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.
I really enjoyed this post. Just returned from my CPNE workshop and cried the whole flight home. I never felt so stupid. thank's for being so positive. Would love more tips on skills. My worst fear is being 100% ready and failing on a stupid little thing that is not even part of the Skills or PCS/Careplan.
I believe I am one of those people that nerves can shake me pretty bad, no matter how confident I am.
I just got back from Lynn's workshop. It's comforting to know that it helped you. I was really overwhelmed from all the info I got. Sounds like I picked a good workshop. Thanks for your post.
I know someone who failed because the stethoscope supplied was defective. She could hear nothing thru it,And as it was the first BP which is a manual one --failed her PCS. Scary huh?
I've heard many stories about people failing for what seems to be a silly thing. What no one seems to say in the same sentence is that you are given an opportunity to repeat each PCS. So if you fail because of a faulty stethoscope or you dropped your pen on the floor, you get a chance to repeat that PCS. Now, having said that, if the stethoscope didn't work, I'm sure the student could have addressed that with her CE, and even appealed. They tell you that in the study guide and at orientation. You can even appeal it to Excelsior if you choose. The thing is that most people can't handle the stress and get so upset that they don't even think to challenge decisions they don't agree with. You are expected to perform to the standard of a first day new RN graduate, and if you got to a job that gave you faulty equipment, you would ask for something that worked. If you are in a patient's room and drop a pen on the floor, bend over to pick it off the floor, it's a normal expectation that you would wash your hands afterward. That's what people fail for. Not dropping the pen, but not washing their hands again. I gelled my hands over and over again just to be safe, doesn't hurt anything, gives you a second to calm your nerves, and get on with your assignment.
The CPNE is something that while challenging, is completely do-able. I did it, first try. I think the 1st time pass rate is somewhere around 65% so those people did it, too. We're not rocket scientists, because believe me, this has nothing to do with being smart. It's assumed that if you got this far, you "know" how to be a nurse. Can you do it under stress, with someone watching you, in a timely manner? Tough, you bet it is. But when you are a nurse, someone is watching you, the patient, and you better be able to do it in a timely manner because when you are on a floor with 6-8 patients, you need time management skills. And stress? I don't think there is a more stressful job than being a nurse. But it's worth it!
Thanks for the post. I am new and just starting so prob. do not need to worry about this just yet but I'm curious, how long do these things last. I know it is two or three days but how long each day. I'd like to just get it all over with in one day. Oh, these are real patients? I guess they have agreed to let us do this.??????
The CPNE is 3 days, you don't have a choice to get it over with in 1 day. The first day is labs from 4-8:30pm, the 2nd day you have 2 patients, and the 3rd day 1 patient, if you don't have to repeat a PCS. I believe the day ends at 5pm or earlier. but you may get out earlier if there are no repeats. You only have 2 1/2 hours for each patient.
Yes the patients were asked and agreed to have a student care for them.
Thanks for the post. I am new and just starting so prob. do not need to worry about this just yet but I'm curious, how long do these things last. I know it is two or three days but how long each day. I'd like to just get it all over with in one day. Oh, these are real patients? I guess they have agreed to let us do this.??????
Lunah, MSN, RN
14 Articles; 13,773 Posts
Kim, I just want to say I'm sorry for all the loss you've experienced, and glad to hear that you passed in spite of it all! *hugs* That rocks.