Fake Blood, Simulated Patients Generate Real Results for Nursing Students

[dropcap]C[/dropcap]ynthia Washburn remembers the first time she met “Mr. Gushman,” a patient of sorts who has lived and died many times under the care of Ball State nursing students.

Washburn was leading a student nursing team that was treating him for a massive hemorrhage when he suddenly went into cardiac arrest. The team quickly rolled in a crash cart, essentially a medical emergency response kit on wheels, and resuscitated him.

Next time, it could be post-operative complications, or maybe chronic obstructive pulmonary disease.

The students are used to this patient’s constant need for treatment of human maladies. That’s because “Mr. Gushman” isn’t human at all. He’s one of several robotic mannequins — “sim people” —  with simulated lungs, heartbeat and blood pressure that the School of Nursing uses to train its students for various medical situations.

“I’ve really enjoyed working on such scenarios as a nursing student,” said Washburn, a senior who plans to graduate in May with a bachelor’s degree in nursing. “We receive so much practice that it becomes second nature. When you do it over and over, it becomes automatic. If we didn’t have sim people, we wouldn’t have practiced and known the proper procedures. When someone has a cardiac arrest, you can’t just Google how to handle it.”

The mannequins, housed in the School of Nursing’s Simulation and Information Technology Center, simulate people in various medical situations, such as heart attacks, diabetics suffering from low blood sugar and women giving birth.

Simulated care leads to real jobs

The center, housed in Cooper Science Building, contains an 18-bed health care setting that buzzes with vital signs monitors and other hospital equipment. In their work during these simulations, students perform clinical procedures ranging from IV preparation to wound care and receive regular feedback. The center also has a four-bed obstetrical wing and an efficiency apartment used to simulate home health care.

The mannequins used by the School of Nursing have a variety of simulated organs and come in different shapes and sizes. Here, nursing students Tatyana Clark (left) and Maddie Cottrell use an infant mannequin to simulate taking a newborn’s measurements.

These simulations have become an important part of the students’ mastery of basic and advanced nursing skills, said Kay Hodson-Carlton, associate director of the School of Nursing and director of Simulation and Information Technology Center.

They also have helped make the program’s graduates highly sought after across the nation. More than 90 percent are employed after graduation. Feedback from employers indicates high satisfaction with their performance in clinical settings.

“When we started using sims back in the early 1970s, they were very basic systems,” Hodson-Carlton said. “By integrating the sims into increasingly sophisticated computerized management systems over the years, we’ve been able to increase the quality of health care education significantly.”

The simulated medical emergencies include touches to make the experience seem as real as possible. Among them, fake blood (and other human excretions), a patient’s voice that’s piped in through a speaker on the mannequin and portrayals of distraught family members by faculty and other staff.

Clinical laboratory specialists Becky Fights and Allison Ottinger create the imitation bodily substances, one of the key components in the medical simulations.

“Of course, we can’t give out our secrets, but there are ‘recipes’ for each different type of body fluid, based on the scenario,” Fights said. “Having body fluids for realistic-looking drainage on a bandage, gives the students a better experience in being able to assess the patient and respond to changes in the patient’s condition. It helps us give the students additional opportunities to develop and practice critical thinking, which is the ultimate goal of nursing simulations.”

Riley Buckles listens to the breathing of his “patient,” while fellow nursing student Nancy Contreras takes notes.

Fights and Ottinger, both graduates of the Ball State nursing program, work with faculty to set up each scenario. That includes coming up with fake names for simulated patients that allude to terminology in their field.

A case in point: The mannequin used for simulated treatment of low blood sugar, or hypoglycemia, in diabetics is named Dexter Adams. That’s a nod to dextrose, which can be used to treat the condition.

“The names are designed to reduce the tension” said Fights, who noted that “Mr. Gushman” is used to simulate hemorrhaging. “We want students to take this seriously, but we know that high stress levels can hinder comprehension. In the end, it’s about learning.”

Ready for real world

Jesus Salinas has learned a lot. The senior from Indianapolis said the simulations have exposed him to various medical emergencies and given him an appreciation for keeping calm when talking to distraught family members.

Just as important, they’ve also given him confidence in his ability to land a job in trauma care after his expected graduation in May.

“I really can’t imagine going into a hospital without learning about all this through these simulations,” Salinas said. “I feel that I am ready to handle the real world.”