Monday, March 4, 2013

The Gauntlet: What is the CPNE- Clinical Performance In Nursing Exam

This is part of my post series on Excelsior College's ADN nursing program and the CPNE experience. See all related posts over here.
Gauntlet noun
1. A form of punishment or torture in which people armed with sticks or other weapons arrange themselves in two lines facing each other and beat the person forced to run between them
2. An onslaught or attack from all sides
3. A severe trial; an ordeal. 

Yah.... that pretty much sums it up perfectly actually.


So I have been finishing up further nursing degrees through Excelsior College, more on that whole journey later. For now I'd like to journal a bit about my CPNE experience so that it may help any future students gain some insight. I share it here because, well this is my life and this is a HUGE part of what I've been busy doing the past yearish and because I can be long winded so I have plenty of "space" to dish it out here. If there is anything I can do to help anyone attempting this complete insanity of an experience I'm more than happy to do so. It is a weekend that I will never forget as long as I live and goes down in the history books as one of the top 3 hardest experiences of my entire life, for those that know me, that is saying something. 

For those unfamiliar with Exclesior's program, the CPNE (Clinical Performance in Nursing Exam) is the capstone for the ADN nursing program. After finishing the classes/coursework you ship off for the capstone to one of a dozen hospital testing locations. The CPNE is essentially a weekend long hospital examination testing your comprehensive knowledge and application of practice of everything you've EVER learned. It must be completed with 100% accuracy and is highly subjective, survive all 3 days and you are granted your degree, make a mistake and you buy yourself a ticket back home. 

Stress doesn't even begin to explain it. Pressure is laughable. This experience has brought former combat marines to their knees. Seasoned paramedics and nurses with triple decades of experience have crumbled.... with a pass rate of around 40% (or less, even though they will tell you it's 62%) it's a doozie with all of the cards on the line. I won't try to explain this to anyone who isn't going through it because most will laugh at you and think you're overreacting about doing something so basic. All I can say is that I could cherry pick ANY nurse, ANY doc, ANY nurse practitioner, surgeon, etc and bring them to the exam and they'd fail the first 4 seconds easily. I can also say that there are very few things in my life that I have ever doubted my ability in, not just been uneasy about but really and truly doubted myself. This was one. You could be the best nurse in the world, the smartest individual on earth and still fail this exam.



    Day 1 is your lab simulation day, completing an IM or Subq injection after mixing two separate medications in a single syringe. Packing a wound with a wet to moist sterile dressing. Hanging a secondary medication and calculating an appropriate drip rate. Administering an IV push medication. Simple skills that must be done precisely, systematically, to the approval of your examiner in the way that THEY want it done, in the amount of time allotted. If they tell you the sky is yellow you better say it's yellow... 



    Day 2 is the first day of your patient care scenarios. You receive a Kardex with a variety of areas of care that you must assess and/or treat. Simply speaking, you must first write a care plan for the patient which must include specific elements and then be approved to the T by your examiner. Then you must implement all of your interventions and areas of care assigned. Then you must evaluate and document narrative notes on your care plan and all care you implemented. This again must be done within very precise parameters, must include very specific information, and the entire thing must be completed within a set amount of time with timed phases within the entire scenario that you must hit on point.


    Day 3, if you survive to this point, is again patient care scenario/s. You walk out of the hospital with either a passing letter of congratulations or absolutely nothing but a $3000 bill for your efforts and 'encouraging' words to take a break and try again another time. 

I wish I had been prepared for how insane this conquest was when I decided to enroll in Excelsior's program. Sure I was told about the 'clinical weekend' at the end, I was told it was your capstone and that obviously you had to complete a variety of tasks to pass the program. I was told that there were no traditional clinicals for the program and that this weekend served as an 'ultimate' clinical for the school to sign off on your ability as a nurse in practice. I thought well sure, no problems with that, one weekend is much better than hundreds of hours at a hospital! I was NOT told that it was this. That this would be one of the hardest things I've ever done in my life. I was not told that it was a "do or die" set up. I was NOT told the real statistics of the pass rate (they still wont admit it, but I can do math and I know that 1 passer out of 6 each weekend is NOT 62%). So I offer this info to anyone looking into this program as an option thinking it's great. Do your research, talk to students, read the boards, get the REAL scoop. It is obviously do-able, people DO pass and graduate but you will fight for every second of this degree. And IF you make it to the end, to the CPNE, you will fight even harder, pushing yourself farther than you knew you could to survive the gauntlet and get your hands on that precious letter.

Had I known then what I know now, I probably would've opted for a traditional nursing bridge program, forked out the extra cash, and saved my heart the equivalent of 80 years of stress. For those of you finding me that are already in the midst of CPNE prep, 2 things: 1- you're probably thinking those exact same things. 2- It CAN be done, eye on the prize folks, eye.on.the.prize.
Lastly, I will preface this information with the fact that I did this program while working from home. I continued to run my business, deal with your average life stuff, raise my dudes (they were about 1 and 2 1/2 when I got going), and continue to maintain half time status with online classes at my community college while doing this program. I'm a bit crazy when it comes to that, if you have the ability to devote more time than I was able to into this program you're already doing yourself a favor, TAKE THE TIME, realize from the start that it is going to require a LOT, and plan accordingly.

More Excelsior & CPNE posts here-

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