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New family takes up residence in Nursing

By Michelle Osmond

A new family has taken up residence in the School of Nursing. Noelle, who comes with baby Hal, is a birthing simulator and, like the real thing, she can give birth with all of the complications that could go with it.

Recently, Noelle, who was a $46,000 investment, went through her first simulation for a group of fast track students. Christine Castagné and Brenda Oldford, nursing laboratory instructors at the Learning Resource Centre where Noelle and Hal live, spent two weeks getting ready for the simulation with faculty member Paula Kelly.

“There are so many things to remember from medication to equipment so the students have everything they need for whatever situation comes up,” explained Ms. Castagné. “We also need to generate our scenario to determine exactly what the students will have to deal with once the labour starts.”

Noelle can be controlled remotely up to 100 metres, which means the students have to think on their feet as the instructor, who’s off to the side, touches a handheld computer tablet that prompts Noelle to behave a certain way in real-time.

As the fetus rotates and makes its way down the birth canal, Noelle can simulate many of the complications that happen in a live birth such as hemorrhaging (from an internal refillable tank), catheterization with the flow of simulated urine, she can have a vertex, breech or caesarean section delivery, has multiple heart and respiratory sounds, and she comes with monitors for fetal heart rate, uterine contractions and maternal and neonatal vital signs.

She can even talk, saying things such as “Ahhh, the pain!” and “I want an epidural.” During the scenario, the instructor has the ability to change Noelle and Hal’s vital signs so the students must assess their patients and perform nursing interventions. The students are able to monitor blood pressure, heart rate, respiratory rate, pulses, heart sounds, lung sounds and pupil reaction to light. The students can also perform nasal or oral intubation if necessary.

Newborn Hal also has realistic pulses in his umbilical cord and head. He can be made to cry vigorously and move using programmable arm motion. If the scenario requires, the instructors can also program him to change facial color through various intensities of blue or to simulate a seizure.

Sarah Douglas is in her first year of the two year fast track program. She had spent the previous day in a real labour and delivery situation and says she wished she’d had the simulation experience first.

“If everyone can go through and use Noelle before actually going into the labour and delivery room, I think it would help a great deal,” she said. “They’d be able to better understand what’s going on and if they can remember all the steps they took, they would know what was happening next and why. That way, if they had to step in and take a role, they’d have no problem doing that. I definitely feel more prepared to go into a case room than I was yesterday.

“The most important thing I learned was to watch for respiratory depression and to keep a constant eye on the fetal heart monitor just to make sure nothing goes wrong. I had gone through that in the real birth but it was nice to go through it without any panic.”

Ms. Douglas thought the simulation was very insightful. “I liked that we were all there performing different roles and that I could stand back and admire how everyone worked together with great communication and just to see how everything would go in a real labour and delivery room in terms of teamwork.”
The simulation with Noelle only confirmed for Sarah what she wants to do after graduation.

“I absolutely want to go into obstetrics. I loved it. I’m very big on family and kids. I knew as soon as I saw someone having a baby, I’d be very emotional. It’s so exciting. Although it was a fake baby, I was still getting emotional!”