How could I possibly not pass my skills?!

[golosa82]

I had a horrible experience this past week with really screwing up on passing my skills practical exam. For the first 7 weeks of the semester we are given some skills: the 1st set was monitoring iv site, hanging iv bags, piggybacks, flushing saline locks, ivp; the 2nd set was trach care, trach suction, foley irrigation; the 3rd set was flushing NG, feeding thru NG through continuous and through bolus. So then last week we were going to be given 3 random skills and we had to do them within 30min. I had been practicing this whole time for the practical so I was ready. Well I had a lecture exam the same day I had my practical exam so that morning I woke up completely jittery and nervous as heck . Honestly I dont know if it was just b/c I was worried about my lecture exam or just both exams or what but in clinicals I'm not like that and I havent gotten that nervous in such a long time. Anyway I was originally the last student scheduled to get checked off and since a student didnt show up I was pushed to be one of the first few to go and I for some reason panicked and thought I was going to forget everything. So when it was my turn and she hands me the sheet, the 3 skills I had to do were listed and there was a little scenario and for some reason when I read everything it just looked like a foreign language to me. None of it made sense.... I panicked even more and still went ahead and gathered my supplies I was going to need and I did the things I thought I had to do. While I'm doing the skills, my heart had to be beating close to 140bpm, I could literally see myself shaking. My instructor never said anything but watched as I did my skills. When I finished, I had to do my documentation and as I re-read everything, it took me about 2 times for me to read it again and understand what I actually had to have done and realized that I had done everything wrong except for the trach care. I felt so embarrassed and was soo upset I wanted to cry . I couldnt believe how I had screwed it all up. I'm still feeling so disappointed and nervous because I know I did not pass the skills. We are given a chance to re-mediate and perform the skills again but I just believe this should never have happened. I'm so embarrassed to see my teacher next week because I feel so stupid . Has something similar ever happened to anyone? How would you handle such a situation?

[cgravier]

sounds like you choked under pressure.

[babyCNP]

OMG... skill checks. I used to get nervous for those all the time. I would seriously psych myself out and just think about how it would be when I would fail, so I would go in so nervous. I passed most of them, but I failed one or two. Each time I was so upset and did end up hiding in the bathroom and crying. But, no worries, if you are able to re-do it then just make sure you have it down pat.

Something that really helped me was actually typing out each skill step by step. That way I read it over and over and I could actually "practice" it when I was outside the practice skills lab. I promise it really helps! I know how it feels to choke under pressure, because the one-on-one with your instructor is soo intimidating. Just keep practicing and try typing out everything by memory, that way you know you can actually do it once you get in the test.

[golosa82]

@cgravier-I really did unexpectedly. It was just one of those days I guess.

@jmere311-Im more of a visual learner, memorizing the steps doesnt help me, thats why I was going in to practice so much and I can do the skills, my problem was that when she handed me the paper with the list of what I had to do for some reason didnt make sense to me, I was so confused and I didnt feel like I could ask her anything since it was a "test" pretty much. But for the re-do I'm ready to do it.

[dudette10, MSN, RN]

My lab partner first semester did the same thing for health assessment (a full health interview and physical assessment). He knew his stuff, but when it was his turn, he literally couldn't even speak!

It sounds like moderate (bordering on severe) test anxiety. Nurse yourself. Look up what a nurse might do to help an extremely anxious person relax, and do it on yourself. There are a TON of relaxation techniques that you can practice.

Good luck to you!

[decembergrad2011, BSN, RN]

Oh dear, I remember when I failed my foley skills check off. I got SO nervous that I ended up breaking sterile technique. I did everything else correctly, but breaking that sterile technique meant that I failed and had to re-do it. I cried in the car on the way home, and I felt like a complete failure. I have extremely bad test anxiety, and even now I need to pump myself up before tests. Thank goodness the days of skills check offs are over!

Something that helped me was to speak out loud to myself the entire time. "Now I'm going to test the balloon, the balloon is intact. Now I'm going to open up my betadine and place it over the cotton balls, now I'm going to clean the lady parts..." etc etc.

I'm in my fourth semester. If I can make it here, I know you can. Stay with it.

And this is something I watch sometimes when I'm nervous. It makes me realize that everything will be ok:

http://www.positivepause.com/altmusic.html

[anonymousstudent]

Skill check offs are painful for me. I get really freaked out like you did and I shake and it takes me a while to get myself oriented.

Just keep practicing and take the time that you need when they give you your scenario.

I failed one before too and felt like a complete idiot. You'll do fine the second time, just try to relax.

[golosa82]

Thanks everyone for the positive support! I do believe that for the 2nd time, I will do alot better!

[clucito01]

Talk it out! Talk it out! Talk it out!

Trust me when I have skills check offs (I'm a junior in a BSN program) and I have check off's about every other week and I was SO nervous for my first check off's (sterile gloving) that I couldn't get one of my gloves on and I almost had a major breakdown in front of my instructor! So I get what you are going through! It gets better and I just recommend taking a deep breath when you feel you are getting anxious and tense! I've had to teach myself breathing techniques because I started having continuous anxiety attacks right after starting the program in August! Good luck! :)

[chinacatSN]

Everyone has those days. Sounds like you just psyched yourself out and panicked. It really helps to do some deep breathing exercises before the practical to calm yourself.

I also found that writing down the steps on large note cards help. They're easier to access than your lab/skill book and if your instructor changes the way things are done a little, you can write it down as as step and remember it. My instructor rarely followed the steps as written in the skills book. You can also enlist a fellow student or friend to be your mannequin the night before and pretend to do the skills on him/her. Even talking to another student about which steps are next and what to do can help you realign everything in your mind.

Good luck and just remember - you may not do perfect in school, you may fail some tests or skills, you may get med errors - but that does NOT mean you'll make a bad nurse. My instructor reminds us all the time that it's better to learn and make mistakes NOW than it is to make mistakes at your first job. This is what school is for. You just need to learn how to calm down and when you figure that out, it will come much easier for you.

[stressednurse70]

betxq, as another writer stated, this is school. This is where you learn and practice your technique. It is better to make a mistake now before you would make a mistake on a patient with the family watching! After you have done it a hundred times, you could be (and might be!!) asleep when you do some of these skills. But the first few times are nerve wrecking. Saying the steps outloud helps not only you but also your instructor so she knows your thought process. You just got yourself too anxious to even remember your name at that moment! Another trick - think of it as you are teaching your techniques to another student who doesn't know how to do it.

Remember ... You can do this. You have done this in the practice times, now just do it the same as you practiced.

[sandyfeet]

I have to reaffirm saying the steps out loud. I'm not at your level yet so I can only relate to feeling nervous performing a basic skill, but when I say the steps out loud as I do them, it does a bunch of things. First, it makes me focus on what I am doing in the moment instead of trying to jump ahead in my mind to the next step. Second, it makes me feel confident if I say it authoritatively and reduces some stress. And third, like others have mentioned, it keeps your instructor informed of what your thought process is and where you are heading.

I have HORRIBLE test anxiety, and I've posted on other threads about this, but what I do is center myself and completely empty my mind before the test by using imagery. Each inhalation, I imagine a wave crashing on the beach. When I exhale, I imagine the wave rolling back into the ocean and my anxiety rolling away with it. I have another strategy, but it works better for written tests: when my mind starts to fill with anxiety, I do a math problem in my head like 13x13. It makes me focus on the logical side of my brain instead of the emotional and it totally works!