Dawn Mangine

    Designing a nursing curriculum that integrates simulation comes with a fair number of challenges, not the least of which is simply obtaining the needed room and equipment to set up a functional simulation lab. But once those first purchases are out of the way, and you have some manikins to put in beds, what’s next?

    The First 5 Minutes

    This is a common scenario for nursing students to have them practice the first five minutes of a patient crises. Whether the scenario takes place in a doctor’s office, emergency department (ED), or hospital room, it is meant to simulate the first five minutes spent with a patient experiencing a life-threatening complication. This can be constructed as a simulation for sophomore-level students experiencing their first clinical rotations.

    The scenario revolves around practicing the most important items:

    • Activating the emergency response system
    • Obtaining emergency equipment
    • Beginning lifesaving measures, such as chest compressions

    The Next 5 Minutes

    Once a nursing student has mastered "First 5-Minute" scenarios, he or she moves up to the next five minutes. This is where instructors can develop more complex patient scenarios depending on settings. What happens if a patient goes into septic shock? Or labor? Or is assessed to have end-stage liver disease? That’s the next five minutes a nurse spends with a patient.

    The Next 5 Minutes was named after its progression in the order of simulations for the junior student. This simulation focuses on the “middle” of patient’s care, specifically the perioperative tasks and responsibilities. Students have the opportunity to participate in the entire cycle of a patient’s operative experience, from pre-operative testing, to completing the pre-op checklist on the day of surgery, to managing complications upon the patient’s return to the inpatient unit.

    The Last 5 Minutes

    • Walk students through discharge of a patient: paperwork, patient instruction, follow-up appointments.
    • Conversely, run a death and dying scenario to teach students empathy, compassion, and end-of-life care.

    At Franciscan University, this is both the last med-surg simulation (in a given semester) and a simulation focused on end-of-life care. In the first half of the simulation, students have the chance to care for a patient with a respiratory condition, with a mid-point “debrief” focused on the assessment and management of respiratory distress and respiratory failure. Following this, students work through a death and dying scenario aimed at teaching students empathy, compassion, and end-of-life care.

    Many nursing schools that are starting to integrate simulation into their simulations should work backwards. Decide what the end goal of the program is, and with what knowledge and skills seniors should be graduating. As schools continue to develop curriculum using simulation, improvements and changes will be made based on lots of different factors.

    But don’t be afraid to start with simulation! Consult with schools with well-established sim labs, and talk to regional territory managers and account managers at Pocket Nurse. We’re here to help you with the solutions that are right for your program.

    This article was based on a presentation at SimPOW conference at Franciscan University. “Enhancing your program with simulation" was presented by Richard Antinone, RN, MSN, CEN, and Catherine Recznik, RN, MSN, CEN, CPEN. For more information about simulation at Franciscan University, see here. The image shows Brian Loot, RN, MSN, with one of the high-fidelity manikins Franciscan University uses in its sim lab.