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No hands on skill labs?

Updated | Posted

I need to say this because my mind is going to explode from stress.

I got accepted in ABSN program in Texas with a high NCLEX rate, 97%-100%, each year, and a good reputation. I moved there and started. There are two things driving me crazy and I wonder if you guys are experiencing the same.

1-the first thing is the skills lab. What we are doing is watching videos each week, have a lecture then take a quiz on them and that is it! No on-hands training! What makes things worse is that we supposed to have a check-off on medication administration, wound care, Foley's catheter, and no lab! We are supposed to watch videos about them, go to the lab for one hour to practice those skills alone with no help, then do the check-off in front of the professors! 

2-the clinicals are worse. They were telling us that clinicals will be the first semester. Fine! What is happening is we see the pts for an hour looking at their files, then the rest of the time we are discussing random subjects with the clinical professors! No, we don't practice the skills at the clinicals.

Are you guys experiencing the same? How is your skill lab and clinicals look like? I know that COVID makes things more complicated, but I want to know how others do.  I'm really afraid of going through nursing without proper skills. I don't think this is a good way to prepare a nurse. And I can't imagine I paid all of this money in such education. I'm thinking seriously to transfer from this school.

Highly suspect this is the way they did things before their Covid excuse.  What a waste of money.

3 hours ago, caliotter3 said:

Highly suspect this is the way they did things before their Covid excuse.  What a waste of money.

I know! the thing I forgot to tell is that lots of us when they wanted to schedule the 1-hour training, they told them that there are no free spots available! that means they might go to the check-off without even practicing the skill. Is the whole thing legal?

What you speak of is happening in a lot of places.  I'm in California and I can verify there are some schools out here where the skills portion is mainly online w/ some lab meetings.  Now, it's not the school's fault as California is still one of those states that is still very shut down due to the pandemic. 

Due to the pandemic, many skills labs are limited to how many students they can safely accommodate.  For example, I know of a student who told me they usually had 12 people per room when skills lab was going on.  Now it's down to 3 per room.  They have to spread people out and many schools are running into issues of scheduling students and not having many rooms to place students in order to get lab hours.   Of course there are virtual labs with scenarios, but still not the same thing as being in person and practicing skills.  The school I speak of has a stellar reputation and is known for producing stellar graduates from their program, so it's not a run of the mill type of program.  It's even affected this school.  And if the pandemic wasn't enough, some areas had the air quality compromised due to raging fires a few weeks ago and schools and offices shut down due to poor air quality.

I know CA BON did approve getting hours in various ways because they are aware of the situation.  It's definitely not ideal, but they also don't want to leave students in a bind. If it's not one thing, it's another.

There's no way to tell how long all these safety measures will be in place.  Even if you transfer, you may still find the same thing.  You can certainly elect to just stop going to school and wait to see if the pandemic situation improves, but I would caution you to think about the following:  what if the pandemic precautions go on longer than 1-2 years?  Are you willing to wait to get your in-person education.  Also, if you leave your school now, you would have to mark that down on your next application to another nursing school because they always ask the question:  Have you ever attended another nursing school?  

But, yeah, what you are seeing and/or experiencing is happening more than you think and it may not be the school's fault depending on where you live.

This is not just Covid. Covid is going to be a welcome convenience for a lot of things for some time to come, I suspect.

This sort of *** being described (along with the BS in NP programs) is not going to end well. This profession is due for a reckoning. If we're lucky, backlash from all the Covid excuse-making will accelerate it.

Out of curiosity, are your practice sessions in the lab and check off with instructors on the same day? If not, would it be possible to schedule a time to "practice"/go through the motions via video chat with an instructor or peer tutor? That seems strange that there would be no opportunity to practice hands-on (at least visually) with another person before doing a skills check off. If they're not on the same day, maybe you could request this. It's not ideal but it's better than struggling on your own with the steps.

londonflo

Specializes in oncology. Has 44 years experience.

I really feel for you. In the 70s, when I went to school we had no hands on practice. Miserable. There are a few things at play here:

1. Covid

2. Cost of supplies

3. Cost of lab personal

We can't help #1 but #2 and 3 will always be with us. Do you have some sort of student group?  One that the faculty announce the need for reps for? (not like a FB group). For accreditation students must have a mechanism to communicate praise, or complaints to the School personnel. Find out your class rep and ask them to report your concerns....no names need to be said. The student group has to take minutes and send the minutes to the chair of their group (usually a faculty member) and the faculty member must forward it to the faculty group as a whole. Believe me that faculty do not want students doing procedures in clinical when they have not had  familiarity with the procedure/equipment.

You are not alone in this. Where I worked last we had a lab assistant who would deflect everything to a demonstration of the skill in front of the students. I got a grant for IV tubing that goes with the pump (each student was to have a set) and found out NO Tubing was used except one set for each group to observe. I said I needed each student to have some hands on before they attempted  priming in clinical. I explained I have 10 students caring for 10 patients who need medications, fluids, dressing changes etc and I am one person. I was told they could learn enough by watching.  When I left a couple years later I knew there was a box full of tubing sitting in a storage room.

For the lab, that sounds about right, long as the teachers are still available for help before you perform it.  You watched the instruction, your lab is your chance to practice doing it.

For clinical, I would have killed for yours.  Very few students actually practice their skills in clinical.  That's why hospitals do entire structured training programs for new nurses now.  If you're talking about something nursing related, that's good.  For tons of us, clinical was being a free glorified CNA.  And if you actually had experience, you'd knock out your shower, bath, assessment, and linen change within the first hour and then have an entire day of being at the mercy of if you're allowed to follow your nurse or not.

Unfortunately, nursing school is for getting licensed.  Job training is for being a nurse.

londonflo

Specializes in oncology. Has 44 years experience.

On 10/10/2020 at 6:30 PM, olaswaisi said:

The clinicals are worse. they were telling us that clinicals will be the first semester. fine! what is happening is we see the pts for an hour looking at their files, then the rest of the time we are discussing random subjects with the clinical professors! no, we don't practice the skills at the clinicals.

I am basing my comments on the understanding you are 7 weeks into your program.

Have you had some content and practice on clinical roles, assessment, communication, handwashing and PPE? You will need that content before you can be active with patient care.  Yes, clinicals in any setting begin with researching your patient's health care needs and history. Does your clinical schedule show more time as you learn more for application? Do you have a clinical topic assigned for each clinical that coordinates with what is going on in class?

I can understand your frustration but you have to have some useful skills under your belt before you can be useful in the clinical setting. Please don't take this the wrong way, but without any assessment and basic patient care skills you are just getting in the way. Sure you can shadow the nurse a shift or two but  usually a staff nurse does not have a lot of time to provide clinical instruction.

Quote

Unfortunately, nursing school is for getting licensed.  Job training is for being a nurse

The Dude with the Big Dog and I have sparred before with educational issues and  his statement is far from what a professional nursing curriculum is based on. While minimal competency is what is required to pass NCLEX, any school I taught at planned, developed,  and provided a nursing education that has not been limited by minimal competence. I have told students that we never plan repetitive clinical experiences as we have to expose a student to the entire repertoire of experiences that a nurse may encounter. Then, as a staff nurse you will develop a stock of skills or habitual critical thinking for a group of patients experiencing similar health care problems. Anyone who has gone to school has an opinion on what is good or bad but 'going to school' is not the same as planning and delivering a body of knowledge and skills necessary to a profession.

14 hours ago, TheDudeWithTheBigDog said:

For the lab, that sounds about right, long as the teachers are still available for help before you perform it.  You watched the instruction, your lab is your chance to practice doing it.

For clinical, I would have killed for yours.  Very few students actually practice their skills in clinical.  That's why hospitals do entire structured training programs for new nurses now.  If you're talking about something nursing related, that's good.  For tons of us, clinical was being a free glorified CNA.  And if you actually had experience, you'd knock out your shower, bath, assessment, and linen change within the first hour and then have an entire day of being at the mercy of if you're allowed to follow your nurse or not.

Unfortunately, nursing school is for getting licensed.  Job training is for being a nurse.

That’s terrible and has NOT been my clinical experience.  I’ve used every skill that we’ve covered in lab during clinicals several times over.  We are assigned to a patient at the beginning of shift, go introduce ourself to the nurse caring for that patient, then spend the day doing and learning nursing things.

I’m curious - I assume you had a clinical instructor on site employed by your program?  Were they the ones holding you back on your experience or was it the floor nurses? 
 

Edtied to add - as an advanced standing student, I skipped the first clinical rotation (basic care or whatever it’s called) and med-surg was first for us, so there may have been some of those “glorified CNA” days during that rotation..

Edited by FiremedicMike

13 hours ago, FiremedicMike said:

I’m curious - I assume you had a clinical instructor on site employed by your program?  Were they the ones holding you back on your experience or was it the floor nurses? 

The instructors, and that's actually VERY common in schools that aren't directly associated with the hospital.  Yeah, I got to use some skills, but 99% of the actual stuff I did, was at a CNA level.  Talk to nursing students.  You're going to see that it's extremely common in med surg clinicals.

Gellybean07

Specializes in LPN to RN Program. Has 11 years experience.

Hello guys,

I am in the RN program in Florida right now in the second semester.  I am having the same issues as you all.  I literally have to practice skills from a video and check off list.  What's the worst thing about this is that the video they supply us is wrong in applying the skill, and when you have to get checked off with the professor they fail you because they say that you shouldn't be go according to the video, only the check off list.  The video and check off list contradict each another which brings on confusion. I do not understand why we are give a video to look at if its incorrect and are told not to use it.  They literally expect us to just read a bunch of sheets of check off lists and pass??? I have brought this to the one in charge of skills and she is basically going around in circles making excuses and trying to blame me for not going to practice.  I have gone to practice, which only started 4 weeks into the semester, and the instructor circulating at practice had no clue how to answer my questions (she helps students in 1st semester) This whole program is insane!  I just hope and pray I get through my remaining skills and then I'm done for the rest of the program.  Good luck guys!! This is definitely a crazy roller coaster ride.