Nursing News:
Torrance, CA hospital offers nurse training in a different vein

That ³person² may act and look like a real patient, but itıs really a state-of-the-art medical mannequin used to provide hands-on learning for South Bay nurses.
By LEE PETERSON, Daily Breeze
On her first attempt to put the needle into the vein, the nurse missed. When she went in again, the patient expressed his dissatisfaction. ³Go away,² he said clearly. But as the red stuff finally started to flow into the needle, the patient relaxed. This is one patient who will let you know when heıs not feeling well. In fact, heıs programmed like that. The patient is a state-of-the-art medical mannequin. With simulated blood flowing through his veins, self-sealing skin that can take thousands of needle punctures, a chest that rises with each breath and a large repertoire of moans, groans and expressions of misery, this is about as real as a robot-patient could be. The ³SimMan² is one of a family of six mannequin patients, including an infant, whose persistent diseases, heart attacks, wounds and even pregnancies are putting nurses and nursing students through their paces at the George W. and Virginia Schneider Institute for Nursing at Little Company of Mary Hospital in Torrance. ³This is the new generation of health-care education,² said Jane Kleinman, Little Company of Mary project specialist for the Schneider Institute.
The interactive, high-tech mannequins are among the training resources at the nursing skills center, which recently opened up shop in a simulated ward on the Torrance hospitalıs first floor. In addition to the Little Company nurses who will receive training at the center, both new grads and veterans, the facility was also built to accommodate student nurses from El Camino College. The agreement with Little Company will allow El Camino to graduate an additional 24 students per year at a time when hospitals are coping with a long-term nursing shortage as they try to meet new minimum staffing laws in California.
Thereıs no guarantee that when those students graduate they will sign up to work for Little Company, but they might. And, either way, it provides more nurses for the work force in general. With the robotic patients and other tools, the nursing lab aims to provide students and nurses with simulations so real that nurses increase their confidence and competence as they learn to handle a variety of medical crises. The nursing skills centerıs star patients range in cost from $6,500 for a basic model to $35,000 for the most sophisticated SimMan, and are among only 50 currently in use in the state. The goal with the mannequins, or ³smarties² as the staff calls them, is to create a simulation environment akin to how a pilot is trained by using a flight simulator, Kleinman said.
³They throw everything at him so heıs prepared for anything,² Kleinman said. With interchangeable torsos and other body parts, the mannequins can be changed from male to female, they can give birth, they can vomit, and they can be outfitted with wounds, gangrene and amputations. They will tell a nurse who is having trouble hitting a vein to ³go away.² The mannequins can do everything but get up and leave. The trainees use real equipment kept in real equipment cabinets, so they learn how to find and use exactly what they need when dressing a wound, starting an IV or inserting a catheter. An instructor can use a laptop computer or a remote control, and change the patientıs condition on the fly. The trainee must then determine how to respond.
The leader can change the patientıs oxygen stats, reflecting that heıs not getting enough oxygen in his blood, and the monitorıs healthy beep will slow. Nurses must assess how to restore proper breathing quickly. If they fail to adequately respond, by putting in a tube or using a bag and mask, the oxygen saturation situation will only get worse.
That interactivity motivates trainees. ³It makes you try your best,² said clinical educator Claudette Dorsey. If the student responds properly to the oxygen problem, the instructor will make the stats go back up. The crisis scenarios can run off the instructorıs commands or from a programmed scenario. At the end of the exercise, there is a computer printout on the robotıs symptoms and the nurseıs actions, as well as videotape to review.
The SimMan mannequin is as big and heavy as a man, and will verbalize discomfort. ³The big goal is to suspend disbelief and make it as realistic as possible,² Kleinman said. Belief is suspended so well that although itıs possible to make the robot-patient die, thatıs an option thatıs only rarely used. It can take too much of an emotional toll on the trainee. Little Company received the smarties in February, and began using them right away at a facility that was being phased out. This month, the smarties were transferred to the new nursing skills center at the main hospital. Little Company is using them to train the students, and new nursing graduates. Veteran nurses are using them to learn new skills, for example if a labor-delivery nurse wants to transfer to the emergency department. The units can be used to train doctors, medics and nurses. Around the country, the military is the biggest customer so far for Laerdal Medical Corp., the company that makes the SimMan. Nurse training centers are second.