I thought we learned that in nursing school!

[Emergent]

Our hospital is now doing check offs with a manniquin on inserting foleys.First we watch a video. Then, the infection control nurse checks us off. Of course, she, herself, hasn't actually inserted a foley in over 20 years.

We got new foley trays, which are essentially the same as the old ones, but they have towelettes to use before you start. The towelettes are folded up in tight, little squares, much harder to use than washrags. So, us incompetent nurses have to go back to nursing 101.

[NOADLS]

FYI, I get paid the same amount either way. Skills fairs are held during working hours on your shift. I'd much rather be providing patient care and staffing my unit properly rather than being pulled for the skills fair.

That's my point though. We're paid the same either way. A mannequin is easier to deal with than a patient. Easier money.

[nynursey_]

That's my point though. We're paid the same either way. A mannequin is easier to deal with than a patient. Easier money.

Again, not the point. Easier, yes. But does it really benefit my unit when we're already short and patients need care? No. Absolutely not.

[canigraduate]

Again, not the point. Easier, yes. But does it really benefit my unit when we're already short and patients need care? No. Absolutely not.

In the short term, does it benefit your unit? Maybe not (although, if your coworkers are skills deficient, then yes). In the long term, definitely.

It is this kind of short-sighted attitude that lets a lot of the poor staffing situations continue. It is not your responsibility to make sure the unit is staffed, it's the responsibility of your administration. If you duck out of skills check to fill a hole that shouldn't be there, you're perpetuating the problem.

Also, having manned a station or two at the skills check, EVERYONE needs to go and get a basic refresher. I don't care how experienced you are, if you've developed a bad habit, it needs to be corrected.

Nurses obviously don't know they've developed a bad habit (or they wouldn't do it), but if I have to caution 20-year veterans not to cross the sterile field, then you know bad habits happen. It really concerns me when I see ICU nurses who don't "scrub the hub" and sometimes don't even do the token swab swipe on central lines.

"It's just a skills demo," they say. Well, muscle memory indicates your hand would reach for the swab if you do it consistently, whether your brain told it to or not.

I would think that nurses would want to go to the skills checks to make sure they are practicing with current EBP. But I've been wrong before.

[annie.rn]

I miss having skills fair. They don't do it where I work now. In fact, they do very little continuing education and very little hands on teaching. Everything is on the computer. Even ACLS...you test on a mannequin attached to the computer. You do it all by yourself. I don't think you can really learn it that way if you've never taken it before. Dysrhythmia class is online, too. Again, not easy to learn online sitting by yourself w/ no instructor to answer questions. When I took it at a previous place of employment, it was a three day class w/ a lecturer. It was awesome.

I agree that all nurses need a refresher every once in a while. Like ICURNMaggie, I have also seen some pretty atrocious skills exhibited at times by experienced nurses.

[Spidey's mom, ADN, BSN, RN]

In the short term, does it benefit your unit? Maybe not (although, if your coworkers are skills deficient, then yes). In the long term, definitely.

It is this kind of short-sighted attitude that lets a lot of the poor staffing situations continue. It is not your responsibility to make sure the unit is staffed, it's the responsibility of your administration. If you duck out of skills check to fill a hole that shouldn't be there, you're perpetuating the problem.

Also, having manned a station or two at the skills check, EVERYONE needs to go and get a basic refresher. I don't care how experienced you are, if you've developed a bad habit, it needs to be corrected.

Nurses obviously don't know they've developed a bad habit (or they wouldn't do it), but if I have to caution 20-year veterans not to cross the sterile field, then you know bad habits happen. It really concerns me when I see ICU nurses who don't "scrub the hub" and sometimes don't even do the token swab swipe on central lines.

"It's just a skills demo," they say. Well, muscle memory indicates your hand would reach for the swab if you do it consistently, whether your brain told it to or not.

I would think that nurses would want to go to the skills checks to make sure they are practicing with current EBP. But I've been wrong before.

I do want to go! We do these yearly as well. I don't think they are a waste of time at all.

[nynursey_]

In the short term, does it benefit your unit? Maybe not (although, if your coworkers are skills deficient, then yes). In the long term, definitely.

It is this kind of short-sighted attitude that lets a lot of the poor staffing situations continue. It is not your responsibility to make sure the unit is staffed, it's the responsibility of your administration. If you duck out of skills check to fill a hole that shouldn't be there, you're perpetuating the problem.

Also, having manned a station or two at the skills check, EVERYONE needs to go and get a basic refresher. I don't care how experienced you are, if you've developed a bad habit, it needs to be corrected.

Nurses obviously don't know they've developed a bad habit (or they wouldn't do it), but if I have to caution 20-year veterans not to cross the sterile field, then you know bad habits happen. It really concerns me when I see ICU nurses who don't "scrub the hub" and sometimes don't even do the token swab swipe on central lines.

"It's just a skills demo," they say. Well, muscle memory indicates your hand would reach for the swab if you do it consistently, whether your brain told it to or not.

I would think that nurses would want to go to the skills checks to make sure they are practicing with current EBP. But I've been wrong before.[/

QUOTE]

We will just have to agree to disagree here.

[NICUmiiki, DNP, NP]

We got those new foley kits too. Except our education was computer based. Those wipes are very difficult to open when putting in a foley.

Some of the things I see nurses do as a rapid response nurse is frustrating. The not knowing basic skills and such. I really wish we would do a skills fair and have blood draws and IV insertion added to the list. I would even be willing to help.

Can anyone give me an explanation as to why blood cultures need to be drawn 15 minutes apart. I understand the use of two sites, or even doing a peripheral stick with a central line or PICC in place. I just don't understand why the time difference.

Waiting 15 minutes isn't in our policy. Often we double team it and get both at the same time.

[calivianya, BSN, RN]

That's my point though. We're paid the same either way. A mannequin is easier to deal with than a patient. Easier money.

It's not easy money if you have to play catch-up with all the stuff that went down while you were gone. If it's one of those shifts that you barely have time to pee, this is going to cost you by requiring you to stay late and lose sleep time.

That being said, my facility schedules a three hour check off for days when we aren't working, so it is easy money for me.

[brownbook]

We have these AWFUL on line courses we have to do every year. Half of the topics are just ridiculous, have nothing to do with the type of surgery center we work in, nothing to do with our jobs as bedside nurses. Psychiatric nursing, hazmat labels, ICD-9 coding, YUCk!

I don't mean to put down psychiatric nursing...I bless psychiatric nurses and their job....we just don't use restraints, put patients in seclusion, etc.!

Even when the topics are something I know I need a refresher on I just skip, skip, skip through the teaching/reading material, take the test, if I don't pass I just skip, skip, skip through the material again and re-take the test!

I would love to go to class with my co-workers and a live instructor, be able to interact, ask questions. about topics I do deal with! Even review foley catheter insertions.

[canigraduate]

It's not easy money if you have to play catch-up with all the stuff that went down while you were gone. If it's one of those shifts that you barely have time to pee, this is going to cost you by requiring you to stay late and lose sleep time.

That being said, my facility schedules a three hour check off for days when we aren't working, so it is easy money for me.

I think we're working off of two different assumptions here. I am assuming that you are coming in on a day you are not scheduled on the floor. I believe you are assuming that these skills labs are on a floor day.

I think it's crazy to schedule extra activities on the days we are on the floor. There's not enough time ALREADY.

[icuRNmaggie, BSN, RN]

I believe that a major reason for CAUTI is not bad practice with insertion. It is due to nurses who were never educated that irrigating a foley catheter requires sterile technique. This means sterile gloves a sterile drape, sterile NSS, a new irrigation set and a new sterile Toomey syringe, every single time.

Another source of CAUTI is when the drainage tubing comes apart from the catheter and is found

in the bed or on the floor. It is another common and very bad practice to swipe it with alcohol and stick it back in the foley. The straight drainage bag must be replaced.

[prmenrs, RN]

Skills fairs are great--EXCEPT when they make people get "checked off" on stuff that have no use in MY practice. I worked in NICU, but every so often, someone came around announcing a spur of the moment inservice that we were required to participate. Restraints. Adult restraints and how to apply and remove them safely. I had a hard time being civil to these peoples. I mean--look around @ my patients!

Another episode, the hospital equipped all the med-surg beds w/"evacusleds". The way this hospital was set up, my unit was in a one-story wing, med-surg floors were the 2nd, 3rd, and 4th floors. Not to mention if I actually attempted this feat, I'd need a CCU immediately thereafter!

We would have to participate in the hospital wide safety fair, and then another unit specific event, we did Neonatal Resuscitation; mock codes, etc. By the time we were thru, I sure felt competent. But still pissed about the restraint issue!

btw, we always did the Safety Fair and Unit Competencies on their time--we weren't scheduled to work, we came in, did what we had to, and got paid. Inconvenient!!