Imagine yourself experiencing a heart attack. Your heart suddenly stops beating.

“Now, think about the young nurse who responds to your life-or-death crisis,” says the dean of CUA’s School of Nursing, Nalini Jairath. “Would you like to be the first heart attack victim that nurse has ever responded to? Or would you like the nurse to be very skilled in assessing your status and at responding by initiating cardiopulmonary resuscitation, assisting with placing an endotracheal tube down your throat and using a defibrillator to try to resume a heart rhythm? Wouldn’t you like the nurse to already be skilled and practiced in these things?

“Once people think about scenarios like this, in which a nurse’s skill level may influence their likelihood of surviving, they recognize the need for clinical simulation in nursing education,” says Jairath.

What the dean is referring to — clinical simulation — represents a revolution in nursing education in which students practice medical decision making and treatment on lifelike, high-tech manikins. To understand how this works, meet SimMan, aka the Universal Patient Simulator, which is the most advanced of several clinical-simulation manikins and practice models that the School of Nursing will be purchasing in the fall.

SimMan’s blood pressure can be measured; his heart and bowel sounds can be listened to; and his carotid, femoral, brachial and radial pulses can be checked. This manikin also allows students to practice a range of emergency medical interventions on it: e.g., inserting IVs or inserting a tube into the chest cavity to drain fluids.

“An example of a needed skill for nurses is the suctioning of the airway so the patient can breathe freely,” says Dean Jairath. “Obviously this can be done to a manikin multiple times until the skill is mastered — something that would be harmful to a real patient.”

While SimMan allows students to respond to complex medical scenarios, it is very expensive at a purchase price of $35,000. Therefore, other limited-capability practice models will also be purchased and used to reinforce specific skills, such as insertion of urinary catheters and dressing of wounds. SimMan and these other practice models will form the nucleus of the nursing school’s newest asset — its planned Clinical Simulation Lab.

The purchase of SimMan and the other models was made possible by grants from the Alexander Stewart Trust and another philanthropic foundation that wishes to remain anonymous, and by Helen Hennessy’s $25,000 bequest in honor of her sister, Mary Frances Liston, a former dean of CUA’s nursing school. Because Dean Liston had been committed to the advancement of nursing education, Hennessy wanted to pay tribute to her by helping to purchase the manikins that will make up the Clinical Simulation Lab. “This lab represents a critical need in preparing CUA’s students to be the best in their ever-so-critical careers,” says Hennessy.

SimMan can be programmed to display signs and symptoms associated with particular diseases or acute illnesses. The size of its pupils, its respiration, heart rate and blood pressure can be programmed to duplicate the real changes associated with heart attack, stroke or traumatic injury. The nursing instructor can assess the student’s medical decisions and other actions — from administering medications and collecting blood for diagnosis to seeking additional help and providing patient comfort and support.

Diagnosing and treating a manikin experiencing such emergencies is important because a nursing student doing clinical rounds in a D.C.-area hospital “would have limited opportunities to witness such emergencies, let alone participate in their treatment,” Dean Jairath explains.

Other benefits of clinical simulation include the following:

• By preparing students to handle emergencies, SimMan helps students relax during an actual emergency, giving them the presence of mind to attend to the caring aspects of nursing, such as reassuring the frightened patient, attending to his spiritual needs by asking if he wants to pray, etc.
• It increases the nursing school’s innovativeness and appeal to prospective students. SimMan and the rest of the simulation lab are important in the school’s efforts to recruit what Jairath calls the “best, brightest and most caring” students. “When prospective nursing students make college visits, they visit many institutions,” she explains. “Institutions that use cutting-edge technology have a noticeable advantage.”

One need still has to be met before the Clinical Simulation Lab can be put in place, however: creating the physical space for the lab in Gowan Hall. Dean Jairath projects that the space earmarked for the lab will need to be completely refurbished, new plumbing installed and a teaching theater created. Two-way mirrors inserted into a wall of an attached office would be helpful so that faculty could monitor student performance as part of clinical evaluation. Basic required improvements include new carpeting, curtains and blinds, and fresh paint. Needed equipment includes examination tables and patient monitoring equipment such as an electrocardiogram machine.

Those who would like to make a financial contribution to help set up the lab may contact Kathleen Ennis, associate director of university development, at 202-319-6926 or ennis@cua.edu.

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