Skills question

casi, ASN, RN · Aug 24, 2008

In the real world you do what is comfortable for you. Where I work we use a lot of hand sanitizer. So I can walk in the room take a squirt and start talking to the patient about what I'm doing.

For your test a lot of times they are fine with you saying. "I'm washing my hands, knocking on the door...." instead of actually acting it out each and every time.

blessedtobeme · Aug 24, 2008

When i took my skill test it went something like this, "Hi Bob, my name is Cindy, I'm going to be doing some ROM exercises with you, I am going to wash my hands, and provide privacy." Then I would proceed and explain to the patient exactly what I would be doing and so on and so forth. You want to be sure and verbalize everything just to make sure.

Hope this helps!

sbenning5 · Aug 28, 2008

I don't know if this helps or not but the way we had to do it was (here in AZ)-

Knock on the door, greet resident, state that we would wash our hands, explain the procedure, identify that we had the correct resident (you'd be surprised how many people get the wrong resident in real life), provide privacy if needed (cause here you have to provide privacy for b/p but not vitals - whatever) then do the procedure. Then state that we would wash hands again once we completed everything.

Hope that helps some.

Good luck to you.

sonomala · Aug 29, 2008

Here handwashing is the only skill that everyone gets, the other four are ranndom. We were told we're to rub our hands together and say to the test admin "i'm washing my hands" and then proceed

newLNA · Aug 29, 2008

I'm from the state of New Hampshire and was taught to wash hands after greeting the patient. We were given an acronym to help us remember the order in which to do things: KINDLY WASH HANDS

Knock on the door

Introduce yourself and greet patient

Name badge check to verify your patient name

Describe what care you're going to do and ask permission

Leave bedside to wash hands

You'll need your supplies before returning

Watch for privacy, pull the curtain

Always raise the bed to working level, with side rails up for safety

Skills assigned by tester

Have area and supplies cleaned and put away

Have gloves removed and hands washed

Always lower bed before removing side rails

Need to open the privacy curtain

Don't forget to leave the call bell within reach

See if patient needs anything before you leave

Technically though, for your state exam, I would do it in the order that your state requires you to do. If it's really a concern, I would bring up the issue with your instructor, to see if the order really matters, as long as you wash your hands before caring for the patient.

ecmb · Aug 29, 2008

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ecmb · Aug 29, 2008

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ecmb · Aug 30, 2008

I was told that it was not as important to do things in the exact order as written, but imperative to do them in the most logical way. And absolutely do all of the required steps because if you forget these, you will fail. My state puts these required steps in bold print.

I divided my skill procedure into sections:

Beginning

Knock on Door

Call Resident's name (Mrs. Smith?)

Enter Room

Introduce yourself ("Hi, my name is Marie and I am your nursing assistant.")

Explain Procedure ("I am going to assist you with your dinner, brush your

hair, get your vitals - or whatever) but first I will wash my hands (walk toward sink and "pretend wash") and then I will gather the equipment."

Performing the Skill

Gather all equipment, including gloves if needed, and take to residents bed, table or chair.

Pull the curtain for privacy

Lock the bed wheels (If this skill involves a wheelchair, LOCK the wheelchair brakes at the this time also.)

Put up the side rails if needed and I would do this BEFORE raising the

the bed (if you will be doing so)

Raise or lower the bed as needed for the specific skill

Put on gloves at this time.

SKILL (Do the actual skill)

Tell the resident when you are done - don't just stop and walk away.

Rinse and dry equipment as needed and put it all away.

Ending

Go to resident and put bed in lowest position.

If the side rails need to be lowered, do it now.

Give resident the call light, smooth the covers and ask them, "Is there anything I can do for you?"

Open the privacy curtain.

"Pretend wash" your hands

Tell the resident that you are leaving the room

You have to do the above FOUR TIMES, once for each skill that you must act out. Obviously, you already did one skill when you actually washed your hands to demonstrate you knew how.

I think when performing each skill, safety should be your priority. Remember to lock the wheelchair brakes and bed brakes. And don't forget the side rails. I knew of one person who failed the "Position Resident on Left Side" because she put the resident on her right side. So be careful here.

My last suggestion would be to practice, to make this second nature. You don't want to pause often as the timer will be ticking away.

Good luck. You will do fine.

Marie

NurseCubanitaRN2b, BSN, RN · Aug 30, 2008

Hi All,
I'm currently in nursing assistant training and just have a question about the steps involved in the skills portion as far as preparing for the state exam. I have a print out of what my state (PA) requires as well as a skills book from my class I'm currently taking. I realize washing hands is crucial and of course I will do that. But I feel really uncomfortable washing my hands before introducing myself to the resident and explaining the procedure first.
For instance, the state and the class skills book list the skills steps in order to 1) wash hands and 2) explain the procedure to the resident. My instinct is to first say hello to the resident, explain what I will be doing and THEN wash my hands. Am I just reading way too much into the steps? Does anyone else feel the way I do that you say hello to the resident first and then wash your hands? I would really appreciate any advice.
Thanks!

I agree with you 100%, but do what the book says. You can never be wrong with the book. Just do it that way and once your license, then do it your way. Good Luck

ecmb · Aug 30, 2008

I realize washing hands is crucial and of course I will do that. But I feel really uncomfortable washing my hands before introducing myself to the resident and explaining the procedure first. quote]
When we did our clinicals in a nursing home we were told that the resident's room was their home and that we were to always knock and introduce ourselves just as we would when going to anyone's house. Since the sink where we need to wash our hands is IN THEIR ROOM, the steps in the handbook are out of order. You should knock and introduce yourself and then wash your hands. Otherwise, it is as if you'd be barging into someone's home, using their sink and then explaining why. Our instructor told us not to do that!
Another thing that bugged me was inconsistency. Our skills printout (from the state) listed to leave the call light and then wash our hands. Other times it listed to wash our hands and then leave the call light. If you do it the second way, you'd have to wash your hands AGAIN because you have to assume that your hands get recontamminated when you hand them the call light. And this is also wrong. You have to hand them the call light and then wash your hands - last thing before leaving their room.