It was Elmhurst College nursing student Adriana Grimaldi’s first trip in an ambulance. Her heart quickened with each moan from the patient, a young boy who had suffered severe injuries in a car accident. But she managed to steady her hands—and nerves—to insert an intravenous tube into the boy’s arm.
As the ambulance made its way from the Elmhurst College campus to Elmhurst Memorial Hospital, Grimaldi and two other Elmhurst College student nurses joined two Elmhurst Fire Department paramedics to monitor the boy’s vital signs. When his heart rate plummeted and his stomach began to bulge, the team concluded—correctly—that the patient was bleeding internally, and added a second IV. On arriving at the hospital, the team filled in the Emergency Department staff, which promptly took over his care.
For students like Grimaldi, the experience had been very realistic—even if it had not actually been real. “I was shaking at first,” said Grimaldi, a senior in the College’s Deicke Center for Nursing. “But the paramedics were very calm, so they helped me remain calm.”
The patient was not a real boy, but one of Elmhurst College’s lifelike robotic “Sim” patients; his symptoms and responses, while dramatic, were dictated by remote-control. The scenario was part of a series of intensive simulation exercises held on Tuesday, July 1, by the College’s Deicke Center for Nursing, in collaboration with the Elmhurst Fire Department and Elmhurst Memorial Hospital.
The exercises provided simulated learning for first responders, nursing students and hospital personnel. For the nursing students in particular, the simulations exposed them to the intense pressure of real-life medical emergencies, as well as how emergency workers handle those situations. Julie Hoff, associate professor in the Deicke Center for Nursing, said Tuesday's exercises reinforced the nursing department's emphasis on interdisciplinary education by allowing the students to experience a medical crisis from multiple perspectives.
The exercises also were a fitting way for Elmhurst’s Sim patients to make the move from campus to their new home, the Elmhurst College Simulation Center at Elmhurst Memorial Hospital. Construction is nearly complete on the Simulation Center, a 4,600-square-foot laboratory and classroom space located in the hospital’s lower level. The result of an innovative collaboration between Elmhurst College and Elmhurst Memorial Healthcare, the Simulation Center is the only such center in the region to have been established through this kind of health care/higher education collaboration. Set to open next month, in time for the start of the new academic year, the facility will give students the opportunity to practice protocols and procedures, and run through the most intense medical scenarios, with no risk to patient health. Staff members at Elmhurst Memorial Hospital—and, potentially, first responders and other outside medical-service providers—also will be able to use the Simulation Center for additional training and professional development.
The July 1 simulation experiences were a perfect introduction to the kind of cutting-edge, interdisciplinary health care education the new Simulation Center and its resident Sim patients will offer.
In the first exercise, Elmhurst firefighters and paramedics were called to the Elmhurst College campus, where they found a car that had been involved in a serious accident. Using the Jaws of Life to peel off the roof of the car, firefighters freed a Sim “father” and “son” from the vehicle and placed them in the ambulance. Actors portraying family members also were on the scene, pleading with firefighters who politely asked them to step away and let them work.
In the ambulance, the student nurses and paramedics continued to assess their patients, whose actions and fate were controlled via laptop computer by Simulation Center Director Laury Westbury. The father, it was determined, had no pulse and had died at the scene. The team turned its attention to the boy. At Elmhurst Memorial Hospital, registered nurses met the ambulance and took over the care of the Sim boy while asking for input from the nursing students and paramedics.
“Where’s my daddy? Where’s my daddy?” cried the boy (voiced by Westbury from behind an emergency room curtain). During a debriefing session after the simulation scenario, the nursing students said the boy’s question, all too likely to surface in a real emergency situation, stunned them.
“I really didn’t know what to say,” Grimaldi said. Westbury seized on the situation as a teaching moment, explaining that it’s best to focus on keeping the boy calm, and to simply say his father was being tended to by doctors and nurses.
Such debriefings, which will occur after each simulation once the new facility opens, are invaluable for the students to learn what they did right and wrong, Westbury said.
“This was realistic learning. They were thinking on their feet, and then reflecting on what they had done,” Westbury said. “Our ultimate goal is that it will all lead to patient safety.”
The second simulation exercise involved a 51-year-old woman (another Sim patient) in a wheelchair who began having chest pains, nausea and other symptoms after witnessing the car accident. While waiting for paramedics to arrive, student nurses questioned her about her pain, whether she had any allergies, and whether she had any family members they could call.
“This is definitely about the skills our nursing students and the first responders are developing, but it’s also about developing communication and teamwork in a medical crisis,” Westbury said.
Elmhurst Fire Chief Jeff Bacidore said the exercises were the first time his paramedics have trained with nursing students. As future nurses, the students may one day be on the phone with paramedics racing to the hospital.
“This is a great collaborative effort,” Bacidore said. “There needs to be an appreciation of what everybody’s job is, and for the nursing students to see and understand the stressful environment the paramedics are in.”
Collaborations are especially important at Elmhurst College, since the nursing program is not part of a larger allied health science department, Hoff said, adding that plans already are set for senior nursing students to accompany the Fire Department on some calls.
“This is going to be the impetus for a lot more collaborations,” she said. “It’s important that we’re creative in the ways we can expose our students to other disciplines.”