What is general skills lab etiquette?

[Axmann, RN, BSN, NREMT-B]

So, my school has a pretty nice simulation lab. Students are allowed to schedule time in there or just practice when there isn't a class using the lab.

My concern is: I'm afraid to utilize the skills lab. I'm afraid I'm going to use something to practice that I'm not supposed to or be accused of "wasting" things or "fooling around".

For example: even though I'm FAR away from learning this skill, I'd like to practice ET intubation. Our skills lab has laryngoscopes and intubation dummies. However, since I'm not in a class that's even DISCUSSED intubation, I'm all paranoid that someone would say something about me like accusing me (again), of "playing around". Furthermore, I'd like to just take a look at all the equipment in the lab and learn how everything works so I'm not dumbfounded the first time It's introduced.

Essentially, this entire LINE of thinking prevents me from wanting to do ANYTHING in the skills lab, even anything related to class.

Does anyone else feel like this in regards to their skills lab?

[Jenngirl34RN]

Why don't you talk to your lab instructor (or whoever is in charge or your sim lab) and find out what the policies are?

[loriangel14, RN]

If you are going to use the lab I would suggest you be using the time to practice the skills you are currently supposed to be learning. there is no point in practicing stuff you haven't been introduced to yet.

[Axmann, RN, BSN, NREMT-B]

Lori: You're asking me why someone should practice and learn skills they haven't been formally taught yet (but will certainly be taught eventually) on their own? I'd say the reason is because if a person is enthusiastic about learning new skills and is WANTING to enrich their education in a practical way outside of class time because the practice of nursing is their passion, that they're likely bound to be a great nurse, and that beating that enthusiasm out of them is not a very good way to advance the profession. That sounds like a type of "if it's not on the test, it's not worth learning about" mentality to me.

Practicing blood pressures is fine and all, but that can be done at home. Many essential nursing skills require the use of equipment that you can't just pick up for $15 at CVS (blood pressure cuffs are pretty damn cheap).

[Nurse Kyles, BSN, RN]

I would ask about the policy for your sim lab. Nursing school is a very complex learning experience, because you aren't simply just learning skills. You are simultaneously learning the knowledge that you will then apply when performing a skill. It is great that you are so enthusiastic about learning, but you will be getting the cart before the horse if you jump right into intubation. I would stick to practicing skills that you will be learning this semester of nursing school. You must learn to crawl before you walk. Good luck!

[loriangel14, RN]

Lori: You're asking me why someone should practice and learn skills they haven't been formally taught yet (but will certainly be taught eventually) on their own? I'd say the reason is because if a person is enthusiastic about learning new skills and is WANTING to enrich their education in a practical way outside of class time because the practice of nursing is their passion, that they're likely bound to be a great nurse, and that beating that enthusiasm out of them is not a very good way to advance the profession. That sounds like a type of "if it's not on the test, it's not worth learning about" mentality to me.

Practicing blood pressures is fine and all, but that can be done at home. Many essential nursing skills require the use of equipment that you can't just pick up for $15 at CVS (blood pressure cuffs are pretty damn cheap).

Wouldn't you be better off practicing the skills that you are supposed to be learning right now? How are you going to practice something that you haven't been taught how to do properly? There is no point in getting ahead of yourself. Are you perfect at the skills currently being taught? There is nothing wrong with being enthusiastic but you also should be paying attention to what is being taught right now.

[EuropaRN]

What semester are you in? I agree with everyone else, work on perfecting the skills you will be tested out on soon. You need to know the basics before jumping into something else. In my area, RNs very very rarely do intubations. So for me, learning that skill would have been a waste of time because it's not something I use every day (or ever.)

I would suggest, if you want to make your ample free time to enrich your education useful, check out youtube videos. There are some great RTs on there that can explain what to look for and where to position your blades and how to apply cricoid pressure, etc.

Also, communicate with your lab director! S/he is in academia for a reason and he or she would surely love to talk about all of the equipment. Ask for some ground rules and schedule some time to check things out on your own.

[chrisrn24]

Practice what you're learning this second. If you master that, then read what you're supposed to read in your books and master that information.

If you know you will learn intubation later on, just wait and do with your class when it's time.

That way you'll learn the safe and proper techniques.

[rubato, ASN, RN]

I wouldn't practice things I haven't been taught yet. What is the point of practicing something in an incorrect way? You can't do it in the correct way until you are taught. And, each school does things a little differently, so youtube or something like that may not necessarily help you.

[BostonFNP, APRN]

So my school has a pretty nice simulation lab. Students are allowed to schedule time in there or just practice when there isn't a class using the lab. My concern is: I'm afraid to utilize the skills lab. I'm afraid I'm going to use something to practice that I'm not supposed to or be accused of "wasting" things or "fooling around". For example: even though I'm FAR away from learning this skill, I'd like to practice ET intubation. Our skills lab has laryngoscopes and intubation dummies. However, since I'm not in a class that's even DISCUSSED intubation, I'm all paranoid that someone would say something about me like accusing me (again), of "playing around". Furthermore, I'd like to just take a look at all the equipment in the lab and learn how everything works so I'm not dumbfounded the first time It's introduced. Essentially, this entire LINE of thinking prevents me from wanting to do ANYTHING in the skills lab, even anything related to class. Does anyone else feel like this in regards to their skills lab?[/quote']

You are likely putting the cart well in front of the horse. Make sure you practice the basic skills you are taught and both understand and execute them flawlessly.

As for "practicing" intubation, this is not a standard nursing skill and is not within the RN scope of practice unless they are ACLS certified, and even then it would only be in specialized positions or advanced practice. It's great that you want to learn advanced skills but you need to learn the basics first.

[Esme12, ASN, BSN, RN]

Lori: You're asking me why someone should practice and learn skills they haven't been formally taught yet (but will certainly be taught eventually) on their own? I'd say the reason is because if a person is enthusiastic about learning new skills and is WANTING to enrich their education in a practical way outside of class time because the practice of nursing is their passion, that they're likely bound to be a great nurse, and that beating that enthusiasm out of them is not a very good way to advance the profession. That sounds like a type of "if it's not on the test, it's not worth learning about" mentality to me.

Practicing blood pressures is fine and all, but that can be done at home. Many essential nursing skills require the use of equipment that you can't just pick up for $15 at CVS (blood pressure cuffs are pretty damn cheap).

While I appreciate your enthusiasm...and I am sure you nursing instructor do as well....showing that you are focused...and anxious to master the lowly task of nursing for they can actually yield a ton of information....for example...pulsus paradoxus

Systemic arterial pressure normally falls by less than 10 mmHg during inspiration, but this decline is not palpable at the peripheral pulse.

Moderate to severe cardiac tamponade, and occasionally constrictive pericarditis, induce hemodynamic changes that enhance the inspiratory fall in systolic blood pressure. This exaggerated drop in systemic blood pressure during inspiration is termed pulsus paradoxus.

Severe pulsus paradoxus can be palpated in the radial, brachial, or femoral pulses as a weakening or disappearance of the pulse during inspiration (which is best observed by watching or palpating the rise and fall of the chest). However, in most patients pulsus paradoxus is most readily identified while measuring the blood pressure. It may be necessary to have the patient breathe slowly and deeply to elucidate this finding when pulsus paradoxus is not severe.

To measure pulsus paradoxus, a manually-operated sphygmomanometer is employed for blood pressure measurement in the standard fashion except that the cuff is deflated more slowly than usual. During deflation, the first Korotkoff sounds are audible only during expiration, but with further deflation, Korotkoff sounds are heard throughout the respiratory cycle.

The difference between the systolic pressure at which the first Korotkoff sounds are heard during expiration and the pressure at which they are heard throughout the respiratory cycle quantifies pulsus paradoxus. Pulsus paradoxus can be more sensitively quantified by an invasive arterial measurement, and may also be observed by respirophasic variation of the pulse oximetry waveform

and learning about the Kortikoff sounds....

1. the first korotkoff sound is the snapping sound first heard at the systolic pressure. a clear tapping sound; onset of the sound for two consecutive beats is considered systolic.
   
2. the second sounds are the murmurs heard for most of the area between the systolic and diastolic pressures.
   
3. the third = a loud, crisp tapping sound.
   
4. the fourth sound, at pressures within 10 mmhg above the diastolic blood pressure, were described as "thumping" and "muting".
   
5. the fifth korotkoff sound is silence as the cuff pressure drops below the diastolic blood pressure. the disappearance of sound is considered diastolic blood pressure- two points below the last sound heard.
   

or heart tones...http://www.wilkes.med.ucla.edu/intro.html

Before moving on to advanced airway procedures a mastery of the basics is usually required. You will not usually encounter opportunities to intubate patients as a bedside nurse.....as the goal is to intervene prior to the patients arrest.

I am not sure how your lab is set up but I am sure there are many skills that you could be focused on to master. Wanting to run, full speed, to the edge of the cliff....doesn't make you brave or safe.

Nursing is rather like that....... running full tilt to get to the "good stuff" because it is your "passion" doesn't give a sense of control....maturity and caution. Nursing is all about control....knowing what to do and proceeding with confidence based on experience, knowledge, practice and expertise.....not running full speed ahead, skidding to a halt and falling over a haphazard solution.

It is about the journey and learning how to get there.....it's not about getting there and coming to a screeching halt almost missing the destination.

Walk before you run. Look before you leap...You have already been described as immature, playing around, reckless.....nurses are not reckless.

[krisiepoo]

you said that you've been acused of playing around before... what was that about? are you looking for validation from this board for you to hang out in the skills lab? I think the general consensus at our school is you are free to use the lab for skills you've been taught.