skills exam-bed making

deeDawntee, RN · Aug 29, 2007

Do you have a dirty linen container that you can place conveniently nearby so anything soiled can go directly in there?

FireStarterRN, BSN, RN · Aug 29, 2007

Gee, I'm glad I'm not in nursing school. This sounds pretty technical and complicated :rolleyes:

On the peri question, it's always nice to use a new washcloth to rinse. For the linens, in real life you might actually sometimes use the floor, but since nursing instructors know nothing about real life, better bring the linen cart or bag into the room.

casi, ASN, RN · Aug 29, 2007

Linens: If you don't have a linen container that you can bring to the bedside bring a garbage/linen bag to the bedside and drape it open on a chair. I was taught this in CNA training and constantly use it in practice.

Peri Care: I was taught in school to use the same rag, just wring it out in the wash basin. Disgusting and not something I use in practice, but it will get you to pass the test.

bethin · Aug 29, 2007

We were told to use a chair to place dirty linens on. I still think that's gross as someone is going to stick their butt in that chair. In real life, it goes on the floor.

Peri care we were taught to use a different washcloth. The reasoning was this: if you wring out the same washcloth you started with the water is then dirty and by placing a clean washcloth it's going to be dirty.

aerorunner80, ADN, BSN, MSN, APRN · Aug 29, 2007

In the classroom, the linens will go directly into the dirty linen container. In real life where I work, they go onto the floor in the corner and then when you are done, they get bagged up and put in the dirty utility room. I would never throw dirty linens in a chair! Eww!!!

Peri care: in the classroom, new washcloth every time. In real life, new washcloth every time. Would you want to be wiped down with a cloth with remnants of a BM on it? I think not!

The people teaching the classes do know how it goes in the real world but they want you to learn the proper way of doing things. It will be the same in nursing school as well. You learn the proper way of doing things so you pass your test, then as you get more expirience, you learn "real world" ways of doing things but when the Joint Commission comes in, you know how to do it properly and "by the book" because that is how you were taught.

aerorunner80, ADN, BSN, MSN, APRN · Aug 29, 2007

Gee, I'm glad I'm not in nursing school. This sounds pretty technical and complicated
On the peri question, it's always nice to use a new washcloth to rinse. For the linens, in real life you might actually sometimes use the floor, but since nursing instructors know nothing about real life, better bring the linen cart or bag into the room.

Explain to me how nursing instructors know nothing about real life? How do you think they got to be instructors in the first place? You don't graduate nursing school and go directly into teaching. There's no way you could possibly know everything you need to know without practical expirience. I am not a nursing instructor but I am a nursing student. I also work as a tech at a hospital with nurses who teach or have taught the CNA classes.

Your statement is very unfair to the instructors out there who work very hard at what they do.

mrsraisinkain · Aug 29, 2007

Explain to me how nursing instructors know nothing about real life? How do you think they got to be instructors in the first place? You don't graduate nursing school and go directly into teaching. There's no way you could possibly know everything you need to know without practical expirience. I am not a nursing instructor but I am a nursing student. I also work as a tech at a hospital with nurses who teach or have taught the CNA classes.
Your statement is very unfair to the instructors out there who work very hard at what they do.

I am pretty sure that jlsRN was referring more to the writers of the protocol than to the actual nursing instructors themselves. You must admit that many (NOT ALL) administrative, managerial people have been far-removed from the actual clinical setting. I know that at my previous job as a pharmacy tech in a hospital, it was frustrating to us when our pharmacy directory would come out of her office and instruct us on the new process of restocking the med carts in the nurses station (for example) when the old process was working just fine for both the pharmacy and the nursing staff. Then she would turn around and walk back into her office, spending less than 10 minutes a week on the actual nursing floor. That's not saying that she wasn't ever a good pharmacist (she was - once upon a time) or that she wasn't a good instructor, just sometimes it doesn't seem fair that the people implementing new processes aren't the ones that actually have to perform the job.

Now, please don't jump my butt if you are in an administrative position. I am not saying EVERY facility is like this, but it does happen very often.

deeDawntee, RN · Aug 29, 2007

I agree that a lot of the stuff you do in nursing school, especially bed making, is very far removed from what actually happens in real life. I know jlsRN had no intention of insulting your nursing instructors...

but just wait and see how things actually get done when you only have about 5 minutes for a full bad bath and linen change. That is the "real life" experience that you will run into....

You do the best you can. You will understand the comical absurdity of some of the things you are focusing on now when you look back at it!!

allnurses Guide · Aug 29, 2007

We did these skills in the beginning of nursing school and we taught to never place dirty linens on the floor or chair - we brought in a linen cart or at least the plastic bag that goes in the linen cart.

Also, never wash a person (baby, kid, adult) with the same washcloth you use on the peri-area. We were taught to start with the clean areas first, then dirty so you can use the same washcloth. If it is imperative that you wash peri-area first, get a clean washcloth. Please.

When you wash an infant, you wash their eyes, face, head first and then work your way down.

I alway put a linen cart in the room when I change a bed for the CNA while she takes the pt to the shower. I can still feel the steely eyes of that nursing instructor and I'd never toss dirty linen on the floor.

Your instructors MUST have the order in which they want you to do these things.

steph

ShyGecko · Aug 30, 2007

Just a simple question about making an occupied bed for the skills exam...where should I place the "soiled" linens while I'm still making the bed? I know dfinitely not on the floor....but on the bedside table or foot of bed seem unsanitary as well....

Bring along the linen cart or as someone suggested drape a bag over a chair and throw the linens into it. As for the "real life" comment, it actually takes more time and steps to throw the linens onto the floor, then have to pick them up again to put them into a bag, than it does to just put them in a bag to start with, so I guess I just don't get the whole point of the comment about it being far removed from real life. Why make things harder on yourself?

I failed my skills exam a few weeks ago on placing the elastic stocking on the foot...i'm pretty sure it's because I placed it while the patient was sitting, and not laying down...but could they really fail me because of that, since it's not a bolded statement? (or written ANYWHERE in the handbook??) Grr.

We were told in class that it is crucial to put them on while the patient is still laying down, before they get up and move around. If they have sat up or gotten up, the blood/fluid starts to pool in the legs/foot, and putting the TED hose on after that just causes the fluid to stay in the leg/foot. Does that make sense? Sounds to me that your instructor didn't cover that topic very well. There was often a lot of stuff that wasn't "printed" in the book, that our instructor went over with us, telling us that it was something we needed to do...whether it was printed or not.

Edit: Another question, this time about giving peri-care. After washing the perineal area with the washcloth, is it necessary on the exam to use a brand new washcloth to rinse? (I would think/hope so...ew.) If so, where do I place the washcloth I used to wash the area with while I'm rinsing? Sorry, these questions seem so specific, but sometimes, I feel like the handbook isn't specific enough...

We were taught to put 5-6 washcloths directly into the basin as a visual reminder to not put the dirty washcloth back into it. You pull a washcloth out, then do a couple swipes, then just drop it directly down onto the the bed in between their legs (which should have a towel or mat on it) and then go for a new washcloth. Just keep piling the washcloths on the bed until you are done. Such as this...wipe, turn, wipe, turn, wipe, DROP...wipe, turn, wipe, turn, wipe, DROP...etc...until you are finished. Does that make sense? You never want to reuse a washcloth, or even rinse a dirty washcloth in the clean water b/c you make the clean water dirty.

justme1972 · Aug 30, 2007

I agree that a lot of the stuff you do in nursing school, especially bed making, is very far removed from what actually happens in real life. I know jlsRN had no intention of insulting your nursing instructors...
but just wait and see how things actually get done when you only have about 5 minutes for a full bad bath and linen change. That is the "real life" experience that you will run into....
You do the best you can. You will understand the comical absurdity of some of the things you are focusing on now when you look back at it!!

I'm sure that will be an eye-opener if I get my first RN job. Asking my preceptor, "Ok...how is nursing REALLY done?" After you leave the magical city of Eutopia where the NCLEX Memorial is located.

HA!