Last Friday, nursing students working with Theater Department actors and the King County Sheriff’s Department tested their medical skills by simulating how they would respond to the aftermath of a large earthquake. They were required to tend to a group of actors who faked being severely injured, with screaming and fake blood to match. Other actors portrayed panicked and grief-stricken family members desperate to find out what happened to their “loved ones.” Nursing Department mannequins, covered in fake blood, were also present to simulate those who were not lucky enough to get treatment.
According to Associate Nursing Professor April Ambalina, it’s all great job training. “A lot of students I’ve talked to have said they feel more prepared for their careers because of it,” she said. “We want to make sure our students are prepared for mass casualty incidents, such as earthquakes and school shootings. We also want to make sure they are prepared to care for a patient population that is diverse in things like age, which would go hand in hand with these types of incidents.”
This is the second time the Nursing Department has held such a simulation, with the first time being last year after Ambalina and several of her co-workers came up with the idea. It can only be held annually due to the amount of time and effort required to set it up. “This took about nine months to prepare, and the last one took a year,” Ambalina said. “We have to create our scenarios, find and train actors, work with other school departments, make up health records, train staff and students on what their role will be and more.” This year’s simulation also required collaboration with the King County Sheriff’s Department, which hosted a training exercise where students practiced stopping the bleeding of someone suffering a severe injury.
After all this preparation, the day finally came. On Friday, there were, in fact, two simulation sessions, one in the morning and the other in the afternoon. Each session centered around two scenes, called “Disaster Triage” and “Interprofessional Trauma Care,” which lasted 25 and 20 minutes, respectively. The first scene simulated the immediate aftermath of a large earthquake at a hospital. The nursing students, about 15 in total, were assigned with triaging a group of five patients. Working in small groups, they had to determine whether or not their patients were injured, what kind of injuries they had and who they should prioritize. For realism, some patients were more helpful than others, with one simply having a “panic attack,” but who kept saying she was having a heart attack.
The second scene simulated what would occur after the triaging has been completed. Each group of students had to continue to care for their patient. They had to figure out things like medication, getting in contact with and calming family members, and working with other departments, such as nuclear medicine and pharmacists. Realism was also stressed here, with both simulated and actual conflict occurring between different nurses, as well as between different departments, and with some patients continuing to be more helpful than others. There was also fake screaming, such as when nurses were trying to treat a man’s “broken” arm.
During both scenes, staff members observed how students responded to the challenges presented to them. The morning and afternoon sessions both ended with a debrief, where students reflected on their thoughts and feelings about their experience. A mix of pride and frustration was commonly expressed. One nursing student, Kayla de Vera, stated, “I feel more prepared than I used to be. It’s good to know that, as stressful and chaotic as it was, the simulation was simply a glimpse into what it’s going to feel like in real life. It’s not going to be perfect or just step-by-step.”
Compared with the nursing students, the actors who portrayed the patients had a less stressful time. One, Julia Higheagle, stated, “This is one of the most fun things that I have ever done. I’m really glad I was in class to hear about this.” Like the students, however, the actors also felt the simulation was realistic. Higheagle, who played the patient having a panic attack, said she was intentionally difficult to understand and deal with, with her script instructing her to confuse the students as to whether or not she was injured, and to be difficult to calm down.
One takeaway that Ms. Ambalina wants the student body as a whole to have from the simulation is the competence of our nursing students. “Even though they are students, they are knowledgeable and prepared,” she said. “They are highly trained to work under pressure, and we believe they will go on to support their communities if and when tragedies strike.” The final thing she said was that any student who is interested in participating in a future simulation is welcome to reach out.
