Sunday, January 31, 2010

Oops!

Ok, well Friday wasn't nearly as productive as I would've liked for it to be. After my 3 mile run, I was drained!! I was able to get through all the overriding areas of care and I do believe I have a good understanding of them.

I also did 1 care plan. I still have to do the evaluation phase for it which is where I tend to struggle the most. Hopefully I will get that finished up today and sent over to Dr. A for review.

Friday evening I ended up going bowling. It was great to get out and not think about the CPNE for a few hours!! Lets just say I ended up having too much fun and staying out a little too late.. I woke up yesterday feeling a little groggy!

Yesterday ended up being a great day! (Probably because I wasn't studying!) Andy and I went out for Chinese food and had a nice relaxing day at home. Michigan State played at 7 and I kind of watched the game while wasting precious time on the computer! I know, I'm terrible!! Should have got some studying in!

I hope today I will be a little more productive. That may be difficult since I am headed over to my parents at some point. Thank god I only work 2 days this week and then I'm done working until this nasty exam is over!!

I just got done practicing the IV drip and wound packing..5x in a row, each!! I'm not including each step yet because I'm struggling with perfecting the techniques. I keep trying to regulate the IV at 25 gtts per minute. What a pisser that thing is! I'm always 4-5 gtts off. According to the skills kit we can be only be 2-3 and I think that varies on the clinical evaluator.

The wound, that's an entire different story. I'm clumsy and I have fat fingers. Ah! I keep hearing about parachute techniques and ribbon methods.. neither one of them work for me! Something always touches the skin or the outside of the wound. Whether it's a finger or a string of the gauze, it's a very frustrating experience. I told my husband (who has an engineering brain), that he has got to watch me and figure out a better way for me to do these labs.

For anyone who's interested, here is the first part of the care plan I'm going to submit to Dr. A.

This was created for "Jean Kauffman" on pg. 95 in the study guide.

1. Ineffective breathing pattern (r/t decreased mobility, as evidenced by weak cough)
The patient will report ability breate comfortably during PCS
Encourage client to cough x1 during PCS
Assist client to use incentive spirometer x1 during PCS

2. Impaired physical mobility (r/t tissue trauma, as evidenced by right knee surgical incision)
The patient will demonstrate use of walker during PCS
Ambulate client with 1 assist and walker during PCS
Maintain ice bag on right knee during PCS

I'll try to get the evaluation phase done later....I hate doing that part because that means 'data' has to be made up.

Friday, January 29, 2010

New Day

I stayed up late last night (especially for me!) watching TV until 11:30 pm!! I think my mind had to unwind from my endless hours of studying. I was up at 7 and felt unusually refreshed. No sleeping pills last night! Usually I drag myself out of bed and always have a 'hangover' type feeling.

The plan for the day is to start with a 3 mile run. Not looking forward to it since I haven't ran since Monday. After that I will practice my IV drip lab. I finally figured it out thanks to the EPN and the videos I posted yesterday! I felt like I wasted so much time figuring that out. When I look back now, I'm glad it didn't go right because I feel as if I have a complete understanding how an IV works.

The rest of the day will be spent digging further into the areas of care, referencing textbooks and yes, taking more notes! I'm also going to pick one other lab to focus on and understand all the concepts/rationals that pertain to it.

Many people get through this exam by creating 'mnemonics' which are funny words/sayings that help remember the critical elements of each area of care. After the planning phase, people flip their PCS form over and place them into a 'grid.' I had several people tell me 'learn your mnemonics first.' Oh hell no, I wasted so much time sifting through mnemonics and collecting/compiling others and I still looked at them thinking there would be little details that I would forget. I decided it's best to wait until I know the material inside and out before choosing and/or creating the mnemonics I need.

For any of you who are just starting to prepare for the CPNE and seek organization, I recommend the following:

First of all, find a local print shop in your area. Have the CPNE study guide printed. I had mine done for about $12 and spiral bound. However, I now wish I would've had them punch it with 3 holes for a binder.

I used pocket dividers and divided it into the following sections:
Planning, Evaluation, Labs, Overriding Areas of Care, Required Areas of Care, Selected Areas of Care Related to Assessment, Selected Areas of Care Related to Management and Other Areas of Selected Care.

In the pockets I put blank forms for the Planning, Evaluation and Labs to practice with. I compiled all the mnemonics I had and typed them up and put them in sheet protectors associated with each area of care.

It took me a long time to figure out how to 'dissect' and 'break down' this exam. Hopefully this helps someone! It was one of those 'little' things that caused me to waste time.

Time to go run................

Thursday, January 28, 2010

Horrible Day!!

I'm preparing for the mother-load of all tests to complete my nursing degree, the CPNE. This is a 'clinical competency' exam to prove that I'm capable to function as a new grad RN. Sorry, I feel this is WAY WORSE than the NCLEX-RN. The idea of someone evaluating my performance is causing me to have constant heart palpitations and I'm currently addicted to OTC sleeping pills. The date I was given was sooner than I had anticipated and because Andy and I are more than ready to move on with our lives, I chose to keep it. I have spent the last 3 weeks scrambling trying to obtain important supplies and seeing if it was even possible for me to attend a workshop. As I look back now, I see LOTS OF WASTED TIME! And no, I'm not going to a workshop so on days like this, I feel like I'm on a suicide mission.

I began my day practicing my IV drip lab and am having a terrible time perfecting my technique. I'm not sure what I'm doing wrong and need to meet with my infusion RN friend ASAP! I felt so defeated after doing this, it kind of set up the momentum for the rest of the day.

After struggling with the labs, I sent my Aunt Kathe a note on facebook asking her for saints to pray to for tests/nurses. She is the best Catholic resource ever and I will be investing in some prayer cards very soon.

Last week I cut up an index card with all of the areas of care, lab simulations and other various portions of the CPNE study guide. This is the only way I can zero in on what I need to- one thing at a time. Each day I force myself to pick from a small dish and pick apart each critical element. I have always been a 'note taker' and I don't know why. I find myself repeating exactly what is written in the study guide. I think it helps maintain my attention while Boldreading it. But when the day is done, I feel like I've done nothing more than WASTE MORE TIME!

At 3pm I checked the Electronic Peer Network on Excelsior's website only to read of another recent failure. By 3:30 I was at Meijer buying Stouffers Macaroni and Cheese and ice cream. By 3:45 I was shamelessy eating ice cream out of the carton... I have never done this before in my life! I'm afraid preparing for this test is going to cause me to neglect other areas of my life for the next few weeks. Eating, exercising and cleaning the house will probably not be on top of my priority list. This creates another element of 'unbalance' for me as I can't stand disorganization and clutter. Not to mention, so much for losing 10 lbs before my 'dirty 30' in March.

At 4:30 pm, I realized I need to do something to help keep my emotions in check as I prepare for this test. Here I am! I'm hoping this blog will help me stay focused and deal with this emotional roller coaster.. and hopefully receive feedback from others that have been successful at taking the CPNE.

For those of you that know me, yes, I am a highly anxious person. Especially when I'm doing anything that revolves around tests. Please do me a favor and quit telling me 'you always stress out about stuff and do great.' This is not about getting an A or a good grade on a test. It's all about my ability to make clinical judgments and doing it the way Excelsior College wants me to. I'm paying them a lot of money for them to make this decision.. ok, Andy is paying most of it, but it's a tremendous amount of pressure to do this right the first time!

8:30pm: I found some videos to help me with the IV Piggyback situation. Here they are:
IV Piggyback 1/4
IV Piggyback 2/4
IV Piggyback 3/4
IV Piggyback 4/4