Racing hearts? You bet. Bodily fluids? Sometimes. Sweaty palms? Always.
Linfield College alumni are helping strengthen the nursing workforce by creating real-world simulations for students.
Ten-year-old Dominic lies in a hospital bed. He’s scared, feverish and moaning with appendicitis. His mom sits close by, a hand on his arm, waiting to hear about surgery. The one comfort they have is nursing major Teighlor Glavin ’18, who fields their questions as she looks over Dominic’s chart.
Then a piercing alarm from the intravenous-drip machine ratchets up the tension.
A few feet away behind two-way glass, Keondra Rustan, visiting assistant professor, makes notes on a checklist. When Glavin calls the charge nurse to stop the alarm, Rustan answers. Later, when Glavin dials a doctor to verify medication dosage, Rustan answers again, this time using a different voice and persona.
The scenario is simulated – Dominic is a manikin and his mother is volunteer actor Molly Mattick ’16 – but the stress and the education in the Linfield College Nursing Simulation (SIM) Lab is real.
“I learn the most from the reflection afterward,” says Glavin, who quickly silenced the alarm, the result of air in an IV line. “When I’m in there, I know I’m being watched. It’s nerve-racking.”
Mattick, the volunteer, agrees. She remembers well the sweaty palms and anxiety from her student days.
“SIM lab gave us a safe space to make mistakes,” says Mattick, an intake and assessment nurse at Cedar Hills Hospital in southwest Portland. “Now practicing with confidence as an RN, I felt like I could offer positive and supportive feedback.”
Nursing schools have long used simulation labs to train students in stressful scenarios. They’ve become even more prevalent in recent years, as outside clinical sites become scarce because of a number of factors – the rise in nursing programs, lack of credentialed clinical faculty and drop in community partnerships.
The realistic settings are a critical aspect of nursing education, and no one understands that better than Linfield alumni, who like Mattick often volunteer as actors to help train the next generation.
The alumni program is the first of its kind – at Linfield and elsewhere. Program coordinator Rustan says she doesn’t know of a similar model anywhere else in the nation.
“Linfield is a community, and alumni are invested in the school after they graduate,” she says. “It makes a big difference to the students to work with actors who are nurses. It wasn’t that long ago that they were in the students’ shoes.”
An alumnus might play a family member of the manikin, or sometimes act as a patient. Whatever the role, they tend to play it with gusto. Will Chow ’15, a nurse in the acute mental health unit at the Portland VA Medical Center, has acted the part of a concerned relative.
“Patient scenarios are much more believable with a real person participating in one of the roles,” he says. “I enjoyed practicing the various scenarios (as a student) and wanted to help current students.”
That personal aspect is important to students like Olivia Bannerot ’18, who says it’s easier to relate to a real person than a manikin because you can read facial expressions.
“My heart rate races as soon as I walk into the room,” she added. “But it’s a great way to practice without the fear of hurting a human.”
Linfield students have access to more than three dozen manikins, ranging from “low-fidelity” (think department store clothes models) to “high-fidelity,” which speak, contain bodily fluids, cough, vomit and generally are more human-like. Students take part in three trainings each semester, honing skills in time management and patient communications.
“False reassurances such as ‘you’ll be okay’ are the last thing patients want to hear,” Rustan says. “We might not be aware we’re saying things too casually or too formally to a patient.”
After the lab, students receive individualized evaluations and training, such as tips on using the IV pump. Alumni discuss the care they received and how it relates to a real-world scenario.
Rustan sees enormous change in students after simulations, including increased confidence and more purposeful thinking.
“They start out calling for their charge nurse a lot, but as they progress, they call less and less,” Rustan says. “They become professionals.”
Back in the SIM lab, Glavin, the nursing student, is concluding her shift. But first, she fluffs an extra pillow and tucks it under Dominic to help him rest. Mattock, playing the role of his mother, thanks her for the simple act of kindness.
– Laura Davis
