A question of competence?

Monday was most eventful, in fact the activities had the year running at high stress levels for most of the day. Started with an early morning feedback on how the pathway has been. Cue us complaining for an hour about all the things that are wrong, the med school pretending to listen but never claiming liability for anything. Not being at fault is a big thing for the medical school.
My GP got a particularly slating for being useless, paternal and not letting us do anything. Although informative ive got friends who help in minor surgery at their GP and id rather be doing that then drinking yet another cup of tea. (more on the fun and frolics of GP week at another time) Also worked out that we had missed at least 4 teaching sessions over eight weeks, no wonder our knowledge base is so poor but as per usual its not the med schools fault.

So onto the thrill of our clinical competencies which are staggered throughout the morning and early afternoon. Three stations with 5 mins for the introduction, explanation and skill then a minute for feedback. Cannulation, IM injection and venepuncture for all of these things it is very important that you take your time. 5mins is in no way enough time, plus the pressure of knowing there is a time limit stresses one out even further. Despite our pleas about this issue they insisted that it would be fine and threw us into the exam cubicles.

Cubicle 1 - Cannulation
Examiner - Crazy GU frottage Consultant
Quick nod of the head as a hello to the examiner and I'm off talking to a plastic arm(PA).
Me - 'Good afternoon Mrs.Lation, the Dr has informed me that you need to have a cannula put into your arm so we can give you some fluids. This simply involves me passing a small thin tube into a vein in your arm, a needle is used to pass the tube so it will be a little uncomfortable. Is that OK with you'
PA - silence
Me - 'Excellent in which case I'll begin now first i need to check your name tag, Now your full anme is Connie Lation (see what theyve done there!), is that correct and your date of birth is xx/xx/xxxx'
PA - Silence
Me - Right then Mrs.Lation I'll just wash my hands and gather the equipment you wait here and make yourself comfortable'
Wash hands with slimey alcogel, start to throw all the required equipment into a tray, prepare saline flush after checking date, then onto the gloves.
Here is where it started to go wrong, putting gloves on after alcogel is a nightmare as its never dried in time. I start by trying to get my thumb into the little finger part, break that glove then proceed to break one more before im just about ready to begin. The gloves on quite on fully so fine motor control is going to be difficult.
At least point in time my body decides to introduce a parkinsonian tremor into the occasion. Trying to resheath a needle with a trembling hand is not fun.
Me - 'Right then Mrs.Lation i'm going to put this tourniquet round you arm and it will feel a little tight, do tell me if you feel too much discomfort'
PA - Yet more silence
Find veing insert cannula, get flashback, get excited about the presence of flashback, remove needle, vein starts spurting blood out...
Me - 'Its normal to get a little bleeding during this procedure so don't worry.
Examiner - Chuckles loudly to self in corner.
Flush cannula and recap - BUZZZZ end of time and theres no dressing on cannula ah well thinks i, got it in at least.
Examiner - still chuckling 'You've left the tourniquet hence why your patient is bleeding out and going a bit necrotic, plus why are you shaking so much you're normally fine'
Me - 'Gay, gay, gay, gay opps you didnt hear that'

Station 2 - Intramuscular injection and drug dosage
Examiner - Nice enough respiratory consultant
Afternoon to the the examiner and this time im presented with an actual mannequin to converse with.
Roll off injection chat and bizarrely thought to ask about allergies, despite it not being in the study guide.
Potter off to grab equipment, not even bothering to try and coverse with the mannequin.
Drug dosage time
Gentamycin at 3mg/Kg to be given in 3 injections over 24 hrs.
So that 240mg over 24 hrs and 80mgs per injection. They gave us a calculation that cancelled itself out, truly we must be thick. I had to check it twice to ensure it was that easy.
40mg per ml so two mls check amount with examine and show him syringe with 2mls in as was requested in the intro on the door.
Jab the mannequin with a good minute to spare.
Examiner 'Wow first full house of excellents all day did you used to be a nurse'
Apparantly if you need an IM injection I'm the one for the job.

Cubicle 3 -Venpuncture
Examiner - Random female consultant
Yet again a silent plastic arm
So i role of the prep paragraph about what the blood test is for when the results will be back etc, then occasionally comment to the arm as i stab it. Got blood first time managed to fill in all the forms and finish inside the time.
Examiner - You should try and maintain conversation with the 'patient' throughout.
Well i would never have guessed that i urge you all to try talking to an inanimate object that doesnt reply. Im used to it but its still a pain and it never feels normal.
Ive done at least 10 lots of bloods on acutal people so i would like to think this is a better judge of my competence than drawing red ink from a plastic arm.

Other people managed to do just as badly:
One student managed to get a needlestick injury
One of the arms had what looked like veins but were actually skin folds so it took some students 4 attempts to get blood.
One student nearly flooded the place with the tourniquet left on and unable to find the cannula cap. The red stains on the floor are gonna be there for a while.
Plenty of people didnt get blood, or get round to injecting or messed up the calculation.
Lets just say the pubs round here made a lot of money that night.

Today the med school issues this response to our complaints:
Following our feedback session I fed back to the head of clinical skills the essence of your concerns that there was insufficient time to perform the skill. They have more or less agreed that all sites found this to be the case, and part of his reply is copied here, which hopefully will reassure you.

“Therefore, it is likely that the standard setting process will result in a lower pass mark than would have otherwise been the case. In short, the students should wait before assuming ……... We will review the timings for further runs”.

In short they are taking no responsibility or letting us all resit the tragic ones as a first attempt.
Im not really surprised.