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.
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.
So sorry to hear what happened but your history shows that you have outstanding patient care so hold on to that and don't let this rattle your cage. I know easier said than done. You know what to do now and know what is your weakness so take time to get yourself back together and go forward again. Work on those care plans and documentation until you can do them backwards and forwards and then tackle it when you are ready.
This is a great website for support in successfully passing your CPNE. I passed almost 2 years ago after many posts on this site, planning, stress, studying, etc. (You know the drill!)
To PM someone, go to their blue section and next to Registered User click the icon with the pencil...you are limited to 25 or so ims...
best of luck to both of you! YOU CAN DO IT, AND YOU CAN DO WELL!!! Best of luck!!! :wink2:
Don't give up and don't waste the time and money you've already invested. You already know what areas to work on, and unfortunately, Excelsior's nursing classes won't transfer. You can do it, people do it all the time!!! DO NOT GIVE UP!
i failed the cpne in mansfield, ohio march 20, 2009. the ca and ce (with the exception of one that made me kind of nervous) were all really good and professional, but my lack of good careplanning got me failed, plus my nerves were shot. i'm a guy, and i was tore up after failing the second pcs!!
my advice would be not to wait to take conferences as soon as you can. my plan was to wait until they gave me a confirmation date and then take the care plan conference, which i thought might be my weakest point. but they gave me a date in late februry of 2009, just four weeks away!! there was now no time to take those conferences. and in the end, my lack of good care plans and nerves got me failed. i'm not blaming anyone but myself, but i really think that excelsior fails out perfectly good nurses in some cases. failing has really shaken my confidence in myself, even thought i have been recognized by my hospital for outstanding patient care before. don't know if i will have the will (or money for that matter!) to try this again. might see if i can arrange something through my local college. if you don't have an outgoing personality, and deal with stress very well, you might not ever want to attempt to get your degree this way. i will find a way somehow.
give yourself time to regroup. i'm preparing for my third victorious attempt!
i will be practicing an entire pcs every morning, timed from planning to eval phase. i'm joing to use one of those obnoxious clock alarms :crash: . my house alarm would be perfect if i could put it on a timer, just to recreate a sense of impending doom and learn to become immune to it, focus only on my performance.
the care plans really can be simple, once you know how to "see" what they "give" you to make one, or "see" what's there if the pt condition changes. i went to two different workshops but won't advertise, :offtopic:although i will say i prefer warm weather, the sound of the ocean and a golden bridge.
as far as the outgoing personality, i'm not naturally outgoing. however, i do get the impression that nursing instructors in general, regardless of school, are looking for assertiveness. this is key when it comes to the pcs, they don't want to see a first day or even third year student of a four year program. i think the ce's actually look forward to your asking them "would you please assist me in ___fill in the blank ___" as if they were a cna not a ce. i get the impression they don't need "outgoing", they simply need to see "in charge" first day nurse ready to work with a primary nurse, a patient, and a cna....a confident team player who knows their "position".....assertiveness. you can be a nervous wreck and shy and still be assertive. i have a couple of gals that can watch me occasionally. i plan on "bossing" them around, "hey you, yeah you....don't just stand there help me lift this pt up in bed" hah, just joking, you would certainly ask your ce respectfully (or anyone else for that matter). perhaps you could find someone to wear a white coat with ce on it and ask them to help you with cna tasks as you do a mock pcs. then they could alternate helping with standing back to scowl, making monosylabic "hmmm's" or throat clears x 3, while looking at the ce list (in the back of your cardex.)
i certainly understand your grief, and would not judge you if you went to another school, this is no easy test. but....you do have one more shot at it. i won't give mine up.
now 2 more things. why is this with the smilies, does anyone else find it disturbing or is it just me? ..okaaay?:dancgrp:
second, would some of the e-grads do us cpne hopefuls a favor and post reasons or better yet scenarios as to when/why one would inv. c_d-m. this would be priceless!!!! tia
Great info! Please send me your entire experience, how you studyed, any outside study plans used. I am about to test for NC7 and complete my application for CPNE. Current wait time is 5 months, which makes my time to test around Feb. You are an angel and I will apply your advice
I passed the CPNE 7/30 in Racine, Wisconsin. I'm sharing my experience with you, not because I necessarily recommend you do things the way I did them, but so you'll know it can be done.
I became eligible in Oct. 2008, and after calling the MPAC, I received a date of 3/20. My father was hospitalized & unexpectedly scheduled for open heart surgery on that same day. Even though he asked me to go I cancelled. I wasn't charged anything to cancel because of the circumstances.
After a 7 week hospital stay, my father passed away. I had tried to study throughout but hadn't scheduled a new date because his condition remained so unstable.
I got an email that because of the long wait time, EC was scheduling mid-week CPNE's so I called the MPAC again and asked for Mansfield, OH, because it's closer, and I could drive. I would have waited until Sept. so I just asked for the first available, and there was a mid-week in Racine on 7/28-7/30. I took it.
I again started to study. I looked for workshops, and found only one that I could attend, that was Lynn Frederick's, held in Memphis the weekend before my CPNE. I also purchased and downloaded Rob's CPNE videos. Let me say this about that: Both were very helpful in taking the fear of the unknown out of the CPNE for me. Even though I could read about it, having someone go through a mock situation, gave me a much better idea of how to handle myself. Lynn's workshop also spent a great deal of time on care planning, and I didn't have one single problem with any of my care plans.
So, I'm studying. On July 4th, I get a call at 4 am that my 17 year old nephew has been in a bad car accident, I woke my children, drove to the hospital, and he died about 8 hours later. My sister-in-law sometime during the next week told me she did not want me to cancel this time, and even though I felt sure I would fail, I honored her wishes. I kept trying to study, kept trying to learn the mneumonics.
I went to Lynn's workshop, and after introducing myself and telling about my situation, everyone, Lynn included, looked at me with shock, and wished me luck, which is exactly how I felt. I even panicked and called EC and spoke to an advisor, who told me that I would forfeit all monies paid if I cancelled, so I might as well go ahead, and if I failed, then I'd know what to expect the next time.
So off I go. I fly to Milwaukee the day before, get picked up by the Marriott shuttle, and meet a fellow CPNE'er. This is her 2nd attempt. She has all sorts of practice things for the labs set up in her room & invites me to come and practice with her. I do, we watch & critique each other, and we both made it through the labs with no repeats.
I get my assignment for the next day, go back to the hotel and write out my care plan. I get to the hospital the next day, and my patient has been changed and I start all over again. It worked out fine, passed the 1st adult PCS. I was assigned mobility to ambulate in hall x1, abdominal assessment, patient teaching on abdominal assessment, & medications. The CE gives the meds and has you wait in the hall while she does at Racine. The meds are locked in a cabinet just outside the room, you pull those based on the MAR, compare & check & give them to her. No complications with the PCS.
The next patient is my ped's patient, adult substitute. I failed this one in the 1st 20 minutes. Stupid mistake, I was assigned respiratory management, I put a towel in the emesis basin, handed it to the patient, instructed her to take 3 deep breaths then cough, she did, beautiful sputum sample, I then started to listen to the lungs, and was told "can I see you in the hall?" Yikes! The CE tells me to wait, she goes to get the CA and she askes me if I know what I did wrong. I think it's because I listened to the lungs over the gown, but it's because I didn't listen to the lungs before AND after the deep breathing exercise. Nothing left to do but go back to the hotel & get ready for the next day.
A patient change again, because my patient was going to be gone for a test then discharged. So I start over, and this one went fine, except that I almost ran out of time. The patient had a leg injury, had surgery, and was NWB on that leg. He didn't want to get oob but had to to use the restroom. He had figured out a way to do it himself that was less painful, so he didn't want any help, but it took him awhile. He was very pleasant, easy to work with, and other than getting nervous about the time, everything went well, and I passed.
Next and last, my ped's repeat, again an adult sub, a 98 yr. old lady, deaf, CHF. My assignments were i/o since she was on fluid restriction, easy because she didn't eat or drink anything, and had a foley catheter. Skin assessment, assigned to check bilat legs, 2nd area I chose was the occiput. Reposition x1 but she was up in the chair & didn't want to go back to bed, didn't want a pillow behind her back, I finally used the trashcan with a blanket as a makeshift stool & elevated her feet. I was finished in almost 30 minutes.
With each PCS that I passed, there were little things that were brought to my attention to correct. I never in any way felt that the CE's or the CA wanted anything for me but success. Beth is the only one whose name I remember, she was the CA, but she was delightful. Now, having said that, these people are not there to teach you, they are there to observe that you are capable of performing at the level of a 1st day new grad RN. The stress of the pass/fail aspect of the CPNE is the price we pay to be able to do this program at our own pace without 2 years of clinicals.
I was never able to memorize the mneumonics, but in trying I memorized the critical elements. Make a grid and check it often. If you think you missed something, say it, then do it, and you're ok as long as you haven't handed in your care plan. Even if you left the room, you can ask to go back in and finish as long as you have time. Check the ID band frequently. Never hurts, can't do it too much. Also gel your hands frequently, can't hurt, can't do it too much. You only wash hands once before you enter the room the 1st time. Stay calm. One thing Lynn recommended was that you use guided imagery for a comfort measure, it only takes a few minutes and it can help calm you down as well as meet a goal.
Nothing I did was complicated. No one I talked to that weekend had any complicated patients or assigned areas of care. There were 7 of us, 3 were repeating, and 4 passed. 2 of us passed on the 1st try. I've been a LPN for 6 years and work on a med/surg floor in a hospital.
I am scheduled for my degree conferral on 9/18, and then onto the boards.
Your post about the CPNE is awesome.
bjbabs24
127 Posts
So sorry to hear what happened but your history shows that you have outstanding patient care so hold on to that and don't let this rattle your cage. I know easier said than done. You know what to do now and know what is your weakness so take time to get yourself back together and go forward again. Work on those care plans and documentation until you can do them backwards and forwards and then tackle it when you are ready.
Prayers are with you and you WILL FIND A WAY!!!