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A 12 day old baby is lying on a hospital bed. His heart rate is approaching 200 beats per minute while his blood oxygen level drops into the 60s. A team of nurses from Yakima Valley Memorial Hospital surrounds the baby. In a few seconds, a dozen questions are asked and answered. They all race to get the baby back to stable condition.

The baby’s father talks to a nurse who tries to calm him down as she asks about the child’s medical history. He is erratic and noisy. He gets up and paces around the room, embarrassing everyone. He wants to help but can only handle the same question over and over, “what’s going on?” »

This type of situation has become more common for the handful of nurses in the emergency departments, pediatric and neonatal intensive care units in the room. Fortunately, this case was an exercise held in the simulation lab at the Pacific Northwest University of Health Sciences.

Over the past 25 or so years, simulation labs have become commonplace in medical schools across the country. A mix of experienced staff providing guidance, cutting-edge technology and, in some cases, actors allowed medical and nursing students to experience close-to-real-life scenarios without the consequences that can come from first encounter. with unusual urgency.

While PNWU and Memorial have long shared a partnership as organizations focused on improving healthcare conditions in the region, these joint simulations, which also include PNWU students, are the first of their kind in the county. from Yakima.

“Historically, there has always been a desire for a partnership like this (between PNWU and Memorial),” said Lisa Steele, executive director of PNWU’s Simulation Center. “About six months before COVID, this was the first time we had tried to start a simulation running activity with Memorial Hospital.”






Andrea Shirley, center, Adrian Araiza, right, both NICU RNs from Yakima Valley Memorial Hospital, and Memorial float nurse Stephanie Shamsi, examine the baby dummy before beginning a mock exercise at Pacific Northwest University in Yakima, Wash., Wednesday, October 19, 2022.



When the pandemic arrived, hospitals and medical schools around the world were overwhelmed. The timing was wrong.

Conversations about a joint simulation resumed in 2021, Steele said. In 2022, she said Memorial staff are noticing an increase in health emergencies with newborns.

“Hospital staff told us, ‘We have this situation that comes up more frequently in the hospital. It’s not something we see as often and we just want to make sure we’re well equipped and well prepared to deal with it,” Steele said.

Those conversations paid off when the first joint simulation took place last week.







PNWU simulation program

RNs from Yakima Valley Memorial Hospital participate in a mock exercise at Pacific Northwest University in Yakima, Washington on Wednesday, October 19, 2022.



PNWU’s SIM Center is made up of a handful of rooms inside the North Wing of Butler-Haney Hall. The building has several replicas of hospital rooms with equipment and monitors.

Professors, SIM Center staff and other observers sit across the hall inside a control room, where they can monitor students via a live camera from inside the room. hospital room. Monitoring equipment that measures blood pressure and oxygen levels feeds directly into the control room.

Inside hospital rooms, mannequins representing different genders and health needs are used for patients. Some of these mannequins breathe, make sounds, and allow people to insert IVs, catheters, and breathing tubes.







PNWU simulation program

Simulation technologist Andrea Espinosa listens to a simulation from the control room at Pacific Northwest University in Yakima, Wash., Wednesday, Oct. 19, 2022.



In early conversations with Dr. Catherine J. Koozer, a pediatrician at Memorial, Steele said the focus was on using the SIM Center in a way that would benefit the community, not just the staff using it. .

“We started thinking about how we could partner, how we could combine our efforts and really do something that will not only have an impact at an educational level but at a community level,” she said.

Since simulation labs are common enough that many current health care providers have used them at some point in their training, Steele said the people she spoke with at Memorial all saw the value in using simulation labs. simulations as a way to both stay alert to routine procedures and prepare for the unexpected.

“A lot of our vendors coming into the system now, they’ve been exposed (to simulations),” Steele said. “Then they walk into a hospital and find areas of potential improvement or educational opportunities and it’s like, ‘Why don’t we do SIM?’ ”

On the day of the simulation, Chelan Shepherd, Deputy Director of Simulation Quality Assurance, sat down with PNWU and Memorial staff. She walked the group through their scenario with the infant and showed them around the simulation room, where all the tools they would need were ready on a counter next to the hospital bed.







PNWU simulation program

Thomas Eglin, MD and assistant professor of family medicine, orients participants from Yakima Valley Memorial Hospital before beginning a mock exercise at Pacific Northwest University in Yakima, Wash., Wednesday, Oct. 19, 2022.



After two walkthroughs, both followed by a briefing, Shepherd walked around the room asking everyone involved if they had learned anything new.

Although there was more than a century of experience in the room, every nurse, doctor, and professor had learned something new during the 25 minutes spent in the simulation room. Some had learned from the experience itself, others from their colleagues.

Following a debrief after the second simulation, Skylor Davis, an emergency department nurse, said he learned about the correlation between an infant’s gestational age and their blood pressure. Knowing this can help providers know what a healthy blood pressure is for a child.

As he shared this with the group, heads nodded in agreement.

While many of the observations made by PNWU faculty and Memorial staff were technical in nature, Andrea Shirley, a NICU nurse, made a comment that changed the way the seven nurses in the room would work together. .

“I like the idea of ​​hearing that you are happy to see us (NICU nurses) coming to the ER,” she said. “Sometimes I feel like I’m walking on toes. I wonder if it’s okay to do certain things.

Janice Northup, nurse manager for pediatrics and NICU, agreed with Shirley. She said she enjoyed being in a collaborative environment with nurses from other departments.

While it’s not uncommon for these nurses to work together, she said being placed in a simulation like the one they just did helped break down communication barriers and address concerns about the best way to function in someone else’s service.

Steele said that’s exactly what she envisions for the joint simulations hosted by PNWU and Memorial staff. While PWNU’s SIM Center is expected to more than double in size following the addition of the 80,000 square foot Student Learning Collaborative Building next year, Steele said further joint simulations with other healthcare organizations health of Yakima County are on the horizon.

“That’s really the ultimate goal. We ask what are the obstacles? What are the problems, what things are not going as well as we would like? Where are the deficits? What are we not as well prepared for and how do we make those changes? Steele said.