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Simulation is every semester (damnit).  Lots of people love simulation and say it’s  “so fun.”  This has forced me to reexamine the definition of the word “fun” just to ensure it hasn’t changed recently:

A source of enjoyment, amusement, or pleasure.

If you don’t know me by now, then this may come as a surprise to you but… WTF, people?!  By this definition summer vacation is fun.  Watching your drunk idiot friend is fun.  Sex is fun.

Now that I have a definition to back up my claim, I will state:  Simulation is NOT FUN!

We had two simulations this semester, one for Adult I Health and one for Women’s Health.  I will briefly outline each one, give an example of the required paperwork, the expectations and why it was not fun.

Women’s Health

The dummy can actually "give birth"

The dummy mom gives birth to a dummy baby & the cycle of dummies never stops

  • Pre-sim assignment: includes questions like, what is SBAR, what assessment data do you collect on a woman who just came in with water broke, why use Pitocin, what to do if you see decels on the baby monitor, if baby is born not breathing what’s the first thing you do, describe APGAR, and how do you administer newborn meds.  These questions are answered plain and simple in a word doc and is due the night before simulation
  • Case Study: sometimes we’re given a case study before simulation and sometimes we get it the day of.  Here’s an example: OB Sim Case Study.
  • Day of: in groups of 5/6, you enter the simulation lab and review the paperwork (case study, lab work, doctor’s notes, medical file on the “patient” etc.)  Each person is given a role (documentation nurse, charge nurse, assessment nurse, etc.)  And then simulation starts.  It’s always a little different but for instance, I was documentation nurse and had to call the “hospital” from the “clinic” to tell them I was sending them a woman in labor.  Then we’re in the “hospital” and the woman is complaining of pain, pressure, you look at the monitor to see how the baby is doing and then implement the appropriate interventions (for instance, late decels = turn position of mom).

Adult I

Nursing-Sim-111711PF21-resized

  • Pre-sim assignment: we had three for Adult I (diabetes, CHF, and dementia).  An example of the pre-clinical questions is here:  Adult I Pre Sim Work.
  • Day of:  again, we broke up into about 10 students and rotated through three rooms which had “patients” with diabetes, CHF and dementia.  It was different than Women’s in that there was an instructor in each room and they more walked/talked us through information versus throwing us into a pretend situation and saying “go!”

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  • Why it’s not fun:  I don’t find pretend situations helpful.  I understand the idea of “it’s a safe environment so mistakes don’t cost a life” but in all honesty, you have to be entirely checked out mentally to make a mistake in the hospital that actually kills a patient instantly.  More importantly, I have not found that simulation has made me feel more competent as a nurse.  I don’t leave clinical thinking, “whoa, so glad I did simulation b/c if I hadn’t, I would have totally done that wrong.”  If I’m going to make a mistake, it’s because humans do that; simulation doesn’t change that fact.  I also find that breaking up one nurse’s role (documentation, assessment, etc.) is not how real life works.  One nurse does everything; you don’t break up responsibilities for one patient among 6 nurses.  That creates MORE problems and MORE confusion.

I’m not the only one who hates it:

thumbsdown-gladiator

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