Category Archives: Nursing Learning Center

Exciting New NLC Tech Transforms Student Learning Experience

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Assistant Lab Supervisor Kristen Whipple watches as students learn how to operate the new Pyxis MedStation

One of BYU’s top learning facilities got some exciting new upgrades this summer. Among the more exciting improvements, the Mary Jane Rawlinson Geertsen Nursing Learning Center (NLC) now boasts eighteen new hospital beds, two new state-of-the-art classroom manikins, and two new Pyxis MedStation 4000 systems.

“In the NLC, our goal is to simulate real-life nursing scenarios for our students, so they are better prepared when they enter a hospital for first time,” said NLC supervisor Colleen Tingey. “The Pyxis MedStations are what students are most likely to see in Utah area hospitals.”

“Pyxis is actually a real, clinical machine that we use as a teaching tool,” Assistant Lab Supervisor Kristen Whipple added. “But the same Pyxis machine we use here could be used in any hospital.”

Acquired through a donation by the Fritz B. Burns Foundation, the Pyxis MedStation 4000 is a computerized medical dispenser that is quickly becoming a standard piece of equipment for nurses across the country. The Pyxis MedStation is programmed with a patient database to help nurses keep track of all of their patient’s specific medical needs.

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“The whole idea behind the machines is to improve patient safety,” Tingey explained. “Because the patient’s record is already programmed into the machine, it can then dispense the right medication for that patient and help the nurse avoid medical errors.”

Prior to this summer, the NLC had just one older version of Pyxis to use for all nursing simulations, which often ran simultaneously. Nervous nursing students would often waste valuable time waiting to get meds for their simulation because of backlog at the older machine.

“We’re really excited to have two Pyxis machines, instead of just one,” Whipple said. “Now it’s easier for students to access them during their simulations.”

Thanks to the Fritz B. Burns Foundation, NLC also welcomed two new additions to the College of Nursing manikin family. The new arrivals (one adult and one child) are auscultation manikins that help students learn to identify heart, lung, and bowel noises.

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Nursing student Aimee Schouten with the new pediatric auscultation manikin.

Students can use a stethoscope to listen to the manikin’s heart rate and breathing. Computer programs allow the professor to control what sounds the student hears, as well as the area on the manikin that the sound comes from. The professor can also program the manikin to emit different types of sounds or project the sound through a speaker, so the whole class can hear.

“When students practice on each other, they get to hear normal sounds,” Tingey explained. They get to hear what normal, healthy patients sound like. But they don’t get the opportunity to hear abnormal heart sounds. These manikins provide an opportunity for students to hear what an abnormal heart sounds like.”

Nursing faculty are especially excited about the new pediatric auscultation manikin. Whipple said that nursing faculty had specifically asked for this device to better teach pediatrics to nursing students. “Small children don’t just behave like small adults,” Whipple pointed out. “Their bodies are different than adult bodies; so we need to train in what’s specific to them. This pediatric simulator acts like a pediatric body would and helps us identify those sounds that are unique to children.”

The new adult auscultation manikin has several unique features that are useful to professors and nursing students. Professors can use the adult manikin’s computer program to display EKGs, phonograms, and ultra-sounds. This allows students to see the physiology behind any abnormal sounds they may hear.

“Basically, this manikin allows our students to not only identify abnormalities like heart tremors,” Tingey said. “But it also allows students to learn how the sound correlates to what’s happening in the heart.”

 

 

 

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An Arabic Major’s Humorous Experience Learning How to Administer an IV

Watch the video version of this at https://www.youtube.com/watch?v=vJYqP5tS_uA.

“Be sure to inform the patient of the prick…”

I vaguely registered these words as I stared at the computer monitor. The presentation seemed to be dragging itself out a little, and my concentration was slipping.

“Be sure to properly dispose any blood-splattered material…”

My eyes shot open. Run that by me again? Blood-splattered material? Was I practicing to be a nurse or a butcher?

The flurry of medical terms that began erupting from the headphones about cannulation and catheters confirmed that indeed, this was IV placement training, and augmented how out of place I felt in the Mary Jane Rawlins Geertsen Nursing Learning Center.

My name is Steven Tibbitts, and I am a public relations assistant in the BYU College of Nursing. I am also a Middle East Studies/Arabic major. This means that when nursing faculty and students start talking about dyspnea and dilation, I’m usually grabbing a dictionary.

Given my non-medical background, it was decided that I would go through some of the same computer/machine training for IV placement that nursing students complete in order to write a story on the difficulty level.

Summary to the non-initiated—it’s hard. Lazy readers can stop here.

NLC Assistant Supervisor Kristen Whipple guided me through the process, giving me the same instructions she gives to normal students. The whole system is composed of a computer program and a small machine to which you administer the IV. For a nursing student to pass, they have to earn a 73% on the procedure.

I first had to watch several training videos. They made me feel good by reminding me how much easier Arabic is to understand than medical terminology.

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“What does this all mean?”

Following that, an image flashed on the screen about a patient to whom I would administer an IV, complete with a backstory about the accident that put her in the hospital. I could not help but think that the accident might not wind up being the worst part of her day by the time we were done.

It was time to get down to business. I selected the mid-arm as the injection point, and then scrambled to figure out what supplies I would require, my lack of understanding evident in the questions I asked myself aloud. How many needles? Which kind? Wait, IV needles come in gauges? (Nursing students, try not to mock me too much here.)

The program then had me prepare to administer the IV, first by informing the patient of the impending procedure, and then putting on rubber gloves with a satisfying snap. It then instructed me to test the viability of my selected injection site. This was accomplished by touching the part of the machine that mimicked human skin and feeling the pulse that it generated.

Easy, I thought, just like surgery class in first grade when Miss Conn taught us how to identify strong blood flow by palpating the patient’s veins…wait…

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“Here goes nothing…oh wait, there’s blood!”

With a site selected, I washed it on the computer and then realized that it was actually time to use the pointy thing. I apologized profusely to the imaginary patient, picked up the needle, and gingerly began to maneuver it into the hole on the machine that represented the insertion point. I watched my progress on the screen, realizing that most likely a real patient would be filling out lawsuit papers by now with the arm that I had not maimed.  However, after some fiddling, I did manage to place the catheter.

About that point, I remembered that I needed to warn the patient that I was going to place the IV, so they received a heads up a solid two minutes after the fact.

As you might guess, my initial score was not superb.  The report had many tips that Whipple helped me understand, like not moving the needle back and forth in the vein (be grateful that I will never be a nurse) and warning the patient before I poke them.

I practiced several times, achieved a 92 on the third, and then called it quits when my scores began precipitously plummeting to the 60s. In fact, I never managed to completely the procedure successfully by the program’s standards. One of the times even resulted in the patient bleeding profusely (this attempt is highlighted in the above video).

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“I need to flee the country before they sue!”

While I was contemplating my failure, Whipple explained to me the same thing that she does to Type A nursing students who get only a 73.

Obviously, the computer program is not a real patient. It is like a nursing video game whose purpose is to initiate students into IV training. This training is coupled with practicing on manikin arms and other materials, so the skill is finely honed during first semester, despite what people’s initial results may be with the machine. It is all about practice.

The experience showed me that a) I’m happy to stick with العربي and b) nursing students are very well trained and capable. Their program is rigorous and ensures that students are able to provide care in an effective way, all with the Spirit. The BYU College of Nursing holds its students to a high standard, which translates into better patient care and safer medical practices.

In summary, if you’re in a hospital and you find a BYU College of Nursing graduate administering your IV, rest easy, you’re in good hands.

If it’s me, run for the hills.

Professor, Leader, Veteran, Nurse: Dr. Kent Blad

BOOM!

It was January 1991, during the Persian Gulf War. Another Iraqi Scud missile had just been knocked out of the sky by an American Patriot missile battery, a regular event given that Saddam Hussein’s forces were lobbing dozens of missiles at coalition troops. Some might have found the massive explosions unsettling—for military nurse Kent Blad, however, they ensured that he would sleep calmly that night, knowing that his odds of being hit by an Iraqi projectile were being significantly reduced.

Fast-forward twenty-six years to 2017, a year that marks two important milestones for Dr. Blad, now BYU College of Nursing associate dean. In June, it will be his 30th year as a registered nurse. Second, it is the end of his five-year term as associate dean, after which he will continue to teach as a professor. It will be one more transition in a career that has spanned decades and seen Blad serving everywhere from Provo to Saudi Arabia.

Interestingly, Blad didn’t start off studying nursing. He at first was majoring in pre-med to become an orthopedic surgeon. However, once he got married he started to have second thoughts about being a surgeon.

“When I got married, I figured I wanted to be married to this woman, not to a profession,” he says.

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Blad as a military nurse

His older brother was a military nurse, and his example helped Blad decide to enlist in the military and concurrently enroll in nursing school. He worked as a military operating room technician to pay his way, and once he had his degree he was made an officer. He served in Operations Desert Shield and Desert Storm, where he had the harrowing experience of listening to Scud missiles streak across the sky. However, he was not injured during the war and was able to serve his country faithfully.

Blad left the military two years after the Persian Gulf War ended, and by this point, nursing was in his blood.

“The more I got into it, the more I obtained a passion for it because I soon realized that not only is it a profession, but it’s a service profession where you spend your whole life serving others,” Blad says.

For ten years, he worked at the George E. Wahlen Department of Veterans Affairs Medical Center in Salt Lake City, primarily in critical care. He then enrolled at BYU to get his master’s degree, which opened up new, unexpected doors to him. Immediately upon graduation, he was offered a job to work in the College, which he accepted.

This was in 1999, and he describes the following years as “18 wonderful years, not without their share of challenges, but certainly with many, many blessings.”

The first few were spent teaching, until 2012 when Dr. Patricia Ravert, the newly installed dean, asked him to serve as one of two associate deans in the college. He accepted, undertaking the many responsibilities that come with being an associate dean.

“There was never a time that I was able to just sit around and stare out the window,” he says. Blad’s duties include supervising the Nursing Learning Center and the advisement center, distributing faculty assignments, managing the curriculum, and attending various university meetings, all on top of continuing to teach classes and contributing to the discipline.

One of Blad’s biggest pieces of advice to both faculty and students is to find balance, stressing the fact that nothing should come before their top three priorities, namely their family, their well-being, and their religion. He had to take his own advice in this new job, constantly evaluating his life to see how he could better prioritize his time.

Despite the difficulty of managing so many different tasks, there have been numerous positive impacts that Blad can see in the past five years, mainly due to the cooperation between members of administration and the College faculty.

For one thing, the College just passed its accreditation review with no negative recommendations. The Mary Jane Rawlinson Geertsen Nursing Learning Center was completed and is now running smoothly. Blad has also had the satisfying privilege of helping distribute increased scholarship funds to deserving students and helping coordinate teacher-student mentoring. The past five years have also seen a focus on promoting professionalism and courtesy among the faculty, which Blad says has created a wonderful working environment.

“That’s the thing I’m going to miss the most as a leader is that comradery and the love that you share with your peers,” Blad says. “We have tremendously excellent faculty. In my travels around the country, it is seconded by no other faculty in the US. We have the top faculty that can be put together.”

One of Blad’s biggest contributions to the College is also one of his biggest passions: treating veterans. Blad was the one who in 2005 recommended that one of the clinical practicums for the Public and Global Health nursing course be focused on treating veterans, and since then the program has become the leading program of its kind in the United States.

“It’s pretty special,” he says. “It’s a satisfaction in my career that is matched by nothing else.”

Outside of work, Blad spends most of his time either with family or as a bishopric member in a YSA ward. He and his wife have seven children, and eleven grandchildren. Now that he will have more time, he expects them to continue old family traditions like camping, hiking, and picnicking. Blad also enjoys doing yard work and gardening.

Enhancement in Education, Part Six: Standing Room Only

This story is part of an ongoing series about the BYU College of Nursing’s Mary Jane Rawlinson Geertsen Nursing Learning Center and the College’s constant efforts to update it.

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Nursing student Sydney Wilson practices injecting a manikin in the Mary Jane Rawlinson Geertsen Nursing Learning Center.

On November 11, any visitor to the Mary Jane Rawlinson Geertsen Nursing Learning Center’s walk-in lab would not have had much elbow room. That day 52 students were crammed inside, each trying to practice key nursing skills and techniques with what little space they had.

While this may sound chaotic, it is actually indicative of the immense success that the walk-in lab has experienced over the past two years, as well as curriculum changes that are increasing the lab’s attendance.

Since so much of nursing education is focused on repetition, it follows that students will want to take extra time to practice skills they learn in class. The walk-in lab is designed to offer students an open environment to do exactly that.

“Most other colleges don’t have a walk-in lab, so it’s unique in that we have it at all,” Colleen Tingey, NLC supervisor, says. “Most places don’t have [a walk-in lab], and if they do, they’re ones that have been newly built but got the idea from us.”

Other nursing schools often charge students to use college facilities for practice; at the NLC, students have free reign to hone in their skills without an additional cost. This allows them to build self-confidence and learn nursing techniques without shouldering a financial burden.

“The walk-in lab is open for them to come in and practice,” Kristen Whipple, NLC assistant supervisor, says. “They can’t just walk [in the other rooms] and practice.”

Recently, however, the lab has served another purpose. Some professors have begun to require students to complete skills pass offs via video, which means that they have to film themselves completing the tests in the walk-in lab.

“The biggest thing that happened is the med/surg students were assigned to videotape themselves doing their pass offs instead of coming in for a test,” Whipple says. Whipple also notes that many of these students have driven personalities, thus leading to them taping themselves upwards of two or three times to make sure they get it just right.

With entire classes filming themselves multiple times adding on to the already large amount of students present, the walk-in lab suddenly rivals the Creamery as a gathering spot.

“A lot more things are getting assigned in here, more teachers are considering doing the video pass offs, which will impact us a lot,” Whipple says. Tingey also notes that students now are spending longer amounts of time in the lab as they practice the pass offs.

However, Whipple says that they will adapt to the changes, and that the benefits that students get from both individually practicing in the lab and from receiving help from the TA’s continue to be tremendous.

“The ability to practice is huge, and the ability to practice with someone who has experience is even better,” she says.

Enhancement in Education, Part Five: Nursing from the Seoul

This story is part of an ongoing series about the BYU College of Nursing’s Mary Jane Rawlinson Geertsen Nursing Learning Center and the College’s constant efforts to update it.

An Arab proverb states that there is always something to learn from experimentation. Assistant teaching professor Debra Wing and her husband found that true during their recent mission in South Korea, and it may be applicable for students with whom Wing works in the Mary Jane Rawlinson Geertsen Nursing Learning Center (NLC).

As a long-time nurse and College of Nursing employee, Wing has never been a stranger to the medical world. However, a mission in a foreign country definitely offered opportunities for experimentation in unfamiliar circumstances. She accepted the challenge, and as a result of her willingness to try something new, she had unexpected results.

“I have not felt the same spirit of care until serving in a mission,” Wing says. That spirit was developed as she worked with LDS soldiers and their families that many times were facing intense challenges in life. One blessing of the experience was that she developed more sensitivity for nursing students trying to stay on top of a rigorous curriculum.

Another benefit was the opportunity to work in a local clinic where she taught staff about simulation. This was a close-to-home topic, since much of Wing’s work, as well as the nursing curriculum, centers around the simulation program in the NLC.

“Taking those skills and applying them in Korea in the facilities where I worked, I helped the public health nurses with several programs, but a lot of them were really based on simulation principles,” she says.

Teaching Korean medical workers and teaching BYU students are not completely different experiences. For some BYU students, working with manikins while being taped can seem daunting. However, like Wing and those she taught in Korea, sometimes students have to be willing to experiment with new ideas in a new environment in order to benefit from the program.

According to Wing, it brings tremendous benefits.

“It’s an opportunity for students to practice in a safe environment in context of what they’re learning,” Wing says. “It also gives them the opportunity to see experiences that they may not have in the hospital.”

Wing thinks that students who overcome the hurdles of engaging in different activities in the NLC are able to better appreciate the teaching there.

“I think that as they participate more, students do understand how valuable the simulated experiences are for them,” Wing says. “It’s a much more effective way for students to learn than to read chapters in a book, listen to lectures, and go to a hospital and hope that you’re doing everything that you’ve read in the book or heard in the lecture.”

Wing now plans to keep helping the program expand as she applies the insights developed in her mission. With luck, students will continue to have the same vision of their learning and growth potential.

“It’s really exciting to see how it has grown as far as the use,” Wing says. “I don’t know that I see things that need to be improved, particularly as much as I see that we have expanded so much, and that we have more people working now in simulation, and I see the potential that we have for continued growth.”

Enrichment in Education, Part Four: Simulation is the Sincerest Form of Flattery

This story is part of an ongoing series about the BYU College of Nursing’s Mary Jane Rawlinson Geertsen Nursing Learning Center and the College’s constant efforts to update it.

This past summer, sixteen BYU College of Nursing faculty and staff received three days of intensive simulation training. The process, one could say, has modeled a path to success for any nursing college.

The course, offered by Intermountain Healthcare and hosted at LDS Hospital, was tailored specifically to the needs of BYU staff. It was in part the brainchild of assistant teaching professor Stacie Hunsaker, who, after six years of working with simulation, felt that it would be beneficial to standardize the training that college employees received.

“They held a course for us, and it was great because as a team we were able to experience specific issues to our simulation and work on very specific items related to BYU nursing, so it was really helpful for us to be there as a team,” Hunsaker says.

After receiving a thick binder full of notes, the teachers were taught important ideas about using simulation in instruction, including the need for establishing good communication between students and helping them get engaged in the activities.

“By going to that course, all of us were able to get that same consistent information, so now we can hopefully provide a better experience for the students of all semesters who participate in simulation,” Hunsaker says.

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NLC Supervisor Colleen Tingey works with other staff to practice simulation drills intended to benefit students.

Part of the process was participating in and creating scenarios; it was as though the teachers became the students as they practice different situations and were critiqued on how they performed. Staff also worked to implement new ideas into existing simulations as well as develop new ones for this year’s teaching.

“We were able as groups to develop objectives for all of our simulations and then put them into consistent formats throughout all semesters,” Hunsaker says. “So now we have all of them set up so that they’ll have a prebrief, a simulation, and a debriefing moment.”

Getting everyone on the same page was a key motivator to implement the training, and the college is making all efforts to preserve the progress made. Now all new staff will be able to take the course when hired, and there are two meetings a semester to evaluate how well simulation principles are being applied in the classrooms.

While the training may be costly, Dean Patricia Ravert believes that simulation is “really integral to our program” and thus merits the effort to advance it.

“We want to have a top-notch program, which we do, and we want to maintain that,” she says. “We want to make sure that the students really have great experiences.” Both she and Hunsaker believe that the training establishes a stronger base of unity and understanding among the simulation staff.

“It really brings us together as a team because we all have the same foundation now,” Hunsaker says. “We all know we can all give good, valid information, not that it was bad before, but I think that it just brought everything together and provided so much consistency. Now we’re all using the same terminology. We all know how a sim is supposed to run.”

 

Enhancement in Education, Part Three: Enter MedAffinity

This story is part of an ongoing series about the BYU College of Nursing’s Mary Jane Rawlinson Geertsen Nursing Learning Center and the College’s constant efforts to update it.

In the basement of the Spencer W. Kimball Tower, students are training to be observers. All their subjects are kept under intensive watch, with any changes in behavior or well-being quickly typed into computer files. Nothing escapes their notice, or more importantly, their notes.

No, this is not NSA training; these are nursing students using new software, MedAffinity EHR, that helps them practice documenting patient treatment. It’s a system that hopefully will allow students to adjust better to working in a hospital environment where recording patient data on a computer is the norm.

“MedAffinity is electronic documentation, and the way the real world is going is to have an electronic health record,” says Colleen Tingey, supervisor of the Mary Jane Rawlinson Geertsen Nursing Learning Center (NLC). “The world that [students will be] working in is using electronic documentation, and [they] need to figure out how to do it.”

Documentation in nursing is everything, says Tingey. She teaches students that if they don’t document what they did for a patient, then they effectively didn’t do it, leaving them legally vulnerable if there are questions about what they have done to treat patients.

This documentation used to be mainly by hand, but in recent years the trend has been to do it electronically, including in the hospitals where students do their clinicals. That made it necessary to search out a program that could imitate standard documentation software.

After examining many programs over the years, it was decided that MedAffinity was the way to go, but not without some changes.

The program looks just like a typical electronic documentation software that you would find in hospitals. As students complete their labs in the NLC, afterwards (or during) they record what they did on the program. The “patients” they treat and their background information are preloaded by NLC assistant supervisor Kristen Whipple, so students can write about all the different actions they take to treat them.

“Our goal is to make it as real as possible,” Whipple says. In an effort to resemble a typical hospital environment, the NLC now has computers next to patient beds.

MedAffinity is extremely meticulous, in large part thanks to BYU nursing faculty as well as Tingey and Whipple who helped redesign the software to make it more compatible with the nursing program’s requirements. It now covers many more aspects of documentation, with very specific descriptions of treatment and patient reaction.

Another benefit is that this program helps train not only students in the undergraduate registered nurse program, but also those in the graduate nurse practitioner program.

However, Tingey and Whipple stress that the idea of MedAffinity, which is currently employed mainly in the skills labs, is not meant to show students how to use all documentation software, since it can vary throughout the country. “We’re not trying to teach a certain program; we’re teaching principles of documentation,” Tingey says.

Assistant professor Dr. Deborah Himes, who teaches courses involving MedAffinity, sees other benefits in teaching students how to document their work beyond just their legal protection.

“In a sense, learning how to chart well makes you a better nurse because you think about the outcomes you have to chart when you get to the end,” Himes says. “You do a care for a patient, and you go back to chart it, and you can evaluate how it went based on how the patient reacts.”

Implementation has been an intensive labor, but is now moving along relatively smoothly. It requires constant fine-tuning, and always will due to the dynamic nature of the industry. For students, the adaptation from paper to electronic is not always easy, but Tingey believes that it’s a key training for students.

“They’ll be much more prepared to function in the real world,” she says.