January 2017

Here is a success story from someone I met through the ATL workshop.  I decided not to use names or testing sites for anonymity.

First off I want to give you a little background. I have been a paramedic for almost 17 years and have a BS in Emergency Medicine and a Masters in Public Administration. I am a Regional Training Officer for a hospital based EMS Service in NC with about 250 EMS providers. I started the Excelsior program on fall of 2014 and took my first test in Feb of 2015 and applied for my CPNE in February of 2016. After Feb I kept checking for cancelations and in September EC told me that I would most likely not get a cancelation date before the end of the year. At that point I succumbed to studying the 22 edition and in the first week of December I received a call for cancellation dates in January. This set my course in motion to re-solidify my studying efforts, practicing care plans, memorizing mnemonics, adjusting them to make them my own, and practicing labs and entire managements. After the first week in December I dedicated 40 hours a week studying.

Friday night we met and the simulations went OK the medication administration has been extended out to 35 minutes which are used every second of.

I did not pass the sterile simulation lab because I neglected to document no drainage in the pick line… I documented no redness or edema, missing drainage was a critical element.

The CA was very nice and very supportive and answered questions above and beyond what I expected. The clinical examiners were all very nice very supportive and helpful and did their best to keep me calm… I am usually a very levelheaded and calm person but when there’s this much on the line Saturday morning was a little intimidating until I completed the sterile lab again. (I would’ve hated to fly through most of my PCSs and not pass that).

Patients were all very straightforward nothing crazy. The CEs all confirmed fluid management amounts when I would ask that looks like whatever mL. Also when receiving report I asked many questions “during your assessment of this patient…..” and received very detailed answers for what I was asking.

I took 2 1/2 hours on every PCS, had a child substitute and no repeat PCSs.

Unfortunately I was the only one left on Sunday. I did not talk to two of the others about their performance because they were doing laps when I left Saturday. The one that I did talk to said hers were both errors on her part but she did not document everything she was supposed to document. I do not believe from what I gathered Friday from them that in he had done any type of workshop. One was on their 2nd attempt.

Using some Sherry’s mnemonics and some of my own in addition to working grid helped me tremendously. I would not of been successful. I did not have the grid to work and follow.

I narrowed my pneumonic so I had to memorize down to five. I was very well versed on interventions so I did not include them really in my pneumonic.

Mine were MASTERS2D for musculoskeletal management – which never used. RUBBERSS- respiratory SHORTAIRS O2 SKINNED- skin mgt OUCH WOUNDED – which I had a wound. PERIPHME AND every area had teaching so I broke down an extra box for each management With TNWATER- talk to you, now a good time, what do you know, teach, evaluate, record (which I made a check box)

I do not feel that the examiners or the associate wanted anybody to fail. After my first PCS. The examiner stated I would really like to ask you how you prepared but I cannot. Going on to say you’ve got a system work your grid.

It is an incredibly stressful experience I can certainly attest to that. But with appropriate preparation, a support system and controlling my nerves I was successful. Best advice know your elements cold like the back of your hand. Whenever you have a free moment right you’re pneumonics down on a napkin at a restaurant just wherever so you know those cold. And as the clinical associate said the first night during our orientation when you get that piece of paper download your brain so you know exactly what you need to do. My last PCS was a little bit more complicated simply because the patient was blind and and had mental health issues in addition to his medical issues. That one took me a little bit longer in the planning phase to find an appropriate diagnosis.

The diagnosis I used were 1: excess fluid volume, 2) impaired skin integrity, 3) impaired gas exchange. On two patients are used teaching as an intervention in addition to something else. As long as it moved the patient toward the goal there was no issue.

Documentation is just as important as providing the care because if you don’t document all the critical element, you will fail.

I did not do neurological or abdominal assessment. I was not assigned vitals because I had medications to administer and had to do apical heart rate and blood pressure on two of the three.

So in conclusion it is doable: study and know critical elements. Practice everything. The CA nor the CE’s intentionally did anything to make me nervous. It was just the stress of the whole situation.

After my last PCS the CA, another CE and my CE were all exuberant about my successful completion. I certainly believe that the CA’s and CEs can make or break this exam. There was nothing tricky about any of the lab stations or anything, no infiltrated IV’s or picc lines. And I do not believe anybody in Utica this weekend actually got the catheter station.

I am certainly happy that it is behind me. I would not have been able to be successful without Sheri, Greg, the workshop, and the support of this private group of ATL clinical members.

**This website is not affiliated with any school, exam, hospital, or workshop.  CPNE is a registered trademark of Excelsior College for whom I am not endorsed**

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