Celebrating All Who Say "I'm Possible"

With only two years of experience as a nurse and entirely new to the ED, Sara had just begun her evening shift. One of her patients, a seemingly physically fit male in his early 30’s, came to the ED complaining of chest pains that radiated to his back. He had been working in the hot sun all day and potentially had been exposed to solvents. He had no history of heart issues--or any health issues. His skin was cool, yet damp, but he was “joking and talkative” with everyone. “You can’t take symptoms at face value. You have to hit all the bases,” Sara said. “You can’t disregard anything."

Sara was the first to recognize that an ECG was mission-critical. She saw her patient starting to turn gray. “I immediately engaged a safety measure we have in our protocol that allows us to call for a 12-lead ECG without a doctor’s orders,” Sara said. She briefed her team and her actions ultimately led to the conclusion that the patient was on the verge of a catastrophic cardiac event. “I had a near-identical simulation as part of my training before transitioning to the ED. I left prepared to assert myself in a situation like this and manage the stress that can come with it.”

“当我在Med-Surg工作时，我在一个主要独立工作的环境中工作。在ED中，我是一个团队的一员。完全不同。当我们意识到病人正在遵守大规模代码时，我们的整个团队突然订婚了。一位连接心电图的护理人员，一个命令血液工作的护士，另一个建立了静脉注射。就像我在模拟中经历的那样，每个人都扮演分配的角色。”急诊医师进来并命令将患者转移到Cath Lab。患者在急诊室中不超过30分钟。

萨拉说：“我知道每一刻都是至关重要的。”“但是我对自己的平静感到惊讶。我只是不断重复自己，‘时间是大脑。时间是肌肉。尽快达到新的护理。’我是团队中的新护士。而且，我可能有点害羞。但是，我的仿真培训教会了我如何以及何时为患者和团队的利益而自信。它还教会了我如何管理压力。我对模拟的第一天不太满意，所以我要求回去更多。我对自己的自信有多大的自信，让我感到越过月球”

Sara’s story illustrates how simulation is being used in healthcare today to instill patient safety as a mindset. Historically, providers were confined to learning by treating real patients. The National Council of State Boards of Nursing (NCSBN) now recommends that simulation can be used to replace up to 50% of required clinical hours. Across healthcare, simulation is being used not only to teach clinical skills, but to teach critical thinking, leadership, and teamwork skills—the very skills exhibited by Sara to save her patient. “See one, do one” in healthcare is making room for “Simulate twice, act once.”

我们要感谢Sara和佛罗里达医院系统的模拟人员共同为实现零可预防伤害的目标做出了贡献。正是由于他们的奉献精神和努力（包括努力，教育者和领导力），所以萨拉（Sara）的案子不是她的第一个案例。如果不是Sara的模拟经历，那么她可能无法像她那样清晰地思考和果断地行事。You are examples to all of us in the simulation and patient safety community of what it means to say, “I’m possible.”