Help with passing first simulation please!!!

littlemznurse · Jun 21, 2014

Simulations always made me so nervous! My best advice is just to study the skills as much as possible before hand and run through them over and over again. One thing that helped me was studying with my classmates and having one classmate pretend to be the teacher and grade us. and skim over any assigned reading. Just take a breather and go in telling yourself that you can and you will pass the simulation. Try to be as confident as possible! Keep your head up and do your best! Good luck! :)

nurseprnRN, BSN, RN · Jun 21, 2014

I'm not entirely sure what the instructors will be looking for. This is what I know will be on it:
1. The following skills will be included in the patient simulations:
Indwelling urinary catheter placement
IV start and maintenance with IV fluids, including drip rate
O2 Management
2. Students will be expected to complete a simulated patient care scenario from beginning to end which includes completion of these skills and documentation.
3. Critical elements of each simulation include:
a. Reviewing Health Care Provider’s orders
b. Correct patient identification
c. Checking for patient allergies
d. Consistent use of infection control principles, including handwashing and sterile technique
e. Correct completion of ordered skill(s)
f. Consistent use of patient safety principles
4. Simulations will be timed. Students will have 45 minutes to complete the ordered skills (catheter, IV, etc) and 15 minutes to complete documentation, and 10 minutes to debrief with faculty and receive a grade.
Follow documentation guidelines using PIE format found in Potter and Perry, pages 354-355.

I was up late last night but I don't think I'm that fuzzy. How can you say you don't know what the instructors will be looking for if it's right there in the list?

Really. I am clueless as to what your question is.

Review all those things in your books and notes, practice them in the learning lab, get feedback on them, practice some more, and then, well, show the instructor how you would do them all. Let's not overthink this. Yes, it really is that simple.

AFMedic112 · Jun 21, 2014

I guess I worded my question incorrectly. Yes, that is what they are looking for. I was just looking for tips. I can't practice these skills in the lab because we have no more lab time before the simulation. I got to do each procedure on the mannequin exactly once last week but once does not make me an expert or inspire confidence that I will do it perfectly with 3 instructors watching and grading me. I have been watching my skills videos and reviewing my notes. Not trying to "overthink it"... just asking those who have been there before how best to prepare myself.

StudentOfHealing · Jun 21, 2014

I guess I worded my question incorrectly. Yes, that is what they are looking for. I was just looking for tips. I can't practice these skills in the lab because we have no more lab time before the simulation. I got to do each procedure on the mannequin exactly once last week but once does not make me an expert or inspire confidence that I will do it perfectly with 3 instructors watching and grading me. I have been watching my skills videos and reviewing my notes. Not trying to "overthink it"... just asking those who have been there before how best to prepare myself.

I don't think your professors are wanting you to perform all the above to perfection. They know you're a nursing student, I think they just want to know you're safe to be let off in the clinical area. Don't bother yourself to death with psychomotor aspect... (that's a practice thing) I mean practice it but IF its a simulation it'll be more than ... insert this ... do that ... this that ... it'll be scenario... right? so learn about IV therapy ... which size is best for what. Learn about a foley catheter ... the indications ... learn about adequate urinary output. Just take it easy, be safe. =)

If it IS a thing like do this ... then document it... even better ... all you need to know is how to do the skill and I wouldn't stress about it. Look up some videos ... avoid the huge NO NOs. Like I said ... be safe.

Esme12, ASN, BSN, RN · Jun 22, 2014

Set it up in your brain.

You walk into the patients room.

Introduce yourself.

Ask the patient their name. Ask DOB

Explain the procedure. Good morning I am Esme your nurse and you are ....look at the arm band...look at the chart/orders.... "Mrs Smith" What is your DOB? How are you feeling today? Are you having any pain? I see you are wearing O2....are you feeling SOB? Check the order....check the O2 flow meter Quick focused assessment...lungs resps, etc. The doctor has ordered XYZ.

Depending on the scenario will help you decide what to do first

The IV is a simple plastic catheter placed in your vein to deliver IV fluids and other IV meds. It will pinch but will be over quickly. He has also ordered a foley catheter. A foley cath is a soft flexible tube that is inserted into your bladder that has a little balloon filled with sterile water that helps keep it in place...the feeling will be unusual but it will not be painful. The foley is used to accurately measure your output accurately. I will clean very carefully where you urinate with a special soap....are you allergic to any medications, foods?

For the IV collect ALL of your supplies. Prepare tape prior to insertion to secure the IV. Explain the procedure as you go along. Wash your hands prior to start. Put on gloves. Begin.

Repeat procedure with foley.

Open sterile packages away from you. Clean from the center to the outside.

Before any procedure. Wash hands. Ask name, DOB, and allergies.... check ID band each and every time.

Is this what you are looking for?

AFMedic112 · Jun 22, 2014

Yes. When you put it like that it seems less daunting, and more common sense stuff. Nothing to be nervous about. Thank you :nurse:

Esme12, ASN, BSN, RN · Jun 22, 2014

Always remember ABC's...Check your airway, make sure you are breathing and check your own pulse first...then proceed! It helps collect your thoughts! LOL

You got this!

la_chica_suerte85, BSN, RN · Jun 23, 2014

I was up late last night but I don't think I'm that fuzzy. How can you say you don't know what the instructors will be looking for if it's right there in the list?

Really. I am clueless as to what your question is.

Review all those things in your books and notes, practice them in the learning lab, get feedback on them, practice some more, and then, well, show the instructor how you would do them all. Let's not overthink this. Yes, it really is that simple.

It's likely that the major skills are going to be a random draw and not that they will have to do every single thing on the list. At least, that's how it was for us.

All I can say is, you're going to laugh at yourself for feeling so nervous. I was devastatingly terrified for my first skills exam. Then, after that, they were a breeze. I don't think I could physically be so afraid of anything ever again. I have wasted all my fight-or-flight on my 1st skills exam. It won't be as bad as you think. Do NOT forget to breathe. Right as you start, take a breath and focus on the things you know you can do automatically (i.e. pt ID, hand washing, allergy checks, bed in right position, rails up/down as needed, etc.) and just start working it out from there. Talk to the mannequin as you begin your skills and the steps will come naturally. If it helps, review your skills step-by-step and say them out loud to yourself as if you were telling the pt. It really helps solidify the concept and will give you another way to remember what it is that you're doing. It will also keep you breathing. :)

Good luck! You're going to be fine!

AmyRN303, BSN, RN · Jun 23, 2014

First sim is always hard because you're just starting to make the connections between the skills and the "why" behind them. Your critical thinking skills are just starting to take root. I remember one day it starred clicking....like before I'd been seeing everything as linear and all of a sudden I was thinking in 3D, haha.

The others have given great advice. Like Esme said, always check your own pulse first :)

NurseOnAMotorcycle, ASN, RN · Jun 25, 2014

I hated simulations as a student. When I went to do them for real, I was happy I had done them. 45 minutes is enough time to really slow down and relax.

What I got from reading your scenario is that you have 4 skills to do. (1. Indwelling urinary catheter placement, 2. IV start, 3. Maintenance fluids, 4. Oxygen.) The rest is that they want you to do it right. That gigantic long list of fluff is making you overthink and stress yourself out. You already know that you have to check orders or be sterile.

So try this.

1. Take a deep breath.

2. Check the pt.

3. Take another deep breath.

4. Prioritize.

5. Do the skills. Stop between each skill to breathe some more.

6. Check the patient and get some advice on how to do it better next time.

7. Celebrate your excellent victory over your own nerves with fist bumps and high fives. :)

AFMedic112 · Jun 25, 2014

Thank you everyone, it was this morning. I survived and so did my "patient". Got some good advice for what to do next time. I'm glad it's over though! I'm worn out :sleep: Thank you all for your help.