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Vital Signs

Nurse residency program uses simulated patients

Flat line. It is your first day as a new nurse and you find your patient not breathing and pulseless. In that moment, the years of working diligently in school seem erased and you feel insecure and panicked." This is how DHMC oncology nurse Megan Rezendes R.N., M.S.N., described—in a recent article for a nursing journal—the anxiety that a new nurse can feel when faced with his or her first patient emergency.

Historically, nurses have acquired expertise in various specialties through years of experience with real-life patients. But a new graduate nurse residency program at DHMC, which Rezendes helped develop, aims to accelerate that learning curve by using human-patient simulators—sophisticated mannequins that respond physiologically and even talk like real patients.

Skills: The 12-week program is designed to help newly hired nurses, many of whom have just graduated from nursing school, become oriented to DHMC and develop the specialized skills they will need as nurses in a tertiary-care center.


These trainees in DHMC's nurse residency tend here to a simulated patient.

Other academic medical centers have nurse residency programs, but "there are very few that have integrated human-patient simulation to the degree that we have," says Suzanne Beyea, R.N., Ph.D., the director of nursing research. (The Spring 2004 issue of Dartmouth Medicine described the use of human simulators in the DHMC physician residency programs.) Beyea, along with Linda Kobokovich, R.N., director of nursing practice, and others, conceived of the program late in 2003. Orientation for new nurses varied greatly from department to department, so they created a common template. By June 2004, they'd assessed the needs of each department, developed a curriculum, and launched the program. Shortly thereafter, it received a three-year, $471,000 grant from the U.S. Department of Health and Human Services.

Eventually, Beyea and Kobokovich would like to adapt the program for use in the yearly evaluations of nurses. "Simulation will help us ensure the competency of nurses around what we believe are critical care issues," says Kobokovich.

—Jennifer Durgin

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