A critical element to passing the CPNE® is to set up realistic practice beforehand so you’re able to get hands on experience prior to test day. Your lab stations represent the most controlled environment you will experience during your exam weekend therefore they encompass the easiest phase of the weekend to pass presuming you have drilled proper techniques at home. Realistic practice helps you establish muscle memory by walking through each step of each lab exactly as you will for test day and is crucial to success.
If you want to practice your CPNE® labs at home you should assemble your home lab as closely to the ‘real deal’ as possible. Though if you don’t want to spend a lot of money, there is a way to do it on a budget. You can set up all the practice equipment you need at a cost of about forty dollars, depending on where you purchase the few things you will actually need to buy.
1. The IV station. There are some things you can improvise, but when it comes to setting up an IV drip, you’ll want to use real IV bags and tubing. You only need one larger bag of fluid (a 500ml bag is plenty), one 50ml bag, one primary tube set up and one secondary tube set up. You can make an IV pole by bending the pointy ends of a wire coat hangar together and hanging it over the shower rod in your bathroom. Then, just hang the IV bag on the hook part. It’s best to use two separate hangars for the two bags; this will make it a little easier to handle when you’re hanging your secondary bag. Just let the tubing run into the bathtub, and you’re ready to go. If your smaller bag runs out of fluid, just refill it from the larger bag or fill it with tap water using a syringe.
2. The IV push station. For this simulation you will want to use real needles and syringes, and you may want to invest in a box of alcohol swabs you can purchase at a local drug store. You will also want to buy at least two 30ml bottle of normal saline to practice drawing up the appropriate amount of medicine. To make a patient, simply slip a latex glove over a new kitchen sponge, stick a regular hypodermic needle into the sponge at an angle, tape it into place, and you’re ready to go. Or you can construct one from a pool noodle, a rubber cleaning glove filled with cat litter, or a stuffed animal.
If you don’t want to purchase alcohol swabs, you can use paper towels cut into two inch squares.
3. The IM/SQ station. The great thing about this station is you can use the same patient you made for the IV push station. Use the same two bottles of normal saline and practice drawing up and mixing medicine using the same syringes you used for the IV push station. You can reuse your practice materials at home, just be sure to practice disposing of them in a sharps container so you don’t forget to do so when it comes to the actual exam. An empty coffee can makes a great sharps container and will make it easy to retrieve your used syringes so you can use them again. You can use tissues or paper towels as 2 X 2’s and alcohol preps, and your local dollar store will sell you all the band aids you could possibly need for one dollar.
4. The Wound station. This is a great station to use your imagination. If you look at your study guide, there are several pictures of the wound you will be packing for the test. Use this picture as a template to carve a wound into a block of florist foam, a large piece of styrofoam, or a lump of clay. Invest in a box of 4 X 4’s, but, instead of throwing them away every time you practice, allow them to dry out and reuse them. Any plastic bottle with a screw top is a great substitute for the bottle of normal saline – just fill it with tap water and you’re ready to go.
For sterile gloves, take a pair of regular gloves and fold them up in an aluminum foil packet just like sterile gloves. You can use the same pair many times over if you allow them to dry, then refold them. Even if your wound isn’t the exact replica of the real wound, it will still give you the practice you need to perfect the skill involved in packing a wound.
There are many ways you can set up lab stations in your home without going broke in the process. Try to improvise wherever possible, but remember to use the real materials when it is necessary. However you do it, remember to practice whenever possible.
Tips for Practicing at Home
Try not to get caught up in the unimportant details, the key to lab practice at home is to be succinct and efficient. First order of business is to label everything just as you will find it on test day. Label medication vials with the actual medications from your study guide, write out labels for your IV medications and be sure to include expiration dates. Print copies of your actual recording forms and place them in laminated page protectors so you can practice writing everything exactly as required. Dry erase markers can easily be wiped clean each time.
Use realistic practice when calculating drug dosages, pull up sample medication doses from your drug book on the medications listed in the study guide. Practice calculating a variety of ordered doses from different on hand doses. Use a stopwatch or timer to ensure you are used to practicing under the clock. Those 15-20 minutes go quickly! If possible recruit someone to watch over your shoulder and check you off just like an examiner, this will help you feel the ‘stress’ of your actual testing scenario.
Organize each lab into separate totes or bins so you can quickly assemble and disassemble lab stations, this also helps for those with a limited amount of space for practice. When practicing your stations, lay out supplies on the table, place gloves, vials, syringes, tubing, etc in appropriate groupings along the table and set your recording forms in the middle of the table. Work space should be clutter free and contain only the supplies you need for that particular lab station.
Walk up to the table and simulate the examiner intro “This is your IV push medication lab station, these are your supplies, you will have 15 minutes to complete this station the time is now —, begin” Immediately write the time on your sheet and start grabbing your supplies. Lay them out on the table in an organized fashion and slowly walk yourself through step by step double checking your moves along the way. Write down information exactly as asked on the recording forms and stick to the clock.
Take pauses if needed to regroup. If you make a mistake take a moment to think about how to fix it, don’t immediately give up and start over, test yourself and see if you can dig yourself out of the hole and continue within the allotted time. This will give you valuable feedback on how to continue with your practice, take the time to analyze the mistakes you are making and find the best solution to correct these.
If you find yourself making the same mistake over and over stop your entire simulation and start from the beginning until you complete the process flawlessly without that mistake. This will correct the neural pathways in the brain and essentially override the hard drive of your brain. Don’t assume that you will inherently do it correctly on test day, muscle memory is hard to break. You want to be sure you have been performing perfectly at home so that when the stress factor during your CPNE® hits you know the foundation of your technique is strong.
While practicing at home in a mock lab is extremly effective, you may also want to consider attending a hands-on CPNE® workshop where you can practice on the actual equipment and simulators you’ll be using during your clinical weekend. You’ll certainly find that a sense of familarity with the real equipment can help combat nerves during your CPNE®.
Happy studying!
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