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CEN 2016!
I found the Boswell page. Great info on that page. Study his lectures. The questions are kind of similar to what's on CEN. Its not the kind of question you should be concerned about, its the content of the question. You should be able to answer the same question asked 5 different ways. You're gonna see a few general knowledge questions on the CEN. Most will be scenario based. But stick with Boswell.
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CEN 2016!
Pewp can you post a link to both those pages? I can't find the proper Mark Boswell page when I search on FB. And when I type in Jeff Solheim there's like 4 different pages. Just wanna be sure I'm looking at the same questions you are. Thanks.
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Orientation
Welcome to ER amzyRN!!! The swing shift you will be orienting on can be a tough shift. Not a tough shift in terms of workload, but a tough shift in terms of giving/getting report. I will explain further. At 1pm in the afternoon the day shift is already halfway through their tour. You come on at 1pm as a "relief" so to speak, depending on the workload. Depending on the patient volume and acuity level at 1pm, your charge nurse may assign you to take some of the heavy patients off the other nurses workload. This is right when you walk in the door by the way. Plus you'll be added to the roster to receive patients from triage of course. So once you get acclimated and your humming along in your shift, it will be time to go home. Now, at 1am, the night shift is halfway through THEIR tour. But since its your time to leave, now you have to sign out all your remaining patients to the nurses on the night shift who may very well be getting slammed from triage at 1am. If you received really heavy patients from triage or never admitted the heavy patients from 1pm, prepare to get resistance from the night nurses on accepting your patients willingly. Again, this is depending on patient volume at the time. It also depends on your coworkers. Some nurses understand the situation with the swing shift having to sign out to somebody and other nurses always seem to disappear when its time for the swing nurse to sign out. My ER sees over 350 patients per day, so were very busy from about 11am to about 12am the next morning. Getting report from the swing shift can be a nightmare or just a small bump in the road. The swing shift is really no busier than the other shifts. But just remember, at 1pm you could be walking into Grand Central Station but everyone is so happy to see you. Than at 1am, if you have 3 intubated patients, people suddenly forget your name. Good luck.
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CEN 2016!
The Boswell videos seem to be the only content available that is relevant to what's actually on the CEN exam. I also grabbed the Pass CEN exam book by Jeff Solheim and it was overwhelming and not specific to the CEN exam. Mark Boswell is basically breaking down the exam in his lectures without being too specific as to what is actually on the exam and specific questions. Don't waste your time reading books that are too general about ER knowledge and interventions. You will not be asked that on the CEN. This is why the BCEN recommends 2 years experience before sitting for the exam. You need to have experience in the ER to work out certain questions. You can't study for some of the content on the CEN. Congrats Bobjohnny on passing the CEN. Passing is passing whether its 105 or 150.
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CEN 2016!
Hello all, I have been an ER nurse for the past 2.5 years and I just took and passed the CEN on 3/14/16. All of the information in the ENA review is good to brush up on your assessment and intervention protocols. I found nothing from my ENA review course offered by my job to be very helpful. The lectures on YouTube by Mark Boswell were terrific. There were questions on the test that had content he specifically discussed. I found the test to be very difficult. I worked out the questions using rationales from my experience as an ER nurse. There were about 30 or so questions on PEDS. This tip is helpful for anyone like myself who works in an ER that separates adults and children. Here are some specific tips I can tell you from my test. - Brush up on your ACLS protocols. There will be strips to interpret and what interventions to perform. - Be able to identify different kinds of poisonings (meds/herbs/chemical) and what interventions may be specific to the identified poisoning. - Brush up on triage assessments using 5 level algorithms - who is seen first?!!!! - Know your childhood illnesses and what to do for suspected infections of these illnesses. - Brush up on your psychiatric emergencies. - Know the different kinds of shock and their interventions. I passed my test with 114 correct out of 150 scored questions.
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Westchester Community College Spring 2015 ADN Program
And so it begins!!! Good luck in the program!!! Say goodbye to your family and friends for the next 2 years!!! Say hello to professor qaabidh!!!
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Westchester Community College Spring 2015 ADN Program
You might get a phone call also before the letter comes if your accepted....stay near the phone
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Truthful advice for new grads "hunting" for their first job
I really like the direction this topic is going. I do realize my original post may have been harsh, but I had so much to say I just said it. In the event of a med error it is true that its all threes fault (MD, pharm and nurse). But the nurse is the last line of defense and the most likely to get fried if a major med error occurred. Sure there's plenty of veteran nurses who make mistakes, but its mostly for lack of awareness rather than trying to be cavalier and proving themselves. New grads are in desperate need of proper mentoring and nurturing. And Nonyvole, on days when we have upwards of 150 patients in our ED, it looks like a mass casualty scene. Wish I could take picture pictures!!!! I work in a very well known hospital on the outskirts of NYC and people from the neighborhood use it as a primary care facility on top of the critical cases. On the critical side we can have upwards of 40 patients to 4 nurses on nights. On the non critical side we can upwards of 40 patients on either side with 4 nurses each side. And we also have a fast track which handles upwards of 40 patients with 1 nurse.
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Truthful advice for new grads "hunting" for their first job
I love that you all responded to my post so I am going to respond to each and every one of you. To obesity33, I did not get up on the wrong side of the bed. lol. I was actually suffering from insomnia so I figured I would share some insight in the nursing world. lol. To krisiepoo, I have looked deep inside of myself and found no biases. I am actually one of the most open minded non biased person you will ever meet. I apologize if my post came across as biased. I was speaking from a stand point of working with and training new grads. I also remember being a new grad myself and how nerve wracking it was. I also have no bitterness at all because I couldnt start in a hospital. I started in a NH as I described in my original post and was shedding some light for new grads. The main point of my original post was that you dont NEED to start in a hospital in order for you to end up in a hospital. Alot of new grads seem to think that you must get a hospital job as your first job or else you will never get into a hospital. Its not true. Im living proof of this point. I was giving this advice to new grads "hunting" for their FIRST JOB. If a job offer is made but it's not in a hospital setting, TAKE IT!!!! It may be the only job offer as a new grad that you get. You can try and move up later or work as a nurse while looking for another job. Everyone else does it so why not you. Theres no rule in the nursing world where it states if you get a hospital job, no matter what, you stay there til you retire. To HouTx, I never said new grads were destined to kill anyone, let alone patients. But a prospective employer has no clue which new grad will be the one to do it, if ever. This is why employers PREFER experience, rather than demand it. Employers know that they cant just hire nurses w/ experience. But as a new grad sending out 300 resumes and only hearing back from 3 employers, only to be told they hired someone else who had more experience, this is why. Unless you know someone who can vouch for you as a person and state to HR or a hiring manager that they know you personally, they would rather take a chance on an experienced nurse. This is why people who know somebody get jobs much quicker than people who send a resume and it sits in a pool of 500 resumes never to be seen again. You can tell me Im wrong all day long, but think of how many people get jobs because they know someone or they already worked in the institution as a volunteer or a transfer. This also applies to all jobs outside of the nursing world. To Pangea Reunited, I thank you for your input and point of view. And finally to rinkskins, I appreciate that you respectfully disagreed with me and than proceeded to try and tear me apart all at the same time. lol. But lets clear up a few points here on what I was trying to say in my original post. #1 - Lets clear up first the misconception that you may have about me saying all new grads have no critical thinking skills. First off, I never said that!!! I said, "by LIABILTY I mean you do not have the EXPERIENCE to critically think on your own after a maximum 3 month orientation process and adapt to a rapidly changing situation. If you don't develop this ability and sharpen it quickly after a 1, 2 or 3 month orientation , your gonna kill someone." I highlighted the word experience because thats what I was emphasizing in that original sentence. I did not mean to say that ALL NEW GRADS lack critical thiniking skills entirely. If you lacked critical thinking skills you would have never graduated nursing school. I am not brazen enough to make that statement even though I have worked with and trained nurses that make me wonder how the hell they graduated school. lol. New grads lack the experience of taking all of their critical thinking skills and applying them when the pressure is ramped up because a patients acuity level is changing. Why? Because you lack EXPERIENCE. Not because youre a dummy!!! With experience this combination of skills blends together and your experience teaches you what needs to be done before your patient even starts to have issues. This is not an insult to new grads its part of the learning process. Does this mean nurses with 10+ years experience cant have their moment either? Of course they can and do, enough said. #2 - I never said you were better off working in a NH as opposed to a hospital. What I said was, "Stop limiting yourselves (new grads) to only working in certain facilities. Do you think I liked working in the NH. Hell no!!! But it got me the experience needed to move on to the ER after I perfected my basic nursing skills which are not perfected by any means in school. Where ever you get a job, be proud of it. Become the best nurse in the building." I dont know where you came up with that generality of a statement, but OK. You speak of NHs as being GROSSLY understaffed. This can be very true. But are hospitals known for being GROSSLY overstaffed? I dont think so. The NH I started in had 8 RNs and 20 CNAs divided into 4 units. You do the math. So where was the gross understaffing in my NH? The ER I currently work in has 12 RNs at night to care for upwards of 150 patients at times. Does that sound like adequate staffing to you? I apologize if my suggestion to start in a NH offended you because the one NH by you doesnt have their stuff in order. But what if that NH was the only medical facility offering you a job and you didnt have one at the time? Are you gonna sit home with bills mounting up and no pocket money just simply because the NH is understaffed and your better off somewhere else? No!! Youll take it!!! At that point, please re-read the first sentence of this paragraph. As a new grad do not limit yourself and not work certain places. Every facility should be an option!!!! #3 - I am glad to hear you had an enlightening experience during your first code on your first day as an RN in a hospital setting. I also hope you pass on your experience to newer nurses and help them learn and be calm during their first code. I know I would be ****ing my pants if my first code was in a hospital setting and all the medical staff came running into the room to help my patient. but that just me lol. #4 - And last but not least, my most recent endeavor w/ a new grad who gave 100 units of insulin instead of 10 and almost killed a patient. Now, this is partialy my fault because I did not really elaborate in my first post the details surrounding this debacle. Rinskin, you say this was a problem because the RN did not follow the 5 R's of med admin. Well you're wrong!!! The new grad nurse followed the 5 R's to a T and covered all of her bases. She did beautifully from what I heard. The problem was in the fact that the MD didnt realize as she typed in the order, she put an extra zero at the end of the 10 unit dose of Humulin R, making it 100 units. The new grad nurse, having no EXPERIENCE giving out insulin, never questioned the order and gave the medication anyway. Now I ask you rinskin, as an experienced nurse, would you ever give 100 units of Humulin R to a diabetic patient? I dont think so!! You can also blame this on a lousy orientation perhaps, but orientation in any facility cant cover it all. To sum it all up, the main point of my post was to drive home the aspect of why new grads are probably finding it difficult to find jobs without EXPERIENCE. Does it apply to every new grad? Absolutly not. Some new grads get jobs right out of school. Some new grads turn down job offer after job offer because they wait for their dream job. My advice, take the first job that gets offered to you so long as you dont wind up paying more to get to work than you make in a day. Start getting your experience as soon as you can and move on. Its a tough market out there for RNs with no experience but unfortunately your diving into a workforce with much more experienced nurses also applying for jobs. New grad programs are extinct and jobs are demanding much more from RNs these days making it even harder for new grads to get jobs. If you dont know someone and have a hook at a hospital or other facility, your just another face full of promises and ambitions. As a new grad you have a huge ladder of expectation to fulfill when you finally get hired. Having no experience can be very intimidating and employers are demanding you learn everything as fast as humanly possible. Even if your not ready after orientation, you may have no choice, youre on your own!!! But please, please, dont be that new grad that really screws up and almost kills someone. Once again, good luck!!!!
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Truthful advice for new grads "hunting" for their first job
This a little something I have to get off my chest about new grads "hunting" and even seasoned nurses looking to switch jobs or specialties. A little background on myself at this current time. I am an ADN RN w/ just over 2 yrs of experience under my belt. I started out working in a local NH and worked my way into the rehab wing. After working for over 1 year at the NH I applied at a hospital and got my dream job of working in the ER. The advice and experiences im going to share will hopefully shed some light on the nursing profession from my own experiences and hopefully assist you guys in moving forward with all of these job selection dilemmas I read about on this site. #1 - As a new grad nurse "hunting" for your first job you have to remember this one little thing that hiring managers and seasoned nurses are not gonna tell you. As a new grad nurse you are a LIABILITY to patients for about your first year, unless you are properly mentored in a new grad orientation program. By LIABILTY I mean you do not have the experience to critically think on your own after a maximum 3 month orientation process and adapt to a rapidly changing situation. If you don't develop this ability and sharpen it quickly after a 1, 2 or 3 month orientation , your gonna kill someone. All new grad nurses are full of bravado and confidence when searching for jobs and describing themselves on resumes. Watch that same nurse during their first code no matter where they get hired and they have no clue what to do unless properly trained and mentored in multiple codes. It's part of the experience process. You have to be honest with yourself guys. Where would you rather have your first code happen? In a NH where patients are elderly, mostly stable and the most you would have to do is apply O2 and start CPR and have someone call 911? Or would you rather be standing by the bedside in the ER or ICU and have a patient crash on you? Heres the scenario, patient becomes pulseless while your trying to manage 5 pressor drips, orders keep getting shouted to you, MDs are getting ****** cause your not keeping up, family members are yelling cause theyre family member is dying and now you suddenly have to start a code on them and get the crash cart and hope all your other co workers are not tied up with their patients and able to help? After all efforts, patient dies. Could this be a patient that would have died anyway no matter what nurse was caring for them? Seasoned or new grad?Absolutely. But if you looked and acted like you had no clue the entire time you worked on this patient and you really didn't have a clue what to do you were just winging it, guess whos gonna take the heat? Its not the MDs!!!! You can lose your hard earned RN license and catch a case in a heart beat guys. Nursing is a no joke profession and peoples lives are in your hands, literally Once again, new grads are LIABILTIES to patients if not placed into a new grad orientation program for at least a year. These programs are becoming increasingly fewer and fiercely competitive. Don't plan on getting into one. If you do, I envy you and you will be light years ahead of any RN with the same amount of experience who didn't get into a NG orientation program. Trust me. #2 - Stop limiting yourselves to only working in certain facilities. Do you think I liked working in the NH. Hell no!!! But it got me the experience needed to move on to the ER after I perfected my basic nursing skills which are not perfected by any means in school. Where ever you get a job, be proud of it. Become the best nurse in the building. Don't ever forget where you started cause you could end up back there if you get fired or laid off, which happens very often by the way. Burning one bridge in nursing closes off at least 10 roads. Your NM in one job could be the NM at two other hospitals. What the first word in Nursing Home? NURSING. Who cares for NH residents? NURSES. A nursing home is a great place to start and perfect your skills before moving on to a hospital setting. Trust me. I realized how much I didn't know when I started in the ER but I also realized how working for atleast a year in a NH allowed me to gain my independence as an RN and perfect my basic skills and just exactly why ER wont take you w/o that experience under your belt. #3 - Stop bashing psych nursing and other specialties because you wont "get any med-surg skills." This is a fallacy!!! Do you even know what med-surg means? Med-surg skills are not a cub scout badge you earn because you can give an insulin injection at the proper angle or remember not to turn up a COPD patients oxygen therapy above 3l/min. That's nursing common sense!!! Psych and any other specialty are all med-surg. What do you think psych nurses are doing all day/night? Are they assessing patients? Yes. Are they giving out meds and taking vital signs? Yes. Could their patient/s have other co-morbidities along with their bi-polar/schizophrenia? UUmmm yes. Does psych call other departments when a patients BP is too high or their BS is too low? uuumm no. Pscyh nurses have to be able treat and assess patients whos conditions require attention outside the realm of their psych diagnosis while caring for a patient. But just remember who you call when your borderline personality disorder patient trys slitting her wrist with plastic knives at the bedside. My final words to you new grads. Apply everywhere no matter the facility or demographic of patients. I am not pushing for every new grad to work in a NH, but turning down job offers and not working as a nurse when you have a valid RN license is time being wasted. You could be building up your experience and marketability by working your way up the ranks. When places wont hire you because you don't have the experience, don't be an ass about it and cry over it waling "well how do I get experience?!!!" Most places don't want the liability of having to hire and hopefully train new grads for a maximum of 3 months and cut em loose on their own. That is not your cue to keep applying to the same position and waiting months for it because that's your "dream job" and your "ready" right now. You have to pay your dues in the field of nursing. Every nurse has that moment in their career when they realize they don't know as much as they thought they did. Don't let that moment be a reflection back on how you killed a patient over a med error giving 100units of insulin instead of 10. A new grad did this at the NH and it was ugly. Build your skills slowly and surely and the field of nursing is the most rewarding profession in the world and I wish all you guys the best of luck finding a job.
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Any Montefiore RN employees here?
I agree with you 100% estrellaCR!! everybody in here has to get off the "I got a good vibe from the interviewers" band wagon. lol. Its their job to make you feel like you hired that day and theyre gonna promise you the world face to face. Monte is no different!!! don't worry about not getting your dream job for your first one. get a job where you will utilize and perfect med-surg skills needed for furture jobs. I started out at a NH my first job and worked my way to the rehab unit for over 1 year. I applied to monte using an inside connection and it still took two months to hear from my inside connection before I set up an interview. My advice....apply everywhere while you wait and it wont feel like all your doing is sitting around waiting for one place to call back. Good luck. I love working at Monte but there are other hospitals and facilities where they need nurses. If not monte now, maybe later.
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Question about hiring at Memorial Sloan Kettering
you have a very good shot!!!! I have a good friend who works there for years and they hire new grads w/o any experience at all. apply and see what happens.
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Westchester Community College Spring 2015 ADN Program
I graduated from WCC NP May of 2012. I scored an 84% on the TEAS and had all my pre reqs prior to admission to the evening program. I know they changed the admission process and give a TEAS test every semester. With a score of 80% you have a decent chance of getting in. My one piece of advice to you when it comes to applying to any NP is don't listen to other people. You could have scored a 95% on the TEAS and people will still tell you that you wont get in. If you don't get in just keep taking the TEAS. Took me two attempts and two years. Good luck.
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montefiore medical center
I work in the ED at the Moses Campus as of last year. I have an inside connection so my resume went straight the NM. Took about two months to hear from him. I interviewed with him, he sent me to HR after the interview. HR interviewed me as a formality and had me take the two pharm tests before the interview which I aced. I was offered the position that day. I had and currently still have an ADN. Starting salary in a Critical position ICU/ER is 75k/yr. I believe med-surg is around 65k/yr. Night diff is 6k/yr. Experience diff is $1200/yr for every 1-2 years of experience you possess and it increases $1200/yr more every 2yrs you work at Monte. Plan to obtain a work letter from you previous employer HR stating you worked at least 1950 hours per year each year you worked or you will not be credited the experience diff. Education diff for BSN around $1600/yr. Any certification you obtain CEN/CPAN/CCRN etc. is about a $2400/yr diff. Remember also monte provides full reimbursement for college or certification obtainments. Monte also has NYSNA which charges about $95/month in dues. As an example for myself as an RN in the ED with an ADN and 1-2 yrs experience and working nights my salary is about 83k/yr working FT at 13 shifts per month. Hope this info helps.