Simulation puts caregivers in Kalispell through realistic scenarios

Nursing home resident Martha has dementia and she is convinced someone is trying to steal her car. She’s veering from a window toward the parking lot, yelling for help. But her caregivers know there’s no one trying to steal her car, if she even has a car at the facility.

“I just want to know why he's in my car,” Martha demands.

“Well, he's gonna clean and detail it and have it serviced,” certified nursing assistant Debra Pond offers as a distraction. When Martha inquires about the cost, Pond thinks on her feet: “Your daughter's gonna pay for it. Isn't that nice of her?”

“Oh, that is nice. Can we go get some breakfast?” Martha says, finally pulling herself away from the window. 

This is all part of a scenario recently presented by Simulation in Motion Montana for Immanuel Living, formerly Immanuel Lutheran Communities. In the training, simulation specialists Charity Stephens plays the part of Martha and Priscilla Cates plays the role of her nurse. It’s the first time the senior living community has used SIM Montana’s realistic training scenarios to teach its caregivers how to navigate a high stress situation and give their residents the best care, according to LaVonne Basson, Immanuel Living’s certified nursing assistant trainer. With a mix of experienced certified nursing assistants and trainees present, the program was tailored to its participants. 

Basson said beginning last year, the organization held training sessions every four months for certified nursing assistants and those in training. 

“We do two days for skills fairs, we do different competencies that the state requires and what our director of nursing would like us to do. I don't do it interactively like this, but I'm going to start,” Basson said. “Everyone's enjoying today. It's not been a struggle to get our skills done — they've had fun.”

Basson occasionally drops hints and participants receive a little backup from the more experienced certified nursing assistants in the room, but everyone has a turn taking on an issue one-on-one with Martha. 

Cates is the director of nursing at Mountainview Medical Center in White Sulphur Springs and Stephens has 20 years of EMS experience, with time spent as an EMS chief in the Beartooth Mountains. 

Both say they have a passion for education in their field, adding that simulation trainings are an effective way for health care workers to gain skills and confidence while improving patient outcomes. 

“That's what we strive to bring whenever we do scenarios, in whatever situation it may be,” Stephens said. “And I myself, like Priscila, just love to be part of that dynamic to help bridge those gaps in different facilities. So I love teaching too, and that's why I left the position being an EMS chief to jump on board and teach across the state and in other states.”

Stephens puts on a stage worthy performance as nursing home resident Martha and training attendees are brought into her world. In her various scenarios, she tries to attack another resident named Betty (played by Cates), suffers from a stroke, has a fall and, lastly, becomes inconsolable when she hears of Betty’s passing. Training attendees get comfortable navigating the trickier sides of these situations, but also get practical experience with protocol, like when a clean catch urine sample was needed to determine if Martha had a UTI. 

“It gives them the ability to get hands on in a safe place, so that they can practice their skills, work on their teamwork, identify any gaps, learn their processes, their procedures and learn how to use their equipment,” Cates said. 

Of course, many aspects of the training are imaginary. But, those in attendance said it does often feel real. 

Alysha Wigner is two weeks away from obtaining her certified nursing assistant license. She said it was good to experience new situations.

“It felt very real, which is good, because then it gives you experience for when it actually does happen on the floor — when and if it does,” Wigner said. 

Luke St. James has been a certified nursing assistant for two-and-a-half years. He said the simulation is beneficial because it allows people to interact with a tricky situation with a safety cushion. 

“It's really putting you in the position without really a huge consequence if you were to get something wrong, because in here, they'll just give you pointers instead of like in real life, you can actually hurt somebody,” St. James said. “Plus, it's not on a computer, so you're really able to get into it, which is nice.” 

Pond said even with 30 years of experience as a caregiver and certified nursing assistant, you can never learn enough about these kinds of situations in long term care facilities. 

“We kind of laugh around in there because we know it's not real. But yes, it’s very similar. Real things like that have happened,” Pond said. “These are good training exercises, and you know, if they're not fun then we're not going to learn anything.” 

Immanuel Living Director of Nursing Lisa Gandolfi said the training promoted teamwork and reminded participants that they can call on their coworkers for help.

“When you're really stressed out it is easy to forget some of those little things. If someone's new, it's very easy to forget. So that's part of the whole teamwork thing, somebody else comes in, they might do something that you didn't think of doing that's going to make or break the situation,” Gandolfi said. 

SIM Montana offers many other types of training scenarios. Cates said she and Stephens did a postpartum hemorrhage training in Libby the previous day, where they worked with different health care staff through multiple sessions and tailored it for each group. 

Stephens said they can come up with a training for most any health care topic. She referenced a mannequin used for their postpartum training and said they have many others that can be used to simulate a wide variety of situations. 

“Hal, who is about a 5- to 7-year-old boy — we can do extensive trauma on him, he can be intubated, he can be cracked, he can take a needle decompression, he can do retraction and flail chest … so we can make these mannequins pretty much do any real life event,” Stephens said. 

SIM Montana staff work with facilities across the state, particularly in rural communities, to bring customized, life-like scenarios on high impact, low frequency medical events. More information about SIM Montana can be found on their website at www.simmt.org, including how to book a training session.

Immanuel Living is a retirement community in Kalispell. To learn more about the organization, go to www.ilcorp.org.

Reporter Taylor Inman can be reached at 406-758-4433 or by emailing tinman@dailyinterlake.com.