skills lab

bathrobemom, LPN · May 30, 2015

I had a hard time with skills. I watched You Tube videos, read about the skills in my textbooks, and practiced at home. We had sheets with the basic steps outlined given to us. I gave my husband the sheet and then I'd read the sheet off to him until I had it memorized. Then I would practice the skill as best I could. One nice thing about having my husband do it is I would have to explain everything to him since he doesn't work in healthcare and that helped cement the knowledge a bit more. Sometimes I used whatever objects I had lying around and pretended they were what I needed, other times we were allowed to take some things home. Try practicing with other students. Also, lab hours changed and everyone complained so some of the instructors helped by adding groups of their own, advocated for extended hours.

So I would say talk to your fellow students (most likely they are feeling a lack of confidence as well and will be happy to practice with you) and your instructors. My instructors placed a lot of importance on skills and were glad that we were concerned about providing safe, quality care.

RN403, BSN, RN · May 30, 2015

The real world is very different from sim lab. Utilize outside lab hours to practice by yourself or with your instructor 1:1. You will learn these things with time! Good Luck.

Sizzline · May 30, 2015

I spent a LOT of extra time in the open lab last semester (my first semester of core nursing classes). I went on Tuesdays for 3-4 hours and at least one other day a week for 2-3 hours. I also wrote out skills step-by-step, down to the tiniest details, and I would hand it to my husband and verbally go through the steps while he checked to make sure I didn't forget anything.

MKIVSupraRN · Jun 1, 2015

In real world? I see nurses and even physicians break sterile field all the time at the bedside, but when it comes to OR, oh you will LIVE, BREATHE, EAT, SLEEP AND DEFICATE STERILE FIELD lol. OR sterile field where breaking will not only get you thrown out of the OR but everyone will hear about it in less than an hour, the surgeon will yell at you, curse at and you will go home in tears. But that's only in the OR.

Now as for beside, breaking sterile field is pretty common, I've seen it countless times, even with charge nurses and not a single person really seems to care. I've seen bedside trachs done in ICU where even the docs and or residents break their own sterile field and not care and keep going, I've seen docs and residents reaching over their sterile field when setting up when they themselves were not in sterile gowns yet. I've seen residents open new trach kits with unsterile gloves, which can be done but they open it in a non sterile manner and end up touch the trach then drop it on the sterile field, doc sees it, doesn't care. I've seen nurses reach over sterile fields to hand the doc something and guess what? no one cared....I've seen nurses insert Foleys and the Foley tip touches an area outside of the sterile field and they still insert it.

Real world vs a perfectly simulated environment in skills lab, don't stress, don't flip out. Real world, breaking sterile field at bedside happens. Don't even get me started on PICC dressing changes and nurses breaking sterile field and keep hauling on.

Call it bad practice heck yeah it is!! but a real environment compared to a perfectly simulated environment, there is a huge difference, but in reality it happens and it will happen.

You should always practice proper sterile technique, go to skills lab and practice as much as possible, even schedule times with the lab instructor to do private practice with them, they are there to help you. But yes, just because in real world it happens, you still need to learn to NOT break sterile field. You can be that one nurse who doesn't break it and one day saves a patient from going septic :)

nurseprnRN, BSN, RN · Jun 1, 2015

I am horrified that any professional nurse would advise a student that sterile technique is only Really important or practiced in the OR. OP, that is absolutely untrue, and you should - must- disregard it. As to a bedside trach, you do realize this is not common?

This opinion may have been derived from limited experience both in practice and in observation.

As to learning sterile technique, it's a skill you must master, and can with practice. Nobody gets proficient in any skilled task without a lot if practice. Were you an expert driver after a few turns behind the wheel? Super confident when you rolled out the driveway to the highway? Of course not. Did you see other drivers forget their turn signals or do rolling stops at stop signs? Maybe so, but did you learn from those that signaling and complete stops aren't important? I certainly hope not.

And btw, trach care and inserting a new one is a clean, not sterile, procedure once the stoma is established. What residents do is not necessarily what nurses should mimic. Do it right.

Red Kryptonite · Jun 1, 2015

I am horrified that any professional nurse would advise a student that sterile technique is only Really important or practiced in the OR. OP, that is absolutely untrue, and you should - must- disregard it.

It seemed to me that the poster was describing a problem s/he sees often, not advocating for poor practice. Especially ending with this:

You should always practice proper sterile technique, go to skills lab and practice as much as possible, even schedule times with the lab instructor to do private practice with them, they are there to help you. But yes, just because in real world it happens, you still need to learn to NOT break sterile field. You can be that one nurse who doesn't break it and one day saves a patient from going septic :)

nurseprnRN, BSN, RN · Jun 1, 2015

In real world? I see nurses and even physicians break sterile field all the time at the bedside, .... Now as for beside, breaking sterile field is pretty common, I've seen it countless times, even with charge nurses and not a single person really seems to care.

"All the time"? "Pretty common"? "Countless"? "Not a single person seems to care"? This is absolutely not my experience.

I think this deplorable language is gonna be a lot more memorable to an impressionable youngie than the boilerplate "You should always practice proper sterile technique, go to skills lab and practice as much as possible, even schedule times with the lab instructor to do private practice with them," which feels more like a, "Whoops, I'd better not forget this, that make me sound really slipshod," than anything else.