Mannequins help nursing students train

‘Patients’ simulate mental health problems

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Bob Owen / San Antonio Express-News

Simulation specialists control a pediatric mannequin in a hospital bed as nursing students study at the Center for Simulation Innovation at the University of Texas Health Science Center.

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Bob Owen / San Antonio Express-News

Peter Guarnero, an assistant professor, asks nursing students Destiny Chavez-Levey and Esequiel Salcedo (in orange) about the “patients” they interacted with in psychological training.

First the nursing students heard the tune of “Soul Man.” Then, as the music faded, a voice.

“Look down! Look down. Why are you laughing? What’s funny?” they heard, followed by hysterical laughs and breathy murmurs. Then came sounds of someone in distress, of conflicting and sometimes bickering voices.

In another room, a woman with wild gray hair rocked back and forth on a hospital bed, asking two of the students if she could go home.

It was not a psychiatric ward, but the psychological training at the Center for Simulation Innovation at UT Health San Antonio, formerly the University of Texas Health Science Center. The recordings — the music, the voices — are what people with schizophrenia might hear in their heads and are deployed for an exercise called “empathy training.”

And for the first time this semester, in addition to using dozens of mannequins to train students in physical health symptoms and medical procedures, the hospital also hired actors who embodied mental health conditions that students had to work with.

“At the hospital, if they ask a patient ‘Do you feel suicidal?’ and they say ‘Yes,’ the student is kind of done and professionals take over. But here, the student can stay and work with them,” said James Cleveland, director of the center.

The students on Monday were tasked with filling out puzzles while listening to recordings that simulate what a schizophrenic person might hear, including music and delusional voices. Then center manager Lou Ann Click and her team asked questions to increase the students’ distraction, demonstrating how hard it might be for someone with these symptoms to carry on day-to-day activities.

“She kept saying over and over again ‘I want to go home.’ What do you think she was trying to say to you?” Peter Guarnero, an assistant professor, asked two students about the gray-haired actress they had interacted with earlier. “People communicate in layers. As you gain experience, you’ll start to see below the layers.”

The students threw out ideas about the hypothetical patient they had just seen. She was looking for safety, for comfort, maybe also for her pills, they decided. Guarnero pointed out that her home is also where the patient had memories of her late husband.

“This is just the beginning. … There are still all these blocks you have to build. You’ll have to know how to interview all kinds of patients,” he said.

Students Destiny Chavez-Levey, 22, and Esequiel Salcedo, 24, both worked in long-term acute care at a hospital last semester for their clinical experience. They saw patients with poor mental health, some just as a result of their long-term stay at the hospital. They could tell how important it was to communicate effectively to help improve their disposition.

“Then, it’s not just surface interaction. You build a whole relationship with your patients,” Chavez-Levey said. “You understand where they’re coming from, their background, everything.”

“I used to work in the oil field and I made great money, but I didn’t get that satisfaction out of it,” Salcedo said. “Here it’s like we’re helping people, we’re contributing to them getting better.” sfosterfrau@express-news.net

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