TOP TEN LIST: basic skills you should master..fast!!!!

[Never_too_late]

Hello everyone,

Don't know if this one has been done before... I am completing my second clinical and have yet to apply many skills in a hospital setting. I took out my first IV line today..sigh... Things are so slow, I wonder how much practice I will have gotten before the infamous MED-SURG II class next fall. From those of you already working or those of you more advanced in your program, what do you believe are the top 10 basic skills that one should master and be ready to contend with in a hospital setting?

For example, putting in an IV line, suctionning a trach, drawing blood, replacing a bandage, comforting an anxious patient, recognizing and knowing how to treat respiratory distress, recognizing and knowing how to treat dehydration..whatever.

Thanks.

N_T_L

[Never_too_late]

I agree with many of the things that have been posted so far...I too think that learning concepts and how everything fits together is key...technical skills, while nervewracking, can be learned and perfected with practice. Here are some skills that I think are important:

Assessment

Intervention based on assessments

Documentation

Giving a concise but complete report

Teamwork: with co-workers, doctors, etc

Organization of time

Prioritization

"Therapeutic communicaiton" (I always hated that term but it does come in useful)

Medication administration

Education for patients and families

The "Basic" Skills: setting up and turning on suction, foleys, ivs (insertion and maintenence), ngs, dressing changes, maintnence of CTs, sterile procedures, blood administration, etc (All of these will be learned with practice!)

USING COMMON SENSE!

You can always teach someone how to do a skill...learning to to integrate concepts is harder and I feel that this should be focused on during school...if I see X what am I going to do? what needs to be done first?, etc.

Take every opportunity to practice those technical skills while in clinical...But don't forget to watch the RN that you are working with. She/He may not be good a verbalizing what they are thinking so ask (unless things are going downhill fast, then write it down so you can ask later). Ask your preceptor what they look at when they walk into a room. What to they assess first, what catches their attention and what is done to correct or monitor the problem...Stuff like that is harder to catch onto because a lot of it is just practice and experience...the sooner you teach yourself to think about the options and possibilites the easier it will come when you have expereince. Go over scenarios in your head. If my patient has chest pain, what will I do. If I walk into the room and my patient is unresponsive what next? It comes...

good luck to all the new grads and students of the year!

Excellent post! thanks for the great advice.

I guess its pretty basic common sense that knowing what to do..but not being able to recognize when to do it .. is a problem. So that makes assessment most miportant of all. I would have then asked you what are the most important things to look for in that first minute you walk into the room..but yuo ansered that: 'Ask your preceptor what they look at when they walk into a room. What to they assess first, what catches their attention and what is done to correct or monitor the problem...Stuff like that is harder to catch onto because a lot of it is just practice and experience...'.

I think I may have just needed some refocusing and gotplenty of that from all of you. Thanks for your help.

N_T_L

[sofaraway04]

I think the most important thing is to be able to do the general observations. A manual blood pressure, carry out neuro obs- GCS. removing venflons, aseptic technique

[MamaTheNurse, BSN, RN]

I think the most important thing is to be able to do the general observations. A manual blood pressure, carry out neuro obs- GCS. removing venflons, aseptic technique

yes yes yes especially doing a manual blood pressure!! we have too many people on cardiac monitoring and a cuff where it goes off as often as you tell it to or we take the rolling Dynamap (or whatever brand you have) machine from room to room doing BP's - no one does manual BPs anymore!! do one once in a while on a stable patient so you don't freak out if you have to do one on an unstable patient!!

[RainDreamer, BSN, RN]

Great advice, everyone!

[Mystery5]

1) Transfering pts safely.

2) Moving pts in bed, log rolling, changing bed with pt in it.

3) Establishing rapport with pts and their families.

4) Getting tuned into vital Kardex information about pt. Paying attention to diet orders, activity orders, and other important info on Kardex.

5) IV site assessment. Very important not to let infiltrations and phlebitis situations go unnoticed for too long!

6) Get tuned in not only to current VS, but how they compare on the graphic chart, and what could be possible explanations for those changes.

7) Sterile technique

8) Communications skills with staff, teachers, etc. Learn to ask questions, seek information. Learn to temper either shyness or boldness, and be a good communicator.

9) Get familiar with charts, how things are organized in them, how to find information in one.

10) Learn to organize your information in a consise way on each pt your have, for easy access.