Story & Photos by Emily Pagano
While it may be our first instinct to keep sick loved ones in bed, science is starting to prove us wrong. In the last 20 years, a growing body of research has shown that getting critically ill patients out of bed can prevent blood clots, pneumonia and deconditioning. But what’s the best way to teach caregivers to get patients up and about safely?
Cue Evan Prost and Kathy Moss, SHP professors in the fields of physical therapy and respiratory therapy, respectively. Using the Russell D. and Mary B. Sheldon Simulation Center, Prost and Moss designed four activities that would not only teach their students how to mobilize a critically ill patient, but would give them the rare opportunity to work together.
“In the past, PT and RT students have had very little clinical interaction in their educational programs,” Prost said. “Getting a complex medical patient who is on a ventilator – and therefore, unable to speak – out of bed for the first time is a difficult clinical scenario.”
In a hospital setting, physical therapists and respiratory therapists usually time their duties around each other. But when moving a patient on a ventilator, knowledge from both fields is crucial. While the physical therapists prevent the patient from falling, the respiratory therapists ensure the tracheostomy tube isn’t removed. In each critical moment, the different therapists must be able to communicate what each person’s responsibility and expertise is.
On Feb. 5, 2016, Moss and Prost’s students arrived to the Simulation Center knowing only that there was a critically ill patient. Prost divided the students into two teams of four. When the students entered their simulation rooms, they saw a standardized patient “using” a ventilator, a chair and a lab report. Their task? To move the patient out of bed – if she was ready.
In the first scenario, the patient’s vitals indicated that she was not ready for mobilization. However, one group proceeded to move the patient anyway. The professors watched and made notes from behind a two-way mirror. Prost explained that one benefit of using standardized patients is the safe learning environment in which students can make these mistakes before they start working in a real hospital.
In the second scenario, Prost and Moss changed the lab report and told the students that 24 hours had passed. At this point, the patient’s vitals indicated it was safe to move her. Using visual cues to communicate with the patient, the students successfully moved the patient from the bed to the chair as a team.
After some sweat, some fumbles but no falls, the students debriefed with both the professors and the standardized patients to discuss what went well. Megan Dougherty, a senior respiratory therapy student, said she really enjoyed the simulation.
“We all worked well together,” Dougherty said. “By the end of the simulation, we realized how important communication is and will be when working in our professional lives.”
Funding for the use of the Sim Center for these interdisciplinary exercises was provided by the SHP Dean’s Office. Associate Dean Stephanie Reid-Arndt said the innovative, collaborative approach to teaching is a benefit to students. “This activity was a great model for inter-disciplinary education and cooperation. It’s a model for how health care works in the real world, outside our educational clinics and classrooms.”