17.2 Performing, Correcting, and Sequencing Skills

17.2 Performing, Correcting, and Sequencing Skills

Quick Answer: If you make a mistake on the current skill, say so, tell the evaluator which step or steps to correct, then perform only those steps. Do not restart the whole skill. You cannot go back after you begin the next skill. After the first introduction you need not re-introduce. Between later skills you may say "Now I would wash my hands." Every non-handwashing step must be actually performed. End each care skill with the call light in reach and the bed low.

Why strong students still fail the workflow

Candidates who know every skill card still fail because they restart a long skill and run out of the 30 minutes, go back after they have started the next skill, simulate a lock or a side rail, or wait for the evaluator to remind them about gloves and then assume that reminder is a free correction. This section is the workflow that sits on top of Chapters 7–15. It does not recopy those cards.

The evaluator will not answer questions during the evaluation and will not tell you whether a skill was correct. You may not receive help from anyone, including the volunteer client. Corrections are something you initiate on the skill you are still performing.

The correction rule

If you make a mistake, say so. The evaluator will instruct you to tell which step or steps you want corrected and then to perform those steps. You do not redo the entire skill. You name the missed lock, the missed recording, or the missed privacy curtain — then you do that piece.

Two exceptions swallow that credit:

1. Gloves. If you do not put on gloves or do not take them off when required, and the evaluator reminds you, you do not get credit for trying to correct that step. A reminder is not a free do-over. Put gloves on, and take them off, before you need a prompt.
2. Order. If a step must be done in order — it belongs before or after another step — and you forget to say when the corrected step should be performed, you do not get credit for the correction. Locking wheelchair wheels belongs before the stand. Saying you need to lock the wheels after the person is already standing, without saying when that lock belonged, does not repair the sequence.

Once you begin a new skill, you cannot go back to correct the skill that came before it. The instruction card is a one-way street. If you are already counting a pulse, you cannot return to finish the bedpan.

What you actually do versus what you may say

After you have introduced yourself the first time, you do not need to introduce yourself at the start of every later skill. The volunteer already knows who you are. Repeating a full introduction five times burns minutes you need for measurement and transfer.

Hand Hygiene (Skill 1) is a scored skill. You must actually wash for that skill — running water, 20-second lather on all surfaces, hands lower than elbows, fingertips down, as the card requires. For later skills, you do not have to rewash if you tell the evaluator "Now I would wash my hands" at the moment you would wash in a real situation. That spoken line replaces a second, third, and fourth trip to the sink. It does not replace Skill 1 itself.

For every step other than handwashing, you must perform the action. You cannot say "I would lock the wheelchair," "I would raise the rail," or "I would put the call light here." You must do the step. When water is required, use running water. Perform the skills the way you would in a nursing home, not as a narrated pantomime.

Two safety closings appear on almost every care skill. Whenever you leave the client, place the call signal within the client's reach. Put the bed in the low position. Those two closings are not decoration. A perfect transfer that leaves the bed high and the call light on the overbed table still misses scored steps.

A five-skill card walked in real time

Suppose the instruction card reads, in this order:

1. Hand Hygiene (Hand Washing)
2. Assists With Use of Bedpan
3. Counts and Records Radial Pulse
4. Dresses Client with Affected (Weak) Right Arm
5. Transfers from Bed to Wheelchair Using Transfer Belt

Use this as a timing and correction map, not as a substitute for the full cards in earlier chapters.

If at minute 23 you remember you never locked the wheelchair and you have not yet left the transfer skill, you may still correct on the transfer by naming the lock step, saying it belongs before the stand, and locking the wheels. If you have already been moved on to a new skill, you cannot go back.

Keep a private time sense. The warning at 25 minutes means five minutes remain for whatever is left on the card. Candidates who restart Skill 2 from the top after a missed wipe often never reach Skill 5.

Colorado scenario

Omar's card in Colorado Springs is the five-skill set above. He actually washes for Skill 1, then does the bedpan. He forgets the call light. He says, "I made a mistake. I need to correct the step that leaves the signaling device within reach," and he places the call light. He does not restart the bedpan. He says "Now I would wash my hands" and moves to pulse.

On pulse he types 72, then realizes he counted 78. He is still on the pulse skill. He tells the evaluator he is correcting the recording step and enters 78. He does not ask if that is within ±4.

He starts the weak-arm dress. Mid-sleeve he remembers the bedpan privacy curtain was open. He cannot go back. He finishes dressing: right (weak) arm first, call light, bed low.

On the transfer he starts to stand the volunteer before locking the wheels, stops, says he is correcting the lock-wheels step that comes before the stand, locks the wheels, then stands. After the last skill he washes when told. That wash is not scored.

A classmate on the same card waits for the evaluator to say "gloves" during the bedpan and then calls that a self-correction. That reminder earns no credit. Another classmate says "I would lock the wheelchair" instead of locking it. Simulation of a non-handwashing step earns no credit.

Exam traps

• Restarting the whole skill after one miss.
• Waiting for a glove reminder and calling it a correction.
• Correcting an ordered step without saying when it belongs.
• Going back after the next skill has started.
• Re-introducing five times and rewashing five times until the clock dies.
• Saying "I would lock / I would raise the rail / I would hand the call light."
• Leaving the bed high or the call light on the overbed table.