Practice Makes Perfect: Sim Center Builds Skills for Success.

Date: 12/20/2018

Rebecca (Becca) Parent, RN, checked on Robert, her pneumonia patient. Immediately, she’s faced with one of the scariest situations a new nurse will ever experience: Robert has stopped breathing.

Becca called a code blue, and suddenly, four others rush into the room. Becca, a Northern Light Eastern Maine Medical Center nurse on Grant 6, started chest compressions. Ryan Bergeron, RN, an Inpatient Rehabilitation nurse, fitted a bag valve mask over Robert’s mouth for ventilation. Amber Anderson, RN, a Pavilion 6 Cardiac nurse, prepared the defibrillator. The team backs away as the equipment beeps and its robotic voice calling out, “Shock advised. Do not touch the patient.” Seconds later, the team resumed CPR, to save Robert’s life.

Fortunately, the team didn’t lose a patient that day. In fact, Robert isn’t a real patient. He is a simulated patient represented by a mannequin in the Medical Center’s new Sim Center, a sophisticated training center which opened at Northern Light Eastern Maine Medical Center in September. The Sim Center includes five simulation rooms accompanied by five debrief rooms, which allows multiple trainings to occur simultaneously.

SS3.jpgThe mannequin is one of four in the Sim Center’s “family” which includes an adult male, an obstetrics/gynecology female patient, an infant, and pediatric mannequins. The computer-controlled, high fidelity mannequins are lifelike stand-ins for patients. Their lips move, their eyes blink, their lungs stretch and expand just like human lungs. Clinical staff and students can even obtain lab samples. Each has a measurable heart rate, oxygen level and blood pressure, and they can replicate cardiac arrest, pneumonia, trauma, and other scenarios.

Clinical staff throughout the Northern Light Health system benefit from the Sim Center, including first-year nurses enrolled in Northern Light Eastern Maine Medical Center’s Nurse Residency Program, a learning experience that helps graduate nurses transition from the classroom to clinical practice. In the Sim Center, they practice the basics and hone the specialized skills they need to handle any situation.

“As new grads, if we haven’t been put in these situations before. This training helps make us become more familiar with them so when they happen to us in the real world, we’ll know what to do,” said Amber. “Educational opportunities like this just make us more well-rounded nurses. We’re more prepared and competent, and ready to react.”

While the hands-on experience with the mannequin is valuable, the learning goes far beyond what’s happening in the simulation room. While one nurse interacts with the mannequin, others can watch and listen in real-time on a screen in a debrief room. After the ten to twenty-minute simulation is complete, the group talks through the scenario in detail with an educator. Everyone is expected to provide input.

“We discuss what happened, why they made the decisions that were made, and whether they would make them again if they were faced with the same situation,” said Steve Babin, RN, simulation specialist at Northern Light Eastern Maine Medical Center. “It’s really about the critical thinking and clinical reasoning that you can get from having the whole experience.”

SS4.jpgTraining in the Sim Center is included in orientation plans and entire departments are taking advantage of the opportunity to train together. Medical students from the University of New England who complete their clinical rotations at the hospital can stop by the lab to work on specific skills they’re finding to be a challenge, such as starting an IV or passing a Foley catheter. Family practice residents hone their skills as new physicians who will work in community hospitals with patients across the life span with a variety of complex medical conditions.

Northern Light Acadia Hospital nurses are also training in the Sim Center, and there are plans to include staff from other Northern Light hospitals in coming months. It has also become a resource for the community, including Eastern Maine Community College and University of Maine students. In the future, the Sim Center could be used to train fire departments, police departments, and emergency medical personnel.

While it’s too soon to fully measure how the Sim Center is improving patient care, the simulation specialists and clinical educators who work in the lab believe it’s already making a difference.

“Just performing CPR, we’ve been able to look at decreasing the time it takes to shock people who need it,” added Steve. “We’ve looked at the rate of compressions and how fast we provide breaths for patients. We’re seeing that translate into better statistics when we review our codes.”

The lab has gotten rave reviews from staff, who are often nervous when they first begin simulation, but quickly become comfortable once they realize that it’s an educational experience, not a test. Participants often want to come back for more training because they recognize how simulation prepares them to thrive in any situation.

“It is the preparedness to manage difficult clinical situations that gives learners the competency and skills to perform in the live situation at the bedside,” said Sandy Benton, manager of Clinical Education at Northern Light Eastern Maine Medical Center.

Nurse resident Denise Daniel, RN, Grant 5, agrees. “It’s really scary when it’s happening in real time,” she said. “Somebody’s life is in the balance. Each time we do simulation, it gets easier. You just keep getting better at it.”