Medical Personnel Torture: The High Fidelity Code Simulation Lab

Off the top of my head, I’m trying to think of professions that have simulators and airplanes and NASA shuttles are the only ones I can think of. Plenty of professions run simulated experiences– like police, firefighters and the like.

Code Simulation

In medicine, we too run simulations. Often these are called mock codes. Sadly, it’s really hard to practice real code events in a non-threatening situation because people don’t voluntarily offer to be put into cardiac arrest for us to practice bringing them back.

It is important to practice because all sorts of team dynamics can be analyzed and discussed and no one has died in the process. The issue with medicine is that mannequins are static– they don’t give you information. Usually, there is a code facilitator who feeds information to the group. Not only does a mannequin not give information but you often can’t do real procedures on them– like start IV’s or intubate.

Over the last several years this has changed. Mannequins have evolved and become more life like to allow for a more realistic code experience. They draw breath. They can have procedures done to them.

Recently, I participated in a high-fidelity code simulation. The purpose was to do it with fellow nurses that I work with on my unit. This made it more interesting because there are already team dynamics in place. We were all emergency nurses with many years of experience. We know each others quirks and weaknesses.

The photo is fairly close to how our room was set up. The situation is presented in as real an environment as possible. Another nurse comes and gets you and presents the scenario and then generally leaves.

Our team was comprised of three nurses, one nurse practitioner, a physician and a respiratory therapist.

The first scenario went off without a hitch and we were feeling pretty good about ourselves . . . until scenario #2.

I can’t give much away because I did sign a confidentiality agreement to not divulge specifics about the scenario. Let’s just say the scenario was difficult as it presented us with a lot more torture than any of us imagined would be involved in a mock situation.

Team dynamics are a very interesting thing. Not only was there a lot of stress in our scenario, but tension, frustration and hopelessness at one point. It’s amazing to feel all of that even when intellectually you know that no one’s life is at risk.

I think these type of code simulations are invaluable and I hope that more and more hospitals invest in this type of training for their staff. It has been show to increase staff competency.