what skills do you have to check off on?

[anonymousstudent]

Check off on in lab, not at clinical. I'm just wondering what other schools do. We have lab, where we have to "check off" on everything before we can do the skill in clinical.

I'm asking about performance exam check offs, where you show up, draw a skill or are assigned, and do it.

[That Guy, BSN, RN, EMT-B]

Trach care, IV start, med admin, central line dressing change, foley insertion, wet to dry dressing change, NG placement, and then a mock code where you draw your role from a hat

[DeliveryRN2007]

1st year in nursing school we had to sign off on blood draws, IV starts, foley catheter insertion, trach care, NG tube placement, changing central line dressings, removal of staples and sutures, NG tube feedings, different types of injections (IM, subQ, intradermal), bed bath, taking vital signs, wet to dry dressing change, enema admin, and a few others I just cannot remember!

At the start of each semester we are given a dosage calc test that gets more difficult each semester. You have to make an A in order to be able to pass meds at clinicals. You have 3 chances to get that A or you get kicked out of the program. I don't think that has ever happened though!

Also, after getting checked off on the skills we had a comprehensive hands on exam. We drew 3 skills from a hat. Each skill was weighted differently. One skill was worth 50%, another 35%, and the last 15%. We then had 30 minutes to perform our skills for an instructor. I always seemed to talk to much a barely be able to finish it in 30! I felt the need to talk about everything ranging from nursing care to complications of the procedure if it isn't done right! I'm a nervous rambler =)

2nd year first semester we do a mock code blue. Also, this year we have to pass an ACLS course. After taking the class we do a code blue with METI man where we rotate through each role during a code blue.

[CrunchyMama, ASN, RN]

1st semester: drawing up med and injecting, head to toe assessment.

2nd semester: foley, hanging primary IV bag

3rd semester (which I'm in now): we had 2 skills testing this semester...1st was hanging blood, hanging IVPB, giving meds through a CVAD. Then 2nd set, which I happened to do last night was NG insertion and irrigation, and dressing change with drain care.

4th semester: not sure because I'm not there yet but I believe it's trach care and IV insertion

[Nurse Connie]

First semester was Vital signs, assessment, medication administration, sterile dressing and hanging primary IV. 2nd semester IVPB, and pediatric calculation (not really a skill checkoff but had to pass the math test in order to give meds). I'm not really sure about the last 2 semesters, except for trach care and foley placement.

[ImThatGuy, BSN, RN]

Our check offs don't make sense. We've had to formally check off on miscellaneous routes of medication administration and taking vital signs. That said, we've covered more things such as Foleys and NGTs with no check offs. Why check someone off on vital signs and not a whole head to toe patient assessment? A lot of our evaluation process is illogical to me.

[Kelly9405]

I'm in an LPN program.

We just finished our lab, and we checked off on vital signs, assessments, foley catheter, and medication administration.

We practiced other skills, such as NG tubes, trach care, and wound care, but we did not have to do a return demonstration for them.

[Nurse Kyles, BSN, RN]

First semester we did check offs on vitals; system assessments; oral, NG, & parenteral Med administration; foley insertion; trach care; ostomy care; wet to dry dressing; spiking & hanging primary & piggy backs and some others. For our final we had to do a head to toe assessment with narrative documentation and also pulled a Random skill that we had 20 minutes to do. We don't have another skills class with check offs until 3rd semester. I don't know if all programs are like this, but mine is set up so after the first year everyone can take PN boards.

[turnforthenurse, MSN, NP]

In the beginning they were more serious about "checking things off" and then as I went on in rotations, it didn't matter if we haven't performed the skill in lab. Sometimes opportunities present themselves and you should take advantage of those opportunities in clinical.

But anyway, to answer your question, we had to get checked off on the following:

* pt transfer/ambulation

* SQ/IM injections (including drawing them up)

* sterile dressing change

* wet-to-dry dressing change

* vital signs

* trach suctioning/care

* venipuncture/IV's

* foley insertion

Everything else (d/c'ing IJ's, splitting chest tubes, changing atriums (type of chest tube collection box thingy), central line dressing changes, etc etc etc) I have been taught as I went along in clinical.

[SingDanceRunLife]

At my school, generally (but not always), you have to have learned a skill in lab (and often, have to have passed the competency on it) in order to do it in clinical.

I'm just about done with my first semester, and our competencies from this semester were:

• Application of restraints
  
• Urinary specimin collection
  
• Vital signs
  
• Wet to dry dressing change
  
• Hanging/priming an IV
  
• D/Cing an IV
  
• Head to toe assessment (simulation)
  

Other things we learned and practiced included:

• Pulse oximetry
  
• Accu-checks
  
• Medication administration (will be competencied in Jan)
  
• Urinary catheterization
  
• Dry sterile dressing
  

I d/c a foley once long before we learned how to insert/remove them with the help of my instructor. Same for d/cing an IV.

Some instructors don't allow that though. For example, two weeks ago, there was a girl in my clinical group whose patient was going to have her foley d/c and our instructor wouldn't let this girl do it because we hadn't yet learned it in lab.

[decembergrad2011, BSN, RN]

I'm in a BSN program - 3 years or 6 semesters total of nursing school once accepted.

First semester: Manual vital signs, Head to toe patient assessment - everything from how to check cranial nerves to auscultation and palpation (each tested with return demonstration)

Second semester: PO med administration, SQ/IM injections, Foley and I&O catheters with both insertion and D/C (each was tested with return demonstration)

Third semester: IV start, IV Piggybacks, Trach care/suction (1 of the three was tested with return demonstration)

After our second semester, we no longer have labs, and after our third semester, we no longer have skill check offs. We learned plenty of things in lab that were not tested or at least not tested by themselves, such as sterile technique, dressing changes, and NG tubes.