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Transforming Geriatric ED Care Through Immersive Simulations
I work in a teaching hospital, in a town called Sherbrooke, in Canada. We are a level 2 geriatric ACEP accredited emergency department.
We have GEM nurses, physiotherapists, social workers, a pharmacist, special equipment, adapted protocols and transition of care innovations. Yet, our staff would, by default, rapidly go back to a non-adapted way to care for older adults whenever the ED is crowded: “we know how to care for older adults, we just don’t have the time to do it!”. But, is that really the problem here?
Our geriatric committee had to come up with something that will change the way our staff is thinking. Immersive simulation. We developed a one-hour training session, using our six geriatric simulation costumes. They have to do what seems to be simple tasks, but become tremendous in a 90 years old frail body. For one hour, they have functional limitations, sensory deprivations and most importantly, they lose control of their life.
One of the tasks is the try to get up from a stretcher to a chair with an IV line in, a cardiac monitor, blood pressure cuff on, saturometer and a urinary catheter. It is nearly impossible to do so without help. Another task is to lie down on a backboard with a c-collar on for 5 minutes. During all that time, instructors play the busy and slightly annoyed nurses and doctors.
At the end, we take 30 minutes to reflect on what they went through. They ALL are completely shocked and surprised about their ED experience as an older adult. “I felt so helpless and alone”. “No wonder they become delirious after a few hours; I was delirious after 30 minutes!”.
“I will take the extra two minutes to provide better care, it’s worth it”. “I felt trapped in my own body”. “I realize now why it is important to adapt the way we are taking care of older adults”. “Thank you for this eye-opening training, EVERY healthcare worker should go through this in their early training”. These are the reactions we got, just to name a few.
I think we found a key! Immersive simulation changes how we think, how we feel and how we care for older adults. Plus, it is fun and team building. Try it!
You can create low-cost versions of the geriatric suit here.
Audrey Brousseau, Canada