Keeping It Real

by Chad Stanton '10

A shrill alarm blasts from the computer screen in the corner as a young man struggles for a breath. The panic in his eyes is the only sign needed to realize something is gravely wrong. Three nurses race to check vital signs and his chart. Narcotic overdose.

This is a new scenario for the young nurses. They struggle to assess how to properly dilute a medication, knowing that the wrong dosage could mean a turn for the worse. The situation moves at a frantic pace. Vital signs continue to deteriorate.

"I dropped a few swear words because I was not going to let my patient die. I refused to let it happen," Bethany Waletzko '11 remembers. "Finally, I figured out the correct way to dilute Narcan. I hollered for an alcohol swab to clean the IV port and was able to save the patient. After it was over, I literally had sweat dripping from my forehead."

Intense, high stress situations like these take place in emergency rooms of local hospitals all the time. These same situations are being simulated on the fourth floor of the Main Building at Saint Ben's too. Nursing simulations, or SIMS, are an academic tool used by the CSB/SJU nursing department to take the knowledge and skills learned in the classroom and bring them into the context of the real world. "This style of teaching blurs the lines between what is learned in the classroom, in the lab, and in clinicals," says Carie Braun '92, chair of the nursing department. "When it comes to nursing, the students need to see it, feel it, smell it, do it, know it."

The nursing department utilizes high-tech mannequins that can be programmed with heart and lung sounds, to talk, as well as the ability to emit various, realistic bodily fluids. These tools are particularly useful for learning to perform tasks like urinary catheterization that wouldn't be practiced on humans for the first time. Nursing education, however, is about more than just performing tasks. That's when reality steps in to the SIM.

Live actors add an important human element. Teaching assistants, faculty, and student peers assume the roles of other nurses, patients, and family members who force nursing students to think beyond the processes learned through textbooks and PowerPoint presentations. "Although SIMS are nerve racking and stressful, the outcome of them is phenomenal", says Sarah Hund '10. "SIMS help students think on their feet."

The time spent in SIMS allows students to work through the stress and anxiety of working in an emergency room or health care environment. Kathryn Torchia '11 remembers one particular high-stress SIM. "All of us were freaking out! Monitors were beeping, the patient was wailing, and we were frozen; we didn't know what to do," she says. "We were so focused on trying to quiet things down that we forgot basic skills, like introducing ourselves properly and even washing our hands!"

The SIMS also continually present students with 'what ifs'. "In the simulations, students are faced with language barriers, cultural belief systems that restrict certain care, and conflicting messages from family, the patients, and other care providers," Carie says. "We provide situations so real to life that students forget it isn't real. Patients even die. The students never forget this."

Students are filmed during SIMS for critiquing by professors and fellow students. Reflecting on the SIMS allows students to hear feedback about the positives and negatives that took place. This system of simulation and reflection allows students to make significant strides in their knowledge and abilities before they go on to performing clinicals.

"Often times, we don't recognize our mistakes until they are pointed out to us," Kathryn says. "The reflection period is a wonderful opportunity to take a step back, decompress, and really think about what influenced our actions in the SIM."

True to the Benedictine values that guide Saint Ben's and Saint John's, the reflection period teaches students how to listen and reflect on their actions while administering care. Students are also asked to draw upon all that they have learned through their liberal arts experience and apply it to the SIM. "We look at what we know about music, about ethics, about culture, about art - all of these things - and consider how they apply to what we are doing in our field," Carie explains.

Perhaps the most unique aspect of the nursing major at CSB/SJU is the focus on teaching holistic care. Students are taught to respond to the psychological, physical, and social aspects of a patient's needs. As Kathryn puts it, "One of the most powerful things about caring for someone holistically is that it transcends the 'normal' boundaries of what we are comfortable with and allows us to look at someone as the true person they are, not merely the side effects and (potentially shocking) manifestations of their afflictions."

Playing the role of patient or family member also broadens the perspective of nursing students. "Role playing has allowed me to experience patient care from the patient's point of view," says Kara Solberg '10 "It has helped me to understand how uncomfortable it can be to be a patient. As a novice nurse, we need to learn to show empathy while worrying about doing things correctly."

The nursing simulations at CSB/SJU provide that extra piece of understanding that allows students to be successful with their future nursing endeavors. Students learn how to relate to patients and care for them beyond just administering care and aide. Carie wants her students to remember, "Their training is beyond performing tasks. Nursing is about more than putting in an IV."