Reviews :(
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IF THERE IS ONE THING I WOULD LIKE EVERYONE TO KNOW TO BE
SUCCESSFUL IS THAT YOU NEED TO READ EVERYTHING THAT I SEND
TO YOU, AS WELL AS READ THROUGH THE EXCELSIOR COLLEGE
CPNE BOOK (CRITICAL ELEMENTS). TOGETHER, THIS CAN BE A
POWERFUL COMBINATION ! TO SAY I HAVE ALL THE ANSWERS WOULD
BE TOTAL ARROGANCE. THE BEST INFORMATION COMES FROM YOU !
11.22.09 - From Mimi Adams:
"I purchased both of your DVD's that you offer afer reading high
recommendation on the chat sites and I was very disappointed in the quality,
the dvd stopped several times while trying to view, you offer for the price, not to
mention the sims lab dvd with all of the in accurate information that you provide.
There is wonderful competation on utube for free and has the proper instructions
and supplies for the students to view. I would suggest you change your quality
and update the right information. I do feel you are taking advantage of the
students out there trying to find the right information to help them pass the
CPNE. You do have good nmeumonics to offer. Truely consider updating your
quality, price and corrent information provided."
I am sorry to hear that your AOC video is not working. I have an outside
company that duplicates the video for me and sometimes these flaws
happen. I will gladly send you another one. Please let me know what your
address is and I will send it there. As far as your other comments I would
like to discuss each one:
1) the sims lab dvd with all of the inaccurate information that you
provide.
- It is true that there are inaccuracies that have been noted and explained
in the lab sim Ebook. If you know of any other mistakes please let me
know and I will post the new information in my newsletter. Here is an
excerpt from Chapter 6: Corrections to video/Updates that makes
students aware of these mistakes:
{ HERE IS WHERE I PUT THE CORRECTIONS FOR THE LAB SIM VIDEO
THAT YOU CAN FIND IN THE LAB SIM EBOOK, CHAPTER 6 }
2) There is wonderful competation on utube for free and has the proper
instructions and supplies for the students to view. I would suggest you
change your quality and update the right information.
- As far as quality, I feel that the videos are at the best quality for what
students need to see. I did my best to get the best camera angles and I
feel confident that everyone can hear me when I am talking about what
to do. Along with the Lab sim Ebook that documents everything from
mnemonics, to supplies needed, to correct angles and proper documents I
feel that it is a far cry cheaper than going to a workshop and much more
inclusive than the youtube videos.
3) I do feel you are taking advantage of the students out there trying to
find the right information to help them pass the CPNE. You do have good
nmeumonics to offer. Truely consider updating your quality, price and
corrent information proviided.
- I am sorry you feel that way. As I have already gone over the quality
issue I would like to take a moment and talk about price. Here is a
comment I had written previously to another student who had concerns
over the price of my videos:
- Your comments gave me pause to think about what I offer and how it
affects people. At first I thought that maybe I am charging too much for a
simple instructional video. I mean who am I to ask $40.00 for one video
and $30.00 for another?
Then I compared it to how much a workshop charges, plus airfare, plus
time away from work and family and it started to become clearer. (as
well as the cost of the test $1900.00)Then I thought about the free
videos I have given away due to people writing me about stories that
they cannot make ends meet like XXXX XXXX in San Bernardino who is
raising 3 kids by herself (I was raised by a single mother myself so I
know).
Would Excelsior do that? Hardly.....I continued to think about it as I was E-
mailing people with answers to their questions about various issues like
what "offloading" means and what to do if a pt. has appendicitis and you
are given abdominal assessment. (Also, the website costs for bandwith
and to duplicate the DVD's.)
I think about your statement to me and I look at the clock. It is now 9:49
PM and I have been on the computer since I got home from work at 6:30
PM answering questions and troubleshooting problems like I have done
so many nights before and it becomes clear to me - The price charged is
what I feel is fair and just. If it were just as easy as shipping out videos
that would be one thing, but this is a second job as you can tell. And not
just a job that you
clock in and out, but a job where what you do can determine if a person
passes or fails a very important test that could effect their entire life.
I stand behind my product and the service I give. Good luck to you on
your test
I would also like to note that with the inclusion of the LIVE SUPPORT
button on the front page, people can chat with me and ask as many
questions as they want, and get feedback instantly.
- Robbie Wolff
- Here are two of the best responses I received after the above review:
1) "Just wanted to let you know I passed in Grady this weekend.I used both of
your videos and passed. Just wanted to thank you for product,I read in your
comment section someone left a negative comment about your price.Its the
best money I spent during the whole nursing program. Im just glad u made the
videos,without them Id be spending another 2000 dollars for a repeat. Have a
Blessed Day."
- Chris B.
2) "Rob, I wanted to comment on the response on your website for "negative"
feedback. The most recent one you posted was rather interesting to me. First,
as you know, I stated that my reason for failing was my own goof ups on the
labs. Your mneumonics are right on. Your methods are right on. My primary
goof on the IV piggyback was I didn't let go of the clamp while counting. When
the CE counted after I let go, my count was off by 6 drops!!! I know for next
time. Also, at the start of each lab, I highly recommend everyone writes down
the mneumonics and follows it just to be sure!
Anyway, after I got home, I reviewed your cd's again. Then, just for the heck of
it, I looked at the stuff on youtube. There were recent additions of the skills labs
by someone. I hate to be critical, but anyone who follows those will flunk.
Precision in the skills lab is key and I can certainly vouch for that! I would highly
recommend people not to follow or use these particular videos on youtube. Her
quality is not there and she appears to settle for being close enough. As you can
see, close enough was error enough for me to cause me to fail. I think the
criticisms you received from the person who posted to you were a bit
unfounded. You deserve more $$ than what you ask for. It is a lot of work to
pull these together and respond to students. We appreciate all that you do for
us, believe me!! If you wish to post any of this or what I have written to use
since I took the cpne and was unsuccessful, please do so, just don't print my full
name. :) One thing I would like to add is that for the PCS's: keep your nursing
interventions simple by using those you have to perform for critical elements.
Also, follow the critical elements and all necessary components religiously while
documenting. Don't miss a thing! Don't rely on your memory and write
everything down! Also, follow that grid like a checklist when you are in the
patient's room. While I was quite comfortable during the PCS part, (I was
surprisingly not that nervous) I still referred to my grid each and every time so I
wouldn't miss a thing. Lastly, ask each CE about any questions you may have
about the work area. During our CPNE, many of us found we had different
answers and perspectives from each CE. Go by what they tell you or be more
conservative. For example, I never did put my grid down on any surface in the
patient's room. I pulled it out of my pocket and held it on my person when I
needed to document. I took no chances!! This part worked well for me. Also, if
they think you made some error, fight for yourself in the most diplomatic and
polite way possible! One gal in my group did it, and passed as a result.
Otherwise, she would have been failed. Thanks again, Rob. I know next time, I
will pass. Have a good holiday season."
- R. Welsh
7.25.09 - The following is an E-mail from a student who passed, but
wanted to let me know of current happenings. I don't consider this E-mail
"negative" but I felt it best to put it in this section as I like to make
comments along the way. Here is the E-mail:
Rob,
Here are some differences between your video and the lubbock test site; not sure
when you took your examination, but the difficulty level has come down. In no
particular order:
1) Manual BP is taken only once during the entire weekend. After demonstrating
competence once, you use a machine for even the initial measurements. Meds as well
- I saw one oral medication total in all three of my care scenarios.
- I must have forgotten to mention this in the video's. Manual BP is only checked once
while the examiner listens. When your readings and the examiners match up you will
be allowed to take BP readings with the machines. Also, when you successfully
complete your med administration that fulfills your requirements to complete ONE med
pass during your CPNE. HOWEVER, I have other students tell me that they had to pass
meds on ALL of their patients. It is up to the examiner.
2) Mobility and patient teaching are not necessarily prescribed. I had only one mobility
and no patient teaching.
I find it odd that Mobility was only prescribed on only one PCS. Mobility is part of the
OVERRIDING areas of care. The others are: Asepsis, Caring, Emotional Jeapardy,
Physical Jeapardy. Patient teaching does not as it is a Selected Area of Care (optional)
3) Everything, with the exception of the IM/SQ injection station, is now needleless.
Additionally, the meds and flush draws are...pressurized or something, meaning
there's no need to inject air.
I talk about the needless system in the lab sims video, but to be clear EVERYTHING is
needless unless it is IM/SQ
4) Not sure if you mentioned it, but the IV line at the piggyback station is secured that
gravity won't become an issue during or after your drip adjustment.
I did not mention this. Good to know for future use.
5) Everyone had a mandatory pediatric patient - one ped, two adults.
This is true. However, at my first CPNE there were ZERO pediatric patients so I had a
45 year old woman who was my "pediatric" patient. My next CPNE I had a 14 year old
girl as my peds patient. My suggestion is hope for the best, but prepare for the worst
(i.e. getting a toddler. Make sure you know acceptable ranges of vital signs for
pediatric patients )
6) In the IV push station, labeling flushes and medications didn't seem to be
pertinent. There was no tape provided. Additionally, for both the IV push and
piggyback station, it appeared to me that all of the calculations came out to the same
numbers and drip rates; i.e. from what I witnessed, everybody had the same drip rate,
IV med to be drawn up, and time over which it was to be pushed. The instructors did
not open books up at random for med selections; it was all marked and prepared.
Things have become easier for sure. It is good to know how to do IV calculations
because even though everyone has the same math problem you still need to know
how to get the correct answer. As far as labeling flushes, if you feel comfortable in
remembering which syringes are flushes and which one is the medication then great. I
just like to be careful. If there is no tape there and you need it - THEN ASK FOR IT.
7) All temps were tympanic; no oral.
Super easy to tympanics. The instructor will even demonstrate
8) Despite what was checked on my Kardex, one instructor stated that pulse O2 was
"just part of vital signs." Not sure if I would've been "dinged" on it; I think you
mentioned that people should just do this anyway, which is a fine idea. Prior to each
PCS, the instructors sequestered a little handheld pulse O2 for this purpose.
Actually what I put in the video was to check the LPM (liters per minute) on the wall
mounted oxygen level indicator. To me, if the patient is on oxygen, or had O2 sats
checked previously in the chart ( you will be reviewing the pts chart before you go into
their room to get baseline vitals ) it would make sense to check O2 sats
9) Advocate the student walking directly up to the pt WITH THE KARDEX IN HAND and
checking it against the ID band. I didn't do that (because I'd seen the name 2
seconds earlier as I placed my PCS form down on the windowsill and doubled checked
IMMEDIATELY thereafter) and was questioned twice about my "method" of IDing the
patient.
I put this into the "CORRECTIONS TO VIDEO" file when version 15 cam out. To be clear
you should have the KARDEX in your hand and DIRECTLY compare the pts name, DOB,
or Medical record # (2 of 3) to pass
10) Though your tips were perfectly sound, the instructors were not at all concerned
with how handwashing was performed (how the sinks were turned off, time of washing,
etc); little to no attention was paid. As long as it was done once, the foam was
sufficient for the remainer of the PCS.
Way too easy, but that is good. In my video I advocate washing your hands for 45
seconds and then using a paper towel to turn off the faucet handles. If you think
about it then it makes sense. Why touch those handles with your DIRTY hands, wash
them, and then touch the dirty handles again to shut them off. Use a barrier like the
paper towel. I would still do this as this comprises the Overriding areas of Care
"ASEPSIS"
11) Side rails. Every patient had side rails up x2 at all times; what seemed strange to
me was that the "side rails" in question were the upper (at the head of the bed) rails.
Upon entry into each of my scenarios, the lower rails were not raised and were not
expected to be. This obviously makes "Risk for injury" an effortless dx, as there's no
reason whatsoever to lower the upper rails, and the call bell is pretty much planted on
the bed anyway.
Fantastic. This will make everyone's job easier
12) For the final "priority dx", students should also copy verbatim from the dx book; I
seem to have an issue with wording things in my own way, and while I wasn't faulted
for that, I did have to explain why I wrote "r/t potential illness" rather than "r/t
microorganism."
I totally agree here. WRITE EVEREYTHING VERBATIM OUT OF YOUR NCP BOOK !
13) The only place where your video was perhaps unclear (at least for me), was the
explanation of how exactly the PCS phases would work. I was expecting three different
phases, and was a bit weary of how much was involved in each. I think it might serve
students better to say, "The planning phase consists of you writing out two nursing dx
and interventions. That's ALL.. You hand it in, the instructor gives it back.
Then you have your PCS, after which you write out your primary dx with rationale, etc.
The evaluation phase has NOTHING TO DO with you, the student; that's what happens
after you hand in your completed PCS packet."
I was expecting some type of "evaluation phase" and almost handed in a half blank
packet; the instructor was merciful and corrected my misassumption.
OK, Lets clear this up.
Planning phase - You will write up your NCP, do your grid, review the pts chart and talk
to the pts primary nurse. You will hand in your NCP and the examiner will ask you if
you "have completed the critical elements" You say yes, and the examiner reviews the
NCP to make sure there are no HUGE errors ( you shouldn't have if you follow my NCP
guidelines). He.she will then say "you have passed the critical elements for this
section, you may proceed." You will now enter into the Implementation phase.
Implementation phase - Everything that you were assigned to do ( Interventions for
your NCP, critical elements that were checked off on your assignment kardex) now
must be done with the pt. You do these tasks (hence the term "IMPLEMENTATION"
phase - you are implementing you actions). When these tasks are done, you thank
the patient and say you are done. You then tell the examiner you are done with
everything and you are ready to enter into the Evaluation phase. (don't forget to tally
up your final amount on your Intake and Output sheet)
Evaluation phase - You are then going to go outside and chart on everything that you
did (or finish up on your charting - some students will chart as they go like me). You
will write up your NCP with evaluation and rationale, complete the recording form which
will have sections for you to chart on what you did for each critical element and then
turn in the paperwork when you are done. Before you turn in the paperwork you need
to re-check your grid and see if you completed EVERYTHING. This is the reason for
writing up the grid. If you did not complete all tasks you tell the examiner that you
need to go back in and finish up something. If you are done and hand in the
paperwork the examiner will then ask you if you have completed all the critical
elements for this section. You say yes, hand in the paperwork and relax because you
know that you did your best.
Again, I don't think this stuff necessitates any changes to the video, because
everywhere that I was overprepared was no big adjustment, actually a pleasant step
down. If you have the time and are so inclined, you might add an updated note
section every so often to let people know, "Hey here's the recent news" or something
to that effect.
Anyway, great job, tout your superior product over the rest of the garbage and raise
the rates; you deserve it.
Since I had to pay so much for everything I cannot raise any rates (please read the
"ABOUT US" tab. The price will remain the same, but thanks for the vote of confidence
and THANK YOU VERY MUCH for writing this excellent E-mail. Students like you are a
shinning example of "giving back". We are all grateful.
- Robbie
This Email came to me today (5.13.09). A student failed for
some minor mistakes. I felt it necessary to post them -
Hey Rob, I took my clinical in Milwaukee last weekend and I had such a good
experience. I was nervous as hell the first day and I wrote down your
mnomiics for the labs and i did so well. My last one was the IV push and I
focused on the calculation and I kept thinking that can not be right because
it was a push of 2 ml of benadryl over 30 seconds. Well I was so focused on
that that I forgot to aspirate....shit you even say so many people do that.....
ok so I have another chance right.
well the next morning I passed my two Pcs... no problem... I went back to do
the lab and there was a chair there and I sat down to do the IV push--- I
was extra confident that I had it made because of my PCS's being passed.
well I should have never sat down to do that lab. I wrote down the menomic
the calculations were easy.. I went through the steps just fine except.. I was
using the trash can next to me to throw away the alchohol swabs and
gloves and I threw one of the syringes in the trash...I immediately retrieved
it and put it in the sharps but I was dinged. That one stupid mistake cost me
the weekend. If I would have just stood up and done the procedure I would
have put it in the sharps. I have never thrown a syringe in the trash, shit.
anyway the CA and the CEs are the best out there. they really do want you
to pass . I am going back as soon as I can to take it there again. Your
menomics made the weekend if I would have only followed it very closely
that first lab. THey are so nice that I kept remembering what you said they
are not your friends....they are nice but they are there to pass or fail you.
NOTE: I have E-mailed this student a couple of times and she
is VERY competent as to how she does things. Even great
students have difficulty with this test. You MUST practice,
practice, PRACTICE these lab and critical elements until they
are second nature! Perfect practice makes for perfect results
- HERE IS AN E-MAIL THAT WAS SENT FROM A STUDENT
WHO WAS TELLING ME WHY HE DID NOT PASS. I USE THESE
E-MAILS AS CONSTRUCTIVE CRITICISM SO THAT WE CAN
ALL IMPROVE. HERE ARE THE QUESTIONS THE STUDENT HAD
AND MY RESPONSES -
I am sorry you didn't make it this time. I have been there and it is the worst. Don't
worry, if I can do it (and many others who have not been successful prior) then so can
you. I wanted to go over some of the concerns you expressed to me about things that
we should stress. I agree, and I would like to take this time and review with you -
Q; When in the evaluation phase, there is a form that follows the care plan form
called Evaluation Phase Patient Nursing Care Plan. On this form, the student is to list
the priority nursing Diagnostic label and record if expected outcomes were met and if
interventions were effective.
A: I agree! Here is an excerpt from my nursing care plan document:
EVALUATION OF EFFECTIVENESS OF THE NURSING INTERVENTION IN MOVING PATIENT
TOWARD ACHIEVEMENT OF PATIENT OUTCOME:
This takes some skill. What I suggest that you do is look at the outcomes listed in the
planning phase. Use the implementation phase to strengthen your position. If you
have used ineffective airway clearances for your diagnoses, then when you are in the
patients room, you have to “solicit” signs and symptoms from talking with the patient.
Let’s say for instance a patient has pneumonia. You could ask the following question:
“mr smith, do you notice much difference in the way that you breath now compared
prior to acquiring pneumonia.?”
if you pay attention to what he says, you will pick up on signs and symptoms for the
evaluation phase.)
OR for acute pain:
Mr. smith, the pain you are feeling, is it worse than it was yesterday, about the same,
or is it improving?
You will have already given the patient a “goal”. Now we need to find out if it actually
works. Here’s how:
If it is an airway issue:
Your goal was “achieve maximum pulmonary function” and your intervention was
increase activity gradually.
As you talk to the patient, ask the following questions:
“has your pneumonia affected your ability to do some activities?"
He will probably say yes then inform the pt. that, “ what may help you is to provide
rest periods between activities. In other words eat breakfast, rest, and THEN take a
walk, can you try that?”
When you write your evaluation it will ask:
"Evaluation of effectiveness of the NURSING INTERVENTION in moving patient toward
achievement of patient outcomes."
Effective?
- yes. ‘The expected outcome was met. The patient stated that he would pace
activities and provide rest periods between activities.
If when you are talking to the patient he says something you are doing doesn’t help,
ask him what has helped him in the past.
Example: you try a distraction technique for pain. The patient says, that didn’t help.
You say what works to relieve your pain? They might say a warm pack to my back. YOU
say “OK ill give you some time. Now just check off intervention not effective and as an
alternate intervention put what was done. "pt. give a warm pack to back. kept on for
20 minutes. Pt states pain level a 2 on scale of 1-10 after warm pack applied”
Now if you can't carry an intervention out just check “unable to carry out and why”.
Q: The last box is Rationale for Choice as a priority nursing diagnosis. In this box, it
is not only necessary to state your reason for choosing this DX as the Priority Dx but
you must also explain what would happen if these interventions were not carried out.
EX...Acute Pain R/T inflammation of tissue to Right leg AEB Pt's verbal c/o pain to site
which is 7 on the 0-10 pain scale. According the Maslows hierarchy of needs, acute pain
is a top priority. If the pain was to go untreated then pt could have worsening of
condition. Pain could cause a poor appetite, cause pt to fall if attempting to stand and
could cause lack of rest or sleep, and an overall decrease in health status.
A: I agree with you and in my nursing care plans I go over RATIONALLES, here is an
excerpt:
RATIONALES
Rationales are NOT included in Mosby or Carpenito’s NCP book so here is what you can
do for almost EVERY SINGLE nursing care plan that requires a rationale. Use this:
_______________ is a physiological need, without _____________ it may interfere with
his/her ability to perform ADL’s, progress towards healing, and patients participation in
treatment plan.
So, for acute pain we would use:
Freedom of pain is a physiological need, without freedom of pain it may interfere with
his/her ability to perform ADL’s, progress towards healing, and patients participation in
treatment plan.
For Ineffective airway clearance we would use:
A patent airway is a physiological need, without a patent airway it may interfere with
his/her ability to perform ADL’s, progress towards healing, and patients participation in
treatment plan.
So for Mobility we would use:
Mobility is a physiological need, without adequate mobility it may interfere with his/her
ability to perform ADL’s, progress towards healing, and patients participation in
treatment plan.
* here is something that I did not put in: YOU DO NOT NEED TO QUOTE MASLOWS
HIERARCHY OF NEEDS IN YOUR RATIONALLES LIKE SOME PEOPLE TELL YOU! Here is a
direct quote on pg. 315 of the CPNE guidebook that deals with choosing the
rationalle for nursing care plans:
"Control of pain is a basic human need, If pain control is not adequately managed the
patient may be hesitant to fully participate in the treatment plan which could lead to a
complication such as pneumonia that might then delay healing and prolong
hospitilazation"
* it is true that you have to USE Maslows to determine which nursing diagnosis you
should use, but you do NOT have to quote maslows in the rationalle"
Q: OK so that is one issue to observe closely. Next, when performing each
area of care, you must verbalize each step. If you decide that you need to declare
CDM or clinical decision making for any reason, you must stop, tell your CE that you
wish to declare CDM at this time for whatever reason. This option to declare CDM must
be approved by your CE prior to continuing. If you are in fact able to perform this step
at a later time during this PCS, then you should do it and record.
A: I will make mention of that in my next viDeo
Q: I will say that almost everyone that I was in the CPNE with failed on the skills.
Everyone did have to retake at least one skill in the lab. Only two of us passed and
was able to continue on to day 3. The skills seem to be a downfall of many many
students.
A: I agree! That is why I am making the lab sim video that goes along with my
mnemonics. It is not enough to explain, you have to actually SEE it done and I realize
this. Hopefully the video will be out soon
Q; It is also not necessary to complete the Related to and AEB on the planning phase
nursing care plan until after the pt care is completed and you are then in the
evaluation phase.
A: Cant argue with that. In my Nursing care plan document at the very beginning I
wrote this:
"In the planning phase, before you start implementation phase, your nursing
diagnosis should be just this:
Acute pain *and that’s it!*"
"You do not need this:
Acute pain related to reflex muscle spasms as evidenced by patient stating, “my pain
level is a “7” on a scale of 1-10.
*see how long that is! You don’t need to be so long winded in the PLANNING phase.
However, in the EVALUATION phase you MUST put the related to and as evidenced by
because you have actually been in the patients room and assessed the patient. "
Q: At some locations, the patient is able to call for his/her meal tray at anytime. The
trays are not all served at once. This poses a problem with both morning and noon
PCS. Your patient care must be performed in a timely manner but you must allow the
patient time to eat his/her food. This is very difficult.
A: I was not aware of that! I will have to put that in my next video so people will be
aware. Thank you.
Q; Well Rob, I hope this helps. Feel free to respond to this email. Let the other
students know. Thanks again for the PCS video. Anonymous sender.
A; E-mails like this help me tremendously to grow and learn and help others. I
remember when I failed I wrote to all the Yahoo groups documenting what happened.
It was hard to let people know that I didn't make it, but I know it helped others who
would hopefully not make that mistake. I have your address as:
I am going to send you the lab sims video and when I complete the 3rd video Im
going to send that to you as well. When you are ready I want you to email me with any
questions and we can work out any kinks you may have. This test is possible. If I can
do it so can you.
HERE IS ANOTHER STUDENT WHO SAID THAT SHE FAILED
BECAUSE I FORGOT TO MENTION "CHECKING
FINGERNAILS". HERE IS MY
RESPONSE -
- Per your response that you failed because I did not mention "checking fingernails" i
am sorry that you failed because of that. I failed myself and it hurts. However, if you
look at the mnemonic for:
Peripheral Vascular assessment -
Mnemonic is "Please Make sure to check cap refill:
P - Pulses
M - Movement
S - sensation
T - temp
C - color
cap refill - cap refill
*now, if you had oxygen management the mnemonic was:
SOAP
· S-kin assessment - check the skin around the canula, face mask. Is it intact?,
-- red?
· O-xygen status - o2 sats, or cap refill
· A-ctivity level - assess pts response to activity. Tired?, SOB?
* P-osition - Position pt to help facilitate breathing
I dont know if you had peripheral vascular assessment OR Oxygen level but if you
were failed in another critical element that they said you had to check capillary refill
you have a great case for an appeal !
THIS NEXT RESPONSE IS FROM A STUDENT WHO WAS NOT
PLEASED BECAUSE HE WAS SENT 2 VIDEOS OF THE AREAS
OF CARE AND NEITHER OF THEM PLAYED COMPLETELY
THROUGH: HERE IS MY RESPONSE:
Bob,
Sorry that BOTH of the videos didn't work. I will send you another one free of charge.
Also, I am in the process of making a video of the lab sims so when I get it done I'll
send it to you as a way of saying sorry for the inconvenience
\
THE STUDENTS RESPONSE WAS:
Rob,
I appreciate that offer, however I learned so much from what I did
see that I'm not worried at all about buying the new DVD. Last Friday
I did Lynn's MOCK CPNE in NC and did OK (Thanks to you & her)but I
wasn't just super-strong in the Lab portion. If you would send the
your DVD, I'll use PayPal. I go to Racine 2nd weekrend in May, and am
looking very forward to getting it all done(as I'm sure you can
remember). Thanks for your Help & Best Regards,
THE STUDENT DID GO AHEAD AND PURCHASE THE LAB SIM VIDEO A MONTH LATER,
EVEN THOUGH I TOLD HIM I WOULD SEND HIM ONE. HERE IS MY LAST E-MAIL TO HIM:
I told you I would send you a free Lab sim video and I do not forget.
>I will refund you the money and I am going to send you a good copy of
>the Area of Care video along with the lab sim video. Good luck to you
THE STUDENTS RESPONSE WAS:
Rob,
Not only are you a Great Teacher!!, but a Class Act. I've gave your
web-site to 2 friends (from the boards)who will be new customers.
Thanks Again & Best
Regards,
Bob
HERE IS A QUESTION FROM A STUDENT WHO STATES THAT MY
VIDEOS ARE TOO MUCH AND WANTS TO KNOW HOW I CAN
JUSTIFY THE COST.
AnXXXX,
Your comments gave me pause to think about what I offer and how it affects people.
At first I thought that maybe I am charging too much for a simple instructional video. I
mean who am I to ask $40.00 for one video and $30.00 for another? Then I compared
it to how much a workshop charges, plus airfare, plus time away from work and family
and it started to become clearer. (as well as the cost of the test $1900.00)
Then I thought about the free videos I have given away due to people writing me
about stories that they cannot make ends meet like XXXX XXXX in San Bernardino who
is raising 3 kids by herself (I was raised by a single mother myself so I know). Would
Excelsior do that? Hardly.....I continued to think about it as I was E-mailing people with
answers to their questions about various issues like what "offloading" means and what
to do if a pt. has appendicitis and you are given abdominal assessment. (Also, the
website costs for bandwith and to duplicate the DVD's.)I think about your statement to
me and I look at the clock. It is now 9:49 PM and I have been on the computer since I
got home from work at 6:30 PM answering questions and troubleshooting problems
like I have done so many nights before and it becomes clear to me - The price
charged is what I feel is fair and just. If it were just as easy as shipping out videos that
would be one thing, but this is a second job as you can tell. And not just a job that you
clock in and out, but a job where what you do can determine if a person passes or
fails a very important test that could effect their entire life.
I stand behind my product and the service I give. Good luck to you on your test
- Robbie Wolff
SUCCESSFUL IS THAT YOU NEED TO READ EVERYTHING THAT I SEND
TO YOU, AS WELL AS READ THROUGH THE EXCELSIOR COLLEGE
CPNE BOOK (CRITICAL ELEMENTS). TOGETHER, THIS CAN BE A
POWERFUL COMBINATION ! TO SAY I HAVE ALL THE ANSWERS WOULD
BE TOTAL ARROGANCE. THE BEST INFORMATION COMES FROM YOU !
11.22.09 - From Mimi Adams:
"I purchased both of your DVD's that you offer afer reading high
recommendation on the chat sites and I was very disappointed in the quality,
the dvd stopped several times while trying to view, you offer for the price, not to
mention the sims lab dvd with all of the in accurate information that you provide.
There is wonderful competation on utube for free and has the proper instructions
and supplies for the students to view. I would suggest you change your quality
and update the right information. I do feel you are taking advantage of the
students out there trying to find the right information to help them pass the
CPNE. You do have good nmeumonics to offer. Truely consider updating your
quality, price and corrent information provided."
I am sorry to hear that your AOC video is not working. I have an outside
company that duplicates the video for me and sometimes these flaws
happen. I will gladly send you another one. Please let me know what your
address is and I will send it there. As far as your other comments I would
like to discuss each one:
1) the sims lab dvd with all of the inaccurate information that you
provide.
- It is true that there are inaccuracies that have been noted and explained
in the lab sim Ebook. If you know of any other mistakes please let me
know and I will post the new information in my newsletter. Here is an
excerpt from Chapter 6: Corrections to video/Updates that makes
students aware of these mistakes:
{ HERE IS WHERE I PUT THE CORRECTIONS FOR THE LAB SIM VIDEO
THAT YOU CAN FIND IN THE LAB SIM EBOOK, CHAPTER 6 }
2) There is wonderful competation on utube for free and has the proper
instructions and supplies for the students to view. I would suggest you
change your quality and update the right information.
- As far as quality, I feel that the videos are at the best quality for what
students need to see. I did my best to get the best camera angles and I
feel confident that everyone can hear me when I am talking about what
to do. Along with the Lab sim Ebook that documents everything from
mnemonics, to supplies needed, to correct angles and proper documents I
feel that it is a far cry cheaper than going to a workshop and much more
inclusive than the youtube videos.
3) I do feel you are taking advantage of the students out there trying to
find the right information to help them pass the CPNE. You do have good
nmeumonics to offer. Truely consider updating your quality, price and
corrent information proviided.
- I am sorry you feel that way. As I have already gone over the quality
issue I would like to take a moment and talk about price. Here is a
comment I had written previously to another student who had concerns
over the price of my videos:
- Your comments gave me pause to think about what I offer and how it
affects people. At first I thought that maybe I am charging too much for a
simple instructional video. I mean who am I to ask $40.00 for one video
and $30.00 for another?
Then I compared it to how much a workshop charges, plus airfare, plus
time away from work and family and it started to become clearer. (as
well as the cost of the test $1900.00)Then I thought about the free
videos I have given away due to people writing me about stories that
they cannot make ends meet like XXXX XXXX in San Bernardino who is
raising 3 kids by herself (I was raised by a single mother myself so I
know).
Would Excelsior do that? Hardly.....I continued to think about it as I was E-
mailing people with answers to their questions about various issues like
what "offloading" means and what to do if a pt. has appendicitis and you
are given abdominal assessment. (Also, the website costs for bandwith
and to duplicate the DVD's.)
I think about your statement to me and I look at the clock. It is now 9:49
PM and I have been on the computer since I got home from work at 6:30
PM answering questions and troubleshooting problems like I have done
so many nights before and it becomes clear to me - The price charged is
what I feel is fair and just. If it were just as easy as shipping out videos
that would be one thing, but this is a second job as you can tell. And not
just a job that you
clock in and out, but a job where what you do can determine if a person
passes or fails a very important test that could effect their entire life.
I stand behind my product and the service I give. Good luck to you on
your test
I would also like to note that with the inclusion of the LIVE SUPPORT
button on the front page, people can chat with me and ask as many
questions as they want, and get feedback instantly.
- Robbie Wolff
- Here are two of the best responses I received after the above review:
1) "Just wanted to let you know I passed in Grady this weekend.I used both of
your videos and passed. Just wanted to thank you for product,I read in your
comment section someone left a negative comment about your price.Its the
best money I spent during the whole nursing program. Im just glad u made the
videos,without them Id be spending another 2000 dollars for a repeat. Have a
Blessed Day."
- Chris B.
2) "Rob, I wanted to comment on the response on your website for "negative"
feedback. The most recent one you posted was rather interesting to me. First,
as you know, I stated that my reason for failing was my own goof ups on the
labs. Your mneumonics are right on. Your methods are right on. My primary
goof on the IV piggyback was I didn't let go of the clamp while counting. When
the CE counted after I let go, my count was off by 6 drops!!! I know for next
time. Also, at the start of each lab, I highly recommend everyone writes down
the mneumonics and follows it just to be sure!
Anyway, after I got home, I reviewed your cd's again. Then, just for the heck of
it, I looked at the stuff on youtube. There were recent additions of the skills labs
by someone. I hate to be critical, but anyone who follows those will flunk.
Precision in the skills lab is key and I can certainly vouch for that! I would highly
recommend people not to follow or use these particular videos on youtube. Her
quality is not there and she appears to settle for being close enough. As you can
see, close enough was error enough for me to cause me to fail. I think the
criticisms you received from the person who posted to you were a bit
unfounded. You deserve more $$ than what you ask for. It is a lot of work to
pull these together and respond to students. We appreciate all that you do for
us, believe me!! If you wish to post any of this or what I have written to use
since I took the cpne and was unsuccessful, please do so, just don't print my full
name. :) One thing I would like to add is that for the PCS's: keep your nursing
interventions simple by using those you have to perform for critical elements.
Also, follow the critical elements and all necessary components religiously while
documenting. Don't miss a thing! Don't rely on your memory and write
everything down! Also, follow that grid like a checklist when you are in the
patient's room. While I was quite comfortable during the PCS part, (I was
surprisingly not that nervous) I still referred to my grid each and every time so I
wouldn't miss a thing. Lastly, ask each CE about any questions you may have
about the work area. During our CPNE, many of us found we had different
answers and perspectives from each CE. Go by what they tell you or be more
conservative. For example, I never did put my grid down on any surface in the
patient's room. I pulled it out of my pocket and held it on my person when I
needed to document. I took no chances!! This part worked well for me. Also, if
they think you made some error, fight for yourself in the most diplomatic and
polite way possible! One gal in my group did it, and passed as a result.
Otherwise, she would have been failed. Thanks again, Rob. I know next time, I
will pass. Have a good holiday season."
- R. Welsh
7.25.09 - The following is an E-mail from a student who passed, but
wanted to let me know of current happenings. I don't consider this E-mail
"negative" but I felt it best to put it in this section as I like to make
comments along the way. Here is the E-mail:
Rob,
Here are some differences between your video and the lubbock test site; not sure
when you took your examination, but the difficulty level has come down. In no
particular order:
1) Manual BP is taken only once during the entire weekend. After demonstrating
competence once, you use a machine for even the initial measurements. Meds as well
- I saw one oral medication total in all three of my care scenarios.
- I must have forgotten to mention this in the video's. Manual BP is only checked once
while the examiner listens. When your readings and the examiners match up you will
be allowed to take BP readings with the machines. Also, when you successfully
complete your med administration that fulfills your requirements to complete ONE med
pass during your CPNE. HOWEVER, I have other students tell me that they had to pass
meds on ALL of their patients. It is up to the examiner.
2) Mobility and patient teaching are not necessarily prescribed. I had only one mobility
and no patient teaching.
I find it odd that Mobility was only prescribed on only one PCS. Mobility is part of the
OVERRIDING areas of care. The others are: Asepsis, Caring, Emotional Jeapardy,
Physical Jeapardy. Patient teaching does not as it is a Selected Area of Care (optional)
3) Everything, with the exception of the IM/SQ injection station, is now needleless.
Additionally, the meds and flush draws are...pressurized or something, meaning
there's no need to inject air.
I talk about the needless system in the lab sims video, but to be clear EVERYTHING is
needless unless it is IM/SQ
4) Not sure if you mentioned it, but the IV line at the piggyback station is secured that
gravity won't become an issue during or after your drip adjustment.
I did not mention this. Good to know for future use.
5) Everyone had a mandatory pediatric patient - one ped, two adults.
This is true. However, at my first CPNE there were ZERO pediatric patients so I had a
45 year old woman who was my "pediatric" patient. My next CPNE I had a 14 year old
girl as my peds patient. My suggestion is hope for the best, but prepare for the worst
(i.e. getting a toddler. Make sure you know acceptable ranges of vital signs for
pediatric patients )
6) In the IV push station, labeling flushes and medications didn't seem to be
pertinent. There was no tape provided. Additionally, for both the IV push and
piggyback station, it appeared to me that all of the calculations came out to the same
numbers and drip rates; i.e. from what I witnessed, everybody had the same drip rate,
IV med to be drawn up, and time over which it was to be pushed. The instructors did
not open books up at random for med selections; it was all marked and prepared.
Things have become easier for sure. It is good to know how to do IV calculations
because even though everyone has the same math problem you still need to know
how to get the correct answer. As far as labeling flushes, if you feel comfortable in
remembering which syringes are flushes and which one is the medication then great. I
just like to be careful. If there is no tape there and you need it - THEN ASK FOR IT.
7) All temps were tympanic; no oral.
Super easy to tympanics. The instructor will even demonstrate
8) Despite what was checked on my Kardex, one instructor stated that pulse O2 was
"just part of vital signs." Not sure if I would've been "dinged" on it; I think you
mentioned that people should just do this anyway, which is a fine idea. Prior to each
PCS, the instructors sequestered a little handheld pulse O2 for this purpose.
Actually what I put in the video was to check the LPM (liters per minute) on the wall
mounted oxygen level indicator. To me, if the patient is on oxygen, or had O2 sats
checked previously in the chart ( you will be reviewing the pts chart before you go into
their room to get baseline vitals ) it would make sense to check O2 sats
9) Advocate the student walking directly up to the pt WITH THE KARDEX IN HAND and
checking it against the ID band. I didn't do that (because I'd seen the name 2
seconds earlier as I placed my PCS form down on the windowsill and doubled checked
IMMEDIATELY thereafter) and was questioned twice about my "method" of IDing the
patient.
I put this into the "CORRECTIONS TO VIDEO" file when version 15 cam out. To be clear
you should have the KARDEX in your hand and DIRECTLY compare the pts name, DOB,
or Medical record # (2 of 3) to pass
10) Though your tips were perfectly sound, the instructors were not at all concerned
with how handwashing was performed (how the sinks were turned off, time of washing,
etc); little to no attention was paid. As long as it was done once, the foam was
sufficient for the remainer of the PCS.
Way too easy, but that is good. In my video I advocate washing your hands for 45
seconds and then using a paper towel to turn off the faucet handles. If you think
about it then it makes sense. Why touch those handles with your DIRTY hands, wash
them, and then touch the dirty handles again to shut them off. Use a barrier like the
paper towel. I would still do this as this comprises the Overriding areas of Care
"ASEPSIS"
11) Side rails. Every patient had side rails up x2 at all times; what seemed strange to
me was that the "side rails" in question were the upper (at the head of the bed) rails.
Upon entry into each of my scenarios, the lower rails were not raised and were not
expected to be. This obviously makes "Risk for injury" an effortless dx, as there's no
reason whatsoever to lower the upper rails, and the call bell is pretty much planted on
the bed anyway.
Fantastic. This will make everyone's job easier
12) For the final "priority dx", students should also copy verbatim from the dx book; I
seem to have an issue with wording things in my own way, and while I wasn't faulted
for that, I did have to explain why I wrote "r/t potential illness" rather than "r/t
microorganism."
I totally agree here. WRITE EVEREYTHING VERBATIM OUT OF YOUR NCP BOOK !
13) The only place where your video was perhaps unclear (at least for me), was the
explanation of how exactly the PCS phases would work. I was expecting three different
phases, and was a bit weary of how much was involved in each. I think it might serve
students better to say, "The planning phase consists of you writing out two nursing dx
and interventions. That's ALL.. You hand it in, the instructor gives it back.
Then you have your PCS, after which you write out your primary dx with rationale, etc.
The evaluation phase has NOTHING TO DO with you, the student; that's what happens
after you hand in your completed PCS packet."
I was expecting some type of "evaluation phase" and almost handed in a half blank
packet; the instructor was merciful and corrected my misassumption.
OK, Lets clear this up.
Planning phase - You will write up your NCP, do your grid, review the pts chart and talk
to the pts primary nurse. You will hand in your NCP and the examiner will ask you if
you "have completed the critical elements" You say yes, and the examiner reviews the
NCP to make sure there are no HUGE errors ( you shouldn't have if you follow my NCP
guidelines). He.she will then say "you have passed the critical elements for this
section, you may proceed." You will now enter into the Implementation phase.
Implementation phase - Everything that you were assigned to do ( Interventions for
your NCP, critical elements that were checked off on your assignment kardex) now
must be done with the pt. You do these tasks (hence the term "IMPLEMENTATION"
phase - you are implementing you actions). When these tasks are done, you thank
the patient and say you are done. You then tell the examiner you are done with
everything and you are ready to enter into the Evaluation phase. (don't forget to tally
up your final amount on your Intake and Output sheet)
Evaluation phase - You are then going to go outside and chart on everything that you
did (or finish up on your charting - some students will chart as they go like me). You
will write up your NCP with evaluation and rationale, complete the recording form which
will have sections for you to chart on what you did for each critical element and then
turn in the paperwork when you are done. Before you turn in the paperwork you need
to re-check your grid and see if you completed EVERYTHING. This is the reason for
writing up the grid. If you did not complete all tasks you tell the examiner that you
need to go back in and finish up something. If you are done and hand in the
paperwork the examiner will then ask you if you have completed all the critical
elements for this section. You say yes, hand in the paperwork and relax because you
know that you did your best.
Again, I don't think this stuff necessitates any changes to the video, because
everywhere that I was overprepared was no big adjustment, actually a pleasant step
down. If you have the time and are so inclined, you might add an updated note
section every so often to let people know, "Hey here's the recent news" or something
to that effect.
Anyway, great job, tout your superior product over the rest of the garbage and raise
the rates; you deserve it.
Since I had to pay so much for everything I cannot raise any rates (please read the
"ABOUT US" tab. The price will remain the same, but thanks for the vote of confidence
and THANK YOU VERY MUCH for writing this excellent E-mail. Students like you are a
shinning example of "giving back". We are all grateful.
- Robbie
This Email came to me today (5.13.09). A student failed for
some minor mistakes. I felt it necessary to post them -
Hey Rob, I took my clinical in Milwaukee last weekend and I had such a good
experience. I was nervous as hell the first day and I wrote down your
mnomiics for the labs and i did so well. My last one was the IV push and I
focused on the calculation and I kept thinking that can not be right because
it was a push of 2 ml of benadryl over 30 seconds. Well I was so focused on
that that I forgot to aspirate....shit you even say so many people do that.....
ok so I have another chance right.
well the next morning I passed my two Pcs... no problem... I went back to do
the lab and there was a chair there and I sat down to do the IV push--- I
was extra confident that I had it made because of my PCS's being passed.
well I should have never sat down to do that lab. I wrote down the menomic
the calculations were easy.. I went through the steps just fine except.. I was
using the trash can next to me to throw away the alchohol swabs and
gloves and I threw one of the syringes in the trash...I immediately retrieved
it and put it in the sharps but I was dinged. That one stupid mistake cost me
the weekend. If I would have just stood up and done the procedure I would
have put it in the sharps. I have never thrown a syringe in the trash, shit.
anyway the CA and the CEs are the best out there. they really do want you
to pass . I am going back as soon as I can to take it there again. Your
menomics made the weekend if I would have only followed it very closely
that first lab. THey are so nice that I kept remembering what you said they
are not your friends....they are nice but they are there to pass or fail you.
NOTE: I have E-mailed this student a couple of times and she
is VERY competent as to how she does things. Even great
students have difficulty with this test. You MUST practice,
practice, PRACTICE these lab and critical elements until they
are second nature! Perfect practice makes for perfect results
- HERE IS AN E-MAIL THAT WAS SENT FROM A STUDENT
WHO WAS TELLING ME WHY HE DID NOT PASS. I USE THESE
E-MAILS AS CONSTRUCTIVE CRITICISM SO THAT WE CAN
ALL IMPROVE. HERE ARE THE QUESTIONS THE STUDENT HAD
AND MY RESPONSES -
I am sorry you didn't make it this time. I have been there and it is the worst. Don't
worry, if I can do it (and many others who have not been successful prior) then so can
you. I wanted to go over some of the concerns you expressed to me about things that
we should stress. I agree, and I would like to take this time and review with you -
Q; When in the evaluation phase, there is a form that follows the care plan form
called Evaluation Phase Patient Nursing Care Plan. On this form, the student is to list
the priority nursing Diagnostic label and record if expected outcomes were met and if
interventions were effective.
A: I agree! Here is an excerpt from my nursing care plan document:
EVALUATION OF EFFECTIVENESS OF THE NURSING INTERVENTION IN MOVING PATIENT
TOWARD ACHIEVEMENT OF PATIENT OUTCOME:
This takes some skill. What I suggest that you do is look at the outcomes listed in the
planning phase. Use the implementation phase to strengthen your position. If you
have used ineffective airway clearances for your diagnoses, then when you are in the
patients room, you have to “solicit” signs and symptoms from talking with the patient.
Let’s say for instance a patient has pneumonia. You could ask the following question:
“mr smith, do you notice much difference in the way that you breath now compared
prior to acquiring pneumonia.?”
if you pay attention to what he says, you will pick up on signs and symptoms for the
evaluation phase.)
OR for acute pain:
Mr. smith, the pain you are feeling, is it worse than it was yesterday, about the same,
or is it improving?
You will have already given the patient a “goal”. Now we need to find out if it actually
works. Here’s how:
If it is an airway issue:
Your goal was “achieve maximum pulmonary function” and your intervention was
increase activity gradually.
As you talk to the patient, ask the following questions:
“has your pneumonia affected your ability to do some activities?"
He will probably say yes then inform the pt. that, “ what may help you is to provide
rest periods between activities. In other words eat breakfast, rest, and THEN take a
walk, can you try that?”
When you write your evaluation it will ask:
"Evaluation of effectiveness of the NURSING INTERVENTION in moving patient toward
achievement of patient outcomes."
Effective?
- yes. ‘The expected outcome was met. The patient stated that he would pace
activities and provide rest periods between activities.
If when you are talking to the patient he says something you are doing doesn’t help,
ask him what has helped him in the past.
Example: you try a distraction technique for pain. The patient says, that didn’t help.
You say what works to relieve your pain? They might say a warm pack to my back. YOU
say “OK ill give you some time. Now just check off intervention not effective and as an
alternate intervention put what was done. "pt. give a warm pack to back. kept on for
20 minutes. Pt states pain level a 2 on scale of 1-10 after warm pack applied”
Now if you can't carry an intervention out just check “unable to carry out and why”.
Q: The last box is Rationale for Choice as a priority nursing diagnosis. In this box, it
is not only necessary to state your reason for choosing this DX as the Priority Dx but
you must also explain what would happen if these interventions were not carried out.
EX...Acute Pain R/T inflammation of tissue to Right leg AEB Pt's verbal c/o pain to site
which is 7 on the 0-10 pain scale. According the Maslows hierarchy of needs, acute pain
is a top priority. If the pain was to go untreated then pt could have worsening of
condition. Pain could cause a poor appetite, cause pt to fall if attempting to stand and
could cause lack of rest or sleep, and an overall decrease in health status.
A: I agree with you and in my nursing care plans I go over RATIONALLES, here is an
excerpt:
RATIONALES
Rationales are NOT included in Mosby or Carpenito’s NCP book so here is what you can
do for almost EVERY SINGLE nursing care plan that requires a rationale. Use this:
_______________ is a physiological need, without _____________ it may interfere with
his/her ability to perform ADL’s, progress towards healing, and patients participation in
treatment plan.
So, for acute pain we would use:
Freedom of pain is a physiological need, without freedom of pain it may interfere with
his/her ability to perform ADL’s, progress towards healing, and patients participation in
treatment plan.
For Ineffective airway clearance we would use:
A patent airway is a physiological need, without a patent airway it may interfere with
his/her ability to perform ADL’s, progress towards healing, and patients participation in
treatment plan.
So for Mobility we would use:
Mobility is a physiological need, without adequate mobility it may interfere with his/her
ability to perform ADL’s, progress towards healing, and patients participation in
treatment plan.
* here is something that I did not put in: YOU DO NOT NEED TO QUOTE MASLOWS
HIERARCHY OF NEEDS IN YOUR RATIONALLES LIKE SOME PEOPLE TELL YOU! Here is a
direct quote on pg. 315 of the CPNE guidebook that deals with choosing the
rationalle for nursing care plans:
"Control of pain is a basic human need, If pain control is not adequately managed the
patient may be hesitant to fully participate in the treatment plan which could lead to a
complication such as pneumonia that might then delay healing and prolong
hospitilazation"
* it is true that you have to USE Maslows to determine which nursing diagnosis you
should use, but you do NOT have to quote maslows in the rationalle"
Q: OK so that is one issue to observe closely. Next, when performing each
area of care, you must verbalize each step. If you decide that you need to declare
CDM or clinical decision making for any reason, you must stop, tell your CE that you
wish to declare CDM at this time for whatever reason. This option to declare CDM must
be approved by your CE prior to continuing. If you are in fact able to perform this step
at a later time during this PCS, then you should do it and record.
A: I will make mention of that in my next viDeo
Q: I will say that almost everyone that I was in the CPNE with failed on the skills.
Everyone did have to retake at least one skill in the lab. Only two of us passed and
was able to continue on to day 3. The skills seem to be a downfall of many many
students.
A: I agree! That is why I am making the lab sim video that goes along with my
mnemonics. It is not enough to explain, you have to actually SEE it done and I realize
this. Hopefully the video will be out soon
Q; It is also not necessary to complete the Related to and AEB on the planning phase
nursing care plan until after the pt care is completed and you are then in the
evaluation phase.
A: Cant argue with that. In my Nursing care plan document at the very beginning I
wrote this:
"In the planning phase, before you start implementation phase, your nursing
diagnosis should be just this:
Acute pain *and that’s it!*"
"You do not need this:
Acute pain related to reflex muscle spasms as evidenced by patient stating, “my pain
level is a “7” on a scale of 1-10.
*see how long that is! You don’t need to be so long winded in the PLANNING phase.
However, in the EVALUATION phase you MUST put the related to and as evidenced by
because you have actually been in the patients room and assessed the patient. "
Q: At some locations, the patient is able to call for his/her meal tray at anytime. The
trays are not all served at once. This poses a problem with both morning and noon
PCS. Your patient care must be performed in a timely manner but you must allow the
patient time to eat his/her food. This is very difficult.
A: I was not aware of that! I will have to put that in my next video so people will be
aware. Thank you.
Q; Well Rob, I hope this helps. Feel free to respond to this email. Let the other
students know. Thanks again for the PCS video. Anonymous sender.
A; E-mails like this help me tremendously to grow and learn and help others. I
remember when I failed I wrote to all the Yahoo groups documenting what happened.
It was hard to let people know that I didn't make it, but I know it helped others who
would hopefully not make that mistake. I have your address as:
I am going to send you the lab sims video and when I complete the 3rd video Im
going to send that to you as well. When you are ready I want you to email me with any
questions and we can work out any kinks you may have. This test is possible. If I can
do it so can you.
HERE IS ANOTHER STUDENT WHO SAID THAT SHE FAILED
BECAUSE I FORGOT TO MENTION "CHECKING
FINGERNAILS". HERE IS MY
RESPONSE -
- Per your response that you failed because I did not mention "checking fingernails" i
am sorry that you failed because of that. I failed myself and it hurts. However, if you
look at the mnemonic for:
Peripheral Vascular assessment -
Mnemonic is "Please Make sure to check cap refill:
P - Pulses
M - Movement
S - sensation
T - temp
C - color
cap refill - cap refill
*now, if you had oxygen management the mnemonic was:
SOAP
· S-kin assessment - check the skin around the canula, face mask. Is it intact?,
-- red?
· O-xygen status - o2 sats, or cap refill
· A-ctivity level - assess pts response to activity. Tired?, SOB?
* P-osition - Position pt to help facilitate breathing
I dont know if you had peripheral vascular assessment OR Oxygen level but if you
were failed in another critical element that they said you had to check capillary refill
you have a great case for an appeal !
THIS NEXT RESPONSE IS FROM A STUDENT WHO WAS NOT
PLEASED BECAUSE HE WAS SENT 2 VIDEOS OF THE AREAS
OF CARE AND NEITHER OF THEM PLAYED COMPLETELY
THROUGH: HERE IS MY RESPONSE:
Bob,
Sorry that BOTH of the videos didn't work. I will send you another one free of charge.
Also, I am in the process of making a video of the lab sims so when I get it done I'll
send it to you as a way of saying sorry for the inconvenience
\
THE STUDENTS RESPONSE WAS:
Rob,
I appreciate that offer, however I learned so much from what I did
see that I'm not worried at all about buying the new DVD. Last Friday
I did Lynn's MOCK CPNE in NC and did OK (Thanks to you & her)but I
wasn't just super-strong in the Lab portion. If you would send the
your DVD, I'll use PayPal. I go to Racine 2nd weekrend in May, and am
looking very forward to getting it all done(as I'm sure you can
remember). Thanks for your Help & Best Regards,
THE STUDENT DID GO AHEAD AND PURCHASE THE LAB SIM VIDEO A MONTH LATER,
EVEN THOUGH I TOLD HIM I WOULD SEND HIM ONE. HERE IS MY LAST E-MAIL TO HIM:
I told you I would send you a free Lab sim video and I do not forget.
>I will refund you the money and I am going to send you a good copy of
>the Area of Care video along with the lab sim video. Good luck to you
THE STUDENTS RESPONSE WAS:
Rob,
Not only are you a Great Teacher!!, but a Class Act. I've gave your
web-site to 2 friends (from the boards)who will be new customers.
Thanks Again & Best
Regards,
Bob
HERE IS A QUESTION FROM A STUDENT WHO STATES THAT MY
VIDEOS ARE TOO MUCH AND WANTS TO KNOW HOW I CAN
JUSTIFY THE COST.
AnXXXX,
Your comments gave me pause to think about what I offer and how it affects people.
At first I thought that maybe I am charging too much for a simple instructional video. I
mean who am I to ask $40.00 for one video and $30.00 for another? Then I compared
it to how much a workshop charges, plus airfare, plus time away from work and family
and it started to become clearer. (as well as the cost of the test $1900.00)
Then I thought about the free videos I have given away due to people writing me
about stories that they cannot make ends meet like XXXX XXXX in San Bernardino who
is raising 3 kids by herself (I was raised by a single mother myself so I know). Would
Excelsior do that? Hardly.....I continued to think about it as I was E-mailing people with
answers to their questions about various issues like what "offloading" means and what
to do if a pt. has appendicitis and you are given abdominal assessment. (Also, the
website costs for bandwith and to duplicate the DVD's.)I think about your statement to
me and I look at the clock. It is now 9:49 PM and I have been on the computer since I
got home from work at 6:30 PM answering questions and troubleshooting problems
like I have done so many nights before and it becomes clear to me - The price
charged is what I feel is fair and just. If it were just as easy as shipping out videos that
would be one thing, but this is a second job as you can tell. And not just a job that you
clock in and out, but a job where what you do can determine if a person passes or
fails a very important test that could effect their entire life.
I stand behind my product and the service I give. Good luck to you on your test
- Robbie Wolff
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