Univ. of Delaware gives nursing students hands-on training | Delaware News

By RACHEL SAWICKI, Delaware State News

NEWARK, Del. (AP) – Sophia Ciniglia walks into a post-surgery patient’s room and takes a deep breath. His patient has a tracheotomy and can’t speak. Ms. Ciniglia hands him a whiteboard and an EXPO marker and asks him to write down his name and date of birth. She then asks the patient to list their pain on a scale of 1 to 10. The patient writes the number four.

Ms. Ciniglia administers antibiotics, medications and monitors her patient’s vital signs. She listens to the patient’s lungs with her stethoscope and hears “crackling”, indicating that the tracheostomy tube needed to be suctioned to clear the secretions.

Ms. Ciniglia completes the procedure and meets her classmates outside the room and heads down the hall to a classroom for a debrief. Overall, her teacher and classmates said she was doing very well, but listed a few mistakes like breaking sterility and giving the patient breaks between suctions. These mistakes, though minor compared to other things, have no chance of harming her patient, as she is an actress. The lungs Ms. Ciniglia listened to are fully simulated technology inside a vest, and the IV in her patient’s arm wasn’t really connected to her bloodstream.

Heiddy DiGregorio, director of simulation and interprofessional education at the University of Delaware, said the university’s bachelor of science in nursing program and master’s program and advanced practice registered nurse certificate program are accredited by the Commission on Collegiate Nursing Education. Additionally, the Center for Simulation Innovation, Interdisciplinary Education and Entrepreneurship in the School of Nursing is one of 230 programs worldwide to be fully accredited in teaching/education by the Society for Simulation in Healthcare.

political cartoons

The University of Delaware is also one of only five schools in the nation to adopt a ratio of two clinic hours to simulation hour. There is little research comparing simulations to clinics, but a study by Clinical Simulation in Nursing determined that the intensity and effectiveness of simulation was demonstrated by performing more activities at higher levels of Miller’s pyramid, an assessment that provides a framework for clinical evaluation. proficiency in medical education, in much less time than clinical. Basically, students who practice simulation can learn skills twice as fast as students in real clinic.

“Honestly, I couldn’t imagine going straight to the hospital and working on a real person for the first time without practicing,” Ms Ciniglia said. “Being in the simulation and all the labs we’ve done in the years leading up to that has given us so much experience and more confidence than going straight to a real person. You take on more of the little things doing like that, then the patient can come and tell you how he thinks you did.

She added that going straight to a hospital and opening up to a real patient is intimidating, but simulations aren’t as pressing and can give her time to think clearly and calmly about her next steps. Ms. Ciniglia can practice her skills over and over again until she is confident enough to do it for real.

The March 17 simulation was the first time Ms. Ciniglia had to deal with a non-verbal patient. Because she had the chance to practice the script, she said now she would feel much more comfortable communicating with a real, non-verbal patient.

Dr. Elizabeth Speakman, chief nursing administrator at the UD School of Nursing, said the simulations give students the opportunity to practice their skills in low-frequency situations — things that happen very rarely in the classroom. hospital – but can be devastating. Simulation reduces these errors exponentially.

“When I think back to my own nursing training, we had a dummy, which was not movable, not bendable and everything was simulated,” she said. “It’s hard to translate when you walk into a patient’s room. So our state-of-the-art equipment can truly mimic the clinical environment. There were a lot of things that I never had when I was in nursing school.

Dr Speakman noted that nursing turnover has been on the rise for more than a decade and the pandemic has only exacerbated it, drawing public attention to the crisis.

“Nurses were asked to make certain decisions about going in and not seeing their family members because if they were taking care of the patients, they couldn’t go home,” she said. . “There are nurses who have died from COVID. Nurses will be challenged and challenged in ways they never imagined when thinking about their nursing career. But what he’s done, and what we’re seeing from our nursing students who have just been amazing during the pandemic, is they want to step up. So I think that highlighted the value of nurses and had a positive impact.

Dr. Joanne Thomas, a simulation lab instructor, was a cardiovascular intensive care unit nurse for more than 20 years at Christiana Hospital before coming to teach at UD eight years ago. She was also chosen for a one-year simulation leadership program through the National League of Nursing. As the students perform their simulation, Dr. Thomas observes them from behind the one-way glass of a control room. There are cameras in each room to observe the students closely as well.

Dr. Thomas said there are four basic safety procedures that students must perform in every simulation.

“They should identify their patient, introduce themselves, maintain hand hygiene and always wear gloves,” she said. “They should also get a full set of vital signs. But sometimes they get so nervous that they take the pulse but forget to count the breaths or put the pulse. They always usually leave one.

Other things on the checklist are skill-based, like listening to breath sounds and how to tend to the bed. Although the students don’t perform procedures on real patients, Dr. Thomas said many students broke down in tears before their simulation. High pressure situations are subjective, but Dr. Thomas wants his students to “fall forward.”

“We usually have to put them aside and just ask them what’s bothering them,” she said. “Sometimes it’s because they’re not comfortable with a skill they know they need to perform. Sometimes they didn’t prepare well. Many students would consider this pressure high because they just learned these skills (two days ago). »

Ben Korleski, a senior nursing major, is a teacher’s assistant for the class. He took the course himself last year and said the simulations were the highlight of his academics.

“It’s a controlled environment, it’s safe, and you can really do anything with it,” Korleski said.

“You can practice giving one medicine that day, another medicine the next day. In the hospital, you don’t have that opportunity because each patient gets their own medicine, unique to them, and you would just have to wait for another patient to meet the expectations of what you would learn here.

The simulated experiences in the classroom that current students go through are exactly the same ones Mr. Korleski learned about when he took the class last year. He said there were sometimes “hiccups” in the scripts, reflecting the real world, but giving students hints would do more harm than good. Giving them the opportunity to make mistakes and learn from them is the most effective way for students to learn.

“I try to use my experience and give them useful information,” he said. “I won’t tell them exactly what to do because it will break the integrity of the simulation, but I will tell them to breathe deeply, trust your skills, and don’t worry because it’s in a Safe Environment. “

Copyright 2022 The Associated press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Comments are closed.