Monthly Archives: May 2014

Simulation in Nursing at MMU a Student Eye View

The Strangest Clinical Skills Session So Far
by Matthew Daniel-Short

There is a scene at the beginning of the film ‘8 Mile’ (2002) in which Eminem’s character Jimmy ‘B-Rabbit’ Smith participates in a rap battle at a local open mic show. It has taken Jimmy up until this point to gather the courage to get up on stage and compete, and he has been preparing for this night for a number of weeks, writing and re-writing lyrics in a notepad every day as he sits alone at the back of the bus on his way to work at the metal stamping factory, carefully choosing his outfit, practising his performance in front of the mirror; it’s like his whole life has been building up to this perfect moment, this chance to begin to break away from the trailer park he lives in, this opportunity to prove himself. A coin toss determines that his competitor Li’l Tic will rap first, and Jimmy waits patiently throughout Tic’s opening verse, gathering his thoughts, preparing to unleash his greatest freestyle. Now the master of ceremonies introduces our hero to the crowd as music plays loudly over the venue’s PA system, and an expectant hush falls over the audience. Jimmy ‘B-Rabbit’ raises the microphone to his mouth but no words will come out; he relaxes his arm, lets the mic fall by his waist, and then lifts it again, hoping that this time his voice won’t betray him, that the butterflies in his stomach will stop fluttering just long enough for him to do what he came to do, but they don’t, and they’re not butterflies, they’re his dinner and they’re not staying down there any longer. Jimmy drops the microphone and runs off the stage with the boos of the completely unimpressed audience echoing down the corridor behind him. Vomit. Disappointment. Defeat.

If today’s trauma simulation had been performed not in the skills labs at Elizabeth Gaskell but rather on stage at some Detroit hip-hop club, I would have fully expected the crowd to boo me off the stage. Like Jimmy ‘B-Rabbit’ I tried to prepare as best I could beforehand, reading up on different roles in the trauma team, looking at trauma management, I even sat at the back of the bus like Eminem but instead of writing lyrics in my notebook I was imagining myself in each of the various trauma team roles (my thinking being that while none of the of the roles gave me cause for concern, I believed that if I played out every possible scenario and eventuality in my head before doing the simulation then it’d be impossible to get surprised or unsettled once the session actually started). I wouldn’t normally contemplate at such great length about something which is essentially just a fun learning activity at university but ever since the Tony scenario at the beginning of year 2 when I told my little boy about Meti-Man, he’s kind of had this idea of a friendly android who lives at my university (a sort of chronically ill C-3PO I suppose) and as I left the house this morning I told him that Meti-Man had been in a bad accident and I had to go to university to save him. So the pressure was really on. I basically knew what we had to do in terms of interventions and looking after Neil/Meti-Man and his human relatives, and I think I was ready to go in and do my Gordon Ramsey thing if it all went pear shaped in the agricultural vernacular, but when I picked my role ticket and it said ‘Transfer Nurse’ on it I was a bit thrown because that was the one job, straightforward as it is, that I hadn’t given any consideration to. Nonetheless I thought it best to get stuck in and help my colleagues in any way I could, it was comparable to being on placement where I tend to defer to my mentor/leader and be proactive but only to the extent whereby my proactivity does not present any degree of life-threatening risk. My moment to shine came when the radiographer phoned up for my handover, and it was only at this point that I realised I might have been a bit nervous, because while I had been paying attention to the medications administered, I couldn’t make sense of them as they appeared on the page in front of me and I became quite confused by what I thought was the Roman numeral for the number 4 between the word ‘Morphine’ and the given dose (I realised on the way home that it said I.V.) and I kind of stammered through the rest of the handover. Which is shameful given that I’ve written at least two essays on the effects of poor communication. This aside, I did enjoy the activity and I was impressed by each and every member of my team; normally I might append this by saying ‘especially so-and-so’ and ‘not forgetting the wonderful whomsoever’ but there is no point as each and every one of them was great and equally deserving of praise. It is to them that I dedicate this video.

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Clinical Simulation in Nursing at MMU

Clinical Simulation Video Click Here

This is a link to a video of our some of our students in our simulation lab practicing their team working skills. The scenario is a man called Neil James who is a motorcyclist and is in a collision with a drunk driver. He has sustained multiple injuries and the students have to work in the roles assigned to them to assess him on admission. They then have to identify the priorities and manage the situation as it occurs. Neil’s wife arrives part way through (actor) and the student assigned to be the relatives nurse has to think quickly in terms of the information provided. Neil’s condition initially stabilises and then deteriorates as his head injury becomes a priority. The students all worked well together although some groups were much more cohesive than others. Once the scenario is complete the students have a debrief and then are asked to reflect on their experiences after the event and to post their thoughts and feelings on the discussion board on Moodle.

Some of the reflections posted this time were amazing and really demonstrated the value of this kind of approach in facilitating learning and developing skills and understanding. Students from one of our cohorts posted:

“This skills session surprisingly didn’t really knock my belief in my ability to carry out these skills to much but showed the importance, in a practical way, of team work, experience, knowledge and communication, and how effective a team can work together when all these things come together. We are still learning, gaining our knowledge and with experience and opportunity we will become ‘slick’ and life savers in the years to come” (Nursing Student 1)

“The scenario gave insight to the importance of team work and how each member of the team has an important role to play.  I think we worked well as a team, communication and support was good within the group.  The learning experience was positive with both lecturers sharing their skills to guide us through the process. Knowledge and skills will continue to develop as we become more experienced and I will continue to reflect upon my actions and attitudes to the different situations that arise in providing patient focused care” (Nursing Student 2)

“On a personal level, I am so glad for the preparation we were given in the lectures prior to this scenario, the ‘resuscitation’ app (which I have become addicted to), the directed study (in particular the Camp Bastion video) but also for the independent reading I’ve done as part of this unit. Being put in a realistic scenario really ties everything together, highlights our strengths and allows us to reflect and build upon our weaknesses” (Nursing Student 3) 

As a department we continue to develop our skills in simulation and in moving to our new building in August are looking forward to the potential of developing our experience and capability further. Look out for more posts in relation to our student’s reflections on the experience and benefits of simulated learning in nursing.