Skills question

In the real world you do what is comfortable for you. Where I work we use a lot of hand sanitizer. So I can walk in the room take a squirt and start talking to the patient about what I'm doing.

For your test a lot of times they are fine with you saying. "I'm washing my hands, knocking on the door...." instead of actually acting it out each and every time.

When i took my skill test it went something like this, "Hi Bob, my name is Cindy, I'm going to be doing some ROM exercises with you, I am going to wash my hands, and provide privacy." Then I would proceed and explain to the patient exactly what I would be doing and so on and so forth. You want to be sure and verbalize everything just to make sure.
Hope this helps!

I don't know if this helps or not but the way we had to do it was (here in AZ)-

Knock on the door, greet resident, state that we would wash our hands, explain the procedure, identify that we had the correct resident (you'd be surprised how many people get the wrong resident in real life), provide privacy if needed (cause here you have to provide privacy for b/p but not vitals - whatever) then do the procedure. Then state that we would wash hands again once we completed everything.

Hope that helps some.

Good luck to you.

Here handwashing is the only skill that everyone gets, the other four are ranndom. We were told we're to rub our hands together and say to the test admin "i'm washing my hands" and then proceed

I'm from the state of New Hampshire and was taught to wash hands after greeting the patient. We were given an acronym to help us remember the order in which to do things: KINDLY WASH HANDS

Knock on the door
Introduce yourself and greet patient
Name badge check to verify your patient name
Describe what care you're going to do and ask permission
Leave bedside to wash hands
You'll need your supplies before returning

Watch for privacy, pull the curtain
Always raise the bed to working level, with side rails up for safety
Skills assigned by tester
Have area and supplies cleaned and put away

Have gloves removed and hands washed
Always lower bed before removing side rails
Need to open the privacy curtain
Don't forget to leave the call bell within reach
See if patient needs anything before you leave

Technically though, for your state exam, I would do it in the order that your state requires you to do. If it's really a concern, I would bring up the issue with your instructor, to see if the order really matters, as long as you wash your hands before caring for the patient.

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I was told that it was not as important to do things in the exact order as written, but imperative to do them in the most logical way. And absolutely do all of the required steps because if you forget these, you will fail. My state puts these required steps in bold print.

I divided my skill procedure into sections:


Beginning

Knock on Door

Call Resident's name (Mrs. Smith?)

Enter Room

Introduce yourself ("Hi, my name is Marie and I am your nursing assistant.")

Explain Procedure ("I am going to assist you with your dinner, brush your
hair, get your vitals - or whatever) but first I will wash my hands (walk toward sink and "pretend wash") and then I will gather the equipment."


Performing the Skill

Gather all equipment, including gloves if needed, and take to residents bed, table or chair.

Pull the curtain for privacy

Lock the bed wheels (If this skill involves a wheelchair, LOCK the wheelchair brakes at the this time also.)

Put up the side rails if needed and I would do this BEFORE raising the
the bed (if you will be doing so)

Raise or lower the bed as needed for the specific skill

Put on gloves at this time.

SKILL (Do the actual skill)

Tell the resident when you are done - don't just stop and walk away.

Rinse and dry equipment as needed and put it all away.


Ending

Go to resident and put bed in lowest position.

If the side rails need to be lowered, do it now.

Give resident the call light, smooth the covers and ask them, "Is there anything I can do for you?"

Open the privacy curtain.

"Pretend wash" your hands

Tell the resident that you are leaving the room


You have to do the above FOUR TIMES, once for each skill that you must act out. Obviously, you already did one skill when you actually washed your hands to demonstrate you knew how.

I think when performing each skill, safety should be your priority. Remember to lock the wheelchair brakes and bed brakes. And don't forget the side rails. I knew of one person who failed the "Position Resident on Left Side" because she put the resident on her right side. So be careful here.

My last suggestion would be to practice, to make this second nature. You don't want to pause often as the timer will be ticking away.

Good luck. You will do fine.

Marie

I agree with you 100%, but do what the book says. You can never be wrong with the book. Just do it that way and once your license, then do it your way. Good Luck