I usually stay to the student section, but really needed feedback from more people and experienced nurses for this one. I was recently given a timed assessment. I had difficulty completed this in the allotted time. My husband asked me if the amount of time they gave us was even reasonable. Not being an experienced nurse I am not sure so with that I am wondering if you could give me a ballpark idea of how long it would take you to complete the following skills. I am listing all the possible skills in our simulation versus describing the simulation as I do not want any accusations of sharing too much information from the test if other students might be reading. If you could list the time that it takes you to perform each skill I would greatly appreciate it.
Preop checklist
Preop assessment
Postop assessment
Calling report/receiving report from the OR
Inserting a Foley Catheter
Starting IV, hanging fluids to gravity, and starting drip rate (we were allowed to just verbalize the intended drip rate)
Starting a blood transfusion
DC foley
Convert IV to saline lock
Sterile dressing change
Trach suctioning
I think those were all the choices. Thanks for your feedback (and admins if you feel this should stay to the student section please message me so I know for future reference).
Thank you. I also don't think it is realistic that we are given timed skills test and really struggling with failing because I am not fast enough. It adds an incredible amount of stress trying to complete these skills being timed and to be honest I have seriously considered switching schools. It just means waiting and starting over.
We had it at my school too. Think about it though. You are going to be timed when on the floor. Not with a watch and a onlooker but you will have an internal clock. If you take 30 minutes for every easy IV, there is an issue. It sucks, adds a ton of pressure, but you should be able to complete most of those tasks in a very respectable amount of time.
Preop checklist--I don't have to do this much anymore, but at my old job, about five minutes. If the patient has jewelry on, a little bit longer to take it off and store it safely. A lot longer if the IV isn't good anymore.
Preop assessment--I don't work OR, but I did a clinical rotation 1:1 with an experienced nurse. By the end of my rotation, I was doing holding area preops on my own, and it was about five minutes.
Postop assessment--On the floor...if I was the patient's nurse prior to the procedure (same day), the post op assessment takes about five minutes. VS, pain assessment, site/focused assessment, IV site assessment, positioning. What takes longer is talking to family about expectations and post-op orders over the next couple hours post-op. I try to do it all at once (assess/talk).
Calling report/receiving report from the OR--once the conversation starts, three minutes. The OR nurses where I work got their stuff together.
Inserting a Foley Catheter--depends on the patient, really. A a/o x 4/4 patient with no pain who can position herself? Two minutes walking time, one minute to gather supplies, one minute to set up (all the while educating the patient and telling her how to position herself), five minutes to do the procedure itself if the urethra is staring at me like one of Elizabeth Taylor's diamonds. All bets are off for contracted patients who cannot comprehend instructions and whose urethra is buried in the lady parts. For a man, placement is even faster.
Starting IV, hanging fluids to gravity, and starting drip rate (we were allowed to just verbalize the intended drip rate)--If the current PIV is patent, two minutes walking time, one to gather supplies, minute to scan/verify/explain to patient (at the same time), two minutes to hang, prime, attach, program, double check fluids, start, recheck entire system.
Starting a blood transfusion--oh, man. Everything, including order and lab check, pre-infusion vitals/education, consent, gathering supplies, picking up blood, set-up, two RN check, and the first 15 minutes of presence in the room? About 45 minutes. During the first 15 minutes of the infusion, I usually chart in the patient's room and chit chat, then, I do the post-15 VS, reeducate patient, and leave. All bets are off with reactions or questionable pre-infusion vitals.
DC foley--Two minutes tops.
Convert IV to saline lock--30 seconds, if even that.
Sterile dressing change--there is a LOT of variability. Can't even begin to estimate. I will tell you that it helps tremendously to actually have all supplies and the wound care orders IN THE ROOM at all times. If during report, I find out I have to do complicated dressing changes, I print out the orders, take it to the supply room and pull all supplies, put everything in the room during my first assessment, then I'm ready to go when I actually do the changes.
Trach suctioning--inline suctioning for vent-dependents? One-two minutes. I once had a FF patient, not vent dependent, fenestrated trach, and not NPO. That takes longer d/t sterility and set up of equipment.
I have had many docs and patients tell me that I am one of the fastest at procedures/skills. However, med pass usually takes me much longer than other nurses because I do thorough education and explain plan of care on first pass of the morning.
Thank you. I also don't think it is realistic that we are given timed skills test and really struggling with failing because I am not fast enough. It adds an incredible amount of stress trying to complete these skills being timed and to be honest I have seriously considered switching schools. It just means waiting and starting over.
Speed comes with experience in a procedure after you've become a working RN. I, too, think it's a bit unfair to expect speed among nursing students. Focus should be on technique. Speed will come.
An embarrassing confession: I didn't even know how to prime tubing confidently for a 0.9% IVF when I first got hired, let alone anything more complicated than that. My preceptors were so patient with me, thankfully.
Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.
I think these things would have taken me an eternity in nursing school. Yeesh. Sim lab is stressful enough with an instructor watching, but timing you on your skills? Seems a little harsh
That Guy, BSN, RN, EMT-B
3,421 Posts
We had it at my school too. Think about it though. You are going to be timed when on the floor. Not with a watch and a onlooker but you will have an internal clock. If you take 30 minutes for every easy IV, there is an issue. It sucks, adds a ton of pressure, but you should be able to complete most of those tasks in a very respectable amount of time.