I’m actually not quite sure why it was called an adult simulation lab, considering there were two peds patients in the ICU as well. And I got one of them!
So, I’ll start from the beginning. I was in a group of ten J1s (including myself), and as soon as everyone showed up a clinical instructor came up to us and gave us our paperwork for the day. It included a health history, a report sheet, and an assessment sheet. On the back was “nurse’s notes” where we record our documentation for the things done during our shift.
We were then taken to the ER “triage” area to meet our patients and take their vitals signs and get their health history. My partner and I had a 4 year old little boy whose mother brought him into the ER due to a persistent fever and a cough. Because there were no young children brought in to act as actors in our simulation, we had to ask all of our questions to the mom and she had to give us all the pertinent information on our patient. It was fun! And then after we were finished with getting the vital signs and health history, we sat and talked to the “mom” – a current S2 about to graduate – about nursing school and her tips and tricks to make it through while we waited on the S1 students to make their rounds on the patients in triage.
The S1 students then came in, and made their rounds between the 5 patients in the ER triage. My partner and I were pretty quiet as each student came in and got their assessment information, unless they specifically asked us for information. Some of the S1s talked to us and got information from us, but most of them pretty much ignored us as they came in, asked a few questions, and then left again. So that kind of sucked…hopefully when I’m an S1 and doing this simulation again, I’ll be kind to the J1s. Of course, they were probably pretty nervous themselves, and they DID have a whole ton more work to do than we did, since they had to see each of the 5 patients and we were only assigned one.
Then we (the J1s) were released from the ER triage to go sit down and write out a quick care plan on our patient. My partner and I chose three nursing diagnoses that we felt were pertinent to our patient: risk for hyperthermia, risk for injury, and fluid volume deficit. We wrote out our rationales for why we chose those diagnoses, wrote out the nursing interventions for those diagnoses, and then wrote out what patient education we needed to give. In this case, we needed to give the patient education to the mom about what treatments were being given and why.
Afterward, we were ushered into the “ICU” for the next part of the simulation (we were taken into the high fidelity lab!) and we got report from the current J1s assigned to our patient. Once in the ICU, our poor little man seemed like he’d deteriorated. His blood pressure was super low, even with IV fluids hanging, and he was suspected as having meningitis, even though the lab results hadn’t come back yet. My partner and I did our full assessment on him, I talked to his mom a bit about what was going on and why were were running certain tests, and then a “doctor” came in and got pretty agitated with the S1s who were in there because they hadn’t given certain meds that needed to be given before a lumbar puncture. Woah!
So I went with an S1 to the Pyxis to get meds for the patient, but then we realized that one of the meds we were giving had no administration route specified. So we had to call the charge nurse to figure that out, and then the doctor came back and was demanding that someone give the meds that had been ordered over an hour ago so she could perform the lumbar puncture.
It was chaotic! At one point we had 9 people in one tiny little room, not including the mom and the patient themselves! But it was a great learning experience – especially to learn how to work with others on the healthcare team and how to be quick and proficient at completing orders. I felt like I didn’t do much though – the S1s had way more that they needed to do and I felt like I was just in the way most of the time. I didn’t even get to complete a dressing change on the boy’s wrist because by the time we realized that it needed to be changed, the “doctor” and her two “med students” had come back and were about to do the lumbar puncture. And then it was time for my partner and I to leave…where the heck had the time gone??
So we left the boy in the capable hands of the FOUR S1s that had ended up in the room somehow (lol!) and my partner and I went to our post-conference downstairs to talk to another instructor about what we liked, what we didn’t like, and if it was a good learning experience for us or not. We completed a questionnaire/survey, and then we were free to go! In all, we were there a little over 3.5 hours, but it went by SOOO fast. Insane! I can’t imagine what it’ll be like in a real ICU with more than 1 patient that I’m having to take care of…makes me excited to be in the ICU in upcoming semesters. 🙂
All in all I really enjoyed the experience, and I wish were had more of them in a semester! And I can’t wait until my S1 semester when I get to do that one over again, only as an S1!
Also…now it’s Saturday. You know what that means?? I only have one more pharm quiz, my HESI next week, and then FINALS the week after that and I’ll be DONE DONE DONE!!!