At Germanna CC, Students Nurse Human-patient Simulators

LOCUST GROVE Va.

Increasingly, students in the medical field can learn to tend to patients before setting foot in a hospital.

At Germanna Community College, human-patient simulators create scenarios for nursing students to address with little intervention from instructors: an infant who overdosed on fluids, a diabetic with excessive blood-sugar levels and a postoperative patient anxious to go home, for example.

“It has really revolutionized, truly integrated technology in the academic setting,” said Judy Woolcock, nursing lab coordinator.

Germanna’s nursing program is among several in the country that use human-patient simulators in some capacity in conjunction with clinicals and lectures. Health care professionals say this technique allows students more autonomy.

The college used its first human-patient simulator in the summer of 2004, and has spent $418,000 on simulators and software.

The virtual hospital at the Locust Grove campus now uses 10 high-fidelity human-patient simulators equipped with basic human functions. They breathe, blink and sweat.

“They can pretty much do anything we want them to do,” Woolcock said. “It’s just a matter of creativity and the time that we set up for it.”

Nursing students often get so involved with cases they no longer see them as simulators, Woolcock said. Students even cry when their “patients” die.

On a recent morning, nursing instructor Patricia Lisk watched the adult ward through a window in a small room within the classroom. She used computers to control patients’ functions and monitored the room with a camera.

In addition to being an instructor, Lisk is a one-woman hospital for the handful of students in the room.

She simultaneously provides voices for the patients, administers medicine and, when students call for her, becomes the ward’s resident doctor, “Dr. B. Good.”

She watched as a student failed to notice that the lab reports for Ima Wheezy, an 80-year-old with congestive heart failure, were mixed up with another patient’s and erroneously treated her.

“The beauty of this is, if this were a real hospital, this patient would’ve crashed,” Lisk said.

The advantage to using simulators over shadowing professionals at a hospital is students are allowed to make mistakes, Woolcock said. They apply their knowledge at the virtual hospital without consulting a professional something they’re unable to do during clinicals.

“We try to let them be independent, but realistically it’s not very independent,” Woolcock said of clinicals. “Down here, the worst thing is the patient dies, but the patient is a mannequin.”

Beverlee Anderson, executive director of the Society for Simulation in Healthcare, said no accurate data is available for the number of health care programs in the country that use simulators.

But every academic medical center and nursing school, community college and institution training health care professionals has some sort of simulation-based educational program, she said.

“This is an area that has grown so exponentially in the last four years that we’re just now because nobody realized how fast it would grow we’re just now setting the standards for both centers and programs,” Anderson said.

Once accreditation standards are put in place for these programs, more data will be available, she said. Debriefing sessions, she added, set this style of learning apart from lectures and didactic teaching techniques.

“There is that feedback mechanism, and that’s the important difference with simulation,” Anderson said.

At Germanna’s makeshift pediatric ward, second-year nursing student Autumn Hill momentarily decides she no longer wants to be a nurse after her 2-day-old patient overdoses on fluids.

“It’s just frustrating,” Hill, 22, of Spotsylvania, said. “I’m mad at myself. If it was a live person I really could’ve hurt them. I’m just frustrated I didn’t catch it.”

Hill’s classmates tell her how she could’ve handled things differently. She should’ve checked her textbook before administering the dosage, Dawnielle Roller, 32, of Woodbridge, said.

To make patients more realistic, they’re given background stories. According to lab reports, Hill’s patient, Baby Doe, was abandoned.

James Polliard, 26, of Fredericksburg, said mistakes in class are inevitable.

“We all want to do the best. When something goes wrong, it stings,” he said. “This place lets us be human.”

As the end of class nears, Hill is required use a walkie-talkie to call for the doctor, nursing instructor Zoila Ortega, aka Dr. Beck. Before responding to the call, “Dr. Beck” asks Hill to describe Baby Doe’s symptoms.

When Hill doesn’t adequately name them, the doctor tells her she’s too busy to answer the call something Ortega said real doctors would do in that situation.

Ortega then tells her flustered student to consult her textbook before making a second call.

“They are missing some things, but that should happen,” she said.

The Free Lance-Star is published in Fredericksburg.

Information from: The Free Lance-Star, http://www.fredericksburg.com/



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