Saturday, February 14, 2009

SIM... meltdown

It's 1730 you've just been dumped a Pt from PACU, whoever drops him off is talking nonsense and throwing report at you, like a deer in head lights you stand there, not asking the questions that are screaming in your head. The Pt is moaning from the bed he's in pain. You are the Primary Nurse, what do you do first? You can't read the chart, your Aide is standing around, your Secondary Nurse does not really speak English well. Primary Nurse starts to think, Ok delegate, "Secondary looks through the chart to see when last med was given." Secondary nurse begins to freak out over the discrepancy of the age of the pt while he looks for the MAR to find the order for pain meds. Of course he doesn't know how to read the MAR either.

Primary- " Get a set of vitals Aide please." She wanders the room lost. Primary Nurse greets the pt. Assesses his pain on a 0-10 scale, he's talking, then snoring. He is in pain a 46 he says. What does the Primary Nurse do next? She has no idea. Finally trying to gather her thoughts and be assertive she forcefully tells freaking out Secondary Nurse to " Call the Charge Nurse and get the info and check to see if we have the right chart and pt info before we worry about the meds. Secondary Nurse who is locked on the one point calls the Charge but as yet has even looked once at the Pt or the pt ID band.

Charge comes in and we get to the bottom of it, we check the band, it matches the chart, So at least we have his info, but Secondary Nurse is still freaking about the age! So Primary let's the Charge Deal with it and starts to assess the VS, that are still not done. BP 120/72, the AIDE is still standing around looking blank and had no idea what she was doing or how to read the machines. Can't blame her, non of had seen this thing before, but Primary knows enough to look at the computer screen for the data. Sheesh! As we are finally getting through the orders and trying to put on the O2, when Primary noticed the O2 was at 90% and the orders stated keep O2 above 93%, Primary knows she has to assess the pt, but can't for the life of her think of where to begin, and wonders what the hell the cranial nerves have to do with assessment at this point?

"That's enough come on in guys to debrief." the instructors say.

Good news is that all the groups were the same and it turns out that this scenario was for 3rd Block of the RN program, but overall we started to think like nurses by the end, or at least some of us did. So after being scared, sad, pissed, then laughing hysterically we all realized.... "That was fun let's do it again! "


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