Labs and Case Studies

Applying Knowledge in the Clinical Setting 

Each lab for the chronic placement was a great opportunity to practice and expand my skills as a future nurse. We worked on foundational skills such as taking vitals, bedside manner, head-to-toe assessments, and effective communication skills with the patient and other health care providers. We further expanded on these skills through learning about starting an IV, programming pumps, intermittent catheters, suctioning, trach care, postmortem care, palliative practices, medication administration, documentation, wound packing/dressing, home care, and more. Participating in this clinical placement has allowed the opportunity for many of these skills to be applied to real-life practice, including the skills expanded on below. 

Wound Packing 

Wound packing was performed during Lab 2 in the chronic course. Learning and practicing in a safe environment was a great chance to attempt this skill while being able to ask questions, make mistakes, and improve my practice. I found specific advantages also included a perfect setup, an accessible wound site, a compliant patient (mannequin), and access to the necessary resources and guidance in the same workspace. I had the opportunity to transfer these skills to the clinical setting, and try packing a wound with my clinical instructor. As I was preparing, I felt excited and nervous for the experience to pack a real wound site. I was excited as wound care and packing are an interest of mine, and this felt like a positive chance to challenge my skills. I also felt nervous about whether I could maintain sterility due to the location, how my patient would react, and if the packing would be effectively done to encourage healing. Looking back at the experience now, I feel accomplished that I was able to properly clean the area, measure the wound, pack and dress the wound, and properly chart its progression, with the guidance of my instructor. I felt the live experience had advantages over the lab, including practicing interacting with a patient during a potentially painful procedure, and the packing stayed in place from the moisture of the site. Overall, I feel more comfortable in my ability to perform this skill and look forward to future opportunities in my nursing career. 

Priming the IV & Programming the Pump

During Case Study 2, we practiced our skills in priming IV lines and programming the pump. The skill of priming a line was not an overly complicated concept, but I struggled with the timing of flipping the cassette. This caused the second half of the line to fill with air, which is not a safe setup for IV infusions. Thankfully, I was able to practice this skill further during the lab and improve on my timing of filling the cassette and removing any excess air from the line. I was also able to practice with my lab take-home kit. When it came to priming a line in the clinical setting, this was still an area for needed of improvement. I think I was nervous the first time trying to prime a line during clinical, as other students were watching and a patient was in the room. I appreciated the guidance of my clinical instructor as they walked me through remedying my mistakes. Looking forward, I must continue to practice priming lines (with fluids that are wastable), as this will be an essential skill in my nursing practice. This is important to master because it is key that a line is primed with a minimal amount of medication lost to maintain the correct therapeutic dose. It is also very important that minimal air is pushed into the vein. My experience programming pumps during lab and clinical, on the other hand, was not a concern. I found this skill was not overly complicated; the pump asked for the values, and the values were available on the MAR, the medication label, and the fluid bag. 

Head to Toe Assessment 

During each lab, we had the opportunity to practice and improve our head-to-toe assessments, including vitals. This was to ensure we understood the patient's condition and how their chronic illness was affecting their body. This was a great experience as it helped me connect the dots on what to look for in relation to their specific illness. This also helped me to think critically about what questions would be helpful to ask when gathering a patient's full story. These skills came into practice during each shift on B2 as each morning, I conducted my head-to-toe on my patients. During our head-to-toe evaluation, I felt comfortable, following the worksheet closely. Eventually, I was able to develop my own routine for a head-to-toe with a flow that was easy to remember each of the steps. Not only is this relevant for the work of each lab scenario and clinical, but it is also a key skill a nurse must be able to perform.