FEELYRN

RN4KU I would also love a copy of your proficiency. [email protected] I dont expect to be promoted to a 3 but as you know, you still have to do your annual as if you are boarding for a 3. Therefor I need some keywords or phrases to spice things up. thanks in advance!!!!!

Anyone wanting specifics on Excelsior can PM me any time.

Hey thanks everyone, very helpful info :)

To the original poster -- I just failed my CPNE this past weekend. It is a terrible feeling, I made it to day 3 but my nerves got the better pf me. Without going into a long story about what and why I wanted to add my two cents to the usual advice everyone gives about knowing your critical elements and so on. (thats all true, by the way!) I wish I had made this connection earlier: THIS IS AN EXAM. This is not like your job, or a nursing school clinical. You cannot handle things the way you would in "normal" situations, or at work. You can't befriend the patients or make yourself concerned with all their issues, especially the issues that are not assigned to you. You must go in there realizing that this is an exam on specific areas of patient care (those assigned to you) and that there is only ONE way to pass and that is to meet every critical element within a specified time limit. That is the exam, and it is the only way to pass, no margin for error. I failed my peds PCS the first time because I simply ran out of time; even though I had done a great job and felt good about everything i had done to that point. When I had to repeat the PCS I made a stupid mistake - I had ID'd the patient about 3 times already but neglected to reidentify her when i handed her her one pill, a vitamin! I remembered then, but the cup was at her lips and the pill in her mouth already.....failed. Somehow you have to constantly remind yourself that this is an exam, not a real life scenario, and just tick off the elements one by one till the pcs is over. I'm not saying you don't need to ID the pt in real life, etc...but in real life 3 times would be sufficient! But at CPNE, they need identified every time. Handwashing is another trip up -- in real life you wash when entering and leaving the room, unless they become soiled. At CPNE you wash upon entering and leaving, any time you put on or take off a glove (which is often), before you give the patient a med...etc In real life you rarely glove to take a temperature, etc. To pass CPNE, you must wash, glove, wash again just to get a temp. The point I am trying to make is you have to think like its an exam (BECAUSE IT IS), not rely on your day to day experiences to get you through. I was nurse of the year at my facility last year, but I failed my CPNE. A big part of it was nerves but alot of it was just trying to act like this was a pt at work, thinking that would keep me focussed. It ended up being a distraction from the Critical elements. Remember, 100% is the only passing score on the EXAM. I am reapplying tomorrow and plan to take my own advice. Good luck!

Does anyone know? Or I suppose a better question is, how long until Excelsior considers you "graduated" so you can take the NCLEX? Thanks in advance for any input!

Grossest moment : when I was a nursing student I was doing rounds with the ENT nurse. There was a patient with stomach cancer who also had a colostomy and two small fistulas covered with opsite. This woman was beautiful and very self conscious about the colostomy and we were instructed to be very careful about our facial reactions, etc. when dealing with them. The woman was in a wheelchair and I had changed her colostomy appliance and was squatted down in front of her to change the opsite on the two small holes (fistulas) on her abdomen. When I removed the opsite this greenish yellow, purulent, death smelling stuff sprayed out of the hole, onto my face and white uniform. It was horrifying, the worst odor I had ever smelled and I just kept thinking I had to not react with a bad expression. I popped my finger over the hole to stop the spray and after an eternity the ENT nurse and another nurse came into the room because they had smelled something from the hallway. The ENT nurse took one look and smell and started gagging. Fortunately the other nurse pulled it together and took over so I could go wash up. I have run into many gross things in nursing but I always remember that and think "this isn't as bad as THAT!"

Every program I know requires you to have a physical before starting. This is for two reasons: first, to make sure you are physically and emotionally capable of meeting the demands of the program, and second to protect the patients you will be working with in clinical. If you have previous medical condition and it is under control it should not prevent you from entering the program. In my class we had one who was pregnant, one who had bipolar disorder and one who was diabetic. These are just the ones I knew about. The school requires you to disclose this because of medications you may be taking, and because of infection control. We had a strict drug policy and random drug testing so they needed to know up front if you took any meds.

Missy - Some interview tips, dress appropriately. Many people were not accepted into our program (only 30 allowed) because they wore their nose ring or a t shirt to interview. You dont necessarily have to dress up, but clean and neat and well put together. It shows respect for the director who interviews you, for the program, and for yourself. After all if you look sloppy to interview the concern is how will you represent your school in clinical? Also have your "ducks in a row." For example when I went in to interview I was asked for my immunization records and transcripts. I was also peppered with questions such as had I arranged for child care, have I had a dental exam and physical recently (at our school y0u were not excused from class for medical appts.), had my car been checked out recently (if car not reliable, you might not show up for class or clinical on time). I found all this annoying at interview but later realized they were valid questions because in a 10 month program you cant afford to miss days due to poor planning and "preventable" emergencies. As to why you want to be an LPN, be honest but also think of a concise way to say what you want. Dont ramble on and on. Try to appear efficient and in control of things but thats what it takes to get through nursing school and to be a nurse in real life, and thats what they want to see. Good luck, keep us posted!

Agree, half our CNA's are men and they are awesome!

Great post, Nurseinthemaking. I graduated 3 years ago and your advice is right on (laughed about the "drama" part, so true.) I would add to that, take advantage of your clinical opportunities. If someone else has a patient with a wound vac, or chest tubes, or post op CABG incisions, or getting a cesarean section or whatever else you have never seen before, ask if you can watch. Ask the nurse questions. You can't do everything "nursing" there is in clinicals but there is generally more opportunity available than just what you get with your assigned patients. When I went to take my boards, I had a lot of questions about chest tubes and removal of them and we did not learn this in school -- however I was able to see it (on someone elses patient) in clinical and asked the nurse some questions about it, which saved me at board time. Also, even though you will be scared/nervous take advantage of clinical opportunities to do ANYTHING with a patient when someone askes for volunteers to do things like cath, draw blood, hang tube feed, start an IV, etc. It is much better than doing it for the first time, on your own, at your workplace. And always better to practice on a real person, with an experienced person to guide you. Being organized and on top of things is really critcal to your success, also. Good luck!

I work in an acute care rehab facility. We have 8-12 patient per nurse/aide. Midnight shift has up to 16 each. Patients are high acuity and in my opinion this ratio is too high for proper care.

Are you floating to different team assignments or different areas of the hospital? I agree being a float can be challenging at times but you also get a broader base of experience, develop better time management and pt relation/communication skills. Anywhere you start should give you an orientation period to feel comfortable with the areas you will be floating. Helping the other nurses is the best way to get help yourself when you need it. I was hired as a float and it was hard but now I float to all three units at our rehab hospital, know more patients and get to interact with all the different staff members. I also have more opportunities to see and learn new things since my patient load is diverse. I am starting school for RN this fall and I feel very prepared thanks to my experiences and the nurses (good and bad) I have seen in action. Good luck, Are you in physical rehab or psych type rehab?

I think everyone who has not worked in healthcare gets nervous, at the start of any clinical rotation everyone was nervous in our group. Help each other out and you will get through it. Often by trying to keep patient comfortable and calm you calm yourself in the process. Confidence comes with experience, dont be too hard on yourself.

I work in an acute care rehabilitation facility mainly with brain and spinal cord injury patients. I started here fresh out of nursing school.

Letting the patients help out as much as possible not only relieves your and their discomfort about "private areas" but also gives them a useful rehab tool (washing yourself IS exercise for some elderly patients) and a feeling of independence.

Helping to bathe patients is always uncomfortable when you first start but believe me, you get over it, just as you "get over" dig stimming a person rectum or disimpacting them. Nursing is not a "pretty" job at times, but with experience you learn not only to overcome your own discomfort but to help patients overcome theirs. As someone mentioned earlier, bathing pat. is an excellent time for head to toe assessment, you often see things you might not have otherwise, or that pt was too embarassed to tell you.

I agree it depends on where you are, in my area it is opposite of AEGIRL's experience; vocational school gave us clinical in LTC, 2 Hospitals, OR, Peds, Rehab, Psych and OB, whereas CC is mostly LTC with a 2 week med/surg. Credits don't transfer here either but you do have the option to try and test out of Pharm, Nutrition, Anatomy and Physiology and Nursing Fundamentals if you go for RN at the University. So, it depends. You should definitely do some research on both. Vocational schools also tend to have smaller class sizes, which is nice if you are a person who needs or wants more 1:1 time with your instructors.

I was 37 when I started in my LPN program, I have now been a very successful LPN for 2 years and going back for my RN in the fall. I am 40 and definitely don't think I am too old to be there. It is very hard work though, and you need to be commited to it or you will give up - it is just as hard for the younger students. The person who gave advice in an earlier post was dead on, get started finding out what you need to do to get in because it sometimes takes a while, and go straight to the RN program. LPN is great but in one more year I would have been an RN and made a better living doing what I basically already do. Good luck to you!

A PS to my post -- You learn every day, especially time management!!! Rehab nursing is hard work, for the nurse and CNA, but also very rewarding.

Our ratio is 9:1 -- one nurse (LPN or Rn) and one aide -- unless we are short staffed then the numbers go up. We are a free standing acute care rehab with stroke, brain and spinal cord injuries, ortho and post op cardiac patients, with a mix of other stuff thrown in. In my opinion this is too many patients to give adequate care because many have intensive wounds that need dressed/packed, IVs and tube feeds, traction devices, etc. We also have co-morbidity issues like Alzheimers patients and dialysis. It can be trying, to say the least, but you learn so much every day.

I did not experience any bullying whatsoever, in fact the other nurses seemed glad to have the help! I think your attitude also makes a difference; you are a new grad and so asking a more experienced nurse for their opinion or advice on occasion is not only smart (helps you learn) but also makes them realize you dont "think you know it all." Even though you may be nervous in your first job it is important to appear confident and in control -- asking for help is great as long as you carry your weight and dont appear incompetent. I think one reason for hostility at times towards new grads is that they sometimes start out at equal or higher pay than the nurses who have been there awhile. Give them some respect for the time they have put in and they will treat you fine.

In my experience Vocational schools traditionally give you a broader base of clinical experience than JCs. I suppose it depends on what experience you have going into LPN program and what type of learner you are.

First of all, don't freak out when you take your boards, don't focus over-long on any one question. I had a variety of topics on my boards and the person who posted about using your common sense is correct. If you haven't been paying attention in class/clinicals you will be in trouble because the boards ask you questions that require you to apply your knowledge in practical situations, rather than typical test type questions. Eliminate the obvious wrong answers then try to put yourself in the scenario and think what you would really do, not what you think the right answer is. I had a few pharm questions that were easy and some nutrition questions about cultural preferences but most were scenario based and priority questions. I don't know anyone who didn't feel they had failed after taking them, so thats normal. Just relax, breathe, and don't get hung up on a question. If you really have no clue, pick what seems most logical and move on. Also, in regards to the "how many questions you get" postings, i never knew anyone yet who failed with 75, so if you shut off at 75 you probably did ok.