Tuesday, July 16, 2013
Simulation center gives nurses an edge
In a quiet room, five nursing students examine a 60-year-old man in a hospital gown.
After they have taken his history, one listens to his lungs and heart with a stethoscope.
The sounds are audible to everyone in the room, and they don't sound very healthy. But when a student checks his feet for swelling, she finds none—until instructor Mary Benbenek produces a picture of swollen feet.
The man is no patient, but an actor trained to report symptoms of heart failure without volunteering too much. He plays his part well, but even an Olivier couldn't fake swollen feet.
The students, in the University of Minnesota's Doctor of Nursing Practice (DNP) program, are learning to become family nurse practitioners. The simulation with the actor is just one of many that give nursing students hands-on, worry-free practice in the School of Nursing's new Bentson Healthy Communities Innovation Center.
"This is the closest you'll get to a clinical setting without risk of hurting the patient or embarrassing yourself," says DNP student Vanessa Kruse. "And an actor gives you feedback that a real patient may not verbalize.
The Bentson Center is an inviting place for nursing students to work and study.
The center comprises a suite of rooms that simulate everything from homes and nursing homes to acute care and hospitals. In the above case, the heart and lung sounds were actual heart failure sounds that matched the "patient's" symptoms, played through a "ventriloscope."
The students also work with mannequins, which have the advantage that you can insert IV tubes and catheters, draw blood, and perform other procedures that nurses do every day. From the center's control room, every move can be observed and recorded, and mannequins can be controlled to simulate the patient's condition and responses.
The space has 38 remotely controlled video cameras and recorders so students can play back their performances and spot areas for improvement.
"Especially things like filler words and body language," notes Kruse. "This lets you see it."
Even though DNP students are already seasoned RNs, simulations are invaluable.
Calling all nurses
A 2010 report by the Institute of Medicine on the future of nursing calls for increasing the percentage of nurses with at least a baccalaureate degree from 50 to 80 and doubling the number of nurses with a doctoral degree by 2020 to respond to the nation's health care needs.
"We've been doing assessments on real patients, and I've done this for three years, but without help," says DNP student Janna Zwillaing. "I love the idea of being able to observe myself."
Continuum of care
With 11,000 square feet, the Bentson Center has enough space to expose students to what Mary Rowan, director of pre-licensure programs in the School of Nursing, calls "the continuum of care."
"[N]ursing care in the community and in home settings is increasingly important, and can be authentically simulated in the Bentson Center," she says.
Leading a visitor through the suite of rooms, she points out some of the simulated environments:
- A home with a kitchen and, in the family room, a large digital screen for practicing health care from a distance, using the center's telehealth technology.
- A room in an extended care facility. Its ceiling-mounted patient lift—not typically found in a nursing school—teaches safe operation of the equipment. Its state-of-the-art beds have built-in scales and mattresses that are softer near the foot to lessen pressure on heels, a source of dangerous bedsores. It even has a working, glass-walled bathroom for learning how to help patients use the facilities safely.
- A large ward room, where pre-licensure students use mannequins to learn basic nursing interventions like taking vitals signs and performing IV therapy
- An ICU simulation room, where students can practice managing a critically ill patient on a ventilator or requiring tracheal suction
The Bentson Center's name honors the Bentson Foundation's lead gift, of $3.7 million toward the $7.8 million project. The center began operations in January 2013 and serves nearly 900 undergraduate and graduate students.
Camaraderie in action
"Students just love coming in here," says Rowan. "It has elements like soft light, earth tones, and curved walls [like] the health care facilities being built today, designed to help people feel better emotionally, which helps them heal physically."
The center also brings together teams of professionals—nurses, physicians, pharmacists, physical and occupational therapists, oral health professionals—to simulate team care in, for instance, large-scale, complex situations like what a hospital may see after a disaster.
"Hospitals don't have the luxury of closing for a day to do this kind of training for their staff," says Tom Clancy, assistant dean for faculty practice, partnerships, and professional development. "We offer that here."
"The profession of nursing has changed in recent years, giving nurses broader and deeper responsibilities and opportunities to lead," says Connie White Delaney, dean of the School of Nursing. "The Bentson Center gives our students an edge and gives our school an opportunity to grow and provide a world-class nursing education."
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