Kokomo Tribune; Kokomo, Indiana

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October 15, 2012

Simulation lab prepares IUK students for real-life situations

Janie Woods trembled uncontrollably, sweat through her bed sheets and threw up on her nurses at Indiana University Kokomo as the mannequin battled alcohol withdrawal following knee surgery.

“I didn’t eat anything for breakfast because I threw up two times before you ladies walked in,” an IU Kokomo professor made the mannequin say.

Nursing students Heather Fakhouri and Miranda Pearson went into a hospital room to check Woods’ vital signs after surgery. The new symptoms came as a surprise.

“I knew right away she was having withdrawals,” Fakhouri said. “She was sweaty. That’s a huge sign of alcohol withdrawals.”

The mannequin’s withdrawals were part of an exercise last week at IU Kokomo’s nursing simulation lab.

The $1 million lab gives nursing students a chance to experience the hospital environment and its accompanying chaos without worrying about whether patients will pull through.

Attached to computer control rooms with observation mirrors, four mock hospital suites mimic real-life scenarios nurses encounter in hospitals.

While students treat their mannequin patients, instructors watch from control rooms, grading the students on their performance.

Recently, a class learning about psychiatric patients was surprised to find they were dealing with one in the simulation lab.

Students went in to administer medicines and a flu shot to the patient and check on her after her surgery. She was exhibiting some unusual symptoms, though.

“They have to figure out that she’s going through withdrawals,” professor Lizann Atkin said. “Then they determine how severe the withdrawal is.”

The students should know to conduct a psychiatric evaluation, Atkin said.

Some students missed it altogether, though. They went through the entire lab without recognizing the cause of Woods’ symptoms.

The first-year students come in with a plan of action and often have a hard time adjusting when a patient throws them for a loop, said Stephanie Pratt, acting director of the simulation lab.

“They have to start making choices about the patient,” she said.

Fakhouri solved the puzzle, but the lab wasn’t easy, she said.

By the end, her scrubs were soaked in sweat.

“It’s nerve-racking, not because we don’t know what to do, but because you never know how the patient is going to react,” Fakhouri said.

And Woods was not a happy camper.

Pratt was speaking as the patient from the control room. She demanded medicine to help with her anxiety.

And Pratt made the mannequin vomit multiple times.

Fakhouri counted. It was at least five times, she said with a laugh.

Pratt later asked the nurses if they were insinuating she had a drinking problem and insisted she only had a glass of wine with dinner.

The patient’s constant barrage of questions and comments makes it harder for the nursing students to focus, Pratt said.

It’s a good test because that’s what they will deal with in real life, she said.

It can make students forget the small details, she said.

Fakhouri and Pearson were halfway through administering medicines to their patient when they realized they forgot to check the ID bracelet first to make sure they weren’t giving medication to the wrong person.

That cost them a couple points on the lab.

Pratt said one student forgot to put gloves on before holding a pan up for a patient to vomit in.

Those small things will become second-nature to the students as they advance through their degrees, Pratt said.

But the more advanced the classes get, the more challenging the labs become.

“On senior students, the patient codes, so they can practice giving CPR,” Pratt said. “In clinicals, we can’t control what happens. Students may never have a patient that codes.”

Upper-level students also have to treat two patients at once to learn about prioritizing care, and they also treat a mannequin that’s giving birth.

“That lady will bleed out,” Pratt said. “They’ll find blood in the bed with clots in it.”

Linda Wallace, dean of IU Kokomo’s nursing school, said the labs aren’t easy.

“They can be intimidating,” she said.

All students learn differently. Some like the hands-on lessons and some don’t, Wallace said.

Every student has to complete the labs, though, to pass the clinical classes.

“That’s what nursing is; it’s hands on,” Wallace said.

Pearson said she likes the simulations even if they are intense.

“I think they do a good job of preparing us for the real world,” Pearson said. “[The job] is unpredictable.”

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