Nursing students get hands-on practice with new technology

( Bobby – or Bobbie, depending on how the animatronic mannequin is dressed – is the newest member of the University of North Carolina at Pembroke’s nursing department.

The patient simulator, a SimMan 3G created by medical supply company Laerdal, can talk, cough, sweat, cry, bleed, exhibit illnesses, react to medication and die, just like a flesh and bone patient.

It is the latest technology aimed to give nursing students a dose of what they could face in real life.

Nursing programs throughout the region are embracing this kind of technology, expanding beyond the typical “teaching-testing” platform and immersing their students in real-life simulations to meet the needs of the rapidly-advancing health care industry.

“As our population gets older, we are living longer, the diseases are becoming more complicated, and technology is advancing, we, as health care providers have to keep up,” said Dr. Afua Arhin, head of the Fayetteville State University Department of Nursing.

Recently the Institute of Medicine released a report recommending an increase in the proportion of nurses with a baccalaureate degree from 50 percent to 80 percent by 2020 – a recommendation that many hospitals are turning into a requirement, encouraging registered nurses with an associate’s degree to go back to school.

Meanwhile, nearly 1 in 5 nurses in North Carolina is older than 55, an average that continues to rise, according to data from the North Carolina Board of Nursing, and 24 percent of the workforce is expected to retire within 10 years.

According to the North Carolina Center for Nursing and North Carolina Area Health Education Centers, these factors have rippled into an expected shortfall of nurses in the state that will exceed 30,000 by 2020.

On Aug. 14, UNCP opened a $29 million Health Sciences Building, which houses the nursing and social work departments and biology laboratories.

The building’s second story features a 14,500-square-foot Clinical Learning Center where nursing students will care for Bobby, other computer-enhanced mannequins, and one another in seven laboratories set up to mirror hospital rooms.

“We can really simulate an actual situation the students may face in a hospital setting,” said Dr. Barbara Synowiez, chairwoman of the Nursing Department.

Faculty members, like Martha Hepler, director of the center, will monitor the students from control rooms, where they can talk for the mannequins and control their functions. Cameras will record the students’ actions, which can be used to correct mistakes after the lesson is complete.

About 30 juniors began classes in the simulation clinics this week.

The nursing program was formerly housed at Southeastern Regional Medical Center in Lumberton, where it squeezed into 15,000 square feet. Now it occupies 52,000 square feet of the new 87,000-square-foot building.

More space means more students, Synowiez hopes. Plans call to double the size of the program to 200 students. Synowiez said the department is waiting for approval of a master’s degree program in nursing, as well.

Methodist University’s Nursing Department also has a new home to welcome its juniors, who began the university’s first Bachelor of Science in Nursing program on Monday. The class is expected to graduate in spring 2014.

Mary Hall, chairwoman of Methodist’s Department of Nursing, said the department began moving into the $3.2 million facility in July.

A simulated hospital, dubbed MU General, occupies about 40 percent of the 10,000-square-foot building. It includes an admitting and discharge area, a pharmacy, four critical-care rooms, a pediatric ward and a triage suite.

Groups of six nursing students and three instructors will work 12-hour days, evening and night shifts that require them to care for multiple patients, including the computer-enhanced mannequins. Initially, two students will work on one patient. As the students progress, they’ll individually take care of one patient, then two, until eventually they are caring for six patients at once.

“Training on mannequins provides a safe way to make an error,” Hall said. “It still feels devastating even though it’s a mannequin.”

Hall said it is important for students to be immersed into nursing’s culture because there is a high turnover rate with young nurses who are unaccustomed to the demands of a 12-hour shift and minimal supervision.

“Statistically, newly graduated nurses leave their first job after only eight months,” Hall said. “You can’t attack the nursing shortage when they go into an environment where they feel unfamiliar and overwhelmed.

“We want to get some people out there who stick,” Hall said.

Synowiez said the simulations are just that, and cannot replace practical clinical experience.

Students at UNCP are required to spend their clinical hours are Southeastern Regional Medical Center, while students at Fayetteville State and Methodist work at Cape Fear Valley and federal hospitals in Fayetteville.

Teresa Barnes, vice president of acute clinical services and chief nursing officer at Southeastern, said the partnership between the school and the hospital has been mutually beneficial.

“This has afforded us a pipeline of BSN-educated nurses,” Barnes said.

Other feeder schools in the area, like Robeson Community College, have associate degrees for registered nurses and also have partnered with UNCP for a bridge program.

Fayetteville State’s four-year bachelor’s program was reinstated last year after a two-year suspension of admissions.

Arhin said the program looks to be on track to graduate its first class in fall 2014.

The college also has a “robust” associate to bachelor’s degree program with 220 students enrolled this fall. Arhin said many of those students are practicing as registered nurses and have gone back to school to meet the new requirement by the Institute of Medicine.

“I have no doubt that we will be successful,” Arhin said. “I’m aware of how rigorous nursing can be and we want to prepare our students so they can put forth a good product.”

While the programs have a set number of students they can enroll – around 30 in each class, as authorized by the state nursing board – entry into the programs is highly competitive. Methodist received about 80 applications for its slots. UNCP and FSU reported similar numbers.

Charles Kurtz, a 52-year-old junior in UNCP’s program, is pursuing a second career after spending 28 years as a special needs teacher.

Kurtz said a nurse who cared for one of his former students suggested UNCP’s program, which had 100 percent passing rates in 2011 and 2012 on the licensure exam administered by the state Board of Nursing.

This summer, Kurtz and other juniors in the program got advanced lessons in the school’s new building.

“Basically the way the labs are set up, it’s as close to the real thing as you can get without having human patients sitting in the room,” Kurtz said. “It gives you a chance to deal with and practice your skills in a more relaxed mode.

“The technology is pretty amazing, that the simulations can so accurately represent the clinical setting,” he said.

The program began in the simulated clinical setting, then transitioned into nursing homes, Kurtz said. This semester, the group will be working in hospitals.

“I think it’s somewhat comforting to know that we’ve done these skills and processes before,” he said. “We’re not as nervous or anxious about going through them in a high pressure situation because we’ve perfected them already.”