Still dressed in their scrubs, the nurses gathered to figure out what went wrong. The patient, 5-year-old Angel Calderon, had come in presenting symptoms of respiratory distress. Pneumonia, most likely.
The nurses put on paper gowns and latex gloves but forgot their masks - a must when dealing with an unknown respiratory ailment. Their mistake puts their own health, and the health of everyone else in the hospital, at needless risk.
Various digital instruments of modern medicine spiked and beeped, signaling a drop in the level of oxygen in Angel's blood. A nurse tilted his head back to ease his breathing, a standard procedure. Still, Angel's levels kept falling.
"Why is he turning blue? Do something!" shouted Angel's mother. "You're supposed to be our nurses!"
As his oxygen levels fell, Angel's heart raced, trying to compensate by moving more blood through his system. Angel's mother begged the nurses to call a doctor as her child turned bluer and bluer. A nurse put an oxygen mask on Angel's face to help him breathe, but couldn't seem to make it work. At one point he placed the mask upside down on Angel's face, prompting a strangely distant cry of, "What are you doing? I can't breathe!"
This child, thankfully, was a mix of soft plastic and circuits. His mother a second-semester student, as were the other "nurses" in the room. Appearances aside, this scenario played out not in a hospital room but in the new 31,000-square-foot Clinical Skills Center of Las Vegas. One of the largest of its kind west of the Mississippi, the center is located at UNLV's Shadow Lane campus in the heart of Las Vegas's medical district.
The center is a unique collaboration among the nursing schools at UNLV and Nevada State College and, more unusually, the University of Nevada School of Medicine. By training future nurses and doctors alongside each other, the facility's simulations will be all that more realistic.
The inspiration for the center came during a taxi ride Carolyn Yucha, UNLV's dean of nursing, shared with her Nevada State counterpart after a conference three and a half years ago. Both marveled about the simulation facilities elsewhere and lamented the struggle of funding one for Southern Nevada. Yucha looked up and asked, Why don't we do one together?
With the addition of the medical school, the project became a Nevada System of Higher Education priority. Having three institutions involved helped shelter the project from Nevada's budget woes. The state provided $14 million to remodel a space on the Shadow Lane campus. Then the project attracted the attention of The Lincy Foundation, which provided $3.2 million to purchase furnishings and top-of-the-line equipment. Additional equipment purchases came from federal appropriations.
The most expensive pieces of equipment are the computer-controlled training mannequins. Their pulses appear to race, their blood chemistry to change. You can sew stitches on some and perform CPR on others, says Suzanne Sharp, a nurse and technician who controls the simulations. One even recreates a live birth.
"Do you have any children of your own?" Sharp asks. "No? Then you probably don't want to know (how it happens)."
For the record: A metal motor shoves a life-sized infant doll out of a life-sized mom mannequin. Red finger paint makes the simulation as life-like as possible when there's a turn for the worse.
Several mannequins simulate bodily fluids. There's a dye to mimic the red backflow of blood when a needle is inserted into a vein. One mannequin sweats. Others have full bladders. And then there's fake vomit, mixed from canned soup, canned corn, and foul-smelling sulfurous compounds. It assaults more than one sense as it's passed in a blue, kidney-shaped bowl under the noses of the students.
But Yucha says the most important feature of the mannequins is "they allow our students to make mistakes."
Traditionally, nursing students learn theory in the classroom and receive practical training with real patients at a hospital while their instructors watch, prepared to step in if a student begins to make a mistake. This is morally necessary but educationally unfortunate. Mistakes are powerful teachers, as the nursing students who trained on "Angel Calderon" can attest.
After their simulation, the entire class reviews its performance on a digital replay. The student who put that mask on upside down watches his performance, putting his head in his hands and shaking it. There's much still to learn.