Live in the present moment wisely and earnestly



It is a flawed world

It is a flawed world. Funny about me, I keep looking for ways to ‘perfect’ it. Who has the right to perfect it, under whose standard? If it is suppose to be my standard, isn’t it too egoistic? And further more? I am no different in a society with its institutionalised schools, religious organisations and rigid bureaucratic establishment that are confining humans’ minds and creativity?

And I think of Lee laoshi, he who knows the flaw, knows how to accept without dampen by the situation, and neither sinking into it fully. He, in his ways, lightened up the situationand the most endearing thing that many of us feel and touch by, with the heart and time to guide us. And you can feel it, not out of ego, out of feeling good, (he has so much in his hands) and we can feel it, the act of a pure heart, and such a down to earth enlightened positive being. Not many that I have met, and we we should have more Lee laoshis in the world.

Anyway, my thought or reminder of the flawed world, as I have been feeling so in this world of mine, and here I find the narration of another from the other side of the world.

I guess ultimately is how we can be sane and have sufficient self intelligence to know we need institutional guidelines to help us to maneuver as a society, as a civilisation. AND NOT GET TIED UP when as individual we know exactly what we are and what we want.

Here’s the 53 yr old lady’s feedback to her medical/clinical folks that I happen to chance upon. I feel she is one I have not met but knowing how she’s constantly upgrading herself and apparently a person positive about life, and constantly being a service to patients, she is someone I am with respect for 🙂

Has anyone out there taken the CPNE Excelsior college exam?Did you take it and are not glad? Did you take it and are not glad you did? Would you recommend taking it to someone who has doubts about the program?
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JustJessie
JustJess…
Best Answer – Chosen by AskerToday is July 1, 2008, yesterday I returned from the Excelsior CPNE examination. I believe that the information from my experience will be of help to you in decision making to pursue or not this course of action.

Let me tell you who I am before I begin to report this experience. My name is Jessie P.; I am 53 years old and have practiced as an LPN for 28 years. I have practiced in five states. My main field of practice is Gerontology, but I have also practiced in Occupational Health, Intensive Coronary Care, Alcohol and Drug Detox and Rehab, and in-home private care as well as hospice. 

I continued to work as an LPN because I wanted to work with the patients, I did not want to do paperwork as is often the case with the RN position. The LPN position funded my continuing education. I have an Associate in Science from the University of Maine, Orono, Maine campus, a Bachelor of Science from Linfield College, McMinnville, Oregon and a Master of Arts from the University of Phoenix, Tigard, Oregon Campus. I also have a certificate of Accounting and Office Management from Pioneer Pacific College, Wilsonville, Oregon. I am a certified Phlebotomist and have yearly certification for IV Therapy Performance. All of my degrees were finished with a GPA of 3.0 or greater. 

Continuing from LPN to RN was on my “bucket list” (what I want to accomplish before I kick the bucket). However, I believe this experience was guided by a Devine hand to allow information to be given to other nurses before more damage occurs. If you are contemplating this course of action, don’t bother, save your money and use your state education system to accomplish your goal. If you went and did not pass, the failure is NOT yours, the CPNE program is so flawed and the tools to measure nursing skills are a joke. I will be giving you examples, not just my opinion. Remember, my MA is in Organizational Management. I have been trained at the Master’s level to develop tools and programs for accurate measurements related to learning and practices.

My experience began when I accepted the assignment of CPNE at Madison Wisconsin, Meriter Hospital. I chose to stay at the Best Western Inn Towner. By the way, Madison is a wonderful town, Meriter Hospital enjoys a fine reputation, and the Inn Towner is a very fine hotel that gives the CPNE students a price break. 

Friday Evening – 4:30 pm 
The CPNE starts with 4 stations in a laboratory setting (a room with tables and rubber hands and arms)

Station 1: IV push – failed – I did make an error, I forgot to palpate the rubber hand at the IV site. This test could be repeated on Saturday afternoon. 

Station 2: insulin administration. The CE (Clinical Examiner) felt there was a technique problem, I did not – failed – repeat on Saturday afternoon. 
Station 3: Piggyback with back flush from primary bag, calculate and regulate drip- passed. 

Station 4: Wound Care – rubber arm with a wound to be packed and sterile technique observed. This experience is too funny to not tell. 
The table was full. Five boxes of sterile gloves, a rubber arm, a stack of boxes of 10 sterile 4×4’s, a box of ABD’s, a liter of normal saline, a box of single sterile 4×4’s, tape, and three boxes of non-sterile gloves s-m-lg. The CE was sitting at the only open spot at the table. When I asked if I could use an adjacent table for sterile gloving, she whined, “then I won’t be able to see.” This CE (Clinical Examiner) had already demonstrated to ability to stand and walk but she chose to occupy the only open table space available for preparing a sterile glove set up. The insanity continued from there. 
I had to open my sterile field containing sterile gloves on my rubber arm patient. Then I had to put strips of tape on one of the boxes as there was very little room to manipulate materials. Now, the CE stated that she THOUGHT I contaminated my gloves, my fluffs were not fluffy enough, and she was not satisfied with the tape holding the dressing. I stated that the book said that I did not have to tape all of the edges of the dressing. When the CE (Clinical Examiner) checked with the CA (Clinical Associate), she wanted to fail me three times for one station. The CA (clinical associate who is Present to make sure I am tested fairly) stated that I could only be failed once per station. She also said that I could only be failed for a witnessed error. The clinical examiner was hell bent on failing me for something. Of course this one was a fail due to my fluff not being fluffy enough. 

Saturday: PCS time

PCS (patient care situation) #1 passed care plan, patient too upset by private situation to cope with student nurse. The Patient never met me; I knew it was not personal. 
PCS #1B Care plan Passed. This patient had an injury of infection related to a surgical event. Two RN’s one primary and one charge nurse was attempting to start an IV site for antibiotic administration. Both arms were in service. When one arm became vacant as the RN left the room to retrieve an op-site, I was (according to the CE) too run up to the patient and check his name band against my assignment sheet. Since his arm was bleeding from the existing IV site (the arm with the ID band) and the RN leaving the room had said he would be right back, I stayed out of the way. The CE stopped the PCS 12 minutes into the 20 minute window to complete the initial Identification of the patient. She did not see the reason to stay out of the way when the patient was receiving care for a bleeding IV site by the primary nurses. This was a Fail. 

PCS or not, these people who are patients are not there for my convenience and deserve common courtesy. As stated in the CPNE instruction study guide, on page IV 3 D a, b, and c we should be on guard to prevent putting the patient in emotional jeopardy. I was beginning to see a problem, I could not, with the information that I had, make a determination of the cause of a non-flowing evaluation of nursing skills.

PCS #2 Care plan passed – (total hip replacement) Lung assessment completed, patient with clear lungs but uncomfortable with positioning. I allowed patient to readjust position. While patient was resting, I walked to the end of the bed and asked if I could check her feet circulation and sensation. Patient consented. 
I was asked to step out of the room at this point, when I asked what was wrong, I was told CE Clinical Examiner) had to check with CA (clinical associate) about something. CA (clinical associate) informed me that I had failed the PCS because I was out of sequence. It would seem that I had left the patient’s chest and started an assessment on the main point of care without having the patient cough and deep breath. 

I informed the CA (clinical Associate) and CE (Clinical Examiner) that I was not finished and how could they judge my clinical skills if they did not let me finish. Coughing and deep breathing could wait until the patient was comfortable again at the end of the Lower Extremity assessment. I was told I was out of sequence that having the patient cough and deep breath was next on the list. 

“NEXT ON THE LIST???” I suppose I should have forgotten that the lung assessment had caused discomfort through the pain medication given two hours before. With this type of reasoning I would rather have a group of monkeys who were juggling cupcakes assess my nursing skills than “NEXT ON THE LIST and forget about the patient’s comfort level” assessment.

I stopped the test at this point and informed the CA (clinical associate) and CE (clinical examiner) that they knew better than this type of skills assessment. I also told them that they had prostituted all that they had worked for and stripped themselves of their autonomous clinical assessment skills for a “Next on the list” program. This was shameful and unnecessary. I also stated that I would not allow a “rinky-dink” operation like this blow me out of the water. I announced that we were done. There was no competent testing occurring at this test site. The CE (clinical examiner) agreed with me and the CA (clinical associate) was crying, so my work here was done. 

However, my work is not done. There are no quality controls in the CPNE. No BSN’s with 10 years acute care experience have taken the CPNE incognito, to ferret out the bugs in the program. The CPNE is very well protected legally; remember all the papers that you sign?

In my group of six, there were three repeating the CPNE, three taking the test for the first time, and only 3 passed, two failed and one had a hissy fit and stopped the test. The test along with airfare, hotel, food and miscellaneous expenses is approximately $3,200.00 – $3,500.00 each time. You can take the test a total of 3 times at the cost of $9,600 to $10,500.00. Then Excelsior, richer to be sure, cuts you loose, passed or failed. 

Excelsior College requires of its students a 70% or greater score of success to pass and be awarded credits on all tests, yet Excelsior College has failed to meet this standard in the CPNE. There was a 50% pass rate on my group alone and it is reported on their own site that they achieve a 65% pass rate for a first time testing, 65% pass rate for those testing the second time and a 55% pass rate for those testing for the third time. I believe this 65% number to be greatly inflated.

Just let me say it, “EXCELSIOR COLLEGE, YOU HAVE FAILED AS A TESTING PROGRAM”. 

Well folks, I have given you all the information that I have, I am separating myself from Excelsior College. I need to salvage what I can and will be attempting to transfer credits to a state university. All transferable credits are suspect at this point and I may have wasted a boat load of money if the credits do not transfer. 
Since I have told you my experience, please use this forum to report your take on this, if you took the CPNE and passed, report where your testing
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 to rate Asker’s Rating: * 5 out of 5 Asker’s Comment: * Wow! All I can say is thank you for sharing this information with me or whoever may read this–if someone as intelligent as you are had this kind of experience–my doubts were warranted. You sound like a strong person and I’m sure you will succeed in a more responsible RN program. Thank you.
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