"I need a nurse. I can't breathe! Send a nurse!"
Maria Gonzales is in distress, and her caregivers need to figure out what to do.
She is sitting upright in her hospital bed, knees bent toward her chest. Beside her, a team of nurses and technicians scan the bar-coded bracelet on her wrist, and Gonzales' patient history flashes across the computer screen beside the bed. They quickly assess its contents — she was admitted two days ago with an inflamed pancreas — and check to see if she is flagged from receiving any medications.
A nurse applies a pulse oximeter to Gonzales' index finger to monitor oxygen saturation. Her levels are low. They place an oxygen mask over her nose and mouth. They check the screen again.
She has a history of high cholesterol. The medical team notes the clinical signs: alert and responsive, but expressing pain. What to do?
Complicating matters, her heart rate is low.
From an adjacent monitoring room, an instructor observes the scene through one-way glass but makes no move to help. The nurses, actually students, are on their own. The scene isn't playing out at St. Luke's or Lehigh Valley Hospital, but in a nursing simulator on the campus of Northampton Community College.
And Maria Gonzales is really in no danger. This "46 year-old wife and mother of two" is a mannequin.
This mannequin, however, is a smart dummy. "Maria Gonzales," one of six mannequins recently purchased by NCC at a cost of $75,000, has a full personal profile and medical history available to the students online. Instructor Marie Everhart in this class provided Maria's voice by speaking into a microphone from the observation room, where she also can alter the mannequin's health status.
Maria also has speakers in her ears and a camera installed in her head. This allows the instructors to video the exercise and then debrief the students afterward, said Mary Jean Osborne, program director for the nursing lab.
Gonzales is equipped to simulate 30 scenarios, such as pancreatic inflammation, sickle cell anemia, fractures and allergic reactions to blood transfusions. Instructors can alter the sex of each smart dummy to practice gender-specific exercises.
The technology, which began in the aviation industry with dummy test pilots measuring G-force, goes back about a decade in nursing applications. Neighboring centers of learning such as Lehigh Valley Health Network have been using simulators for some time, but they are new to NCC.
Using a high-tech mannequin "allows us to standardize experiences we'd like each student to have so they have an opportunity to practice what their responses should be," said Mali Bartges, director of nursing practice at the college.
"And to use their reasoning skills — what should I do first?"
As the exercise continues, Maria says she is in extreme pain and her oxygen levels drop.
Everhart leans into the microphone again and coughs for Maria. She presses another button, and Gonzales begins to blink.
"They better call for help," Everhart says.
Ultimately the students do, and the exercise reaches its conclusion. Afterward, the students realize that a rapid response team should have been summoned once the patient's heart rate dropped.
Worrying about administering pain medication, they agreed, is secondary.
There's an obvious benefit to using mannequins for learning.
"When you're using a mannequin you never have to worry about anyone dying or getting hurt," said Joan Yankalunas, education specialist for the Division of Education at Lehigh Valley Health Network.
"You can't do CPR on a live person, but you can certainly do that on a mannequin," she said. "So in those situations, getting the practice helps the student know how they're going to react and what they need to do in an emergency situation. And it's a safe way to learn it."
Student Jennifer Lamont, one of Gonzales' nurses, said the exercise with the mannequin provided a valuable learning experience.
"We are the nurses," she said. "Their lives are in our hands."