Simulation Scenario

Process:
Students will approach five patient beds within the simulation lab. Each patient’s name is clearly
designated at the head of the bed. There are orders, armbands, Kardexes, hand-off report sheets,
and an explanation of each scenario at each patient bedside. Students are to review each scenario
as a clinical group, collaborate with clinical group, and after review of each patient, determine
priorities and/or delegations of care, documenting their decisions on the form provided. Students
will be informed of the correct priorities at debriefing.
1. Patient: Susan Right
Age: 23; DOB 11/4/1995
Scenario:
You are the nurse. The health care provider has completed an assessment of the patient.
You cared for her yesterday after delivery. She appears more confused than when you
cared for her previously. The newborn is in the crib in the corner, sucking on her fist.
Vital Signs are: Temp 100.9, HR 116, RR 32, BP 80/60, SPO2 85% on Room Air
On your assessment, you note a boggy fundus, large clots, fundus remains boggy on
massage. Saline lock is in Right hand.
What will you do next?
2. Patient: Emma Right
Age: 1 day; DOB 11/13/XX
Scenario:
You are the nurse. The newborn is in the crib in the corner of the mom’s room.
Vital Signs are: Temp 37.2 C., HR 140, RR 34, BP 70/55, SPO2 95%
Weight: 7lb 2oz. Admit Apgar 8 at 1 minute and 9 at 5 minutes
On assessment, you note the vital signs are the same as what was given to you in the handoff report. The baby is sucking on her fist and moving around. You attempt to obtain a
feeding schedule from the mom, but she has a flat effect, not looking at the baby, and not
responding to the question.
What will you do next?
3. Patient: Elizabeth Willyou
Age: 24; DOB 3/24/1994
Scenario:
You are the nurse.
Vital signs are: Temp 98.6, HR 80, RR 16, BP 116/80.
On assessment the fundus is boggy with clots; the fundus firms with massage.
Hgb is 8 from 11 on yesterday
Hct is 28 from 32 yesterday
You received from hand-off report that the patient is receiving a unit of PRBCs. Upon
entering the room, the patient was having respiratory distress.
What will you do next?
4. Patient: JoAnna Train
Age: 27; DOB 04/19/1991
Scenario:
You are the nurse for the patient who is 39 weeks gestation, Gravida 2 Para 2.
Vital Signs are: Temp 99.1, HR 88, BP 122/60.
Her underpad is wet. You place the external fetal monitor and interpret the reading as
contractions 8 minutes apart, irregular, FHR is 120-130, moderate variability.
What will you do next?
5. Patient: Rebecca Dowee
Age 24: DOB 4/23/1994
Scenario:
You are the nurse.
Vital signs are: Temp 98.6, HR 110, RR 28, BP 98/60.
On assessment the fundus is boggy; she is diaphoretic. The patient is Muslim. Her
husband is not present at the time of your assessment.
Hgb is 8 from 11 on yesterday
Hct is 28 from 32 yesterday
What will you do next, while being culturally sensitive?
Decision/Delegation/Prioritization Activity
“What Would You Do Walk-Through”
1. Which patient requires attention First and how might you accomplish this?
Please explain the rationale for your decision:
2. Which patient will you see next, and how might you accomplish this BEST?
Please explain the rationale for your decision?
3. Which patient will you see next?
Please explain the rationale for your decision?
4. Which patient will you see next?
Please explain the rationale for your decision?
5. Which patient will you see last?
Please explain the rationale for your decision?
6. Place yourself in this situation, with this patient assignment. Reflect on what your BEST
course of action would be and how you might ensure patient-centered care.
Please Explain:
Rather than work as a group, you can work in pairs, share among the entire group and
come up with one document.
Write a progress note individually on one of the patients with PIE
Using SBAR, individually write a communication message to the Charge Nurse