A New Paradigm in Nursing and Healthcare

Ann Pauley

nursing-class“Let’s all gather around,” says Dr. Carrie O’Reilly, assistant professor of nursing, to her students.  They are dressed in their nursing scrubs – Trinity purple – seated on rolling medical exam stools.

The students are assembled in the gleaming nursing lab in the Payden Academic Center, surrounded by eight brand new hospital beds, each one outfitted with a panel of equipment – the same equipment these students will use in a hospital. Next door is another nursing lab, identically equipped.

Between the two labs are smaller spaces with three highly advanced, computer-controlled “simulation manikins” that emulate real-life patient symptoms and on which nursing students can practice skills and procedures. There is a “SIM Mom” that gives birth, a “SIM Man” that displays neurological and physiological symptoms, and a “Pediatric SIM” – providing students patient scenarios across the lifespan.

While the students are eager to use the state-of-the-art equipment to apply the knowledge they acquired in class that week and in hours of studying, O’Reilly takes time to lead them in a discussion first, to query their knowledge.

“Today we are going to focus on medication administration,” says O’Reilly. “Your training to be nurses is grounded in evidence-based practice. What is the evidence about administering medications?”

“One out of five medication encounters in health care includes an error,” says Jessica Siaw.

“That’s exactly right,” O’Reilly affirms. “So, if that’s the evidence, how does that inform your patient care as a nurse?”

“We have to check the medications list before we administer them, we have to review the last dosage, we have to be sure the patient is not allergic and we have to know if there might be an adverse interaction of two different medications,” Siaw says.

The conversation continues and, after O’Reilly is sure the students understand the foundation of knowledge for today’s lesson, she sends them off to the hospital beds for hands-on practice. They work in small groups and each student takes a turn going through the process of administering medications. They log in to a medical records simulator and look up a patient’s medication.

O’Reilly keeps a watchful eye on each group and then brings them back together. “How did Jessica do?” she asks the group? “Are there skills she can improve? Did she access the medical records properly?”

This is the new paradigm of teaching and learning nursing in the Payden Academic Center:  The deep foundation of knowledge and inquiry that has always been a hallmark of a Trinity degree, enhanced by state-of-the-art equipment that simulates the professional health care environment in which they will work.

“In health care, lives are on the line every day,” says O’Reilly, “so in our nursing program at Trinity, we have very high professional standards. The students have to be on time, they have to be fully prepared, they have to be dressed in their scrubs, they have to know the material in advance and they have to know how to use the equipment and technology. When they come to the nursing lab, they have to be ready to learn and practice the skills. We want them to think like they are with a real patient; we want them to be able to trouble shoot. Everything they practice here must become second nature when they are in a clinical setting.”

Those high expectations are not lost on Shirley Salazar, a nursing student who is now doing her clinical rotations at Providence Hospital and Children’s National Medical Center.

“When our class begins at 9:00 a.m, we’re expected to be here at 8:30 a.m,” says Salazar. “We need to be focused and ready to step right in and begin. The nursing labs in Payden are like a real job environment. I’ve learned time management skills and communication skills. My professors focus on the importance of self-discipline and taking responsibility.”

“Now that I am doing my clinicals in two hospitals, working with real patients, I see exactly why my professors emphasize those professional standards and keep reviewing what we learn,” Salazar notes. “Nothing is ever singular: When we learn a new skill in class, we don’t just study it once. We review the procedure again, and then, later, we review that skill in another context. And, at a certain point, you realize that this skill has become second nature. That matters. If you don’t learn that skill, you’re putting someone’s life at risk.”

Salazar, who wants to pursue a career in geriatric nursing, says that, “Nursing chose me and now it’s my passion. Nursing is challenging because there is so much information to learn, so to do well in the nursing program, and to become a nurse, it really has to be your passion.”

Salazar is a Joanne and William Conway Nursing Scholar, a scholarship program that is supporting more than 80 aspiring nursing students at Trinity. This past year, she was also awarded the Erin Kent Fink Nursing Scholarship.

“When I got the call about the Fink Scholarship, I dropped the phone and I cried,” Salazar recalls. “I was so humbled and so grateful that Trinity has such confidence in me.”

Salazar loves to take classes and study in the Payden Academic Center. “The labs are amazing and there’s so much space where we can study and crack open our books. The space really fosters a sense of community among the nursing students. We’re here for each other, we help each other and we count on each other for support. We all have a sense of pride in this place. On exam days, we gather and pray together.”

Dr. Denise Pope, associate dean of nursing and the chief nursing officer at Trinity, echoes the importance of that sense of community that Salazar describes. “The nursing students have a home here in the Payden Academic Center. Everything is here – their classes, their classmates, their professors. They are here early in the morning to study and do their homework. If they have a question, they can go down the hall where the faculty offices are and those doors are open. Having the faculty offices close together fosters collaboration among the professors and creates a great sense of professionalism – which the students see and respond to very positively.”

Dr. Mary Romanello, dean of the School of Nursing and Health Professions, highlights the added value of faculty collaboration. “Dr. O’Reilly and Lisa Simmons, director of the occupational therapy assistant program, are collaborating on developing a case study for their students focused on a patient who has fallen. The nursing students and the occupational therapy students will be using a simulation manikin and the electronic medical records system. It’s important for these students to learn together because collaboration in the clinical setting will improve patient care.”

Pope notes the professional, state-of-the-art setting of the Payden Academic Center, combined with the high standards of the Trinity nursing program, fosters a sense of pride among the students. “Students here say, ‘I am a Trinity nurse’ and that means something – to them and to the health care community,” says Pope.

The quality and professionalism of a Trinity nurse is indeed being noted by the health care community.

One indicator is the number of graduates of Trinity’s nursing program who have been selected for competitive nursing residencies at top hospitals in the region. Marc Hill and Antoinette McNeil completed their bachelor of science in nursing degrees in December 2016 and are now in year-long nursing residencies at Georgetown University Hospital. Additional graduates selected for nursing residencies include Diamond Green ’16 and Joanne Alabos ’16 at Sibley Hospital; Margaret Halloran ‘16 at the National Institutes of Health, and Aviya Maverick ’16 at Children’s National Medical Center.

This track record extends to current students. This summer, two nursing students will have paid internships at Children’s National Medical Center:  Daniela Cabezas will be in the neonatal intensive care unit (NICU) and Jennifer Hernandez will be in the liver and kidney unit.

Beyond nursing, students in Trinity’s growing health care programs are also being recognized for their scholarly work. For example, Kristal Hayes, who is earning her master of occupational therapy, was just one of 20 students nationwide selected to participate this summer in the American Occupational Therapy Association’s institute in Boston, which focuses on the scientific research of occupational therapy and pairs students with doctoral-level mentors.

Gieshla Moore is earning her master of science in nursing, with a focus on nurse education, and will graduate from Trinity this May. “I have a passion for nursing and I want to teach future nurses,” she says. As part of her training at Trinity, she has an opportunity to observe and evaluate undergraduate nursing students in the labs.

Moore is a pediatric trauma nurse at Children’s National Medical Center. “As a practicing nurse at a top hospital, I am very impressed by the nursing labs and state-of-the-art equipment in the Payden Academic Center,” says Moore. “This building is beautiful and the medical equipment that you see in the labs, that the students are learning on, is what they will use in a hospital.”

Back in the nursing lab, the students are wrapping up for the day. O’Reilly reflects on what she finds so rewarding as a nurse educator. “My greatest joy is knowing that for those who are called to this profession, their lives will be transformed and they will have a positive impact on the lives of others every single day.”