Airline pilot Chesley Sullenberger successfully landed an airplane on the Hudson River near Manhattan in 2009 after a flock of geese ran into the engines midair, disabling the plane. All the passengers and crew survived.
“Afterwards, he was proclaimed a hero and he said, ‘No, I did what I trained to do,’” said simulation and skills lab coordinator Kim Baily. “’I’ve practiced this in the sim lab a hundred times.’”
Kim Baily, who chairs the Southern California Simulation Collaborative and has been in nursing education for over 20 years, spearheaded the new Health Sciences sim lab that was unveiled at the Community Education Center on Monday, Nov. 9.
The lab, which included a $150,000 remodel and three new state-of-the-art simulation mannequins, is designed to help nursing students practice working with patients in different scenarios—creating a realistic atmosphere with no risk to real patients.
The Health Sciences also has a skills lab area where students learn simple procedures like starting IVs, measuring blood pressure, wound care and how to swaddle a baby. The idea is to perfect procedures in the skills lab and bring those skills to the simulation lab to put them into practice.
“They cannot come into the sim lab until they know the skills,” said Baily. “We are not teaching skills in the sim lab, we are putting all the pieces together.”
Baily said that simulation plays an integral role in training nursing and medical students because it forces them to adapt to different situations and think on their feet.
“We don’t need to spend this kind of money or have this kind of space to teach you how to give an injection,” said Baily. “We do need to have a space like this where we’ll walk in and a patient will say, ‘I’m allergic to that,’or ‘I had that injection’ or to interact with the patient—because students are so tunnel-visioned about their skill that they forget that there is a patient there.”
Scarlet Nestor, a 4th semester nursing student set to graduate in December, said that the scenarios that they train for are a completely different ball game when they are let loose in the sim lab, which looks strikingly similar to a hospital room with beds, monitors that display patient’s vital signs and even little details like a box of latex gloves on the wall.
“As soon as you walk through that door, everything that you had planned is gone,” said Nestor.
The mannequins, which include a pregnant mother with the ability to simulate birth, really bring the experience to the next level as they are designed to interact with students through speech, movements and fluctuating vitals.
“They’ve actually come a long way since first semester,” said 3rd semester nursing student Molly Shea. “They can pretty much do everything but sweat. They can talk to us and then their vitals can just drop—so it’s going to put you on the spot.”
Baily has created twenty odd scenarios, from postpartum hemorrhaging to asthma attacks, to keep students using critical thinking skills to solve problems as efficiently as possible. The class is first pre-briefed on the information and then they have to facilitate a course of action for that case study. While a few students take the lead in the simulation lab, the rest of the class sits in the debriefing room where they can view the scenario from behind mirrored glass.
“It’s a very different skillset than answering a multiple choice question,” said Baily. “And sometimes when the students go in there, they have to explain to the patient what this tube is or what that is and they have difficulty doing that because they can’t use the right language—simple language.”
Baily joined PCC only a few short years ago and has transformed the nursing program significantly by really pushing for more simulation training.
“Dr. Baily has really advanced this program. In the beginning, we’d just have tape and she’d be like, ‘this is the wall and don’t walk across the wall’ and now there is actually a room,” said Jennifer Gaunt, who is in her 3rd semester of the registered nursing program. “We were first semester, she started here at the same time and evolved the program so much and so fast that it’s amazing to me—I’ve always respected her for that.”
Baily said that simulation is being used in hospital more and more to screen new applicants, but to also train staff to work efficiently as a team. She has seen teams fall a part in critical moments because they didn’t communicate clearly.
“Three people run to get the IV and nobody will do the chest compressions, I’ve seen that happen,” said Baily.
The lab remodel was funded by the capital outlay fund and executive director of facilities Rueben Smith facilitated the labor, using in-house staff. It was designed based on the International Nursing Association of Simulation standards.
Baily said that case studies have shown that, when done effectively, simulation is as effective as bedside nursing experience—which is field experience that students in the registered nursing program also get in addition to their simulation exercises.
“It has to be done well and it has to be done right otherwise it doesn’t count for anything,” said Baily. “Just like Sully in the airplane, it becomes automatic. We welcome the mistakes because that’s a learning experience.”