Simulation Journal

The following is a reflective journal I used for an assignment regarding my first simulation in class yesterday!

Today we had our first simulation experience. I was relatively nervous as I had no idea what to expect. I feared I lacked the knowledge and skills needed to do well. I was, however, relieved when our instructor came to bring us into the room and explain the procedure. I found out we wouldn’t be marked on our performance and that this was just to be used as practice. I was relieved because I had no previous experiences or practice with something like this before.

We were given a sheet to read about a patient who was being portrayed by a life-like dummy in the simulation lab. We were told we would be videotaped and recorded, then we would watch the video afterwards to see how we did and where we needed improvement. This made me more nervous, but I really did like the concept. Our patient, “Mr. S”, was a 70-year-old male who had suffered a stroke. His speech was slurred, making it difficult to understand everything he was saying. He was also disoriented and confused about his surroundings. The main challenge, however, seemed to be in interacting with his irate daughter. I and three others waited eagerly outside of the simulation room until we received our cue to enter and begin the assignment. We began by knocking on the door and turning on the lights. Our main focus was on washing our hands, so no one said anything right away; rather we headed toward the hand washing station. The patient (a speaker system of our instructor’s voice used to portray Mr. S) started to ask who we are and what was going on. We each introduced ourselves, our nerves evident. Just as we began to approach the patient, who in reality was just a robot, I started to feel more comfortable. I was just getting into the swing of things when a live person came bursting into the room – an actor, who was another instructor at Sheridan, suddenly became a part of the simulation as Mr. S’s angry daughter. The patient kept screaming for cheeseburgers, which made it hard for my peers and I to keep a straight face. The daughter was not happy about that. We did our best to stay calm despite her offensive nature. Personally I found it hard to defend anything having little knowledge on the matter at all! When she asked for a chair, I promptly brought her one. When she demanded her father be brought a hamburger, I informed her he is on a specific diet and can only have pureed foods because of his stroke. When she asked for a doctor, my peer did a great job by using the phone by the bed to call for a doctor, complying to the daughter’s requests. Taking her feelings into account, my peers helped to eventually calm her down and our simulation ended.

The entire experience was interesting, in my opinion. Things that made it a bad experience were that my nerves really interfered with demonstrating proper communication techniques. When dealing with the confrontational daughter, I couldn’t keep on my toes because I had to think too long about how to respond, and by then the moment had passed. Also the insatiable urge to laugh when the patient yelled about cheeseburgers and a nervous smile didn’t help my situation. The experience became better when we ended the simulation and our instructor showed us our video, pointing out a lot of things we did well which I hadn’t even noticed. Including keeping our composure, open stature, being attentive and introducing ourselves properly.

Next time it will help to try and take the simulation more seriously, that is, to forget we are being taped and that this is a simulation in the first place. It would make it a lot easier to act appropriately given the situation. I will use all of the things I did right this time, and work on the things I did wrong next time. (Facial expressions, nervous laugh, orient patient better, speak up.) In the future I will be more confident. I have learned today that mastering proper communication is one of the most important things a nurse must do.

I asked my instructor for the tape of our simulation, which she easily could have given to me… Unfortunately, I made the mistake of telling her it was for intent of an online blog. She said it would be too much a breach of privacy on the other students’ behalf, and so sadly, I can’t show the simulation. But it was really awesome, and I wish you guys could see!