Within the next decade, the American healthcare system will experience a sea change. The Baby Boomer generation is rapidly aging, rates for chronic issues like obesity and diabetes keep rising, and there is a growing emphasis on preventative care. Healthcare systems across the country will soon experience an influx of older patients who require specialized, long-term care. Nurses will provide much of this care; however, many states are experiencing a shortage of nurses.
The Bureau of Labor Statistics estimates that the need for registered nurses will grow by 15% from 2016 to 2026. The need for licensed practical nurses (LPNs) and nursing assistants is expected to grow by 12% and 11% respectively. By 2030, California will be short some 45,500 registered nurses, the most of any state.
These statistics paint a dire picture for states like California who could see patient outcomes and safety suffer as understaffed healthcare systems struggle to provide adequate care. Fortunately, many educational institutions are stepping up to meet the demand for nurses. They are also using innovative methods to prepare future nurses to meet these patients’ needs and increase safety.
Gurnick Academy (GA) is a private college in California offering allied health and nursing programs. Gurnick Academy has campuses in San Mateo, Concord, Sacramento, Modesto, Fresno, and Los Angeles. Students can earn an AS in Vocational Nursing, an AS in Nursing, a BS in Nursing, and many other healthcare degrees.
In 2016, the school formed the Program Advisory Committee (PAC), a group of stakeholders and programmatic directors who meet biannually with faculty and staff. These meetings give PAC members and faculty time to discuss programmatic updates and improvements to the training students receive.
This year’s meeting was especially significant as Gurnick Academy established a new simulation center and started an RN program in 2018. The meeting focused on the school’s efforts to increase the use of high-fidelity simulation in the sim center in order to earn accreditation from the Society for Simulation in Healthcare (SSIH).
GA uses Gaumard’s entire family of high-fidelity patient simulators to train their nursing students. In addition to a variety of lower fidelity simulators and nursing skill trainers, students run through various patient care scenarios using the high-fidelity manikins Pediatric HAL, Super Tory, Noelle, Victoria, and Adult Hal.
GA’s simulation center is designed to look like a hospital. Each bay in the center represents a unit in a hospital such as a delivery room, a med-surg unit, a pediatric suite, etc. This gives students the opportunity to practice core concepts of the nursing process and gain hands-on experience treating a variety of patients and ailments before they enter a real hospital.
Moreover, the scenarios are designed to engage the students’ critical thinking and clinical judgment skills, so they practice how to reason through a case and provide timely, accurate care. This is in contrast to traditional clinical hours wherein students mostly observe an experienced nurse.
Furthermore, students can become overly cautious with a real patient out of fear of harming them if they make a mistake. “I tell students: if you make a mistake, I want you to do it here. It’s better they make a mistake on the simulator than on a real patient,” says Shelvia Salvano, Simulation Coordinator for Grunick Academy.
Simulation scenarios encourage students to think critically about how best to treat the patient. Mistakes are not life-threatening in a simulation scenario. Instead, students learn from mistakes and are instructed to think critically about the choices they make while treating a simulated patient. This type of training can potentially reduce errors in the real world.
What’s more, scenarios are created with the help of the latest educational materials and content matter experts. In addition, local hospital policies are consulted to make the entire experience as accurate as possible.
Therefore, the scenarios reflect the rigors and stress of a real emergency. Training in the sim center allows students to become accustomed to the work environment they will enter into, so they feel less overwhelmed when confronted with an emergency.
When the simulation is complete, students will participate in a debriefing session. Debriefing after a scenario is a key part of the training students receive in the sim center since it provides them with a chance to discuss their performance in the scenario and find areas of improvement.
Ms. Salvano has gone through Stanford’s Simulation Instructor Course. Thus, she is up to date on evidence-based practices, knows how to design and implement simulation scenarios, and has well-developed debriefing skills.
This is the vision Dr. Larisa Revzina, Chief Academic Officer at Gurnick Academy and one of the founding PAC members, had for the nursing program. She sought to give students a space where they could receive a career-focused education while developing their professional skills.
Providing students with this training is especially important, considering that the shortage in the healthcare workforce is partially caused by a growing shortage of clinical training sites. An increasing number of nursing schools are cutting the number of students they accept into their program because access to clinical sites is limited. Thankfully, simulation allows students to get the hands-on clinical practice they need; therefore, schools can keep up with the demand for nurses.
California currently allows for a maximum of 25% of the curriculum to be taught using simulation. GA’s investment in the sim center ensures their learners have no gaps in their education. Coupled with GA’s commitment to providing students with a pipeline to employment partners after they graduate, the investment could also help ease California’s nurse shortage.