is my school normal? skills teaching for clinicals

Nursing Students General Students

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I am having a VERY HARD time with the skills portion of my nursing program. I'm an A student normally, excellent study skills, responsible, and organized. This is my 1st semester in a RN program, but I feel so lost.

Today, I just finished a clinical lab skills test, and I really did a poor job.... I need help!

The way they do it here is have you buy a textbook and a different company's videos. You're given a list of skills each week. You must figure out where they are in the book/videos and learn them completely on your own, with nobody demonstrating them. The book contradicts the video, and both might be contradicted by tidbits they give us in the lecture class. Then we go in for Test Out and get deficiency points if we don't know the skill well enough. It's as if we're set up for failure, not success. :confused:

I can't learn skills from a book. The video is a little help but it doesn't cover all the skills or it shows some things in a different ("incorrect") way.

The lab is open for us to practice on our own. However, in two weeks I've had two different lab partners totally flake out on me. If others want to be C-students and barely squeak by, that's their choice..... but me being forced on depending on uninterested people is killing me.

Is this normal: to send students home with only a textbook, in order to do procedures and hands-on skills?

Is it normal NEVER to demo ANY skills to students first?

I feel a bit resentful and abandoned. If they're not teaching the material they're testing on, why am I paying them tuition? Why should I be scolded by them when I do poorly when questioned?

It also doesn't help that access to their (small) lab is extremely limited, and it's been closed most of the times I've dropped by. It is undersized for the number of students (70) who use it every week. When it is open, sometimes every seat is filled, and we're waiting in long lines for a turn at the mannequin, lift, and other equipment.

I am going to meet with my Nursing adviser for help. I don't want to graduate still feeling I don't really know what I am doing. Any suggestions on what to tell her? Is this just how nursing schools work? Am I wrong for being concerned?

Our vital signs checkoff material (bp, temp, respirations, 9 pulse points etc) was never discussed during class because we ran out of time. We were told to look through our book, our ATI modules (online videos) and spend a lot of time in the lab.

We did go over wet to dry dressings once in class this time and watched a video. Other than that it's all on your own in the lab. That lab can get crowded!

Specializes in Emergency Dept. Trauma. Pediatrics.

WOW I am shocked at how much this stuff varies. My school we have skills labs weekly for 3 hours, and some weeks it's twice a week if returns were that week or something. It varies but it's weekly, an instructors shows us the technique and we practice. We have lots of open lab hours with teachers present for help again if we need it.

We have simulation mannequins, one is really cool and is really hi teck, we will use him on simulation days where we work as a group and try to help our pt. who is maybe complaining of respiratory issues and we have fake standing orders and it's all set up like a hospital room. Well our whole lab is set up like a 15 pt. bed hospital room. But the man doll is in front of a double mirror. Anyway our lab room looks similar to an ER unit with the curtins on each bed and all.

If we wish to look in our book for instruction for a supplement we can but it's not required, our teachers believe when it comes to skills it's all hands on learning, lots of practice and muscle memory so that is what we do.

I don't get it -- what am I doing wrong?? I've got a high-A average in this semester's Microbiology lecture & lab classes so far. I did my Nursing Calculations exam today, and if I didn't score a 100% I'd be suprised. However, in these Nursing classes, where I am expending far more energy & time, I feel completely adrift and not learning a darn thing. I'm terrifed I'll be lucky to get C's the way things are going. What is wrong? Am I doomed?!

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Our set up was usually an instructor demo, practice with a partner and be tested; no open lab hours. If, upon testing, we discovered that one little movement wasn't exactly what the instructor wanted, we were threatened with failure and bluntly told that maybe we just weren't cut out for the grave responsibilities of nursing. Without any instructor feedback before the final test, how could we seriously be expected to nail exactly what the instructor wanted? Made me mad! But nursing school is also about testing one's mettle to deal with tough situations where things aren't fair, where there are no definitively best choices, etc. The test there is are you going to whine about fairness, tattle to a superior, allow criticism or a set-back to crush you, etc or are you going to make the best of the situation, get done what needs to be done, and keep giving it your all?

But what about your situation? Some possibilities, depending on your school and your personal style...

- Mentally separate the skills testing from actual nursing practice. Perhaps even make sure to not practice both styles (school, real-world) during the same time period. Sometimes I think instructors are harsh to see how you perform under pressure - being observed, being judged, at the risk of failing out of the program. Figure out what you need to do to pass the skills tests and do that. Separately, if you feel like you'd like more practice with skill to feel as confident as possible in your practice, then do that.

- Mentally prepare yourself to *always* be critiqued. No matter how well you do something, how much you prepare, there is always room for improvement or an instructor-preferred variation. You're either learning something useful or you're learning something useful about your instructor.

- Be prepared to accept and be satified with grades that aren't A's. It's like the difference between grades on a math test and on a literary essay. It's clear when you've practiced & gotten right enough math problems to be confident about passing a test. With essays, there's no absolute method of guaranteeing an A.

- Don't overlook other opportunities by focusing just on grades and school work. If you have the time (perhaps by not obsessing over As), join a school committee or student nursing association or volunteer somewhere or take a job as an aide. Such experiences help build a resume, confidence, & network connections. Confidence based on experience can be worth more than straight As in building one's career.

- To instructors, demonstrate an attitude of a grateful student given an opportunity to grow. If they criticize you, even unfairly, don't jump to defending yourself. There's always something to learn; such as not letting harsh words interfere with being professional.

Best Wishes!

That is so far off of the experience I've had at my school. We have an hour of PLA where we watch the videos together and then one of the lab teachers demonstrates the skill(s). We then have to have at least one hour of practice before we can check-off. The lab is open for practice M-F 9-5ish.

We then have three tries to pass. Our teachers are really rooting for us as well. If the skill isn't right, then they aren't going to pass us, but they are definitely not looking to flunk us out. I ended up on the third try for VS and when I passed my instructor started jumping up and down and ran over to hug me.

I'm sorry your school is making it so difficult.

This thread makes me appreciate my nursing program more and more.

same and I'm so shocked with some things people are saying. No demonstration is just down right wrong. Im guessing everone in your program is in the same boat, so maybe you all need to ask for a demo on skills???

Wow. I can't believe that! We covered everything with a demo and then practiced on eachother in lab....our favourite was the boob and balls lab as they called it (the subject was self exams). We even had silicone breasts and testes with different kinds of lumps. We had a full sims lab too with heart sound and lung sounds. But we always had alot of support from our professors and clinical instructors. It sounds like your school is not very focussed on its students.

My suggestion is to take leadership and start a study group in the lab where you practice on eachother. Maybe even ask one of the professors/senior students if they will join you. Take initiative and make an anouncement in class and everything. That kind of lack of support is unacceptable in my opinion. It is just the beginning of the program so just keep verbalising your concerns and seek help like you're doing. Whatever the case, it will all come together when you're in clinical so for the practical reason of knowing your stuff for later on the job, don't worry just yet.

Good luck! And let us know how its going!

Tristan

Specializes in L&D/Maternity nursing.

For Fundamentals we had 6 weeks of lab where we were scheduled to go once a week, for about 3 hours. We practiced skills on the SIMS there.

We also had a packet of DVD skill video that came with one of our textbook bundles. Not everyone watched them, but I think I went through them all on my own.

Then for the remaining 8 week of the semester, we had clinical twice a week. If there was anything that we could do, we did it. Bed baths, ambulation, toileting, and the like were pretty much a given...but if there was an opportunity to do a foley, or assist with a dressing change, or d/c an IV we did it. Every other clinical day we went around with our instructor and did meds, including PO, prns, IVs and any injections (sub-qs, IM-although I never had the opportunity to do an IM). Our instructor asked the floor RNs if there was a task that we could do, to please let us do it, and they did. Everyone I came across with generally was pretty accommodating.

For Med-Surg we had 2 days of clinical and a lab each week where we'd role play a scenario using the SIMS. One of us would be the RN, another would be the LNA, and other students would be the Dr when we had to have orders clarified.

This semester is community/public health and OB/Maternity. We just have clinical. No lab time. But the lab is always open. We just have to grab one of the clinical instructors to help us practice.

There are also a few flu clinics that we can attend to get our IM's down pact. I fully intend to sign up.

Specializes in Psych.

Do you have any sort of peer mentoring or tutors available? A more advanced nursing student ought to be able to help you out. Can you connect with one before your next set of checkoffs?

Specializes in Urgent Care NP, Emergency Nursing, Camp Nursing.
We have a skills lab but the teacher demonstrates it on a nursing student to show us how its supposed to be done. But we also watch videos and go to our books for reference. We have open lab to practice with 1 or 2 faculty member around to show us if we have questions. We also get another demonstration before check-offs. Its a bit odd to me that your intructors dont demonstrate it :confused:

I feel sorry for the student who had an NG tube put up their nose. :chuckle

Anyhow, my program had us buy the 6th edition of Perry and Potter (since apparently the first run of the 7th edition was next to useless) along with the complementary dvds, which we were required to watch before skills lab. They also had us buy the ATI kit which includes its own dvds, which we weren't required to watch. Once we were in lab we had the skills demonstrated on us, which we then practiced either on each other or on the mannequins, depending on how invasive it was. We weren't required to test out until the end.

Specializes in Urgent Care NP, Emergency Nursing, Camp Nursing.
.

Our set up was usually an instructor demo, practice with a partner and be tested; no open lab hours. If, upon testing, we discovered that one little movement wasn't exactly what the instructor wanted, we were threatened with failure and bluntly told that maybe we just weren't cut out for the grave responsibilities of nursing. Without any instructor feedback before the final test, how could we seriously be expected to nail exactly what the instructor wanted? Made me mad! But nursing school is also about testing one's mettle to deal with tough situations where things aren't fair, where there are no definitively best choices, etc. The test there is are you going to whine about fairness, tattle to a superior, allow criticism or a set-back to crush you, etc or are you going to make the best of the situation, get done what needs to be done, and keep giving it your all?

But what about your situation? Some possibilities, depending on your school and your personal style...

- Mentally separate the skills testing from actual nursing practice. Perhaps even make sure to not practice both styles (school, real-world) during the same time period. Sometimes I think instructors are harsh to see how you perform under pressure - being observed, being judged, at the risk of failing out of the program. Figure out what you need to do to pass the skills tests and do that. Separately, if you feel like you'd like more practice with skill to feel as confident as possible in your practice, then do that.

- Mentally prepare yourself to *always* be critiqued. No matter how well you do something, how much you prepare, there is always room for improvement or an instructor-preferred variation. You're either learning something useful or you're learning something useful about your instructor.

- Be prepared to accept and be satified with grades that aren't A's. It's like the difference between grades on a math test and on a literary essay. It's clear when you've practiced & gotten right enough math problems to be confident about passing a test. With essays, there's no absolute method of guaranteeing an A.

- Don't overlook other opportunities by focusing just on grades and school work. If you have the time (perhaps by not obsessing over As), join a school committee or student nursing association or volunteer somewhere or take a job as an aide. Such experiences help build a resume, confidence, & network connections. Confidence based on experience can be worth more than straight As in building one's career.

- To instructors, demonstrate an attitude of a grateful student given an opportunity to grow. If they criticize you, even unfairly, don't jump to defending yourself. There's always something to learn; such as not letting harsh words interfere with being professional.

Best Wishes!

This reads more like someone appologizing for their instructors' crappy teaching skills. There's no reason to intentionally be that bad of a teacher.

And I've had nearly straight A's in nursing school - much better than my grades in my non-nursing undergrad.

Wow, what a terrible school. I feel very fortunate to be in the school that I am in. As long as we are trying our best, our instructors really go out of their way to help us out. We have a four hour lab every week the first 8 weeks, then it drops down to 1 hour a week with two 5 1/2 hour clinicals a week. Plus we have our open lab hours with an instructor there to help us. They will ask us what they can do to make things better in lab. They really want to see us all succeed. I feel bad for you to be in such a bad school. I agree with the comment by Tristan, that you should take the initiative and get a group together to practice. And if you make an announcement in class about it in front of the instructors, maybe they will wake up to the fact that they need to do their job and teach you all. If not, getting together with a group to practice might help you.

On another note, I agree with "The Squire" about the Perry and Potter 7th edition book. My school uses it, and it is horrible. Besides all of the typos, a lot of the nclex review questions have the wrong answers, and some of them will have one answer in the answer key and a different answer on the CD. If your class is using a better edition, you're lucky.

But getting back to your problem, try getting a group together to practice. I think that will help. Don't let them discourage you. They will get their paycheck whether you stay in the program or not. Do what you have to do to succeed, and maybe in the process you can help others also. Good luck to you.

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