the NPH, total dose was 22 units. Signed my MAR and another pass!! Wahoo…last and final lab station was IVPB. Got my assignment, did all of my calculations, hung the new med and began counting my drops (25 gtts/minute…so 6 gtts/15 seconds). It took me a few tries to get my proper drip rate and I signed my MAR and asked to count again…the CE said I counted your drops with you, you’re fine. And she asked that wonderful question again, I answered yes and she said congratulations. WaHoo!! I was 4 for 4!! Went and handed my lab papers in to the CA and she gave me directions of how to get back to the main lobby of the hospital. And let me tell you, I couldn’t run back to the hotel fast enough!! I opened my hotel room door and was screaming with excitement and I scared my husband. He had no clue what was going on because he was going to meet me in the hospital lobby at 8pm, when we were supposed to be finished. I was back at around 7:15pm. I was so excited, called my mom to tell her the good news. After my phone calls, my hubby and I went and got some dinner at Panera, then we came back to the hotel room and I got started writing my care plans. Nothing jumped right out at me and I got a little frustrated. But got through it and wrote out a practice grid and rationales for both diagnoses that I wrote. Ok, so showered and went to bed, but unfortunately couldn’t fall asleep till around midnight.

5:40am Saturday morning my alarm stared going off…hit snooze twice and got up at 6…went through my morning routine and reviewed some information to help get me through the day. Met the 5 others in the cafeteria by 7:10am. We were anxious to just start the day and we talked about how we each did with the labs. Only 2 of us had successfully gotten through all of them on Friday night. I noticed that my CE was the last to arrive and she was talking to the CA. Then all of the other CE’s came over to get their students. I walked up to mine who was still with the CA and I was told that my patient had gone to dialysis which was not previously planned. So I was told that I had to get a different patient but I would have 30 extra minutes for my PCS. My CE could sense my nervousness but she told me not to worry and that she had picked a good patient and that everything would be alright. Okay so got up to the unit received my new PCS packet and patient information and got started writing a new care plan. I chose Impaired physical mobility and Ineffective peripheral tissue perfusion, (if I’m remembering correctly). The AOC’s I was assigned were Respiratory Assessment, PVA of the upper extremities and Medications (which were the same from my original PCS, but my original PCS was PVA of the lower extremities and Respiratory Management with Cough and Deep Breathe and Incentive Spirometry X10). The patient had no IV fluids running. I had to take a manual blood pressure which had to be taken on the left arm. Okay no problem, but then the patient said it had to be taken on her forearm because she had a PICC in her upper arm. Okay, I can do this…got it no problem. Then also had to check an Apical pulse. Got through the implementation phase and moved on to my evaluation phase…did all of my documentation and narrative notes and then I realized that I forgot to check the patient’s hydration status. Grabbed my CE and told her I had to go back in to check it, she said I thought you were going to forget so I’m glad you remembered. Then I came back out of the patient’s room finished and re-checked my paperwork and then I handed it to my CE and of course she read that dreaded question. Which then made me second guess myself so I checked everything over again and said yes. She took my packet and I became extremely nauseous. After what seemed like an eternity she walked back over to me and gave me a thumbs up! Wahoo, I passed!! And I could breathe again… Okay so we walked back down to the cafeteria for a break and where I would be matched up with my next CE for my pediatric PCS. Once again we all sat around talking, there were many mixed emotions from everyone, but I just listened and didn’t take any of the negativity in. I had to stay focused on myself and my success.

It was around 10:30am and my second CE came to take me up to the pediatric floor, she told me that I had a 17 year old patient with Crohn’s disease. I said okay and I was excited to have one of the ‘older’ pediatric patients. So we got up to the unit and I was oriented to where everything was and was given my PCS packet and told a little about my patient and received the chart and was logged on to the computer to look at vital signs and pain levels. For this patient I chose Acute Pain and Imbalanced Nutrition: less than body requirements. I had almost completed my planning phase and then the patients primary nurse said that the patient had been up all night in tremendous pain and that she had just medicated him approximately 30 minutes prior and he was sleeping and thought that maybe he shouldn’t have a student today. Okay, so the CE called the CA and it was determined that I would get another patient and have to start all over. Just my luck! So now I would be working with an 8 year old who fell off a horse and ruptured her spleen. AOC’s were Comfort Management, Respiratory Assessment, and Skin Assessment of heels and elbows with Patient Teaching assigned. Everything was going well had all of my AOC’s completed and left the patient to try and eat some lunch. CE asked if I wanted to declare my vital signs and ‘stupid me’ said yes without taking a second set. Big difference between my pulse and the CE’s pulse…oh no, she had to call the CA. Fail L The CA came up and talked to me and said to stay positive and focused. It was now around 1:15pm and I was bummed but okay. I knew that I would not make that mistake again and I was still positive and focused. So I met my husband in the hospital lobby and we went back to the hotel room and I made my phone call to my mom. Then we went and had some lunch, came back to the room, I showered, put my pj’s on and watched tv and took a nap. I reviewed my mneumonics and read through some of my notes from Tina’s NEC Workshop. The only thing that was hard now was waiting for the time to pass. We ordered in some pizza for dinner and I was in bed and sleeping around 10:30pm.

Then, I found myself wide awake at 3am and I did not feel right at all. Started freaking out and crying. Finally fell back asleep around 4am, just to wake up to my alarm going off again at 5:40am. Hit snooze a couple time and got out of bed at 6am. Okay here goes day 3, had to do my final Adult PCS and make-up my Pediatric PCS. So I thought to myself ok, it’ll just be like yesterday. Stay focused, positive and to make sure I double checked my pulses! Okay so it wasn’t so easy to be 100% positive after my 3am mental breakdown. But my husband told me that everything will be okay and that I CAN do this but I can’t let my nerves get to me. He told me that he had fate in me and that all my hard work will pay off. Okay so met everyone back in the cafeteria by 7:10am to find out that there were 4 of us left. 2 that only had their last PCS to complete, me with one PCS to repeat and the other who had to complete 3 PCS’s. The CE came and took me up to a Trauma unit and I was told that my patient had been run over by a truck at his job site and that his pelvis was shattered, but he was a very nice, outgoing guy. Okay, AOC’s assigned were PVA of the lower extremities, Medications, and Oxygen Management. Was working on my planning phase, but I can’t remember what I chose (sorry). Okay so successfully completed the planning phase and we went to start the implementation phase. Got to the patient’s room and the primary nurse and other staff were transferring my patient on to a different bed because his had begun to malfunction. We were waiting for about 25 minutes, which my CE told me would be added on to the end of my PCS if I needed it. Okay so did all my areas of care once in with the patient and it all went well. Had radial pulse assigned, yet again, and I made sure to do it twice, but I was still uneasy about it. Asked the CE if I could check his apical pulse, she said yes. Okay so counted and wrote my third number down. Then declared my vital signs and we said thank you to the patient and walked out of the room. The CE told me that my pulse was different from hers by 10 and I started to freak out, “Oh NO I failed”, that’s what ran through my head. The CE called the CA to come up and she talked and the CA said that since I changed my location that I could re-check my apical pulse. OMG I couldn’t believe it! I couldn’t stop thanking her!! So I pulled myself together and we went back into the room to recheck the apical pulse and I realized I had to check the patient’s hydration status too. So the CE told me to listen for the apical pulse for a little while before counting, and that when I start counting to count it all out loud. At this point I was shaking and terrified that I would screw this up again. But finished counting for a full minute and said stop, the CE asked me what I got, I told her and she gave me a high five. I then began to cry because I was so happy. Apologized to the patient for crying in front of him, explained why I was crying and thanked him. He told me that it was no problem and to call him ‘Skip’, a nickname he was given as a kid. He also told me that I was going to be a great nurse; this meant so much to me! Okay so I got my vital signs, Wahoo! Now time to work on my evaluation phase. The CE wanted some time to look at it, so she told me to go report off to my primary nurse. Then the CE called me back in and said that I had passed. I was so excited and started crying again. Happy tears this time, but still scared about my make-up Pediatric PCS that was still to come. I was brought back down to the cafeteria and I sat there by myself. Anxiously waiting, shaking and staring at my Grandpa’s prayer card (which I had brought with me throughout the whole weekend as my good luck charm).

After waiting the CE came and brought me back up to the pediatric unit. My patient was an 8 year old who had an appendectomy. I think I used Impaired Physical Mobility and I can’t remember my other diagnosis. AOC’s assigned were Respiratory Management with Deep Breathe and Coughing, Comfort Management, and Abdominal Assessment. Got through all of the AOC’s with a lot of encouragement towards the patient. She wouldn’t cough even with pillow splinting suggested saying that it hurts to bad. Patient had a NG tube with suction, which the CE disconnected before we sat the patient up on the edge of the bed and it was left disconnected until I finished my Abdominal Assessment. I was very nervous about this PCS because the patient really didn’t want any part of it. Thankfully the patient’s mother spoke to her in their primary language and I think she was explaining to her to cooperate because I was there taking a test. For this PCS I had radial pulse assigned which I checked and then asked the CE if I could check the patient’s apical pulse and she said yes. I wanted to make sure that I didn’t mess this up. By the time I finished up this PCS the patient was sleeping, I quietly thanked her and her mother for letting me help with her care and I left the room to begin my evaluation phase. The CE asked if I would like to declare my vital signs and I held my breath and showed her what I got. She said very good, and that I could continue. Phew was I relieved. Okay so I began writing and writing. My narrative notes were so long, but I wanted to make sure not to miss anything. Everything was riding on this. With one minute to spare I handed my PCS packet over to the CE. I sat there once again staring at my grandpa’s prayer card while she was going through my packet. There was a lump in my throat and I was terrified of the outcome. She told me to go report off to my primary nurse, but I couldn’t find her so I went to the bathroom instead. I came back and waited some more and then she said those magical words, congratulations you have passed!! OMG I was so excited I could barely contain myself. We then found my primary nurse and the CE said I passed and I just went on giving report and the primary nurse said congratulations and thanked me for all my help and that she knows how hard the program is because they’ve seen so many students come through and see what they go through during the weekend. I was so happy I was crying and thanking the CE. Then we went back to the ‘hub’ to meet up with the CA to tell her the good news. The CA was so happy for me and she handed me my congratulations paperwork and gave me a big hug! I gave a hug to the CE as well and thanked her so much and I just kept saying thank you to them and that I was so happy. And then I told them that I’m so glad I never have to take the CPNE again, the CE thought I was going to say that I was so happy I never had to see them again…we laughed and I made my way down to the hospital lobby to meet my husband. I couldn’t get down to the lobby fast enough. Got there told him the good news and he gave me a big kiss! I said to him let’s get out of here and go over to Excelsior College! I wanted to go over there if I passed to take pictures because I figured when would I be in Albany again? We got in the car; I called my mom who was screaming with excitement through the phone when I told her of my success! I then called Tina and told her to add ‘GN’ on to the end of my name! She was having a workshop that weekend and she told me that she and all of the students were waiting on pins and needles to hear how I made out. I told her about my whole experience and I thanked her for everything that she had done to prepare me for the CPNE!

So all in all I left the CPNE at Albany Medical Center as a ‘GN’ (along with 2 other students being successful). It took a lot of hard work preparing for it, but it is do-able! Never give up and do whatever it takes to achieve your dreams! Next goal on my list is ‘RN’ status! Good Luck to everyone preparing for the CPNE! You CAN do this!

Christy Rudler, GN

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Wow! Congratulations!! Thank you so much for posting this journal. It really gives insight as to what to expect. I probably won't be taking CPNE until winter but I read as many journals as possible so I know what to expect. I'm so happy for you!! CONGRATULATIONS!!!!:yeah:

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

:ancong!:

Awesome!!! :)

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Specializes in Surgery, Med/Surg/ICU, OB-Peds, Ophth.

First, WAY TO GO! :yeah: I can almost feel like I am there when you guys post such great details in your journals. You had some interesting turn of events, and it is really helpful to read about the things that you are not expecting that can pop up in this clinical, and way to roll with the punches like getting your patients switched! I have been preparing for a month, was hoping to get a cancellation in Sept/Oct but the more I work on the practical portion, the more I think I need hands on workshop. I can be very robotic with my PCS, but I can't seem to get a "flow" going and that is where I worry I may miss something. Do you know Christy, could I check things off of my grid, literally--right after I do them? When you guys practice your AOC, do you practice all 11 of them at one time or do you do one patient scenario and do the entire works planning>evalaiton top to bottom? I know that you didn't have to, but if had to revise your plan of care, would you do this after you declare vitals?

Did you run into any equipment that you were unfamiliar with? Thanks so much in advance and congrats again on a job well done :yeah::yeah: Good luck with your boards!

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Specializes in Med/Surg Nurse, Homecare, Visiting Nurse.

Congrats, one of the best feelings.

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First, WAY TO GO! :yeah: I can almost feel like I am there when you guys post such great details in your journals. You had some interesting turn of events, and it is really helpful to read about the things that you are not expecting that can pop up in this clinical, and way to roll with the punches like getting your patients switched! I have been preparing for a month, was hoping to get a cancellation in Sept/Oct but the more I work on the practical portion, the more I think I need hands on workshop. I can be very robotic with my PCS, but I can't seem to get a "flow" going and that is where I worry I may miss something. Do you know Christy, could I check things off of my grid, literally--right after I do them? When you guys practice your AOC, do you practice all 11 of them at one time or do you do one patient scenario and do the entire works planning>evalaiton top to bottom? I know that you didn't have to, but if had to revise your plan of care, would you do this after you declare vitals?

Did you run into any equipment that you were unfamiliar with? Thanks so much in advance and congrats again on a job well done :yeah::yeah: Good luck with your boards!

Yes you can check things off on your grid as you go along, make as many notes as you can on it so when it's time to write your narrative notes you will be able to put in all of the information without forgetting anything. Don't worry if everything doesn't flow smoothly....sometimes you have to jump around to make things work. I never physically practiced all of the AOC's. I just learned my mneumonics and made sure I knew what steps to take to get them completed. I was unfamiliar with the temporal thermometer but the CE showed me how to use it.

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Christy,

Congratulations!!! I am so happy for you. Although I do not know you , I had tears in my eyes reading your journal. I went through this weekend before, but was not successful. I will be taking it again in the next couple of months. I was just curious, other than Tina's workshop, how else did you prepare.

Traci

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Christy,

Congratulations!!! I am so happy for you. Although I do not know you , I had tears in my eyes reading your journal. I went through this weekend before, but was not successful. I will be taking it again in the next couple of months. I was just curious, other than Tina's workshop, how else did you prepare.

Traci

Traci, Sorry that you were not successful, but you will do it next time!! I took Tina's workshop, bought the skills kit that EC sold and I practiced writing care plans. Good Luck to you!

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Specializes in Revenue Integrity, Rehab, RAC Auditor.

:clpty: Congrats so happy for you!! :clpty:

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Specializes in Surgery, Med/Surg/ICU, OB-Peds, Ophth.
Yes you can check things off on your grid as you go along, make as many notes as you can on it so when it's time to write your narrative notes you will be able to put in all of the information without forgetting anything. Don't worry if everything doesn't flow smoothly....sometimes you have to jump around to make things work. I never physically practiced all of the AOC's. I just learned my mneumonics and made sure I knew what steps to take to get them completed. I was unfamiliar with the temporal thermometer but the CE showed me how to use it.

Did you use Tina's, Robs or your own mnemonics? Thanks for the feedback, I can put on the "performance" pretty good here at home now, but the craziest things are coming into my head, like bowel sounds--my son has one constant bowel sound! I need to count six, but if there is one steady bowel sound, how long do I listen in that one spot?! I tried to ask this at our EPN Facilitated Chat last night, and I never go a clear answer, lmao :uhoh3: I just wonder how much I am going to run into this. You did such a good job with your nursing dx, and it you didn't even use an @ risk label (I have been whining about this with the 18th Edition changes). Nice work!

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Specializes in Surgery, Med/Surg/ICU, OB-Peds, Ophth.
Christy,

Congratulations!!! I am so happy for you. Although I do not know you , I had tears in my eyes reading your journal. I went through this weekend before, but was not successful. I will be taking it again in the next couple of months. I was just curious, other than Tina's workshop, how else did you prepare.

Traci

Sorry to hear this Traci, where did you test? Did you appy for another date yet?

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Specializes in Tele/Neuro/Trauma.

I am so super proud of you Christy!!!! Congratulations!!! :-)

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