First skill evaluation - Hand washing and donning/removal PPE

C0SM0 · Sep 13, 2017

While I really don't have any useful tips I will say this: I'm in my 4th and final semester as a nursing student and I thought the skills lab checkoffs in first semester (Foley, sterile dressing change, suctioning, etc.) was hands down the most STRESSFUL part of nursing school. Nothing else even comes close. We literally could not make a single mistake or we failed and only had three attempts before we were kicked from the program. Just to clarify, it is the most stressful, not the most difficult. That honor goes to Pathophysiology. When I did my checkoffs I'd become extremely diaphoretic. Can you imagine trying to pull of a sterile procedure while sweating everywhere in the process?

shibaowner, MSN, RN, NP · Sep 13, 2017

It's normal to feel nervous for skills checkoff. And it's normal to fail the first time and have to repeat the skill checkoff.

My suggestions: practice at home -

1. You can get some PPE to take home. The more you do it, the easier it gets. You can find videos on youtube to guide you.

2. Hand washing. I don't know what to say about this. There are plenty of videos on youtube. I have no idea why you would have soap on your hands after rinsing. When you rinse, you still have to rub your hands together. Do you have lotion on your hands or something? Does this only happen at school? Try practicing at home.

3. Positive visualization - in spare moments and before going to sleep, imagine yourself putting on PPE, handwashing, etc and doing it perfectly. This is a good mental rehearsal and builds confidence.

Good luck

Elven_RN, ASN, RN · Sep 14, 2017

Thanks so much for the advice! I did end up passing yesterday, but I agree that as easy as the skills were, it was definitely a stressful event! The first two instructors who watched me made me feel uncomfortable, but I loved who I got when I finally passed! She made me feel more relaxed, was so sweet and reassuring, and acted like a real person who understood as opposed to the first nurse who seemed too 'clinical'. I found out after my evaluation that that last instructor is going to be my first clinical instructor, which I'm really happy about. Just about everything in nursing is a new experience for me, as opposed to someone who was a CNA or LPN coming into the program, and new situations make me feel nervous, so I'm really glad my first clinical instructor might help make the new experience less stressful.

Oh, in speaking of Foley, that became my new thing to stress over in nursing school. How difficult is it to pass that skill? The whole thing seems so painful and makes me squirm thinking about it sometimes and I'm scared to do one in real life!

I love that you used the term 'diaphoretic' because we just learned this word today in class!

Elven_RN, ASN, RN · Sep 14, 2017

It's normal to feel nervous for skills checkoff. And it's normal to fail the first time and have to repeat the skill checkoff.
My suggestions: practice at home -
1. You can get some PPE to take home. The more you do it, the easier it gets. You can find videos on youtube to guide you.
2. Hand washing. I don't know what to say about this. There are plenty of videos on youtube. I have no idea why you would have soap on your hands after rinsing. When you rinse, you still have to rub your hands together. Do you have lotion on your hands or something? Does this only happen at school? Try practicing at home.
3. Positive visualization - in spare moments and before going to sleep, imagine yourself putting on PPE, handwashing, etc and doing it perfectly. This is a good mental rehearsal and builds confidence.
Good luck

Thanks! Really great ideas. I ended up passing, but for future skills I definitely want to be practicing a lot at home. I did imagine doing the PPE before going to sleep! There's something about doing things right before sleep that helps reinforce it in the brain.

C0SM0 · Sep 14, 2017

Oh, in speaking of Foley, that became my new thing to stress over in nursing school. How difficult is it to pass that skill? The whole thing seems so painful and makes me squirm thinking about it sometimes and I'm scared to do one in real life!

The Foley was probably the most difficult in my opinion because you're testing twice for one skill (male & female) so it makes things a little more difficult. I got lucky when I put in my first Foley in the clinical setting. It was in the OR so the patient wouldn't know it was a student or if I messed up on something.

Julius Seizure · Sep 14, 2017

Are you sure there was still actual soap to be rinsed off your hands. Sometimes those "hospital" soaps have lots of emollients in them to help moisturize (because we wash our hands 1000 times a day), and they can feel a little slimy even after you've rinsed as much as possible. Drying them with a paper towel usually gets the slimy feeling off, so if that happened, I would guess thats what it was.

operations · Sep 15, 2017

Let me tell you about Foleys.

Learned them in training and got checked off at my new tech job years ago. That day I was thinking of that I should follow some nurses around when I start and watch them every chance I get, then do one. Felt completely unprepared and had similar doubts. How am I going to do this?

Fast forward to the next week and my second day off orientation (only a few days on the job). Was floated to a very understaffed PICU as the only tech. It wasn't bad for me, the nurses just had a lot to do and I did basic care to help. That changed pretty quickly halfway through the shift when we flew in an unresponsive status eppilepticus 5yo female with Downs into our last empty bed. There were only a couple nurses available to accept and take care of airway and all the monitors and drugs. Kid didn't have a Foley, and wouldn't you know a nurse instinctively delegated that task to me

I said " wait wait I haven't even actually done one of these on an adult... I am just off orientation!" She said "You can do this, I will help you and take over if you freeze, it's fine" . So I got my peds kit and listened to her instructions very carefully. Wouldn't you know I got it on the first try! And pretty smoothly, as if I did them regularly ...on a female peds pt! I don't know how I did it, I do know that having such an encouraging nurse guide me made the difference.

Confidence and focus is what you need. And some encouragement. Watch one do one teach one :)

marienm, RN, CCRN · Sep 15, 2017

Also, some hospitals are using pre-packed Foley kits with instructions right inside them now. You still have to know how to do the skill, and stay sterile appropriately, but the ones my hospital uses have numbered steps right inside the sterile tray!

Julie Carr · Sep 19, 2017

Just breathe SAY I CAN DO THIS I CAN. If you need help ask same when you become a nurse never ever be afraid to ask a question or help no matter how silly or little . As a nurse or anyone in the medical field every day you learn something new. Learn as much as you use the instructors NOW for help. ok Remember BREATHE

Saraghawas · Sep 25, 2017

I'm glad to hear you've passed