Reflections of Nursing Students Involved in a Simulated “Very Bad Day”
Introduction
This article describes a simulated activity in which nursing students participated in a 2-hr delegation and priority setting experience. The simulation centered on a nurse caring for four patients with a variety of needs. Nursing students acted in the role of a patient and/or a family member, an on-coming nurse, an off-going nurse, or a patient care technician (PCT). The patient or family member had a script that delineated dialogue and a time frame to call the nurse. In addition, the off-going nurse and the PCT could assist the student who played the role of the primary nurse. The on-coming nurse was responsible for delegating and managing the care for these scripted patients. The scenario involved four patients in pain, one who fell, as well as a patient needing a blood transfusion. At the end of the simulation, the students were asked to debrief about the experience. Overwhelmingly, the students felt that that this was a “very bad day.” They noted that they had no idea so many things could happen during a shift, and they realized that it was very important for them to develop an organizational plan and method to manage their time. This simulation allowed for a safe environment in which students could experience the difficulties of caring for multiple patients and also allowed for expression of their feelings.
Section snippets
Background
One of the concerns with new nursing graduates is that they often are not exposed to making critical nursing decisions. They do not get the opportunity to delegate and prioritize to manage their time effectively. The instructor and clinical staff often protect students. Students are told what medications to give and when to give them. The critical decisions may be discussed, but the student does not make the decision. Nursing graduates are often underprepared to practice in the fast-paced,
Simulation
We wrote four patient scenarios involving multiple problems for the simulation experience. A patient description and a timed activity were contrived for each scenario. The nursing students who chose the patient or family roles were told to follow the script, watch the time, and use the call light system to call for their needs. The simulation was conducted in a skills laboratory with multiple beds and an integrated call light system. Each patient room was set up with what was needed for the
Results
The debriefing began by asking the following questions of the group:
- 1.
If you were a patient, how did you feel about the care you received?
- 2.
Did you feel that your needs were met?
- 3.
Did you feel that the nurse answered your needs in a timely manner?
- 4.
If you were the off-going nurse, what could you have done differently to ensure that the on-coming nurse had a better experience?
- 5.
If you were the PCT, what else could you have done to help either the nurse or the patients with their care?
- 6.
If you are the
Conclusions
In conclusion, many students expressed the following, “I think this simulation is a wonderful representation of the emotions felt by both the staff and the patients.” The students did report that they had a better understanding of what could be delegated and how to ask for assistance in a clearer and more formal method. The students wrote that this simulation was a great way to practice a high stress situation and to understand that problems can arise quickly. One student noted, “It really
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Cited by (1)
We have no conflict of interest and received no funding sources for this article. This information has not been previously presented.