By Marcia Frellick
Interprofessional training has gained prominence in the RN-to-BSN program at Drexel University in Philadelphia with a 10-week program launched in fall 2015 focusing on patient safety. Nurses watch video scenarios with actors including anesthesiologists, surgeons and other care providers from several disciplines, and use online simulation to respond as a nurse in a specific emergency.
Gloria F. Donnelly, PhD, RN, FAAN, dean and professor at Drexel’s College of Nursing and Health Professions, provides an example from the course: A patient arrives for a routine procedure. A nurse is working with an anesthesiologist who can’t access the airway but brushes aside the nurse’s concerns that the patient has been hypoxic for too long. The nurse sees the anesthesiologist is not following protocol. The nurse must use the TeamSTEPPS model — a system developed by the Agency for Healthcare Research and Quality that encourages open communication and calling out procedure violations.
Nurses in the class videotape themselves and submit their responses. Members comment as a group and rate the responses. “A problem with claims and suits against nurses is failure to act,” Donnelly said. “This program raises the nurse’s level of awareness of her obligation to speak up. Your license is on the line.”
The RNs already work daily with other disciplines; the course helps them practice in a safe, simulated environment and take what they’ve learned back to their workplace. They learn skills such as when to be the leader and when to let others lead.
Karen Goldschmidt, PhD, RN, department chairwoman of the RN-to-BSN program says they chose to focus on video simulations, instead of putting nurses together with students from other disciplines, because the nurses’ experience level was hard to match. “I have students in my program who are ages 21 to 75,” she said. She said she sees the value in learning together simultaneously, and looks at the video training as a first step toward that goal.
Nurses reflect on the video experience as part of the class. She said reaction has included statements such as, “I need to speak up” and “I need to find my voice.” “We’re giving them the tools through TeamSTEPPS to make that happen,” Goldschmidt said.
Among them are the “CUS words”: state your Concern, let the team know you are Uncomfortable and state that this is a Safety issue and why, and state what action you will take. She said she was surprised to find many students were uncomfortable even taping their responses in the comfort of their own home. Some were uncomfortable critiquing each others’ work.
Nurses in the Drexel program also learn to work with other disciplines in a community and public health course. They analyze a system that provides health services such as a senior center, meal delivery service or diabetic care program, and research how the service is funded, how staff work together, how many people they serve and whether they have a nurse on staff. “We have to get them out of the acute care mindset,” Goldschmidt said.
Students in the program also can choose, instead of the public health course, to travel on the annual trip to Paraguay with physicians, nurse practitioners and PAs to help with issues such as diabetes control and to repair medical facilities in an underserved population.
Marcia Frellick is a freelance writer.
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