There had been an accident.
Mia, a pregnant woman, was wheeled into the ER after having been rear-ended in a car accident.
The nurses on staff hurried over to their patient to assess the clearly distraught woman. During the accident, the air bags had been deployed and Mia, who had a history of scoliosis, was in considerable pain. She was also experiencing some bleeding. The nurses conferred with each other. An emergency c-section seemed likely.
Although this scene could have been any real-life situation, it actually took place in the halls of the School of Nursing during an interdisciplinary simulation in Assistant Professor Jenna LoGiudice’s second degree nursing class.
The students, which included several from the nurse anesthesia program, were expected to translate classroom knowledge into patient care while working with all members of the healthcare team (midwifery, ob-gyn, anesthesia) to accurately identify the patient as having a placental abruption and needing an emergency cesarean section. A number of other nursing students observed the simulation.
"Watching the simulation was very helpful in our learning process because it allowed us to connect the dots in what truly happens in real life situations," said nursing student Nicole Rumery '16.
Professor LoGiudice agreed. “Learning about the signs and symptoms of a patient experiencing a life-threatening emergency is very different from being in that scenario and having to assess her physical state and help her remain calm while explaining what's happening.”
Anka Roberto, RN, MSN, MPH and director of the Learning Resource Center, Simulation and Clinical Coordinator in the School of Nursing, played the roll of Mia, while a student played Mia’s husband. Since he was not allowed in the operating room, he spoke to several nurses who explained what was happening to his wife, which was a good opportunity for the students to prepare for communicating with family members. "Being in this situation and having to think about the interventions and communication with the patient, physicians, other members of the staff plus a nervous husband was more challenging than I had imagined," said Sherifa Douglas '16.
Despite the dire circumstances, Mia and her baby made it through and were reunited with “Dad” soon after.
Johanna Gonzalez '16, who took on the role of one of the RN's in the emergency room, said, "The simulation of Mia was an excellent way to piece together what we have learned both in the classroom and clinically. It is one thing to read a scenario in a textbook and quite another to put clinical reasoning to use in a high stress environment. This tool ultimately served as a gateway to prepare us for situations we, as nurses, may encounter in real life as we edge closer to graduation day. Thankfully, in Mia's case we all worked together as a team to accomplish the mission and the outcome was a success."
Following the recorded simulation, the students that observed the simulation assessed and identified what went well and what could be improved.
Caitlin Bendernagel '16 said, "It was insightful to see the entire patient experience coming into the Emergency Department, sent to Labor & Delivery, into the Operating Room, and then recovering in maternity. Each nurse had different tasks to perform and everyone communicated affectively and worked efficiently in order to ensure the best possible outcomes for mom and baby."
Alyssa Hemric '16 said, "It was an awesome learning experience to be sitting in the audience. I was able to really process the scenario and figure out what steps I would take in my future practice.”
While simulations are common in nursing courses, Professor LoGiudice said that inter-professional simulations are newer but well worth the time. “When our nurses graduate, they will be working with all members of the healthcare team. Working with other nurses in different fields through this simulation opens up the door for effective communication.”