Keep failing checkoffs

[citylights89, BSN, RN]

Today was my turn to do any random selection of 6 skills: NGT, trach care and suctioning, foley catheter, central line dressing change, and tube feeding. I had to do trach and female foley and totally flubbed. Then I started crying. I already cried once before in front of my instructor and I'm pretty sure she thinks I'm unstable now. My nerves got the best of me, although I didn't know the stuff well like I should have. I had of all this other work going on and neglected practicing. This is the third time this has happened!

We repeat a set of skills sometimes as part or our program's checkpoints. I failed VS checkoffs first semester, med checkoffs (the 2nd one although I passed the first) second semester, and this one (which was also the second time around). I doubt myself a lot concerning my skills. I did pass the EKG and math portion, thank goodness. Strangely, I felt no motivation so when I was failed it was no shock. Still not sure why I cried. I guess because my prophecy came true. Are there other ways to deal this anxiety, besides practice? That unmotivated, paranoid feeling is horrible to have. I contemplated not even showing up to checkoffs because of being so nervous and aware of the outcome. Not winning.

[kfactor]

I'm sorry for your struggles - and for what it's worth for me sincerely the only antidote to rising levels of performance anxiety was practicing over and over and over - I hope you can hang in there!

[inthere]

Practice, practice, practice...even on a doll...anything

[windmill182]

What is making you anxious? Is it that you just don't know what you are doing, or is it something physical like palpitations or shaking because of performance anxiety?

[ashburns4ever]

YOu have to practice practice practice... sounds like you may have a lot going on...the only way to pass is to make this stuff your life and study ALL the time. The farther into nursing school you get the harder it is. These are basic skills to care for a patient and you need to be proficient in them to enter the next level. Be confident in yourself and practice makes perfect.. good luck :)

[mangopeach]

I feel ya! I get soooo nervous on checkoff days. However, I have to agree with practicing more. The one skill that I did not pass on my first attempt at doing it, I did not spend enough time practicing it. I knew going in that I was a bit iffy on some things. After that I spent almost every day in the lab practicing it and passed it on my 2nd attempt. It was the only skill I failed this semester, we had 6 and I passed all the others on the first attempt. We only get 3 attempts and fail the 3rd one and you are out of the program. That is always in the back of my mind. However, practicing a lot does ease some of my anxiety. I try to do a run through with one of the lab instructors before my checkoff day. That way they can point out anything I'm doing wrong and give me some pointers.

Also, one thing that helps ease my nervousness during checkoff is talking myself through it. It helps me remember the next step. I'm always going so first I would do this, then next I would do that, then this, followed by that, etc, etc. I talk to the mannequin as if it were a real patient. I try to envision taking care of a real patient, not a checkoff. I would need to do this, this and this for a real patient.

Even with all those things, I still get nervous and anxious on checkoff days. However practicing as much as you can does help. If you are a nervous nellie like I am, knowing that you know the procedure helps to ease some of that performance anxiety.

Good luck!

[Hygiene Queen]

There are some really good videos on Youtube. Try to watch them, especially just before you do your return.

Visualize yourself doing the task and doing it confidently.

Pretend you are teaching it to someone and talk through each step.

Grab a fellow student and practice it togehter.

If you still feel insecure, do not let that insecurity show.

Try to present yourself as confident, even if you don't feel like it.

If you mess up, during the return, take ownership, don't fall apart and incorporate into your demo.

Example:

"I am putting on my sterile gloves... but I just broke sterility. I am going to have to get another pair and will make sure I keep my thumb out of the way this time because this procedure must be sterile for my pt's safety."

Some instructors will accept that because you: owned the mistake, stated what you needed to do to rectify it, explained why it was important and expressed concern for pt safety.

Some instructors may not accept this, but I have done this in both returns and clinical and it usually is accepted.

Then I don't make the mistake again.:)

Please don't run away from what you fear. You will never rise over your obstacle if you do that. The only way to learn to do it and do it right is to face it and trudge on.

Don't give up!

[ooomonkeys]

Atenolol works wonders for nervousness/stage fright.

[MidnightAzalea]

I find talking the whole thing out as I'm doing it during the test helps. Then I'm rationalizing it to myself, so I'm more likely to catch a mistake or missing something. I just pretend I'm telling the patient. "Ms. Mannequin, next I'll be blah blah blah for blah blah blah reason, this is important because blah blah blah, and now, I'll be..." It helps the instructor clearly understand what I'm doing also, so there's no accidentally missing me performing a skill.

[B3li3v3~n~nur5ing]

PRACTICE PRACTICE PRACTICE! For me it helps to practice in front of people b/c even if i KNOW them, i still get nervous as though they are the instructor.

[citylights89, BSN, RN]

Thanks for the words of encouragement. I had to take a break from it, but I'm going to start practicing tonight. So far, the teachers have been helpful and offering assistance if I need any. I can make As on tests but eff up my skills. It really is shameful.

[BeenThereDoneThat74, MSN, RN]

When you are practicing, actually PRACTICE: dint just go through the motions. Don't watch others do it (I know students think watching helps; IMO doing it is the key). Repitition is crucial; thru say it takes an adult up to 8 times of performing a skill to master it. Think about learning how to ride a bike or drive a car. You were nrmervous the first (second, third, fourth) time. Then it becomes second nature.