I was happy to receive "Preparing Clinicians for Transitioning Patients across Care Settings and into the Home through Simulation" by Molloy and colleagues, an article featured in this issue. Simulation has been used for many years to allow healthcare students to practice certain clinical procedures in a supportive, low-risk environment. As technology advanced and new procedures emerged, simulation also became an important part of the preparation of licensed clinicians in the acute care setting. It is only more recently that simulation has been used to prepare home care clinicians for care of patients in the community.
Simulation began as a way to prepare student nurses for patient care around the year 1911, when the practice mannequin "Mrs. Chase" was installed at the Hartford Hospital Training School in Hartford Connecticut. (Nickerson & Pollard, 2010). Ms. Sutherland, principal of the Hartford Hospital Training School asked a local toy manufacturer to make a life size doll for student nurses to learn patient care procedures (Hermann, 1981). By 1916, a "Mrs. Chase hospital doll" was described in an article about a nursing school "demonstration room", and the author noted a crib was set aside for a "Baby Chase doll" (Bloomfield, 1916). This suggests simulation had expanded to pediatric care and had become an established method of student education in nursing schools in a very short amount of time.
Mrs. Chase went on to become the most recognizable "patient", and nurses of any age will remember her as an important component of their nursing school days. The first Mrs. Chase mannequins, used mostly for learning to make an occupied bed and perhaps to administer a "hypodermic", didn't have palpable pulses, audible blood pressures, or countable respirations as do today's high-fidelity (realistic) mannequins. They certainly couldn't talk or have a traceable heart rhythm. Over time the dolls became more "high tech" with orifices to allow for urinary bladder catheterization, nasogastric tube insertion, and ostomy care practice.
The famous Mrs. Chase even appeared in the popular Cherry Ames series. Cherry Ames, a well-known literary nurse heroine, was introduced to Mrs. Chase in her nursing school laboratory when she was a student nurse. When a lonely pediatric patient asked for doll, Cherry got the idea to "borrow" Mrs. Chase from the nursing school laboratory, and let the little patient play with her. Cherry received admiration from the patient's physician but earned a stern reprimand from her supervisor when her scheme was discovered (Wells, 1944).
In their article, Molloy et al. describe a simulation experience designed to prepare students or home care clinicians to transition patients from hospital to home, a time fraught with the potential for miscommunication and errors. Practicing in a safe environment can give learners experience and confidence to perform the activity on their own. The scenario described by Molloy and colleagues provides the opportunity for students or clinicians to communicate with the patient and family, conduct medication reconciliation, assess the safety of the home environment, and conduct a focused physical examination.
I hope you enjoy the article, as well as the others we have for you this issue. As always, we appreciate your comments and feedback. Email me at HHNEditor@gmail.com.