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?

[Stephalump]

I think you need to keep things in perspective here. Wild enthusiasm doesn't advance the profession. What you do and how you handle yourself is the crux of the matter.

And quite frankly, a student being a tad bit better at the mechanics of incubating someone during check-off is useless to the profession.

The issue isn't passion, it's the logistics of what you're doing. My main concern is muscle memory. If you begin practicing things incorrectly, it's going to a a doozy to relearn it.

That and your lab coordinator's sanity. Please ask him or her before you start doing random things to mannequins. Odds are the lab will be set up for the things they want you to practice, and that's it.

[LoriRNCM, ADN, ASN, RN]

Good grief, not me! I'm so swamped with what we have done in lab and subsequently in clinical so far that I have no interest in what we have to know down the road. Not yet! I only have a certain number of brain cells. They are being used at an alarming enough rate as it is. I wish I had time to use the lab for just practice. I spend six to seven hours a week in there as it is and most of my time outside of lab is either in class, clinicals, or studying my tail off.

[lifelearningrn, BSN, RN]

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?

You will be accused of 'playing around' if you're playing with things that have nothing to do with the current program you are attending. The lab director at my school would probably ban you from the lab all together.

I don't believe it's even taught in nursing school unless you're doing a post-grad cert or are continuing to advanced practice.

[applewhitern, BSN, RN]

In my area, intubation has been taken away from nurses. We used to have to perform this for ACLS, but not anymore. We are no longer allowed to intubate. I agree, best to follow the class curriculum anyway.

[i♥words]

My instructors always teach skills a little differently then how the book outlines, so I'd be lost if I practiced one way and then had to switch it up later on.

Besides, when is there time to learn things we haven't even gotten to yet? I'm still trying to work on what we covered weeks ago!!

[psu_213, BSN, RN]

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.

nurses are not reckless.

I liked all of Esme's post, but I particularly liked these parts.

I addition to what has already been said, I just wanted to add that you are, like it or not, being judged

by your instructors. If you make a bad impression on an instructor, you never know how long it may haunt you. What if you barely pass a skills check off, yet the instructor sees you in the lab "playing around" rather than practicing the skills that count? I realize the dangers of starting a phrase with "if it's not on the test..."; however, if you struggle in the least with the skills being taught at present, yet are seen playing around with skills that may never be taught (and I suspect that actually intubating a patient may never be taught), that is going to make a really bad impression on your instructors.

[psu_213, BSN, RN]

Other thoughts about intubation--perhaps the instructors will intubate a mannequin so that you can then practice care for a pt with an ET tube in place.

Working in the ER, I am (at least in part) responsible for setting up intubation equipment, ensure adequate oxygenation of the pt just before intubation, handing the doc the correct blade and ET tube, make sure they are stable after the intubation, etc, etc. Point is, I have to be familiar with the procedure even though I have never actually intubated someone. Perhaps this is why the equipment is in the lab. I know this is just one example of what you (the OP) want to practice, but my suspicion is you will never actually learn how to intubate and you will never be tested on that skill.

[Wrench Party]

Back in school, my lab instructor would have had a total fit and banned us from the lab if we didn't work on our

assignments during practice time.

Skills are usually taught in a sequential order for a reason (ex. how to assess lung sounds before working with a Pleuravac).

Even if you mastered this emergency intubation technique, when in a standard medical-surgical setting would you even have access to the equipment to perform one? It doesn't make much sense for a floor nurse to learn.

[douxmusique]

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.

I am finishing up my funds and skills and was thinking "I didnt think rns did intubation.....?"

Personal opinion: focus on whats on your plate currently and channel your excitement towards perfecting what youre responsible for one step at a time. Our skills lab is pretty regimented but we are allowed to practice, use, "waste" what we need to in order to be comfortable with our skills. I dont generally work ahead other than readin up on and checking out youtube videos of skills I know are coming up based on the syllabus.

[douxmusique]

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 and learning about the Kortikoff sounds....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.

I do enjoy your words.

[psu_213, BSN, RN]

make sure they are stable after the intubation

BTW, I originally mean the patient when I said "they," but it also refers to the first year EM resident who just completed his/her first intubation.

[Axmann, RN, BSN, NREMT-B]

you said that you've been acused of playing around before...

No I didn't; I said I was fearful of that.