1 00:00:08,842 --> 00:00:10,977 WELCOME TO THE CLINICAL CENTER GRAND ROUNDS, 2 00:00:11,044 --> 00:00:14,781 A WEEKLY SERIES OF EDUCATIONAL LECTURES FOR PHYSICIANS AND 3 00:00:14,848 --> 00:00:17,417 HEALTH CARE PROFESSIONALS BROADCAST FROM THE CLINICAL 4 00:00:17,484 --> 00:00:20,387 CENTER AT THE NATIONAL INSTITUTES OF HEALTH IN 5 00:00:20,453 --> 00:00:22,188 BETHESDA, MD. 6 00:00:22,255 --> 00:00:25,725 THE NIH CLINICAL CENTER IS THE WORLD'S LARGEST HOSPITAL TOTALLY 7 00:00:25,792 --> 00:00:29,429 DEDICATED TO INVESTIGATIONAL RESEARCH AND LEADS THE GLOBAL 8 00:00:29,496 --> 00:00:32,365 EFFORT IN TRAINING TODAY'S INVESTIGATORS AND DISCOVERING 9 00:00:32,432 --> 00:00:34,534 TOMORROW'S CURES. 10 00:00:34,601 --> 00:00:43,910 LEARN MORE BY VISITING US ONLINE AT HTTP://CLINICALCENTER.NIH.GOV 11 00:00:43,977 --> 00:00:59,459 >> GOOD AFTERNOON. 12 00:00:59,526 --> 00:01:00,927 WE INVITE TO YOU PROVIDE 13 00:01:00,994 --> 00:01:06,533 FEEDBACK BY SCANNING THE QR CODE 14 00:01:06,599 --> 00:01:09,602 AND FOR THOSE WANTING CME YOU'LL 15 00:01:09,669 --> 00:01:12,338 PROVIDE A LINK AND THE USE THE 16 00:01:12,405 --> 00:01:16,576 FEEDBACK FOR THE PRESENTATION 17 00:01:16,643 --> 00:01:17,844 AND QUESTIONS FOR THE SPEAKERS 18 00:01:17,911 --> 00:01:19,412 WILL BE TAKEN FOR THE 19 00:01:19,479 --> 00:01:23,249 MICROPHONES IN THE AISLES. 20 00:01:23,316 --> 00:01:24,417 ADDITIONALLY, VIDEOCAST VIEWERS 21 00:01:24,484 --> 00:01:26,653 MAY SCROLL DOWN AND CLICK THE 22 00:01:26,719 --> 00:01:28,721 LIVE FEEDBACK BUTTON LOCATE ON 23 00:01:28,788 --> 00:01:31,624 THE VIDEOCAST WEBSITE. 24 00:01:31,691 --> 00:01:32,525 QUESTIONS WILL BE ANSWERED AS 25 00:01:32,592 --> 00:01:35,395 TIME PERMITS AT THE CONCLUSION 26 00:01:35,462 --> 00:01:36,863 OF THE PRESENTATION. 27 00:01:36,930 --> 00:01:39,165 TODAY WE'RE PROUD TO PRESENT OUR 28 00:01:39,232 --> 00:01:41,868 ANNUAL GRAND ROUNDS SPONSOR THE 29 00:01:41,935 --> 00:01:43,169 CLINICAL CENTER NURSING 30 00:01:43,236 --> 00:01:44,270 DEPARTMENT TO RECOGNIZE NATIONAL 31 00:01:44,337 --> 00:01:44,871 NURSES MONTH. 32 00:01:44,938 --> 00:01:48,875 THE PRESENTATIONS WILL FOCUS ON 33 00:01:48,942 --> 00:01:50,643 SIMULATION TRAINING AND NURSING 34 00:01:50,710 --> 00:01:57,383 AND HONORED TO HAVE MAYBEL GOMEZ 35 00:01:57,450 --> 00:02:03,389 MEJIA AND DR. JENNIFER JABARA 36 00:02:03,456 --> 00:02:06,359 AND EUGENA BERGVALL. 37 00:02:06,426 --> 00:02:10,697 DR. GOMEZ IS A GRADUATE FROM 38 00:02:10,763 --> 00:02:11,297 COLOMBIA. 39 00:02:11,364 --> 00:02:14,634 AFTER COMPLETING HER RESIDENCY 40 00:02:14,701 --> 00:02:17,637 IN INTERNAL MEDICINE CARDIOLOGY 41 00:02:17,704 --> 00:02:23,910 SHE BECAME AN INSTITUTIONAL 42 00:02:23,977 --> 00:02:31,184 CARDIOLOGIST AND THEN HELD 43 00:02:31,251 --> 00:02:37,891 POSITIONS OF INCREASIE IIE IING 44 00:02:37,957 --> 00:02:39,359 RESPONSIBILITY IN THE CRITICAL 45 00:02:39,425 --> 00:02:42,595 CARE DEPARTMENT. 46 00:02:42,662 --> 00:02:44,631 SHE'S CURRENTLY EARNING A 47 00:02:44,697 --> 00:02:46,833 MASTER'S DEGREE IN EPIDEMIOLOGY 48 00:02:46,900 --> 00:02:48,334 WITH THE SCHOOL OF HYGIENE AND 49 00:02:48,401 --> 00:02:56,809 TROP TROP -- TROPICAL MEDICINE 50 00:02:56,876 --> 00:02:58,845 AND FOLLOWING HER FELLOWSHIP AT 51 00:02:58,912 --> 00:03:02,081 HARVARD SHE JOINED AS A CLINICAL 52 00:03:02,148 --> 00:03:05,218 SIMULATION FACILITATOR. 53 00:03:05,285 --> 00:03:07,053 DR. GOMEZ DEVELOPED AND 54 00:03:07,120 --> 00:03:07,787 IMPLEMENT THE STRATEGIC ROAD MAP 55 00:03:07,854 --> 00:03:09,489 FOR THE CREATION OF A CLINICAL 56 00:03:09,556 --> 00:03:12,859 CENTER WIDE SIMULATION PROGRAM. 57 00:03:12,926 --> 00:03:14,360 STANDARDIZING AND IMPROVING 58 00:03:14,427 --> 00:03:15,862 CAPABILITIES WITHIN THE CLINICAL 59 00:03:15,929 --> 00:03:17,630 CENTER AND HAS LED A FACULTY IN 60 00:03:17,697 --> 00:03:20,433 THE DEVELOPMENT AND EXECUTION OF 61 00:03:20,500 --> 00:03:26,639 16 HIGH FIDELITY TRAINING 62 00:03:26,706 --> 00:03:28,841 INITIATIVES WITH FOCUS ON 63 00:03:28,908 --> 00:03:30,376 INTERPERSONAL COLLABORATION AND 64 00:03:30,443 --> 00:03:31,945 COMMUNICATION AND HER ACADEMIC 65 00:03:32,011 --> 00:03:33,646 INTEREST IS IN COLLECTIVE 66 00:03:33,713 --> 00:03:34,814 INTELLIGENCE AND DEBRIEFING IN 67 00:03:34,881 --> 00:03:36,082 HEALTH CARE. 68 00:03:36,149 --> 00:03:42,021 OUR SECOND SPEAKER, DR. JENNIFER 69 00:03:42,088 --> 00:03:42,522 JABARA IN THE NURSING 70 00:03:42,589 --> 00:03:43,056 PROFESSIONAL DEVELOPMENT 71 00:03:43,122 --> 00:03:49,295 PROGRAM. 72 00:03:49,362 --> 00:03:49,862 LIEUTENANT COMMANDER IN THE 73 00:03:49,929 --> 00:03:54,834 PUBLIC HEALTH SERVICE SHE EARNED 74 00:03:54,901 --> 00:03:59,973 HER BACHELOR'S OF NURSING AT 75 00:04:00,039 --> 00:04:02,442 PENNSYLVANIA AND WORKED IN END 76 00:04:02,508 --> 00:04:06,913 OF LIFE PEDIATRIC CARE AND 77 00:04:06,980 --> 00:04:11,784 FAMILIES AND CHALLENGED PR 78 00:04:11,851 --> 00:04:18,925 PRACTITIONERS FOR END OF LIFE 79 00:04:18,992 --> 00:04:22,428 PLANNING AND WAS IN NURSING AND 80 00:04:22,495 --> 00:04:23,396 HEALTH CARE LEADERSHIP PROGRAM 81 00:04:23,463 --> 00:04:25,098 AT VANDERBILT. 82 00:04:25,164 --> 00:04:28,001 IN ADDITION TO HER ROLE AS A 83 00:04:28,067 --> 00:04:30,536 NURSE EDUCATOR AND PART OF THE 84 00:04:30,603 --> 00:04:33,439 SIMULATION TEAM AMONG 85 00:04:33,506 --> 00:04:34,407 RESPONSIBILITIES INCLUDE THE 86 00:04:34,474 --> 00:04:36,509 COORDINATOR OF THE FUNDAMENTALS 87 00:04:36,576 --> 00:04:38,077 OF NURSING RESEARCH NURSING 88 00:04:38,144 --> 00:04:40,513 CURRICULUM, THE GENOMICS AND 89 00:04:40,580 --> 00:04:45,184 GENOMICS AND GENETICS EDUCATION 90 00:04:45,251 --> 00:04:46,686 PORTFOLIO AND COORDINATING JS 91 00:04:46,753 --> 00:04:48,321 EDUCATING PROGRAM. 92 00:04:48,388 --> 00:04:50,923 AS A U.S. OFFICER SHE HAS 93 00:04:50,990 --> 00:04:53,860 UTILIZED SIMULATION AND HER 94 00:04:53,926 --> 00:04:54,894 EXPERTISE IN HEALTH CARE 95 00:04:54,961 --> 00:04:56,596 SIMULATION PREPARING FELLOW 96 00:04:56,663 --> 00:04:57,830 OFFICERS FOR DEMANDING ROLES IN 97 00:04:57,897 --> 00:05:01,567 THE FACE OF EMERGING INFECTIOUS 98 00:05:01,634 --> 00:05:06,372 DISEASES OR NATIONAL DISASTER. 99 00:05:06,439 --> 00:05:10,677 SHE'S A PROFESSIONAL LEADERSHIP 100 00:05:10,743 --> 00:05:13,813 FELLOW AND A GLOBAL HEALTH 101 00:05:13,880 --> 00:05:16,182 GRADUATE IN THE PROGRAM. 102 00:05:16,249 --> 00:05:18,951 THE THIRD SPEAKER IS 103 00:05:19,018 --> 00:05:21,154 DR. BERGVALL NEUROSPECIALIST IN 104 00:05:21,220 --> 00:05:23,022 THE NURSING DEPARTMENT. 105 00:05:23,089 --> 00:05:24,891 SHE'S A DISTINGUISHED ADVANCED 106 00:05:24,957 --> 00:05:28,027 PRACTICE NURSE AND TRIPLE BOARD 107 00:05:28,094 --> 00:05:31,297 CERTIFIED AS A CLINICAL NURSE 108 00:05:31,364 --> 00:05:32,598 SPECIALIST AND HOLDING SPECIALTY 109 00:05:32,665 --> 00:05:36,102 CERTIFICATIONS FOR CRITICAL CARE 110 00:05:36,169 --> 00:05:36,736 AND NEUROSCIENCE NURSING. 111 00:05:36,803 --> 00:05:40,573 SHE EARNED HER BACHELOR'S OF 112 00:05:40,640 --> 00:05:43,409 NURSING AT THE UNIVERSITY OF 113 00:05:43,476 --> 00:05:46,345 COLORADO AND NURSING PRACTICE AT 114 00:05:46,412 --> 00:05:48,347 THE MARYLAND BALTIMORE AND 115 00:05:48,414 --> 00:05:52,318 COMPLETING A POST-DOCTORAL 116 00:05:52,385 --> 00:05:53,886 PROGRAM AT THE OHIO STATE 117 00:05:53,953 --> 00:05:54,721 UNIVERSITY. 118 00:05:54,787 --> 00:05:58,558 AS LEADER IN HER FIELD, 119 00:05:58,624 --> 00:06:00,860 DR. BERGVALL DEVELOPED THE 120 00:06:00,927 --> 00:06:02,428 NURSING EDUCATION SERIES AND 121 00:06:02,495 --> 00:06:04,997 CO-DIRECT THE EBPFULLOSHIP 122 00:06:05,064 --> 00:06:09,402 PROGRAM AND PUBLISH THE EPILEPSY 123 00:06:09,469 --> 00:06:11,104 CHAPTER IN THE NURSING CORE 124 00:06:11,170 --> 00:06:12,939 CURRICULUM AND WAS A CORE 125 00:06:13,005 --> 00:06:14,407 CONTRIBUTOR TO THE FIRST 126 00:06:14,474 --> 00:06:15,541 CERTIFICATION PROGRAM FOR 127 00:06:15,608 --> 00:06:16,008 SEIZURE AND EPILEPSY 128 00:06:16,075 --> 00:06:18,478 PROFESSIONALS. 129 00:06:18,544 --> 00:06:21,714 SHE BRINGS AN OVER TWO DECADES 130 00:06:21,781 --> 00:06:23,082 OF EXPERIENCE IN CLINICAL 131 00:06:23,149 --> 00:06:24,450 NEUROSCIENCE AND CRITICAL TRAUMA 132 00:06:24,517 --> 00:06:30,456 NURSING WITH 17 YEARS AT THE 133 00:06:30,523 --> 00:06:40,399 BEDSIDE IN ICU IN GERMANY. 134 00:06:40,466 --> 00:06:43,269 SHE HAS PUBLISHED ON EBP AND 135 00:06:43,336 --> 00:06:44,070 TECHNOLOGY INTEGRATION. 136 00:06:44,137 --> 00:06:46,939 SHE'S AN ACTIVE MEMBER OF 137 00:06:47,006 --> 00:06:48,474 MULTIPLE NATIONAL NURSING 138 00:06:48,541 --> 00:06:49,509 ORGANIZATIONS AND SERVING ON 139 00:06:49,575 --> 00:06:50,777 SEVERAL NATIONAL COMMITTEES AND 140 00:06:50,843 --> 00:06:53,946 FOUND BOARD MEMBERS OF THE 141 00:06:54,013 --> 00:06:55,381 AMERICAN ASSOCIATION OF -- 142 00:06:55,448 --> 00:06:56,449 MARYLAND ASSOCIATION OF CLINICAL 143 00:06:56,516 --> 00:06:58,017 NURSE SPECIALISTS. 144 00:06:58,084 --> 00:07:00,686 TITLE OF TODAY'S PRESENTATION A 145 00:07:00,753 --> 00:07:01,988 TRANSFORMING NURSING EDUCATION 146 00:07:02,054 --> 00:07:03,990 AND PREPAREDNESS IN SIMULATION. 147 00:07:04,056 --> 00:07:06,392 PLEASE JOIN ME IN WELCOMING OUR 148 00:07:06,459 --> 00:07:09,996 SPEAKERS, DR. GOMEZ, DR. JABARA 149 00:07:10,062 --> 00:07:10,396 AND DR. BERGVALL. 150 00:07:10,463 --> 00:07:17,770 THANK YOU. 151 00:07:17,837 --> 00:07:19,939 >> THANK YOU, EVERYONE FOR 152 00:07:20,006 --> 00:07:20,673 HAVING US TODAY. 153 00:07:20,740 --> 00:07:25,478 IT'S A REAL PLEASURE TO BE HERE 154 00:07:25,545 --> 00:07:27,613 CELEBRATING THE NIH CLINICAL 155 00:07:27,680 --> 00:07:31,751 CENTER NURSING DEPARTMENT 156 00:07:31,818 --> 00:07:32,418 ACHIEVEMENTS IN RECOGNITION OF 157 00:07:32,485 --> 00:07:34,120 THE SIMULATION PROGRAM. 158 00:07:34,187 --> 00:07:36,289 WE WOULD LIKE TO TAKE YOU TODAY 159 00:07:36,355 --> 00:07:40,560 ON A JOURNEY ESPECIALLY THIS 160 00:07:40,626 --> 00:07:43,095 BEAUTIFUL FRIENDSHIP BETWEEN 161 00:07:43,162 --> 00:07:44,964 NURSING EDUCATION AND 162 00:07:45,031 --> 00:07:45,364 SIMULATION. 163 00:07:45,431 --> 00:07:47,533 SO I HAVE TO TAKE YOU BACK IN 164 00:07:47,600 --> 00:07:49,802 TIME AND REVIEW THE HISTORY OF 165 00:07:49,869 --> 00:07:52,205 SIMULATION AND NURSING EDUCATION 166 00:07:52,271 --> 00:07:53,940 TO UNDERSTAND THE PAST, TO 167 00:07:54,006 --> 00:07:55,775 UNDERSTAND THE PRESENT AND 168 00:07:55,842 --> 00:07:57,610 PREPARE FOR THE FUTURE. 169 00:07:57,677 --> 00:07:59,912 DR. JABARA WILL TALK ABOUT 170 00:07:59,979 --> 00:08:02,515 SIMULATION IN THE CLINICAL 171 00:08:02,582 --> 00:08:05,151 CENTER AND DR. BERGVALL WILL 172 00:08:05,218 --> 00:08:10,256 SHOW YOU THE BEHIND THE SCENES 173 00:08:10,323 --> 00:08:11,390 USING SIMULATION. 174 00:08:11,457 --> 00:08:14,694 SO TO START, I WOULD LIKE TO ASK 175 00:08:14,760 --> 00:08:16,529 YOU ALL A QUESTION. 176 00:08:16,596 --> 00:08:19,932 SO PLEASE LOOK AT THIS LADY, USE 177 00:08:19,999 --> 00:08:23,069 YOUR CELL PHONES, SCAN THIS C.R. 178 00:08:23,135 --> 00:08:24,737 QR CODE AND LET US KNOW WHO DO 179 00:08:24,804 --> 00:08:35,214 YOU THINK THIS LADY IS? 180 00:08:37,717 --> 00:08:39,986 THE FIRST PATIENT AT BELLEVUE IN 181 00:08:40,052 --> 00:08:45,524 NEW YORK OR AMERICA'S FIRST 182 00:08:45,591 --> 00:08:50,663 TRAINED NURSE OR YOU GOT IT. 183 00:08:50,730 --> 00:08:54,767 THE AUDIENCE SAYS THIS IS MS. 184 00:08:54,834 --> 00:08:55,401 CHASE. 185 00:08:55,468 --> 00:08:56,769 THAT'S CORRECT. 186 00:08:56,836 --> 00:08:59,038 SHE WAS THE FIRST SIMULATION 187 00:08:59,105 --> 00:09:00,172 USED IN 1911. 188 00:09:00,239 --> 00:09:03,409 SHE WAS DEVELOPED WHEN THE 189 00:09:03,476 --> 00:09:06,312 PRINCIPLE OF THE HOSPITAL HERE 190 00:09:06,379 --> 00:09:09,181 IN THE PICTURE, THEY THOUGHT 191 00:09:09,248 --> 00:09:10,850 MAYBE IF STUDENTS COULD PRACTICE 192 00:09:10,917 --> 00:09:18,524 SKILLS ON SOME TYPE OF DOLL, AND 193 00:09:18,591 --> 00:09:24,797 REACHED OUT TO A DOLL MAKER FROM 194 00:09:24,864 --> 00:09:26,198 PAWTUCKET, RHODE ISLAND TO 195 00:09:26,265 --> 00:09:28,801 DEVELOP THE SIMULATOR. 196 00:09:28,868 --> 00:09:31,237 MS. CHASE BECAME POPULAR IN 197 00:09:31,304 --> 00:09:35,408 NURSING EDUCATION AND USED UNTIL 198 00:09:35,474 --> 00:09:40,012 THE EARLY '80s. 199 00:09:40,079 --> 00:09:42,014 MS. CHASE WAS EXPENSIVE AND NOT 200 00:09:42,081 --> 00:09:43,983 AFFORDABLE FOR MANY NURSING 201 00:09:44,050 --> 00:09:44,417 SCHOOLS. 202 00:09:44,483 --> 00:09:47,954 LIKE IN REAL LIFE, RIGHT? 203 00:09:48,020 --> 00:09:52,391 SO NURSES BECAME VERY CREATIVE 204 00:09:52,458 --> 00:09:58,064 AND IN 1914, A NURSE FROM NEW 205 00:09:58,130 --> 00:09:59,098 YORK PUBLISHED IN THE AMERICAN 206 00:09:59,165 --> 00:10:02,068 JOURNAL OF NURSING INSTRUCTIONS 207 00:10:02,134 --> 00:10:07,173 ON HOW TO MAKE A HOMEMADE 208 00:10:07,239 --> 00:10:11,377 HOSPITAL DOLL FOR $7.30. 209 00:10:11,444 --> 00:10:17,116 SHE ALSO ADDED A PATH TO 210 00:10:17,183 --> 00:10:18,317 PRACTICE HYPODERMIC INJECTIONS. 211 00:10:18,384 --> 00:10:20,419 OF COURSE TECHNOLOGIES HAVE 212 00:10:20,486 --> 00:10:24,924 EVOLVED OVER THE YEARS FROM MS. 213 00:10:24,991 --> 00:10:26,792 CHASE TO THE FIRST TO PRACTICE 214 00:10:26,859 --> 00:10:29,362 RESUSCITATION SKILLS AND THE 215 00:10:29,428 --> 00:10:34,066 FIRST COMPUTERIZED MANNEQUIN 216 00:10:34,133 --> 00:10:40,306 USED FORRANCE -- FOR ANESTHESIA 217 00:10:40,373 --> 00:10:46,979 AND I WANTED TO MENTION HERE 218 00:10:47,046 --> 00:10:53,652 PATTY DUGER THE FIRST 219 00:10:53,719 --> 00:11:00,793 STANDARDIZED PATIENT AND A 220 00:11:00,860 --> 00:11:03,396 NEUROLOGIST TRAINED FOR A 221 00:11:03,462 --> 00:11:06,032 PATIENT WITH MULTIPLE SCLEROSIS. 222 00:11:06,098 --> 00:11:08,701 AT THE TIME IT WASN'T ACCEPTED 223 00:11:08,768 --> 00:11:11,404 PEOPLE WERE MAD BUT AFTER A 224 00:11:11,470 --> 00:11:12,471 COUPLE YEARS IT PROVED TO BE A 225 00:11:12,538 --> 00:11:16,142 GREAT TOOL TO TEACH. 226 00:11:16,208 --> 00:11:18,744 OF COURSE CHANGING NEEDS AND 227 00:11:18,811 --> 00:11:24,550 SIMULATION BECOME AN ESSENTIAL 228 00:11:24,617 --> 00:11:26,919 TOOL LED TO SOPHISTICATED 229 00:11:26,986 --> 00:11:29,488 MANNEQUINS LIKE THE ONES YOU SEE 230 00:11:29,555 --> 00:11:32,792 HERE WITH A VARIETY IN PATIENTS 231 00:11:32,858 --> 00:11:35,361 LIKE WE HAVE NOW WE HAVE ADULT 232 00:11:35,428 --> 00:11:35,928 AND GERIATRIC POPULATION AS 233 00:11:35,995 --> 00:11:38,597 WELL. 234 00:11:38,664 --> 00:11:41,300 BUT SIMULATION TECHNOLOGY HAS 235 00:11:41,367 --> 00:11:42,768 EVOLVED IN RESPONSE TO CHANGES 236 00:11:42,835 --> 00:11:45,004 IN NURSING EDUCATION. 237 00:11:45,071 --> 00:11:48,441 AND NURSING EDUCATION HAS 238 00:11:48,507 --> 00:11:51,110 CHANGED BECAUSE WE HAVE A HEALTH 239 00:11:51,177 --> 00:11:52,711 ENVIRONMENT THAT IS CHANGING ALL 240 00:11:52,778 --> 00:11:52,978 THE TIME. 241 00:11:53,045 --> 00:11:54,814 OF COURSE NOW WE HAVE A NEW 242 00:11:54,880 --> 00:11:57,683 CONTENT OF TEAM WORK WHERE WE 243 00:11:57,750 --> 00:12:00,486 BRING WE ALL BRING SKILLS AND 244 00:12:00,553 --> 00:12:02,721 KNOWLEDGE TO PERFORM WELL AND TO 245 00:12:02,788 --> 00:12:03,622 HELP OUR PATIENTS. 246 00:12:03,689 --> 00:12:06,759 SO LET'S START WITH THE NURSING 247 00:12:06,826 --> 00:12:07,026 EDUCATION. 248 00:12:07,093 --> 00:12:11,397 HERE WE HAVE LINDA RICHARDS, THE 249 00:12:11,464 --> 00:12:14,733 FIRST TRAINING NURSE IN THE 250 00:12:14,800 --> 00:12:15,301 UNITED STATES. 251 00:12:15,367 --> 00:12:18,838 SHE ESTABLISHED A MODEL AT THE 252 00:12:18,904 --> 00:12:19,572 BELLEVUE HOSPITAL. 253 00:12:19,638 --> 00:12:22,274 IT BECAME THE PRIMARY MODEL OF 254 00:12:22,341 --> 00:12:25,678 TRAINING NURSES FOR NEARLY A 255 00:12:25,744 --> 00:12:26,645 CENTURY. 256 00:12:26,712 --> 00:12:28,948 ESSENTIAL THEY TRAIN IN 257 00:12:29,014 --> 00:12:31,217 THEORETICAL AND PRACTICAL SKILLS 258 00:12:31,283 --> 00:12:32,718 AND IT PROVIDE THE NECESSARY 259 00:12:32,785 --> 00:12:35,087 KNOWLEDGE SKILLS AND ATTITUDE TO 260 00:12:35,154 --> 00:12:37,323 CARE FOR THE ILL. 261 00:12:37,389 --> 00:12:38,724 THE FOCUS OF THE MODEL WAS 262 00:12:38,791 --> 00:12:41,460 TECHNOLOGY SKILLS. 263 00:12:41,527 --> 00:12:43,896 HISTORICALLY HEALTH CARE 264 00:12:43,963 --> 00:12:47,199 PROVIDERS HAVE BEEN TRAINED BY 265 00:12:47,266 --> 00:12:50,336 OBSERVING IN AND ASSISTING AND 266 00:12:50,402 --> 00:12:53,873 FINALLY PERFORMING UNDER THE 267 00:12:53,939 --> 00:12:55,007 SUPERVISION UNDER MORE 268 00:12:55,074 --> 00:12:58,677 EXPERIENCED PRACTITIONERS AND 269 00:12:58,744 --> 00:13:01,247 SEE ONE, DO ONE, TEACH ONE OR IF 270 00:13:01,313 --> 00:13:04,150 THE LEARNERS HAD ACCUMULATED 271 00:13:04,216 --> 00:13:07,419 ENOUGH TIME OR EXPOSURE TO A 272 00:13:07,486 --> 00:13:09,622 PARTICULAR SKILL. 273 00:13:09,688 --> 00:13:14,727 THIS MODEL PROVED TO BE LIKE NOT 274 00:13:14,793 --> 00:13:15,728 PERFECT FOR MANY REASONS. 275 00:13:15,794 --> 00:13:18,464 SO WERE LEARNERS READY FOR 276 00:13:18,531 --> 00:13:19,865 INDEPENDENT PRACTICE? 277 00:13:19,932 --> 00:13:22,268 OF COURSE WE COULD PROVE THAT 278 00:13:22,334 --> 00:13:23,602 ACCUMULATED HOURS OF CLINICAL 279 00:13:23,669 --> 00:13:26,539 EXPERIENCE DO NOT TRANSLATE TO 280 00:13:26,605 --> 00:13:26,972 COMPETENCE. 281 00:13:27,039 --> 00:13:30,376 THAT'S NUMBER ONE. 282 00:13:30,442 --> 00:13:31,677 NUMBER TWO, TECHNOLOGY SKILLS 283 00:13:31,744 --> 00:13:34,246 ARE VERY IMPORTANT BUT WE ALSO 284 00:13:34,313 --> 00:13:36,081 NIECE NON TECHNICAL SKILLS. 285 00:13:36,148 --> 00:13:39,652 THE OTHER IS LEARNERS FINISH 286 00:13:39,718 --> 00:13:42,054 TRAINING ONE INCOMPLETE LEARNING 287 00:13:42,121 --> 00:13:42,254 CURVE. 288 00:13:42,321 --> 00:13:43,189 THE REASON BECAUSE WE DIDN'T 289 00:13:43,255 --> 00:13:45,658 HAVE ENOUGH CASES TO PRACTICE 290 00:13:45,724 --> 00:13:46,892 DIFFICULT CASES. 291 00:13:46,959 --> 00:13:49,895 AND THE LAST ONE THE LACK OF 292 00:13:49,962 --> 00:13:52,598 OPPORTUNITY TO DEVELOP 293 00:13:52,665 --> 00:13:53,432 INTERPROFESSIONAL TEAM WORK 294 00:13:53,499 --> 00:13:53,699 SKILLS. 295 00:13:53,766 --> 00:13:58,938 SO AFTER FINISHING THE TRAINING, 296 00:13:59,004 --> 00:14:00,706 THESE EXPERTS OR PROFESSIONALS 297 00:14:00,773 --> 00:14:03,809 NEEDED TO GO INTO THIS NEW WORLD 298 00:14:03,876 --> 00:14:05,110 WITH THE TRANSITION FROM 299 00:14:05,177 --> 00:14:07,913 TRAINING TO EXPERT. 300 00:14:07,980 --> 00:14:09,915 PERCEPTION OF UNPREPAREDNESS 301 00:14:09,982 --> 00:14:11,684 BECAUSE SKILLS LIKE MANAGEMENT 302 00:14:11,750 --> 00:14:12,952 AND LEADERSHIP WITH HIGHER 303 00:14:13,018 --> 00:14:14,753 DEGREES OF ANXIETY, STRESS AND 304 00:14:14,820 --> 00:14:18,057 BURNOUT AND DIMINISHED JOB 305 00:14:18,123 --> 00:14:18,457 SATISFACTION. 306 00:14:18,524 --> 00:14:21,227 SO SIMULATION CREATED A SAFE 307 00:14:21,293 --> 00:14:22,761 ENVIRONMENT WHERE THE LEARNERS 308 00:14:22,828 --> 00:14:24,496 COULD PRACTICE UNTIL THEY COULD 309 00:14:24,563 --> 00:14:29,235 EXCEL THOSE SKILLS. 310 00:14:29,301 --> 00:14:32,705 IN OTHER WORDS, JUST DELIBERATE 311 00:14:32,771 --> 00:14:33,672 PRACTICE, SYSTEMATIC PRACTICE TO 312 00:14:33,739 --> 00:14:34,640 IMPROVE SKILLS. 313 00:14:34,707 --> 00:14:36,942 THIS IS NOT ONLY FOR NEW 314 00:14:37,009 --> 00:14:37,509 LEARNERS. 315 00:14:37,576 --> 00:14:46,852 IT ALSO ALLI LILLI LILLI LILLLL 316 00:14:46,919 --> 00:14:48,153 LEARNERS WELL TRAINED AND WE CAN 317 00:14:48,220 --> 00:14:49,622 IMPROVE THE SKILLS WE ALREADY 318 00:14:49,688 --> 00:14:51,156 HAVE. 319 00:14:51,223 --> 00:14:53,325 IN OTHER WORDS, WE WENT FROM 320 00:14:53,392 --> 00:14:56,562 EACH ONE TO SEE ONE, DO ONE, 321 00:14:56,629 --> 00:14:57,663 SIMULATE MANY, SEE ONE, DO ONE, 322 00:14:57,730 --> 00:15:01,133 TEACH ONE. 323 00:15:01,200 --> 00:15:06,238 SO YOU KNOW THE FLORENCE 324 00:15:06,305 --> 00:15:08,240 NIGHTINGALE ADVOCATED FOR NURSES 325 00:15:08,307 --> 00:15:09,408 TO CONTINUE LEARNING BY URGING 326 00:15:09,475 --> 00:15:11,377 THEM TO REMAIN CURRENT AND 327 00:15:11,443 --> 00:15:14,346 COMPETENT IN THEIR NURSING 328 00:15:14,413 --> 00:15:14,747 PRACTICE. 329 00:15:14,813 --> 00:15:19,184 SO THAT MEANS WE HAD HIGHER 330 00:15:19,251 --> 00:15:21,520 STANDARDS OF PREPARATION TO 331 00:15:21,587 --> 00:15:24,023 PRACTICE AND NURSES NEEDED TO BE 332 00:15:24,089 --> 00:15:25,324 READY FOR MORE COMPLEX ROLES 333 00:15:25,391 --> 00:15:27,393 LIKE LEADERSHIP, PATIENT SAFETY, 334 00:15:27,459 --> 00:15:28,694 RESEARCH AND EDUCATION. 335 00:15:28,761 --> 00:15:30,729 AND WE DEVELOPED TWO NEW 336 00:15:30,796 --> 00:15:33,832 CONCEPTS IN NURSING EDUCATION, 337 00:15:33,899 --> 00:15:36,702 THE NURSE EDUCATOR ROLE AND 338 00:15:36,769 --> 00:15:40,939 PROFESSIONAL DEVELOPMENT IN THE 339 00:15:41,006 --> 00:15:42,374 EARLY '50s. 340 00:15:42,441 --> 00:15:43,676 THE SECOND IS THE INCREASING 341 00:15:43,742 --> 00:15:46,645 COMPLEXITY IN THE HEALTH SYSTEM 342 00:15:46,712 --> 00:15:49,315 EVOLVING REGULATORY REQUIREMENTS 343 00:15:49,381 --> 00:15:52,351 INCREASING FOCUS ON IMPROVING 344 00:15:52,418 --> 00:15:53,018 PATIENT SAFETY. 345 00:15:53,085 --> 00:15:56,855 LED US TO ACKNOWLEDGE THE HUMAN 346 00:15:56,922 --> 00:15:58,023 ERROR, WHY? 347 00:15:58,090 --> 00:16:00,993 BECAUSE WE ARE HUMANS AND 348 00:16:01,060 --> 00:16:01,260 FALLIBLE. 349 00:16:01,327 --> 00:16:03,228 THERE ARE MANY WAYS TO REPORT 350 00:16:03,295 --> 00:16:05,464 ACTIONS WE CAN TAKE TO MITIGATE 351 00:16:05,531 --> 00:16:07,766 THOSE HUMAN ERRORS. 352 00:16:07,833 --> 00:16:12,705 SO WHAT HAPPENED IN HISTORY? 353 00:16:12,771 --> 00:16:17,476 HERE WE HAVE DR. PEARCE WHO 354 00:16:17,543 --> 00:16:18,777 URGED FOR ONGOING PATIENT SAFETY 355 00:16:18,844 --> 00:16:20,512 SUSTAIN RESEARCH, TRAINING AND 356 00:16:20,579 --> 00:16:21,046 DAILY APPLICATION IN THE 357 00:16:21,113 --> 00:16:23,315 WORKPLACE. 358 00:16:23,382 --> 00:16:26,719 THEN WE HAVE THE PUBLICATION OF 359 00:16:26,785 --> 00:16:29,021 THE TO ERROR IS HUMAN FROM THE 360 00:16:29,088 --> 00:16:35,260 INSTITUTE OF MEDICINE AND WHAT 361 00:16:35,327 --> 00:16:37,262 WAS PUBLISHED FOR THE AGENCY OF 362 00:16:37,329 --> 00:16:39,365 AND QUALITY IN COLLABORATION 363 00:16:39,431 --> 00:16:40,566 WITH THE U.S. DEPARTMENT OF 364 00:16:40,632 --> 00:16:40,999 DEFENSE. 365 00:16:41,066 --> 00:16:45,204 THERE'S OTHER CONCEPTS IN HEALTH 366 00:16:45,270 --> 00:16:48,374 CARE WE HAVE ADOPTED FROM OTHER 367 00:16:48,440 --> 00:16:53,345 FIELD LIKE FOR EXAMPLE THE HIGH 368 00:16:53,412 --> 00:16:54,480 RELIABILITY ORGANIZATIONS 369 00:16:54,546 --> 00:16:59,184 REPAIRED -- PREPARED TO DEAL 370 00:16:59,251 --> 00:17:01,754 WITH UNEXPECTED SITUATIONS. 371 00:17:01,820 --> 00:17:03,889 THIS NEW ENVIRONMENT, NURSES ARE 372 00:17:03,956 --> 00:17:05,824 REQUIRED TO RESPOND TO DIFFERENT 373 00:17:05,891 --> 00:17:07,259 TYPES OF DEMANDS. 374 00:17:07,326 --> 00:17:08,861 PATIENT CARE DEMANDS AND ALSO 375 00:17:08,927 --> 00:17:11,397 HEALTH SYSTEM DEMANDS. 376 00:17:11,463 --> 00:17:13,832 SO THEY NEED TO BE SUPER 377 00:17:13,899 --> 00:17:15,868 FLEXIBLE WHICH ADDS MORE 378 00:17:15,934 --> 00:17:17,403 COMPLEXITY TO THE NURSING WORK 379 00:17:17,469 --> 00:17:20,072 WHICH IS ALREADY VERY COMPLEX. 380 00:17:20,139 --> 00:17:23,809 IT REQUIRES PHYSICAL, 381 00:17:23,876 --> 00:17:24,443 ORGANIZATIONAL AND COGNITIVE 382 00:17:24,510 --> 00:17:31,016 WORK AND NURSE HAVE A UNIQUE 383 00:17:31,083 --> 00:17:31,383 PERSPECTIVE. 384 00:17:31,450 --> 00:17:32,851 THEY CONTRIBUTE WITH CARE, 385 00:17:32,918 --> 00:17:34,319 KNOWLEDGE, EXPERTISE, VALUES OF 386 00:17:34,386 --> 00:17:37,689 CARING AND COLLABORATION AND THE 387 00:17:37,756 --> 00:17:41,260 NURSES HAVE ADOPTED CHANGED AND 388 00:17:41,326 --> 00:17:43,395 DEVELOPED AND CONTINUED CHANGES 389 00:17:43,462 --> 00:17:44,696 IN HEALTH CARE. 390 00:17:44,763 --> 00:17:46,799 THE NURSES TRANSFORMED THE WORK 391 00:17:46,865 --> 00:17:48,667 ENVIRONMENT TO MEET THE 392 00:17:48,734 --> 00:17:50,903 SIGNIFICANT DEMANDS IN HEALTH 393 00:17:50,969 --> 00:17:52,504 CARE, IN THE QUEST FOR 394 00:17:52,571 --> 00:17:52,805 EXCELLENCE. 395 00:17:52,871 --> 00:18:00,746 WHEN I WAS PREPARING THESE 396 00:18:00,813 --> 00:18:04,116 PRESENTATIONS, I FOUND THIS IS 397 00:18:04,183 --> 00:18:07,419 WHAT NURSE DOES. 398 00:18:07,486 --> 00:18:11,156 THEY'RE PATIENT ADVOCATES, 399 00:18:11,223 --> 00:18:13,992 NAVIGATOR AND COORDINATOR AND 400 00:18:14,059 --> 00:18:16,261 WHEN A PATIENT IS GETTING INTO 401 00:18:16,328 --> 00:18:17,563 TROUBLE UNTIL THE PATIENT'S 402 00:18:17,629 --> 00:18:21,500 NEEDS HAVE BEEN MET. 403 00:18:21,567 --> 00:18:23,402 WHAT A BEAUTIFUL CONCEPT THE 404 00:18:23,469 --> 00:18:28,040 NURSES BRING. 405 00:18:28,106 --> 00:18:31,643 THAT IS THE ELEMENT I WANT TO 406 00:18:31,710 --> 00:18:35,380 PREVIEW TODAY THE TEAM WORK AND 407 00:18:35,447 --> 00:18:35,714 COLLABORATION. 408 00:18:35,781 --> 00:18:37,316 THIS IS A CLINICAL TEAM TAKING 409 00:18:37,382 --> 00:18:38,417 CARE OF A PATIENT. 410 00:18:38,484 --> 00:18:39,585 THEY HAVE A COMMON GOAL. 411 00:18:39,651 --> 00:18:41,320 THEY WANT TO KEEP THE PATIENTS 412 00:18:41,386 --> 00:18:44,223 SAFE AND AVOID COMPLICATIONS. 413 00:18:44,289 --> 00:18:47,125 ALL OF THEM ARE WELL TRAINED AND 414 00:18:47,192 --> 00:18:49,561 HAVE THE BEST INTENTIONS AND 415 00:18:49,628 --> 00:18:53,532 THERE'S MANY ELEMENT ELEMENTS 416 00:18:53,599 --> 00:18:57,069 THAT CONTRIBUTE TO A GROUP 417 00:18:57,135 --> 00:18:57,369 PERFORMANCE. 418 00:18:57,436 --> 00:19:00,906 EACH TEAM MEMBER HAS A PRIORITY. 419 00:19:00,973 --> 00:19:02,508 IF A MEDICAL ERROR WAS MADE 420 00:19:02,574 --> 00:19:07,412 DURING THIS PROCESS, IT WAS NOT 421 00:19:07,479 --> 00:19:08,180 DISCUSSIBLE. 422 00:19:08,247 --> 00:19:10,115 THAT'S THE REASON WE NEEDED AN 423 00:19:10,182 --> 00:19:12,417 EVOLUTION IN TERMS OF HOW TO 424 00:19:12,484 --> 00:19:15,854 WORK AS A TEAM AND WE COULD 425 00:19:15,921 --> 00:19:18,423 DEMONSTRATE THAT COLLABORATIVE 426 00:19:18,490 --> 00:19:19,391 PRACTICE AND INTERPROFESSIONAL 427 00:19:19,458 --> 00:19:20,726 EDUCATION ACTUALLY HAS AN IMPACT 428 00:19:20,792 --> 00:19:23,495 ON A TEAM'S PERFORMANCE AND 429 00:19:23,562 --> 00:19:25,097 PATIENT'S SAFETY AND EFFECTIVE 430 00:19:25,163 --> 00:19:26,798 TEAM WORK BEHAVIOR MUST BE 431 00:19:26,865 --> 00:19:28,233 LEARNED AND IMPLEMENTED THROUGH 432 00:19:28,300 --> 00:19:30,102 TRAINING AND PRACTICE AND I CO 433 00:19:30,168 --> 00:19:32,604 GAC AGAIN TO THE CONCEPT OF WE 434 00:19:32,671 --> 00:19:35,774 HAVE TAKEN FROM OTHER FIELDS 435 00:19:35,841 --> 00:19:39,144 LIKE THIS ONE, HOW TO TEACH 436 00:19:39,211 --> 00:19:40,279 SMART PEOPLE HOW TO LEARN. 437 00:19:40,345 --> 00:19:43,448 WE HAVE WELL TRAINED CLINICIANS 438 00:19:43,515 --> 00:19:47,119 HERE BUT WE ALWAYS HAVE A 439 00:19:47,185 --> 00:19:47,486 ROUTINE. 440 00:19:47,553 --> 00:19:50,222 WHO IS CONSIDERED THE FATHER OF 441 00:19:50,289 --> 00:19:51,390 THE ORGANIZATIONAL LEARNING SAID 442 00:19:51,456 --> 00:19:53,525 THAT TO KEEP SMART PEOPLE WE 443 00:19:53,592 --> 00:19:56,528 NEED TO GO FROM SINGLE LEARNING 444 00:19:56,595 --> 00:19:59,097 WHERE YOU IDENTIFY A PROBLEM TO 445 00:19:59,164 --> 00:20:01,466 FIX A PROBLEM TO DOUBLE LOOP 446 00:20:01,533 --> 00:20:03,335 LEARNING WHERE YOU IDENTIFY THE 447 00:20:03,402 --> 00:20:04,369 PROBLEM AND REFLECT ON YOUR 448 00:20:04,436 --> 00:20:13,278 ACTIONS TO SOLVE THE PROBLEM. 449 00:20:13,345 --> 00:20:14,112 HERE'S IT'S COLLECTIVE 450 00:20:14,179 --> 00:20:16,281 INTELLIGENCE THE ABILITY OF A 451 00:20:16,348 --> 00:20:17,849 GROUP TO ACHIEVE MORE 452 00:20:17,916 --> 00:20:20,385 INTELLIGENT OUTCOMES THROUGH 453 00:20:20,452 --> 00:20:21,086 COLLABORATION EMERGES WHEN 454 00:20:21,153 --> 00:20:22,955 PEOPLE WORK TOGETHER OFTEN WITH 455 00:20:23,021 --> 00:20:26,758 THE HELP OF TECHNOLOGY TO SOLVE 456 00:20:26,825 --> 00:20:29,628 COMPLEX PROBLEMS. 457 00:20:29,695 --> 00:20:32,764 SO THIS IS SIMILAR TO WHAT WE DO 458 00:20:32,831 --> 00:20:34,066 EVERY DAY WE USE TECHNOLOGY AND 459 00:20:34,132 --> 00:20:35,167 HAVE TO SOLVE COMPLEX PROBLEMS. 460 00:20:35,233 --> 00:20:38,770 HOW CAN WE APPLY THIS CONCEPT TO 461 00:20:38,837 --> 00:20:41,006 THE HEALTH CARE ENVIRONMENT? 462 00:20:41,073 --> 00:20:41,440 IT'S EASY. 463 00:20:41,506 --> 00:20:43,275 WE USE AVAILABLE EXPERTISE, 464 00:20:43,342 --> 00:20:45,577 KNOWLEDGE AND SKILLS FOR MORE 465 00:20:45,644 --> 00:20:48,814 EFFECTIVE DECISION MAKING, 466 00:20:48,880 --> 00:20:49,848 PROBLEM SOLVING AND TASK 467 00:20:49,915 --> 00:20:51,283 EXECUTION SO THE TEAM DOES ITS 468 00:20:51,350 --> 00:20:52,951 COLLECTIVE BEST FOR THE PATIENT. 469 00:20:53,018 --> 00:20:58,924 HERE IN THE PICTURE, YOU CAN SEE 470 00:20:58,991 --> 00:21:02,628 A CLINICAL TEAM PRACTICING WITH 471 00:21:02,694 --> 00:21:07,633 SIMULATION AND YOU CAN SEE HERE 472 00:21:07,699 --> 00:21:12,137 THE TEAM LEADER WE HAVE TWO ICU 473 00:21:12,204 --> 00:21:15,374 NURSES, THE NURSE PRACTITIONER 474 00:21:15,440 --> 00:21:23,015 AND THE SPECIALIST IS SOME WOULD 475 00:21:23,081 --> 00:21:25,150 BEHIND AND THE ANESTHESIOLOGIST 476 00:21:25,217 --> 00:21:27,386 AND AFTER THAT HAVING A 477 00:21:27,452 --> 00:21:30,656 CONVERSATION WHERE EVERY TEAM 478 00:21:30,722 --> 00:21:32,524 MEMBER BRINGS VALUE TO THE 479 00:21:32,591 --> 00:21:33,525 DISCUSSION WITH RESPECT AND 480 00:21:33,592 --> 00:21:36,628 EXCHANGE OF KNOWLEDGE AND 481 00:21:36,695 --> 00:21:37,896 PRODUCTIVE CONVERSATION. 482 00:21:37,963 --> 00:21:42,734 SO WHY SIMULATION IN AN 483 00:21:42,801 --> 00:21:44,436 ENVIRONMENT LIKE THE NIH 484 00:21:44,503 --> 00:21:45,604 CLINICAL CENTER? 485 00:21:45,671 --> 00:21:48,874 IT'S NOT ONLY A TOOL TO SUSTAIN 486 00:21:48,940 --> 00:21:51,743 OR IMPROVE PERFORMANCE IT HAS 487 00:21:51,810 --> 00:21:52,844 SIMULATION THAT FOCUSES ON 488 00:21:52,911 --> 00:21:56,081 QUALITY, SAFETY AND SYSTEMS. 489 00:21:56,148 --> 00:22:00,352 WE CAN DEVELOP AND TEST WORD 490 00:22:00,419 --> 00:22:01,520 PROCESSES USING SIMULATION AND 491 00:22:01,586 --> 00:22:03,388 SOP AND SAFETY AND QUALITY 492 00:22:03,455 --> 00:22:05,323 ISSUES AND ENHANCE TEAM AND 493 00:22:05,390 --> 00:22:05,924 SYSTEM RESILIENCE. 494 00:22:05,991 --> 00:22:08,760 HERE WE HAVE THREE EXAMPLES. 495 00:22:08,827 --> 00:22:11,063 THREE DIFFERENT TEAMS USING 496 00:22:11,129 --> 00:22:11,630 SIMULATION TO PRACTICE THE 497 00:22:11,697 --> 00:22:14,032 RESPONSE. 498 00:22:14,099 --> 00:22:17,302 AT THE BLOOD BANK, AT 1 499 00:22:17,369 --> 00:22:24,743 SOUTHWEST AND IN RAID YOLLY -- 500 00:22:24,810 --> 00:22:28,947 RADIOLOGY AND HERE WE HAVE OUR 501 00:22:29,014 --> 00:22:29,948 MANNEQUIN VISITING THE ROOM IN 502 00:22:30,015 --> 00:22:35,087 THE THIRD FLOOR NEXT TO THE ICU 503 00:22:35,153 --> 00:22:35,821 JUST TO SEE HOW EMERGENCY 504 00:22:35,887 --> 00:22:40,192 RESPONSE WORKS IN THAT SPACE. 505 00:22:40,258 --> 00:22:43,161 SO THE FUTURE OF SIMULATION FOR 506 00:22:43,228 --> 00:22:44,296 NURSING PROFESSIONAL DEVELOPMENT 507 00:22:44,362 --> 00:22:46,732 NEEDS TO EVOLVE AS WELL. 508 00:22:46,798 --> 00:22:49,134 RIGHT NOW THE CURRENT SIMULATION 509 00:22:49,201 --> 00:22:50,736 PRIORITIES ARE IN EDUCATION AND 510 00:22:50,802 --> 00:22:53,271 TRAINING ASSESSMENT AND METRICS, 511 00:22:53,338 --> 00:22:54,840 IMPROVEMENT AND CULTURE CHANGE. 512 00:22:54,906 --> 00:22:57,542 BUT WE NEED TO MOVE INTO FUTURE 513 00:22:57,609 --> 00:22:58,944 RESEARCH PRIORITIES LIKE WE NEED 514 00:22:59,010 --> 00:23:01,646 TO MEASURE THE IMPACT ON PATIENT 515 00:23:01,713 --> 00:23:03,548 AND LEARNING OUTCOMES, THE COST 516 00:23:03,615 --> 00:23:05,917 EFFECTIVENESS AND RETURN ON 517 00:23:05,984 --> 00:23:09,321 INVESTMENT OF TRAINING PROGRAMS, 518 00:23:09,387 --> 00:23:09,988 SUSTAINABILITY SIMULATION 519 00:23:10,055 --> 00:23:13,024 EFFORTS AND EMPLOYEE WELLNESS. 520 00:23:13,091 --> 00:23:14,893 SO IF I DIDN'T CONVINCE YOU YET 521 00:23:14,960 --> 00:23:20,732 I WOULD LIKE YOU TO THINK OF ONE 522 00:23:20,799 --> 00:23:22,134 NON-PROFESSIONAL EXPERIENCE IN 523 00:23:22,200 --> 00:23:23,735 YOUR LIFE WHERE YOU HAVE ONE 524 00:23:23,802 --> 00:23:25,971 OPPORTUNITY TO DO EVERYTHING 525 00:23:26,037 --> 00:23:26,238 PERFECTLY. 526 00:23:26,304 --> 00:23:30,375 YOU KNEW EVERYTHING IN THEORY 527 00:23:30,442 --> 00:23:31,009 BUT IT WAS FAILED JUST THINK 528 00:23:31,076 --> 00:23:41,286 ABOUT THAT. 529 00:23:42,621 --> 00:23:43,388 I KNOW. 530 00:23:43,455 --> 00:23:51,396 REAL LIFE HAPPENS. 531 00:23:51,463 --> 00:23:53,865 SO SIMULATION IS NOT GOING FIX 532 00:23:53,932 --> 00:23:54,699 EVERY PROBLEM IN HEALTH CARE BUT 533 00:23:54,766 --> 00:23:57,402 CAN HELP US TO BE PREPARED FOR 534 00:23:57,469 --> 00:23:59,137 UNEXPECTED EVENTS. 535 00:23:59,204 --> 00:24:02,707 I'M SURE THIS GENTLEMAN CHECKED 536 00:24:02,774 --> 00:24:04,843 THE FORECAST, KNEW THE SPEECH 537 00:24:04,910 --> 00:24:07,813 AND ALL THE THINGS BUT HE DIDN'T 538 00:24:07,879 --> 00:24:10,782 PRACTICE OR REHEARSE THIS 539 00:24:10,849 --> 00:24:11,116 ACCIDENT. 540 00:24:11,183 --> 00:24:15,821 SO THINK OF THIS AND I'LL LET 541 00:24:15,887 --> 00:24:18,523 DR. JABARA CONTINUE WITH THIS 542 00:24:18,590 --> 00:24:28,733 JOURNEY. 543 00:24:29,100 --> 00:24:30,268 >> ALL RIGHT, THANK YOU, AND 544 00:24:30,335 --> 00:24:30,869 THANK YOU ALL FOR THE 545 00:24:30,936 --> 00:24:32,404 OPPORTUNITY TO KICK OFF NURSES 546 00:24:32,470 --> 00:24:32,838 MONTH TOGETHER. 547 00:24:32,904 --> 00:24:37,242 AS I LOOK AROUND THE ROOM I SEE 548 00:24:37,309 --> 00:24:39,110 MANY FAMILIAR FACES AND MANY MA 549 00:24:39,177 --> 00:24:40,779 THAT HAVE BEEN PART OF THE 550 00:24:40,846 --> 00:24:41,947 INITIATIVES IN THE NEXT SEGMENT 551 00:24:42,013 --> 00:24:43,381 WHERE WE'LL FOCUS ON THE 552 00:24:43,448 --> 00:24:44,382 PARTNERSHIP OR RELATIONSHIP 553 00:24:44,449 --> 00:24:47,319 BETWEEN THE CLINICAL CENTER 554 00:24:47,385 --> 00:24:48,353 NURSING DEPARTMENT AND THE NIH 555 00:24:48,420 --> 00:24:50,789 CLINICAL CENTER SIMULATION 556 00:24:50,856 --> 00:24:52,290 PROGRAM. 557 00:24:52,357 --> 00:24:54,292 ABOUT FIVE AND A HALF YEARS AGO 558 00:24:54,359 --> 00:24:55,760 WE CAME TOGETHER AND STARTED TO 559 00:24:55,827 --> 00:24:57,195 EXPLORE HOW TO EXPAND SIMULATION 560 00:24:57,262 --> 00:24:58,263 AT THE CLINICAL CENTER. 561 00:24:58,330 --> 00:24:59,898 THERE WAS A ROBUST PROGRAM FOR 562 00:24:59,965 --> 00:25:01,433 CRITICAL CARE AND WE WANTED TO 563 00:25:01,499 --> 00:25:02,601 HAVE AN OPPORTUNITY TO EXPAND 564 00:25:02,667 --> 00:25:05,704 THAT AND INCLUDE OTHERS O IN THE 565 00:25:05,770 --> 00:25:06,338 INTERPROFESSIONAL ENVIRONMENT 566 00:25:06,404 --> 00:25:08,640 AND THROUGHOUT THAT WE DEVELOPED 567 00:25:08,707 --> 00:25:10,375 THIS DEFINITION OF OUR ENHANCED 568 00:25:10,442 --> 00:25:11,209 SIMULATION CENTER. 569 00:25:11,276 --> 00:25:17,382 THUS IS PUBLISH -- THIS IS 570 00:25:17,449 --> 00:25:19,050 PUBLISHED IN THE CLINICAL CENTER 571 00:25:19,117 --> 00:25:22,621 WHERE WE ARE COMMITTED TO 572 00:25:22,687 --> 00:25:24,789 PREVENTING LAPSES AND ERRORS 573 00:25:24,856 --> 00:25:26,825 BEFORE WHERE PROBLEM AND I AM 574 00:25:26,892 --> 00:25:29,427 PROVING CAPABILITIES. 575 00:25:29,494 --> 00:25:31,396 OUR OPERATIONS INVOLVE HIGH RISK 576 00:25:31,463 --> 00:25:34,399 AND LOW VOLUME PROCEDURE THOUGH 577 00:25:34,466 --> 00:25:36,234 TRAINING PROGRAMS HAVE BEEN USED 578 00:25:36,301 --> 00:25:38,503 BY THE CRITICAL CARE AND NURSING 579 00:25:38,570 --> 00:25:39,938 DEPARTMENT THE SIMULATION 580 00:25:40,005 --> 00:25:40,672 CAPABILITIES NEED TO BE 581 00:25:40,739 --> 00:25:41,473 COORDINATED. 582 00:25:41,539 --> 00:25:43,375 ALSO, WE NEED TO ADD TRAINING 583 00:25:43,441 --> 00:25:45,243 FOR CONTINGENCIES IN PEDIATRIC 584 00:25:45,310 --> 00:25:47,178 PATIENTS TO THE CURRENT 585 00:25:47,245 --> 00:25:47,846 SIMULATION CAPABILITIES AS SOON 586 00:25:47,913 --> 00:25:48,480 AS POSSIBLE. 587 00:25:48,546 --> 00:25:52,183 THE CURRENT SIMULATION 588 00:25:52,250 --> 00:25:55,620 LABORATORY IS INADEQUATE AND A 589 00:25:55,687 --> 00:25:56,821 NEW LOCATION WILL BE IDENTIFIED 590 00:25:56,888 --> 00:25:58,023 AND RESOURCED AND THIS SETS THE 591 00:25:58,089 --> 00:26:00,425 STAGE FOR WHAT WE'VE DONE. 592 00:26:00,492 --> 00:26:01,526 WE RECOGNIZED WE HAD A LOT OF 593 00:26:01,593 --> 00:26:03,428 TALENT AND SOME RESOURCES AND 594 00:26:03,495 --> 00:26:05,263 DID THROUGH THE USE OF OUR 595 00:26:05,330 --> 00:26:07,432 EXPERTISE WERE ABLE TO DO A 596 00:26:07,499 --> 00:26:10,669 REALLY ROBUST EVALUATION OF WHAT 597 00:26:10,735 --> 00:26:11,403 WE ALREADY HAD WITHIN THE 598 00:26:11,469 --> 00:26:12,404 CLINICAL CENTER AND WHAT 599 00:26:12,470 --> 00:26:14,072 OPPORTUNITIES WE HAD FOR 600 00:26:14,139 --> 00:26:14,706 MATERIAL RESOURCES AS WELL AS 601 00:26:14,773 --> 00:26:16,341 PERSONNEL WE ADDED A STIMULATION 602 00:26:16,408 --> 00:26:19,044 TECHNICIAN TO OUR TEAM. 603 00:26:19,110 --> 00:26:24,082 WE'VE HAD A COUPLE DIFFERENT OHS 604 00:26:24,149 --> 00:26:25,650 AND PROUD TO SHARE WHERE WE'RE 605 00:26:25,717 --> 00:26:28,620 AT THE PROGRAM VISION IS TO 606 00:26:28,687 --> 00:26:34,693 ADVANCE PATIENT CARE AT THE 607 00:26:34,759 --> 00:26:35,627 CLINICAL CENTER WITH STATE OF 608 00:26:35,694 --> 00:26:37,696 THE ART STIMULATION IN THE 609 00:26:37,762 --> 00:26:39,264 CONTINUUM FOR TRAINING AND 610 00:26:39,331 --> 00:26:41,967 CLINICAL AND ADMINISTRATIVE 611 00:26:42,033 --> 00:26:42,300 PROFESSIONALS. 612 00:26:42,367 --> 00:26:43,969 MANY IN THE ROOM ENGAGED IN THE 613 00:26:44,035 --> 00:26:45,503 CLINICAL SIMULATIONS. 614 00:26:45,570 --> 00:26:47,939 WHAT MAKES US UNIQUE HOW WE DO 615 00:26:48,006 --> 00:26:49,474 IT AT THE CLINICAL CENTER IS THE 616 00:26:49,541 --> 00:26:50,842 RECOGNITION FOR MANY PATIENTS 617 00:26:50,909 --> 00:26:53,778 MANY OF OUR PROTOCOLS WE MAY BE 618 00:26:53,845 --> 00:26:56,614 DOING THINGS FOR THE FIRST TIME. 619 00:26:56,681 --> 00:26:58,049 WE PRIDE OURSELVES WITH OUR 620 00:26:58,116 --> 00:27:00,585 FIRST IN HUMAN SCIENCE AND HAVE 621 00:27:00,652 --> 00:27:02,320 TO FIND UNIQUE WAYS TO PREPARE 622 00:27:02,387 --> 00:27:03,855 AND SIMULATION SETS US UP FOR 623 00:27:03,922 --> 00:27:06,391 SUCCESS TO COME TOGETHER AS AN 624 00:27:06,458 --> 00:27:06,958 INTERPROFESSIONAL TEAM AND 625 00:27:07,025 --> 00:27:09,227 PRACTICE PRIOR TO THOSE PATIENTS 626 00:27:09,294 --> 00:27:10,428 COMING TO THE CLINICAL CENTER 627 00:27:10,495 --> 00:27:10,962 WE'LL HIGHLIGHT A COUPLE 628 00:27:11,029 --> 00:27:14,799 EXPERIENCES FOR YOU. 629 00:27:14,866 --> 00:27:17,402 OUR MISSION IS WORDY BUT WE AIM 630 00:27:17,469 --> 00:27:19,104 TO DEVELOP AND ESTABLISH AND 631 00:27:19,170 --> 00:27:20,438 SUSTAIN ONE COORDINATED CENTER 632 00:27:20,505 --> 00:27:23,208 AND PROGRAM FOR SIMULATION AND 633 00:27:23,274 --> 00:27:25,176 TRAINING TO SUPPORT PROFESSIONAL 634 00:27:25,243 --> 00:27:26,344 DEVELOPMENT OF THE CLINICAL 635 00:27:26,411 --> 00:27:27,879 CENTER STAFF BY DELIVERING STATE 636 00:27:27,946 --> 00:27:29,347 OF THE ART STIMULATION WE 637 00:27:29,414 --> 00:27:31,716 COMMITTED TO AND IMPROVE SYSTEMS 638 00:27:31,783 --> 00:27:33,718 AND TEAM PERFORMANCE AND SUPPORT 639 00:27:33,785 --> 00:27:36,154 A SAFER ENVIRONMENT ENHANCING 640 00:27:36,221 --> 00:27:37,255 PATIENT OUTCOMES ACROSS THE 641 00:27:37,322 --> 00:27:37,989 HEALTH SYSTEM. 642 00:27:38,056 --> 00:27:39,591 WHEN YOU READ THAT MISSION I 643 00:27:39,657 --> 00:27:41,426 HOPE AS YOU SEE THE WORK WE DO 644 00:27:41,493 --> 00:27:42,894 WE CONTINUALLY REFLECT BACK ON 645 00:27:42,961 --> 00:27:43,862 THE MISSION STATEMENT FOR WHAT 646 00:27:43,928 --> 00:27:45,663 ARE THE PRIORITIES AND WHERE WE 647 00:27:45,730 --> 00:27:46,798 ARE WE SPENDING TIME AND ENERGY 648 00:27:46,865 --> 00:27:47,932 AS A TEAM. 649 00:27:47,999 --> 00:27:50,535 YOU'RE SEEING MOST OF OUR TEAM 650 00:27:50,602 --> 00:27:51,369 THROUGHOUT TODAY AND CERTAINLY 651 00:27:51,436 --> 00:27:53,371 WE ARE COMMITTED TO THIS MISSION 652 00:27:53,438 --> 00:27:55,407 OF MAKING SURE IS THAT THIS IS 653 00:27:55,473 --> 00:27:56,508 AN INTERPROFESSIONAL PROGRAM 654 00:27:56,574 --> 00:27:57,809 WHERE WE'RE REACHING ALL ENDS OF 655 00:27:57,876 --> 00:28:05,884 THE CLINICAL CENTER. 656 00:28:05,950 --> 00:28:06,217 DR 657 00:28:06,284 --> 00:28:07,318 WE HAVE 16 ACTIVE SIMULATION 658 00:28:07,385 --> 00:28:08,620 PROGRAMS IN THE MIX AND WE HAD 659 00:28:08,686 --> 00:28:10,155 AN OPPORTUNITY TO PARTNER WITH 660 00:28:10,221 --> 00:28:12,257 THE OFFICE OF QUALITY AND SAFETY 661 00:28:12,323 --> 00:28:13,658 THROUGH INITIATIVES SPECIFICALLY 662 00:28:13,725 --> 00:28:14,993 SOME MAY HAVE PARTICIPATED IN 663 00:28:15,060 --> 00:28:16,561 QUALITY AND WEEKS WHERE WE'RE 664 00:28:16,628 --> 00:28:17,829 COMMITTED TO BRINGING FOLKS 665 00:28:17,896 --> 00:28:19,364 TOGETHER IN THE SIMULATION 666 00:28:19,431 --> 00:28:22,934 CENTER TO REALLY HIGHLIGHT SOME 667 00:28:23,001 --> 00:28:25,470 OF THE OPPORTUNITIES THAT 668 00:28:25,537 --> 00:28:26,204 ENHANCE PATIENT SAFETY AND WE'RE 669 00:28:26,271 --> 00:28:27,372 JUST GETTING STARTED. 670 00:28:27,439 --> 00:28:30,208 HOW DOES THAT REFLECT THE 671 00:28:30,275 --> 00:28:31,242 CLINICAL CENTER NURSING 672 00:28:31,309 --> 00:28:32,043 DEPARTMENT MISSION AS YOU LOOK 673 00:28:32,110 --> 00:28:34,879 AT THE NURSING GRAND ROUNDS? 674 00:28:34,946 --> 00:28:36,881 THOSE WHO JOINED FOR THE 9:00 675 00:28:36,948 --> 00:28:38,850 A.M. CALL WE WILL GIVE A SHOUT 676 00:28:38,917 --> 00:28:40,051 OUT REFLECTING ON THE MISSION 677 00:28:40,118 --> 00:28:40,418 AND VISION. 678 00:28:40,485 --> 00:28:42,720 THE MISSION IS TO IMPROVE HUMAN 679 00:28:42,787 --> 00:28:46,224 HEALTH BY SUPPORTING CUTTING 680 00:28:46,291 --> 00:28:47,025 EDGE RESEARCH AND PROVIDING 681 00:28:47,092 --> 00:28:48,259 EVIDENCE-BASED NURSE CARING TO A 682 00:28:48,326 --> 00:28:49,127 DIVERSE POPULATION OF PATIENTS 683 00:28:49,194 --> 00:28:50,228 AND FAMILIES. 684 00:28:50,295 --> 00:28:51,696 OUR VISION, TO BE THE PREMIER 685 00:28:51,763 --> 00:28:53,231 NURSING DEPARTMENT WHERE THE 686 00:28:53,298 --> 00:28:55,800 WORLD'S BEST CLINICAL RESEARCH 687 00:28:55,867 --> 00:28:58,470 NURSES PROVIDE EXPERT PATIENT 688 00:28:58,536 --> 00:28:59,771 CARE, GENERATE NEW KNOWLEDGE AND 689 00:28:59,838 --> 00:29:01,606 DEVELOP INNOVATIVE PRACTICES TO 690 00:29:01,673 --> 00:29:03,007 IMPROVE PATIENT OUTCOMES. 691 00:29:03,074 --> 00:29:04,342 WE THINK WE HAVE A SEAT AT THE 692 00:29:04,409 --> 00:29:07,412 TABLE IN SIMULATION AS WE TALK 693 00:29:07,479 --> 00:29:09,714 ABOUT CREATING THE WORLD'S BEST 694 00:29:09,781 --> 00:29:10,748 RESEARCH TO PROVIDE THE EXPERT 695 00:29:10,815 --> 00:29:13,685 PATIENT CARE AND WE FEEL WE HAVE 696 00:29:13,751 --> 00:29:14,586 THE OPPORTUNITY TO EMPOWER AND 697 00:29:14,652 --> 00:29:16,554 GIVE THE GREAT CARE. 698 00:29:16,621 --> 00:29:20,391 SO SIMULATION IN NURSING 699 00:29:20,458 --> 00:29:21,092 PROFESSIONAL DEVELOPMENT. 700 00:29:21,159 --> 00:29:22,227 IN THE NURSING DEPARTMENT IN 701 00:29:22,293 --> 00:29:23,094 COLLABORATION WITH THE SIM 702 00:29:23,161 --> 00:29:24,629 PROGRAM WE CONTINUE TO FIND WAYS 703 00:29:24,696 --> 00:29:25,997 TO USE SIMULATION TO ANTICIPATE 704 00:29:26,064 --> 00:29:27,065 AND PREPARE. 705 00:29:27,132 --> 00:29:29,033 WHEN WE FIRST STARTED TALKING 706 00:29:29,100 --> 00:29:31,202 ABOUT HOW WE WERE GOING TO USE 707 00:29:31,269 --> 00:29:32,737 SIMULATION AND ENGAGE PEOPLE 708 00:29:32,804 --> 00:29:35,039 ACROSS THE NIH ENTERPRISE, ONE 709 00:29:35,106 --> 00:29:37,142 OF THE THINGS WE RECOGNIZED WAS 710 00:29:37,208 --> 00:29:38,843 HIGH RISK, LOW VOLUME 711 00:29:38,910 --> 00:29:39,144 POPULATION. 712 00:29:39,210 --> 00:29:40,712 HOW DO WE MAKE SURE THAT WHEN 713 00:29:40,778 --> 00:29:42,280 PATIENTS ARE COMING HERE AND 714 00:29:42,347 --> 00:29:44,549 WE'RE GOING TO BE PROVIDING CARE 715 00:29:44,616 --> 00:29:45,884 WE'VE NEVER DONE BEFORE WE HAVE 716 00:29:45,950 --> 00:29:47,152 THE OPPORTUNITY TO BE PREPARED 717 00:29:47,218 --> 00:29:49,220 AND TO BRING THE TEAM TOGETHER 718 00:29:49,287 --> 00:29:51,389 TO REALLY TALK ABOUT ALL THOSE 719 00:29:51,456 --> 00:29:52,390 WHAT-IF SCENARIOS. 720 00:29:52,457 --> 00:29:53,925 AS A CLINICAL NURSE THAT WAS 721 00:29:53,992 --> 00:29:55,393 OFTEN ONE OF THE STRESSORS WHEN 722 00:29:55,460 --> 00:29:58,029 WE THINK ABOUT THE REALITY THAT 723 00:29:58,096 --> 00:30:05,470 RESEARCH DONE IN THE LAB WE CAN 724 00:30:05,537 --> 00:30:07,438 ANTICIPATE CERTAIN THINGS AND 725 00:30:07,505 --> 00:30:08,239 THE ABILITY TO PRACTICE IT IN 726 00:30:08,306 --> 00:30:10,575 THE LAB AND THEN HAVE THE 727 00:30:10,642 --> 00:30:12,177 POWERFUL DEBRIEFING WHERE WE 728 00:30:12,243 --> 00:30:13,611 COME TOGETHER AND SAY BUT WHAT 729 00:30:13,678 --> 00:30:15,847 ABOUT THIS OR WHAT WOULD YOU DO 730 00:30:15,914 --> 00:30:17,282 HERE, WHAT WERE YOU THINKING 731 00:30:17,348 --> 00:30:20,385 WHEN YOU DID X, Y AND Z. 732 00:30:20,451 --> 00:30:21,653 THE POWER IN THE DEBRIEFING. 733 00:30:21,719 --> 00:30:22,820 AS WE TALK ABOUT THE MODEL I 734 00:30:22,887 --> 00:30:23,855 WANT TO HIGHLIGHT IT'S NOT JUST 735 00:30:23,922 --> 00:30:26,891 THE ACTIVITY THAT HAPPENS AS OUR 736 00:30:26,958 --> 00:30:28,693 NURSES AND INTERPROFESSIONAL 737 00:30:28,760 --> 00:30:33,965 TEAMS ENGAGE WITH THE MANNEQUINS 738 00:30:34,032 --> 00:30:36,167 BUT THE RICHNESS ON THE FRONT 739 00:30:36,234 --> 00:30:37,735 END AND THE DEBRIEFING WHERE WE 740 00:30:37,802 --> 00:30:39,204 DIVE INTO WHAT WENT WELL AND 741 00:30:39,270 --> 00:30:40,004 WHAT OPPORTUNITIES THERE ARE NOT 742 00:30:40,071 --> 00:30:42,473 JUST FOR THE CLINICAL PRACTICE 743 00:30:42,540 --> 00:30:46,444 BUT AS MENTIONED THE PIECES 744 00:30:46,511 --> 00:30:48,546 AROUND SYSTEMS. 745 00:30:48,613 --> 00:30:49,447 SOMETIMES WE LOOK AT THE 746 00:30:49,514 --> 00:30:50,982 ENVIRONMENT AND SAY ARE THERE 747 00:30:51,049 --> 00:30:55,386 OTHER TOOLS THAT WE NEED OR O 748 00:30:55,453 --> 00:30:55,753 OTHER RESOURCES? 749 00:30:55,820 --> 00:30:58,122 SOMETIMES IT LOOKS LIKE 750 00:30:58,189 --> 00:30:59,390 SIMULATION SEVERAL TIMES OVER 751 00:30:59,457 --> 00:31:00,959 UNTIL WE FEEL LIKE WE'VE GOTTEN 752 00:31:01,025 --> 00:31:04,996 IT RIGHT AND PREPARED FROM A 753 00:31:05,063 --> 00:31:06,364 RESOURCE AND PERSONNEL 754 00:31:06,431 --> 00:31:06,664 PERSPECTIVE. 755 00:31:06,731 --> 00:31:08,366 THE ADVANTAGES OF UTILIZING 756 00:31:08,433 --> 00:31:09,601 SIMULATION FOR NURSING EDUCATION 757 00:31:09,667 --> 00:31:12,036 IS THE OPPORTUNITY TO PRACTICE 758 00:31:12,103 --> 00:31:13,738 HIGH RISK-LOW VOLUMES. 759 00:31:13,805 --> 00:31:17,008 IT CAN BE REPRODUCED AN 760 00:31:17,075 --> 00:31:17,442 MANIPULATE. 761 00:31:17,508 --> 00:31:18,843 WE CAN TAKE SOMETHING AND HAVE 762 00:31:18,910 --> 00:31:20,912 PLAN A THIS IS WHAT HAPPENED AND 763 00:31:20,979 --> 00:31:25,049 THEN TURN AROUND AND WORK MAGIC 764 00:31:25,116 --> 00:31:26,317 WITH THE SIMULATION TECHNICIAN 765 00:31:26,384 --> 00:31:28,086 TO MAKE IT A DIFFERENT OUTCOME 766 00:31:28,152 --> 00:31:29,220 IN HOW WOULD YOU RESPOND? 767 00:31:29,287 --> 00:31:31,089 WE HAVE A SAFE SPACE TO MAKE 768 00:31:31,155 --> 00:31:32,657 MISTAKES AND LEARN FROM THEM. 769 00:31:32,724 --> 00:31:34,192 WHAT BETTER PLACE TO HAVE 770 00:31:34,259 --> 00:31:35,326 SOMETHING GO WRONG THAN WITH ONE 771 00:31:35,393 --> 00:31:39,030 OF THESE SIMULATORS RATHER THAN 772 00:31:39,097 --> 00:31:40,064 A PATIENT. 773 00:31:40,131 --> 00:31:43,601 THERE'S A GREAT T-SHIRT WE SEE 774 00:31:43,668 --> 00:31:44,902 AT SIMULATION CONFERENCES THAT 775 00:31:44,969 --> 00:31:49,807 SAYS DON'T WORRY, I PRACTICED ON 776 00:31:49,874 --> 00:31:50,575 A MANNEQUIN. 777 00:31:50,642 --> 00:31:51,743 THERE'S AN AN INCREASED COMFORT 778 00:31:51,809 --> 00:31:53,411 WHEN YOU'VE DONE THAT BEFORE. 779 00:31:53,478 --> 00:31:55,146 ONE OF OUR GREATEST SUCCESSES 780 00:31:55,213 --> 00:31:56,014 HAS BEEN WHEN WE'VE HAD THE 781 00:31:56,080 --> 00:31:57,548 OPPORTUNITY TO PREPARE A TEAM 782 00:31:57,615 --> 00:32:00,251 FOR A NEW POPULATION OR A 783 00:32:00,318 --> 00:32:01,386 PATIENT EXPERIENCE THAT MAYBE 784 00:32:01,452 --> 00:32:02,520 THEY HAVEN'T HAD THE OPPORTUNITY 785 00:32:02,587 --> 00:32:04,489 TO WORK THROUGH IN A WHILE. 786 00:32:04,555 --> 00:32:06,891 WE BRING THEM IN THE SIM LAB OR 787 00:32:06,958 --> 00:32:08,192 GO TO THE UNIT AND PROVIDE THAT 788 00:32:08,259 --> 00:32:10,461 CARE AND STAFF WILL COME BACK 789 00:32:10,528 --> 00:32:11,629 WEEKS LATER AND SAY I HAD A 790 00:32:11,696 --> 00:32:12,764 PATIENT WHERE THAT HAPPENED AND 791 00:32:12,830 --> 00:32:14,465 I FELT MORE PREPARED BECAUSE OF 792 00:32:14,532 --> 00:32:19,370 THE EXPERIENCE WE HAD. 793 00:32:19,437 --> 00:32:22,173 THAT INTERPROFESSIONAL 794 00:32:22,240 --> 00:32:23,308 ENGAGEMENT IF YOU'RE CLINICAL 795 00:32:23,374 --> 00:32:24,842 EDUCATOR IS ENGAGED IN YOUR 796 00:32:24,909 --> 00:32:28,980 INITIATIVE CAN BE TRICKY TO GET 797 00:32:29,047 --> 00:32:30,515 INTERPROFESSIONAL COLLEAGUES 798 00:32:30,581 --> 00:32:30,882 INVOLVED. 799 00:32:30,948 --> 00:32:32,684 ONE ADVANTAGE OF SIMULATION IS 800 00:32:32,750 --> 00:32:35,253 HAVE TIMES WHERE WE SAY OUR 801 00:32:35,320 --> 00:32:37,622 SUCCESSFUL PROGRAM WE HAVE A 802 00:32:37,689 --> 00:32:38,189 HABITUAL SIMULATION EVERY 803 00:32:38,256 --> 00:32:38,623 FRIDAY. 804 00:32:38,690 --> 00:32:40,358 WE KNOW THAT GROUP OF FOLKS WILL 805 00:32:40,425 --> 00:32:42,627 COME TOGETHER AND WE DON'T JUST 806 00:32:42,694 --> 00:32:45,063 HAVE NURSES OR PHYSICIANS, WE 807 00:32:45,129 --> 00:32:47,298 HAVE ANESTHESIA AND RESPIRATORY 808 00:32:47,365 --> 00:32:51,903 THERAPY AND NURSES FROM FLOOR 809 00:32:51,969 --> 00:32:52,136 AND ICU. 810 00:32:52,203 --> 00:32:52,704 IT'S THE INTERPROFESSIONAL 811 00:32:52,770 --> 00:32:53,304 ENGAGEMENT WHERE YOU GET THE 812 00:32:53,371 --> 00:32:54,706 BENEFIT AND RICHNESS OF THE 813 00:32:54,772 --> 00:32:55,373 EXPERIENCE IN THE ROOM AS WELL 814 00:32:55,440 --> 00:32:59,377 AS THE VARIOUS PERSPECTIVES. 815 00:32:59,444 --> 00:33:01,946 WHEN WE LOOK AT THE LEARNING 816 00:33:02,013 --> 00:33:04,215 MODEL HOW DOES IT REFLECT IN 817 00:33:04,282 --> 00:33:04,782 SIMULATION? 818 00:33:04,849 --> 00:33:06,284 IT'S THE CONCRETE EXPERIENCE. 819 00:33:06,351 --> 00:33:08,619 WE DO SKILLS MANAGEMENT AND HAVE 820 00:33:08,686 --> 00:33:10,221 A NUMBER OF PIECES OF EQUIPMENT 821 00:33:10,288 --> 00:33:11,923 WE CALL SKILL TRAINERS FOR 822 00:33:11,989 --> 00:33:12,757 SPECIFIC TASK. 823 00:33:12,824 --> 00:33:14,926 SOME HAVE HAD THE JOY OF GOING 824 00:33:14,992 --> 00:33:17,295 THROUGH THE NIH CLINICAL CENTER 825 00:33:17,362 --> 00:33:18,596 WORKSHOP WE HAVE TASK TRAINERS 826 00:33:18,663 --> 00:33:20,965 FOR THAT OR REFLECT ON THE WORK 827 00:33:21,032 --> 00:33:24,268 AROUND THE CARE IN THE LAST YEAR 828 00:33:24,335 --> 00:33:25,970 THAT'S A SIMULATION EXPERIENCE 829 00:33:26,037 --> 00:33:27,438 WHERE YOU'RE DOING A HARD SKILL 830 00:33:27,505 --> 00:33:28,573 AND PRACTICE IT SEVERAL TIMES 831 00:33:28,639 --> 00:33:31,275 AND START TO EMBED THAT SKILL. 832 00:33:31,342 --> 00:33:33,678 BUT WE WANT TO TAKE IT A STEP 833 00:33:33,745 --> 00:33:36,114 FURTHER WITH SIMULATION AND 834 00:33:36,180 --> 00:33:36,848 REFLECTIVE OBSERVATION. 835 00:33:36,914 --> 00:33:38,483 I MENTIONED THE RICHNESS OF THE 836 00:33:38,549 --> 00:33:39,817 DEBRIEFING AND HOW POWERFUL IT 837 00:33:39,884 --> 00:33:41,786 CAN BE TO HEAR FROM YOUR PEERS 838 00:33:41,853 --> 00:33:43,354 WHEN YOU SAID OR DID THIS, THIS 839 00:33:43,421 --> 00:33:44,655 IS WHAT I WAS THINKING OR WHEN 840 00:33:44,722 --> 00:33:46,491 YOU'RE ABLE TO LOOK BACK AT AN 841 00:33:46,557 --> 00:33:47,425 EMERGENCY RESPONSE SIMULATION 842 00:33:47,492 --> 00:33:50,428 AND SAY, I FOUND MYSELF SORT OF 843 00:33:50,495 --> 00:33:54,432 DRIFTING TO THE BACK OF THE 844 00:33:54,499 --> 00:33:56,134 GROUP RATHER THAN ENGAGING. 845 00:33:56,200 --> 00:33:57,568 THROUGH THE DEBRIEFING WE CAN 846 00:33:57,635 --> 00:33:59,370 HAVE CONVERSATION TO EMPOWER 847 00:33:59,437 --> 00:34:00,838 THAT PERSON BUT ABOUT WHAT WERE 848 00:34:00,905 --> 00:34:01,706 YOU THINKING WHEN YOU WERE 849 00:34:01,773 --> 00:34:03,107 STEPPING BACK IN THE CORNER. 850 00:34:03,174 --> 00:34:04,375 DID YOU FEEL LIKE YOUR VOICE 851 00:34:04,442 --> 00:34:06,544 COULD BE HEARD IN THE MIDST OF 852 00:34:06,611 --> 00:34:07,678 THAT EMERGENCY RESPONSE? 853 00:34:07,745 --> 00:34:10,415 THERE'S RICHNESS WITH THAT AND 854 00:34:10,481 --> 00:34:12,617 BUILDING ON THE LEARNING. 855 00:34:12,683 --> 00:34:13,918 ABSTRACT CONCEPTUALIZATION AS WE 856 00:34:13,985 --> 00:34:17,922 HAVE THE DEBRIEFING AND WALKWAY, 857 00:34:17,989 --> 00:34:21,058 ONE EXCITING THING IS REPLICATE 858 00:34:21,125 --> 00:34:23,461 THE SAME SCENARIO WITH INCREASED 859 00:34:23,528 --> 00:34:24,562 COMPLEXITY AND SEE HOW THEY 860 00:34:24,629 --> 00:34:25,463 APPLY THE KNOWLEDGE. 861 00:34:25,530 --> 00:34:27,365 WE HAVE GROUPS WHERE WE WORK ON 862 00:34:27,432 --> 00:34:28,866 PROFESSIONAL DEVELOPMENT AND 863 00:34:28,933 --> 00:34:30,001 LEADERSHIP DEVELOPMENT WITHIN 864 00:34:30,067 --> 00:34:30,835 TEAMS. 865 00:34:30,902 --> 00:34:32,670 TO BE ABLE TO SEE THOSE 866 00:34:32,737 --> 00:34:33,504 INDIVIDUALS COME BACK TIME AND 867 00:34:33,571 --> 00:34:35,840 TIME AGAIN AND SEE THE BUILDING 868 00:34:35,907 --> 00:34:37,241 BLOCKS STARTING TO CLICK. 869 00:34:37,308 --> 00:34:40,211 AND ACTIVE EXPERIMENTATION. 870 00:34:40,278 --> 00:34:42,079 WE HAVE THE ABILITY ON A DIME WE 871 00:34:42,146 --> 00:34:43,481 CAN SHIFT TO SIMULATION IF WE 872 00:34:43,548 --> 00:34:44,482 WANT TO. 873 00:34:44,549 --> 00:34:46,884 MANY WE DO SCRIPT OUT AHEAD OF 874 00:34:46,951 --> 00:34:52,356 TIME IN A VERY METHODICAL WAY 875 00:34:52,423 --> 00:34:55,026 BUT WE HAVE THE ABILITY THROUGH 876 00:34:55,092 --> 00:34:57,128 SIMULATION TO SAY THAT ISN'T 877 00:34:57,195 --> 00:34:58,863 WHERE WE THOUGHT IT'D GO BUT SEE 878 00:34:58,930 --> 00:34:59,697 WHERE IT GOES FROM A LEARNING 879 00:34:59,764 --> 00:34:59,997 PERSPECTIVE. 880 00:35:00,064 --> 00:35:03,935 WE HAVE THE ABILITY TO ACTIVELY 881 00:35:04,001 --> 00:35:04,402 EXPERIMENT. 882 00:35:04,469 --> 00:35:05,636 ANOTHER POWERFUL WAY TO USE 883 00:35:05,703 --> 00:35:07,672 SIMULATION IS SET UP A SCENARIO 884 00:35:07,738 --> 00:35:10,374 AND GO THROUGH AND EVERY ONCE IN 885 00:35:10,441 --> 00:35:12,643 A WHILE IT'S HARD AND DOESN'T GO 886 00:35:12,710 --> 00:35:14,245 AS WELL AS EVERYONE WOULD LIKE 887 00:35:14,312 --> 00:35:17,482 AND WE HAVE THE ABILITY TO SAY 888 00:35:17,548 --> 00:35:20,885 TIME-OUT LET'S HAVE A MINI 889 00:35:20,952 --> 00:35:21,786 DEBRIEF AND WHY IT FEELS 890 00:35:21,853 --> 00:35:23,154 COMPLICATE AND RESTART. 891 00:35:23,221 --> 00:35:25,056 WE DON'T GET THAT OPPORTUNITY 892 00:35:25,122 --> 00:35:29,160 WITH PATIENTS. 893 00:35:29,227 --> 00:35:30,027 WHEN SOMETHING GOES WRONG WE'VE 894 00:35:30,094 --> 00:35:32,296 HAD A BAD DAY AND THEY HAVE A 895 00:35:32,363 --> 00:35:34,499 BAD DAY AND WE CAN MANIPULATE 896 00:35:34,565 --> 00:35:35,867 THE SCENARIO IN SIMULATION TO 897 00:35:35,933 --> 00:35:38,102 SUPPORT LEARNING IN WHAT WAY THE 898 00:35:38,169 --> 00:35:38,936 ACTIVE PARTICIPANTS CAN BE 899 00:35:39,003 --> 00:35:43,774 SUPPORTED. 900 00:35:43,841 --> 00:35:49,313 ONE OF OUR PILLARS IS THE 901 00:35:49,380 --> 00:35:50,948 INTERNATIONAL ASSOCIATION OF 902 00:35:51,015 --> 00:35:57,321 NURSING SIMULATION AND WE AN 903 00:35:57,388 --> 00:35:58,756 ELEVATE THIS AND THEY'VE DONE 904 00:35:58,823 --> 00:36:00,391 WORK ON SIMULATION SPECIFIC TO 905 00:36:00,458 --> 00:36:04,862 NURSING BUT WITH A VESTED 906 00:36:04,929 --> 00:36:06,264 INTEREST IN THE NATIONAL NURSING 907 00:36:06,330 --> 00:36:07,265 ASSOCIATION FOR CLINICAL 908 00:36:07,331 --> 00:36:08,232 SIMULATION AND LEARNING AND THIS 909 00:36:08,299 --> 00:36:10,535 IS PART OF A QUALITY SIMULATION 910 00:36:10,601 --> 00:36:11,903 AND WE TRY TO MIRROR OUR WORK 911 00:36:11,969 --> 00:36:13,938 FROM THIS. 912 00:36:14,005 --> 00:36:15,339 THE GOAL IS PROFESSIONAL 913 00:36:15,406 --> 00:36:16,974 DEVELOPMENT, THERE IS DEDICATED 914 00:36:17,041 --> 00:36:18,209 ATTENTION TO SIMULATION DESIGN. 915 00:36:18,276 --> 00:36:19,777 WE LIKE TO HIGHLIGHT THIS FOR 916 00:36:19,844 --> 00:36:20,311 FOLKS. 917 00:36:20,378 --> 00:36:21,779 SOMETIMES WHEN PEOPLE THINK OF 918 00:36:21,846 --> 00:36:23,347 SIMULATION THEY THINK ABOUT WHEN 919 00:36:23,414 --> 00:36:25,750 THEY GO FOR THEIR CPR CARD EVERY 920 00:36:25,816 --> 00:36:27,485 COUPLE YEARS AND YOU'RE DOING 921 00:36:27,552 --> 00:36:29,854 COMPRESSIONS ON THE MANNEQUIN 922 00:36:29,921 --> 00:36:31,856 AND I KNOW FOR MYSELF IT'S BEEN 923 00:36:31,923 --> 00:36:35,026 A MINUTE SINCE I WAS IN NURSING 924 00:36:35,092 --> 00:36:38,529 SCHOOL AND IT FELT LIKE A PROP 925 00:36:38,596 --> 00:36:40,531 THAN WE WERE ENGAGE WITH THEM. 926 00:36:40,598 --> 00:36:42,400 NOW WE'RE THOUGHTFUL ABOUT THE 927 00:36:42,466 --> 00:36:43,267 SIMULATION DESIGN AND THAT CAN 928 00:36:43,334 --> 00:36:45,336 TAKE TIME AND A PROCESS WHERE WE 929 00:36:45,403 --> 00:36:46,103 WORK WITH STAKEHOLDERS AND TRY 930 00:36:46,170 --> 00:36:47,405 TO UNDERSTAND WHAT ARE THE 931 00:36:47,471 --> 00:36:49,073 LEARNING OBJECTIVES AND HOW DOES 932 00:36:49,140 --> 00:36:50,675 THIS RELATE TO THE CLINICAL 933 00:36:50,741 --> 00:36:51,809 PRACTICE THAT YOU'RE TRYING TO 934 00:36:51,876 --> 00:36:53,878 INFLUENCE AND HOW CAN WE SUPPORT 935 00:36:53,945 --> 00:36:55,179 YOUR TEAM THROUGH OUR SIMULATION 936 00:36:55,246 --> 00:36:56,347 DESIGN AND MAKE SURE WE HAVE 937 00:36:56,414 --> 00:36:57,181 SHARED S. 938 00:36:57,248 --> 00:36:59,383 WE WANT TO HAVE THOSE OUTCOMES 939 00:36:59,450 --> 00:37:00,885 AND OBJECTIVES CLEARLY DEFINE. 940 00:37:00,952 --> 00:37:02,954 WE DON'T LIKE TO WALK AWAY FROM 941 00:37:03,020 --> 00:37:05,122 A SIMULATION SAYING THAT WENT 942 00:37:05,189 --> 00:37:06,824 WELL AND WE FEEL GOOD ABOUT IT. 943 00:37:06,891 --> 00:37:08,025 WE SAY THESE INTEREST THE IT 944 00:37:08,092 --> 00:37:08,960 THINGS WE WANTED TO ACCOMPLISH 945 00:37:09,026 --> 00:37:10,428 AND CAN WE SAY WE HAVE AND 946 00:37:10,494 --> 00:37:11,963 THAT'S A SUCCESS TO US. 947 00:37:12,029 --> 00:37:14,966 WE DO A PREBRIEFING. 948 00:37:15,032 --> 00:37:18,803 WE TALKED ABOUT THE DEBRIEFING 949 00:37:18,869 --> 00:37:22,273 AND LIKE TO BRING LEARNERS IN 950 00:37:22,340 --> 00:37:25,643 THE ROOM AND SHARE WHAT TO 951 00:37:25,710 --> 00:37:26,611 ANTICIPATE AND THERE'S SOMETIMES 952 00:37:26,677 --> 00:37:28,179 SURPRISES IN SIMULATION BUT WE 953 00:37:28,245 --> 00:37:30,581 CREATE THE SAFE SPACE FOR 954 00:37:30,648 --> 00:37:31,015 LEARNING. 955 00:37:31,082 --> 00:37:33,317 WE ESTABLISH THIS IS A LEARNING 956 00:37:33,384 --> 00:37:36,120 ENVIRONMENT AND WE OFTEN SAY 957 00:37:36,187 --> 00:37:37,722 IT'S VEGAS RULES, WHAT HAPPENS 958 00:37:37,788 --> 00:37:39,857 HERE, STAYS HERE IT'S A SAFE 959 00:37:39,924 --> 00:37:41,525 SPACE WHERE WE ACKNOWLEDGE 960 00:37:41,592 --> 00:37:42,293 EVERYONE COMING TO THE TABLE IS 961 00:37:42,360 --> 00:37:43,828 AN EXPERT IN THEIR FIELD. 962 00:37:43,894 --> 00:37:45,830 WE'RE ALL IN THIS ROOM SEASONED 963 00:37:45,896 --> 00:37:47,398 CLINICIANS WHO BRING A GREAT 964 00:37:47,465 --> 00:37:48,966 DEAL OF EXPERTS AND TALENT AND 965 00:37:49,033 --> 00:37:51,502 ACKNOWLEDGE THAT BUT THIS IS A 966 00:37:51,569 --> 00:37:53,337 LEARNING OPPORTUNITY SO WE'RE 967 00:37:53,404 --> 00:37:55,339 GOING ENGAGE OURSELVES WITH THIS 968 00:37:55,406 --> 00:37:57,074 HIGH FIDELITY SIMULATION AND 969 00:37:57,141 --> 00:37:58,876 ACKNOWLEDGE MANNEQUINS HAVE SOME 970 00:37:58,943 --> 00:38:02,146 LIMITATIONS AND WORK THROUGH THE 971 00:38:02,213 --> 00:38:02,446 SIMULATION. 972 00:38:02,513 --> 00:38:02,780 FACILITATION. 973 00:38:02,847 --> 00:38:06,417 WE TYPICALLY HAVE A NUMBER FROM 974 00:38:06,484 --> 00:38:08,753 THE TEAM PRESENT TO HELP ENSURE 975 00:38:08,819 --> 00:38:09,854 IT GOES WELL. 976 00:38:09,920 --> 00:38:11,122 ON THE DAYS WE DEFINE SIMULATION 977 00:38:11,188 --> 00:38:13,024 AS SHOWING UP WITH A MANNEQUIN 978 00:38:13,090 --> 00:38:15,092 AND LET'S SEE WHAT HAPPENS. 979 00:38:15,159 --> 00:38:16,827 WE HAVE A COORDINATED 980 00:38:16,894 --> 00:38:17,962 FACILITATION PLAN. 981 00:38:18,029 --> 00:38:19,063 THE DEBRIEFING, WE TALKED A 982 00:38:19,130 --> 00:38:20,064 LITTLE BIT ABOUT. 983 00:38:20,131 --> 00:38:21,532 THAT IS THE OPPORTUNITY TO 984 00:38:21,599 --> 00:38:23,534 REFLECT ON THE EXPERIENCE AND 985 00:38:23,601 --> 00:38:24,535 MAKE SURE THAT EVERYONE LEAVES 986 00:38:24,602 --> 00:38:26,504 FEELING GOOD ABOUT IT AND WE 987 00:38:26,570 --> 00:38:30,207 HAVE SOME DIRECTION OF HOW WE 988 00:38:30,274 --> 00:38:31,409 CAN IMPROVE FUTURE SIMULATION 989 00:38:31,475 --> 00:38:34,745 AND THE IMPACT ON PATIENT CARE. 990 00:38:34,812 --> 00:38:36,580 AND PARTICIPANT EVALUATION IS AN 991 00:38:36,647 --> 00:38:36,881 EXPECTATION. 992 00:38:36,947 --> 00:38:38,849 EVERYONE WHO COMES IN TO THE 993 00:38:38,916 --> 00:38:40,551 SIMULATION HAS THE OPPORTUNITY 994 00:38:40,618 --> 00:38:41,719 TO FILL A QUICK SURVEY TO GIVE 995 00:38:41,786 --> 00:38:43,721 US FEEDBACK ON HOW THINGS WENT 996 00:38:43,788 --> 00:38:45,690 AND WHAT ARE AREAS FOR 997 00:38:45,756 --> 00:38:46,590 IMPROVEMENT AND GIVES US 998 00:38:46,657 --> 00:38:48,292 OPPORTUNITY TO HAVE METRICS WE 999 00:38:48,359 --> 00:38:49,527 CAN SPEAK TO. 1000 00:38:49,593 --> 00:38:51,095 ONE THING WE'RE EXPLORING IS HOW 1001 00:38:51,162 --> 00:38:52,797 CAN WE ENGAGE WITH FOLKS A 1002 00:38:52,863 --> 00:38:55,099 COUPLE MONTHS LATER AFTER SOME 1003 00:38:55,166 --> 00:38:59,070 OF OUR TRAININGS TO GATHER SOME 1004 00:38:59,136 --> 00:38:59,637 SUSTAINABILITY AND HOW LONG 1005 00:38:59,704 --> 00:39:01,872 THINGS LAST THEREAFTER. 1006 00:39:01,939 --> 00:39:04,175 SO HERE WE TALK ABOUT 1007 00:39:04,241 --> 00:39:05,176 INTERPROFESSIONAL EDUCATION. 1008 00:39:05,242 --> 00:39:07,044 TODAY WE'RE HERE TO TALK ABOUT 1009 00:39:07,111 --> 00:39:08,479 NURSING GRAND ROUNDS BUT WE 1010 00:39:08,546 --> 00:39:10,748 CAN'T TALK ABOUT THE SUCCESS OF 1011 00:39:10,815 --> 00:39:13,384 NURSING SIMULATION WITHOUT 1012 00:39:13,451 --> 00:39:14,118 ACKNOWLEDGING THE 1013 00:39:14,185 --> 00:39:14,618 INTERPROFESSIONAL PIECE. 1014 00:39:14,685 --> 00:39:17,121 WE FIND IT IMPORTANT TO ENGAGE 1015 00:39:17,188 --> 00:39:18,122 THIS WAY WHENEVER POSSIBLE. 1016 00:39:18,189 --> 00:39:20,825 WE'LL DO SIMULATION WHERE'S IT'S 1017 00:39:20,891 --> 00:39:21,992 POPULATION BASED OR SKILLS 1018 00:39:22,059 --> 00:39:24,261 TRAINING BUT FOR THE MOST PART 1019 00:39:24,328 --> 00:39:26,063 IF YOU COME TO THE CLINICAL 1020 00:39:26,130 --> 00:39:26,997 CENTER SIMULATION PROGRAM AND 1021 00:39:27,064 --> 00:39:28,232 SAY I'M INTERESTED IN DOING 1022 00:39:28,299 --> 00:39:30,234 SIMULATION ON X, Y AND Z WE'LL 1023 00:39:30,301 --> 00:39:32,203 SEE WHO ARE THE PEOPLE TO CARE 1024 00:39:32,269 --> 00:39:35,473 FOR THE PATIENT AND WHO ELSE 1025 00:39:35,539 --> 00:39:37,341 WOULD ENGAGE THROUGH THE 1026 00:39:37,408 --> 00:39:38,909 PROTOCOL TO GET A FEEL FOR WHAT 1027 00:39:38,976 --> 00:39:41,011 EVENTS MAY BE PART OF THAT 1028 00:39:41,078 --> 00:39:42,179 PATIENT'S JOURNEY TO ENGAGE AS 1029 00:39:42,246 --> 00:39:45,583 MANY AS POSSIBLE TO GET THE 1030 00:39:45,649 --> 00:39:46,951 BENEFIT OF THE INTERPROFESSIONAL 1031 00:39:47,017 --> 00:39:48,686 EDUCATION PIECE. 1032 00:39:48,753 --> 00:39:50,387 IN 2010 IF USED DESCRIBED WHEN 1033 00:39:50,454 --> 00:39:51,555 TWO OR MORE PROFESSIONALS LEARN 1034 00:39:51,622 --> 00:39:54,391 FROM AND WITH ONE ANOTHER FOR 1035 00:39:54,458 --> 00:39:56,093 EFFECTIVE COLLABORATION AND 1036 00:39:56,160 --> 00:39:57,061 IMPROVE HEALTH OUTCOMES. 1037 00:39:57,128 --> 00:39:59,230 THE COMPETENCY DOMAINS VALUES 1038 00:39:59,296 --> 00:40:02,099 AND ETHICS, ROLES AND 1039 00:40:02,166 --> 00:40:04,068 RESPONSIBILITIES FOR 1040 00:40:04,135 --> 00:40:07,404 COLLABORATIVE PRACTICE AND TEAM 1041 00:40:07,471 --> 00:40:08,906 WORK. 1042 00:40:08,973 --> 00:40:11,342 DR. GOMEZ TALKED ABOUT THE TEAM 1043 00:40:11,408 --> 00:40:15,146 WORK AND SOME CAN TALK ABOUT THE 1044 00:40:15,212 --> 00:40:16,580 RICHNESS OF THE DEBRIEFING AND 1045 00:40:16,647 --> 00:40:17,848 BETTER UNDERSTANDING OF ONE 1046 00:40:17,915 --> 00:40:19,216 ANOTHER IN WHAT WE BRING TO OUR 1047 00:40:19,283 --> 00:40:21,252 DAILY CLINICAL PRACTICE. 1048 00:40:21,318 --> 00:40:24,255 SO FACTORS THAT FACILITATE OUR 1049 00:40:24,321 --> 00:40:26,223 HIGH QUALITY PROFESSIONAL 1050 00:40:26,290 --> 00:40:27,525 DEVELOPMENT, IT'S IMMEDIATE AND 1051 00:40:27,591 --> 00:40:28,626 SAFE FEEDBACK. 1052 00:40:28,692 --> 00:40:33,030 UNLIKE WHEN WE WERE ALL BACK IN 1053 00:40:33,097 --> 00:40:35,399 NURSING OR MEDICAL SCHOOL AND 1054 00:40:35,466 --> 00:40:39,003 WAITED TO HEAR FEEDBACK YOU HEAR 1055 00:40:39,069 --> 00:40:43,374 FEEDBACK IMMEDIATELY IN A 1056 00:40:43,440 --> 00:40:44,875 SUPPORTIVE ENVIRONMENT. 1057 00:40:44,942 --> 00:40:50,381 IT'S NEVER PUNITIVE. 1058 00:40:50,447 --> 00:40:55,252 THE VAST MAJORITY IS TEAM 1059 00:40:55,319 --> 00:40:56,086 BUILDING INTERPROFESSIONAL 1060 00:40:56,153 --> 00:40:57,021 LEARNING. 1061 00:40:57,087 --> 00:40:58,656 THE REPETITIVE PRACTICE. 1062 00:40:58,722 --> 00:40:59,924 SOMETIMES ABOUT WHAT WE'LL FOCUS 1063 00:40:59,990 --> 00:41:02,092 ON STARTING IT AND HIT A HARD 1064 00:41:02,159 --> 00:41:04,061 SPOT AND PAUSE AND REPEAT IT. 1065 00:41:04,128 --> 00:41:05,896 OTHER TIMES IT'S SUCCESSFUL BUT 1066 00:41:05,963 --> 00:41:08,165 WE KNOW THERE'S A BIG CHALLENGE 1067 00:41:08,232 --> 00:41:09,066 COMING AND NEW PATIENT 1068 00:41:09,133 --> 00:41:11,001 POPULATION OR INTENSE PROTOCOL. 1069 00:41:11,068 --> 00:41:13,137 WE'RE GOING DO THAT SEVERAL 1070 00:41:13,204 --> 00:41:14,605 TIMES OVER EVEN WHEN IT WORKS 1071 00:41:14,672 --> 00:41:16,440 WELL THE FIRST TIME WE WANT TO 1072 00:41:16,507 --> 00:41:17,575 MAKE SURE IT WORKS WELL THE 1073 00:41:17,641 --> 00:41:18,442 SIXTH TIME. 1074 00:41:18,509 --> 00:41:19,610 IT'S A CONTROLLED ENVIRONMENT. 1075 00:41:19,677 --> 00:41:21,045 WE CAN MAKE SURE WHAT THE 1076 00:41:21,111 --> 00:41:22,279 VARIABLES ARE FOR OUR 1077 00:41:22,346 --> 00:41:22,613 PARTICIPANTS. 1078 00:41:22,680 --> 00:41:25,950 WE DON'T HAVE TO WORRY THE CALL 1079 00:41:26,016 --> 00:41:27,384 BELLS ARE GOING OFF NEXT DOOR, 1080 00:41:27,451 --> 00:41:27,785 DIFFERENT THINGS. 1081 00:41:27,852 --> 00:41:30,120 WE CAN MAKE SURE THEY HAVE THE 1082 00:41:30,187 --> 00:41:32,223 RICHNESS OF THE LEARNING THE 1083 00:41:32,289 --> 00:41:32,957 OBJECTIVES WERE AHEAD OF TIME 1084 00:41:33,023 --> 00:41:35,359 AND PROVIDES THE OPPORTUNITY FOR 1085 00:41:35,426 --> 00:41:37,194 APPLICATION, CRITICAL THINK AND 1086 00:41:37,261 --> 00:41:37,962 IS THE INTERPROFESSIONAL 1087 00:41:38,028 --> 00:41:39,029 COLLABORATION WHERE WE'RE ABLE 1088 00:41:39,096 --> 00:41:40,898 TO GET THE RICHNESS OF THE 1089 00:41:40,965 --> 00:41:43,367 PATIENT EXPERIENCE WHILE BEING 1090 00:41:43,434 --> 00:41:45,002 IN A CONTROLLED ENVIRONMENT. 1091 00:41:45,069 --> 00:41:47,371 I'M EXCITED TO SHARE A COUPLE OF 1092 00:41:47,438 --> 00:41:48,572 OUR SUCCESSFUL STORIES AND THEN 1093 00:41:48,639 --> 00:41:50,908 TURN IT OVER TO ONE OF OUR 1094 00:41:50,975 --> 00:41:51,709 ROBUST PROGRAMS. 1095 00:41:51,775 --> 00:41:53,744 SO WHEN WE LOOK AT THE NURSING 1096 00:41:53,811 --> 00:41:56,146 DEPARTMENT AND SOME OF OUR 1097 00:41:56,213 --> 00:41:56,914 SUCCESSES IN SIMULATION THOUGH 1098 00:41:56,981 --> 00:41:59,383 THERE ARE MANY, THERE'S A COUPLE 1099 00:41:59,450 --> 00:42:00,551 SHINING STARS WE WANTED TO SHARE 1100 00:42:00,618 --> 00:42:01,819 TODAY. 1101 00:42:01,886 --> 00:42:07,224 ONE THE EMERGENT CARE OF THE GM1 1102 00:42:07,291 --> 00:42:08,959 GENE THERAPY PROTOCOL. 1103 00:42:09,026 --> 00:42:14,398 THIS WAS AN OPPORTUNITY TO 1104 00:42:14,465 --> 00:42:15,766 PREPARE FOR A NEW POPULATION. 1105 00:42:15,833 --> 00:42:17,635 A RECOGNITION OF NEW PATIENTS, 1106 00:42:17,701 --> 00:42:19,203 NEW SYSTEMS COMING INTO THE 1107 00:42:19,270 --> 00:42:19,770 CLINICAL CENTER. 1108 00:42:19,837 --> 00:42:21,639 WE DID THIS ON REPEAT SEVERAL 1109 00:42:21,705 --> 00:42:22,539 TIMES OVER. 1110 00:42:22,606 --> 00:42:26,043 WE HAD THE ABILITY TO OFFER THE 1111 00:42:26,110 --> 00:42:27,578 SIMULATION WITH THE 1112 00:42:27,645 --> 00:42:28,579 COLLABORATION WITH THE 1 1113 00:42:28,646 --> 00:42:30,547 NORTHWEST TEAM. 1114 00:42:30,614 --> 00:42:31,582 WE WERE ABLE TO BE EMBEDDED 1115 00:42:31,649 --> 00:42:34,318 WITHIN THE UNIT MAKING IT MORE 1116 00:42:34,385 --> 00:42:36,420 CONVENIENT HOPEFULLY FOR STAFF 1117 00:42:36,487 --> 00:42:38,989 AND ASSESS FROM A SYSTEMS WHAT 1118 00:42:39,056 --> 00:42:40,124 RESOURCES WERE AVAILABLE ON THE 1119 00:42:40,190 --> 00:42:41,525 UNIT AND WHAT PERHAPS WE WOULD 1120 00:42:41,592 --> 00:42:43,627 NEED TO BE FULLY PREPARED. 1121 00:42:43,694 --> 00:42:46,497 THIS WAS ONE OF OUR SUCCESSES 1122 00:42:46,563 --> 00:42:48,666 WHERE AFTER SEVERAL TIMES OVER 1123 00:42:48,732 --> 00:42:50,467 AND SOME WENT WELL AND SOME WE 1124 00:42:50,534 --> 00:42:52,469 HAD SOME CHALLENGES WE WORKED 1125 00:42:52,536 --> 00:42:53,437 THROUGH. 1126 00:42:53,504 --> 00:42:54,605 WE CONTINUED TO PRACTICE UNTIL 1127 00:42:54,672 --> 00:42:57,074 IT BECAME EASIER AND KNEW WE HAD 1128 00:42:57,141 --> 00:42:59,410 THOSE RESOURCES LINED UP FOR THE 1129 00:42:59,476 --> 00:43:00,577 PARTICIPANTS AND THIS WAS ONE OF 1130 00:43:00,644 --> 00:43:03,080 THOSE SUCCESS STORIES WHERE ONCE 1131 00:43:03,147 --> 00:43:04,081 THE PATIENT POPULATION CAME TO 1132 00:43:04,148 --> 00:43:05,282 THE CLINICAL CENTER WE HEARD 1133 00:43:05,349 --> 00:43:08,652 FROM MULTIPLE PARTICIPANTS THEY 1134 00:43:08,719 --> 00:43:10,087 FELT BETTER PREPARED ONCE THOSE 1135 00:43:10,154 --> 00:43:10,487 PATIENTS ARRIVED. 1136 00:43:10,554 --> 00:43:13,857 THAT'S PROBABLY THE BIGGEST 1137 00:43:13,924 --> 00:43:14,658 COMPLIMENT OUR PROGRAM COULD 1138 00:43:14,725 --> 00:43:15,960 HAVE IN REFLECTION THAT 1139 00:43:16,026 --> 00:43:17,528 SIMULATION IMPACTS OUR ABILITY 1140 00:43:17,594 --> 00:43:19,930 TO PREPARE FOR PATIENT CARE. 1141 00:43:19,997 --> 00:43:23,167 OUR PEDIATRIC BRIDGE TO PRACTICE 1142 00:43:23,233 --> 00:43:25,636 WITH OUR CNS TRISH TODD IS A 1143 00:43:25,703 --> 00:43:28,172 COMBINATION OF DIDACTIC AND 1144 00:43:28,238 --> 00:43:28,572 SIMULATION. 1145 00:43:28,639 --> 00:43:29,873 THIS WORK HAS BEEN DONE IN 1146 00:43:29,940 --> 00:43:31,442 COLLABORATION WITH THE PEDIATRIC 1147 00:43:31,508 --> 00:43:33,410 PROGRAM OF CARE IN THE INTENSIVE 1148 00:43:33,477 --> 00:43:35,713 CARE UNIT OVER THE PAST SEVERAL 1149 00:43:35,779 --> 00:43:37,414 YEARS AND OVER THE PAST FEW 1150 00:43:37,481 --> 00:43:39,383 YEARS WE'VE INCLUDED SIMULATION 1151 00:43:39,450 --> 00:43:40,217 AS PART OF THE EXPERIENCE. 1152 00:43:40,284 --> 00:43:42,252 THESE INDIVIDUALS RECEIVE A 1153 00:43:42,319 --> 00:43:44,688 COUPLE DAYS OF DIDACTIC LECTURE 1154 00:43:44,755 --> 00:43:48,192 AND HANDS-ON SKILLS TRAINING AND 1155 00:43:48,258 --> 00:43:50,327 CULMINATE WITH THE SIMULATION OF 1156 00:43:50,394 --> 00:43:51,895 THE DIDACTIC INFORMATION THEY'VE 1157 00:43:51,962 --> 00:43:52,930 RECEIVED OVER THE COURSE OF THE 1158 00:43:52,997 --> 00:43:53,497 TIME TOGETHER. 1159 00:43:53,564 --> 00:43:55,632 YOU CAN SEE PICTURES OF OUR 1160 00:43:55,699 --> 00:43:57,434 FACULTY AND STUDENTS FOR THE 1161 00:43:57,501 --> 00:43:58,469 PROGRAM. 1162 00:43:58,535 --> 00:43:59,770 AND AGAIN THIS IS ONE WHERE 1163 00:43:59,837 --> 00:44:09,546 WE'RE EXCITED AND HAVE DONE POST 1164 00:44:09,613 --> 00:44:10,247 VACCINA 1165 00:44:10,314 --> 00:44:11,248 EVALUATIONS AND SURVEYS AND 1166 00:44:11,315 --> 00:44:12,416 FOLLOWING OVER THE YEAR TO 1167 00:44:12,483 --> 00:44:13,684 HOPEFULLY SHOW METRICS OF THE 1168 00:44:13,751 --> 00:44:15,085 SUCCESS OF THIS PROGRAM BECAUSE 1169 00:44:15,152 --> 00:44:16,687 YOU KNOW WE ALL FEEL IT IN OUR 1170 00:44:16,754 --> 00:44:19,056 HEART BUT WANT TO MAKE SURE 1171 00:44:19,123 --> 00:44:20,224 WE'RE ABLE TO SHARE AND 1172 00:44:20,290 --> 00:44:22,059 DISSEMINATE THAT IN A POWERFUL 1173 00:44:22,126 --> 00:44:24,561 WAY MOVING FORWARD. 1174 00:44:24,628 --> 00:44:27,765 OUR MSS EDUCATION SERIES, THE 1175 00:44:27,831 --> 00:44:29,767 SERVICE HAS EDUCATION DAYS YEAR 1176 00:44:29,833 --> 00:44:31,869 AFTER YEAR AND HAVE AN 1177 00:44:31,935 --> 00:44:32,503 INCREDIBLE COLLABORATION WITH 1178 00:44:32,569 --> 00:44:33,303 THEIR EDUCATION TEAM AND 1179 00:44:33,370 --> 00:44:36,840 PLANNING FOR A ROBUST DAY OF 1180 00:44:36,907 --> 00:44:37,508 DIDACTIC INFORMATION AND SKILLS 1181 00:44:37,574 --> 00:44:39,009 TRAINING AND LAST YEAR WAS THE 1182 00:44:39,076 --> 00:44:40,010 FIRST YEAR THEY CAME TO US AND 1183 00:44:40,077 --> 00:44:42,813 SAID WE WANT TO DO A FORMAL 1184 00:44:42,880 --> 00:44:44,381 SIMULATION PROGRAM. 1185 00:44:44,448 --> 00:44:45,716 UNDER THE DIRECTION OF MARY 1186 00:44:45,783 --> 00:44:49,186 MEYERS AND HER TEAM WE DEVELOPED 1187 00:44:49,253 --> 00:44:51,655 A STIMULATION REFLECTIVE OF A 1188 00:44:51,722 --> 00:44:52,289 DIFFICULT PATIENT EXPERIENCE 1189 00:44:52,356 --> 00:44:54,625 THEY'RE TEAM EXPERIENCED AND 1190 00:44:54,691 --> 00:44:54,925 ENCOUNTERED. 1191 00:44:54,992 --> 00:44:56,160 THEY SHARED ALL OF THE 1192 00:44:56,226 --> 00:44:58,796 CHALLENGES, WORKING THROUGH THE 1193 00:44:58,862 --> 00:45:00,764 PATIENT SCENARIO AND SOME 1194 00:45:00,831 --> 00:45:02,166 DIFFICULTY FOR STAFF AFTERWARDS 1195 00:45:02,232 --> 00:45:03,400 WHERE THEY WERE PROCESSING WHAT 1196 00:45:03,467 --> 00:45:04,868 HAD HAPPENED ON THE UNIT. 1197 00:45:04,935 --> 00:45:08,005 WE TOOK ALL THAT INFORMATION AND 1198 00:45:08,072 --> 00:45:09,807 MODEL IT INTO A CLINICAL 1199 00:45:09,873 --> 00:45:11,675 SCENARIO THAT WAS OBVIOUSLY NOT 1200 00:45:11,742 --> 00:45:13,010 100% WHAT THEY EXPERIENCED BUT 1201 00:45:13,077 --> 00:45:14,812 HAD SOME OF THOSE ELEMENTS WHICH 1202 00:45:14,878 --> 00:45:16,947 GAVE US A POWERFUL WAY TO 1203 00:45:17,014 --> 00:45:19,650 DEBRIEF AND GET TO SOME OF THOSE 1204 00:45:19,716 --> 00:45:21,285 EMOTIONAL PIECES SOME STAFF WERE 1205 00:45:21,351 --> 00:45:23,387 HANGING ON TO AND SHARE THAT IN 1206 00:45:23,454 --> 00:45:24,755 A SAFE SUPPORTIVE ENVIRONMENT OF 1207 00:45:24,822 --> 00:45:26,190 THEIR PEERS WHERE WE COULD LEARN 1208 00:45:26,256 --> 00:45:27,391 FROM THAT EXPERIENCE AND 1209 00:45:27,458 --> 00:45:29,860 HOPEFULLY BE PREPARED FOR THE 1210 00:45:29,927 --> 00:45:30,461 NEXT PATIENT. 1211 00:45:30,527 --> 00:45:32,463 WITH THAT I'M EXCITED TO SHARE 1212 00:45:32,529 --> 00:45:37,000 ONE OF OUR OTHER SUCCESSES, 1213 00:45:37,067 --> 00:45:38,469 DR. BERGVALL WILL SHARE THE 1214 00:45:38,535 --> 00:45:47,945 NEUROSCIENCE 1.0 SERIES. 1215 00:45:48,011 --> 00:45:50,547 >> I HAD THE PLEASURE OF 1216 00:45:50,614 --> 00:45:52,649 BRINGING THIS HOME. 1217 00:45:52,716 --> 00:45:53,650 FIGURATIVELY AND LITERALLY BRING 1218 00:45:53,717 --> 00:45:55,085 IT TO THE CLINICAL CENTER AND 1219 00:45:55,152 --> 00:45:56,019 WANTED TO SHARE THE EXPERIENCE 1220 00:45:56,086 --> 00:45:57,087 WITH YOU. 1221 00:45:57,154 --> 00:45:59,056 IT'S SUPER EXCITING AND WAS AU 1222 00:45:59,123 --> 00:46:02,459 TEAM EFFORT AND IT WAS A NEW 1223 00:46:02,526 --> 00:46:03,227 APPROACH AND IF ANYBODY 1224 00:46:03,293 --> 00:46:04,161 UNDERSTANDS YOU HAVE TO THINK 1225 00:46:04,228 --> 00:46:07,431 OUTSIDE THE BOX ESPECIALLY HERE 1226 00:46:07,498 --> 00:46:07,998 AT THE CLINICAL CENTER. 1227 00:46:08,065 --> 00:46:10,567 SO WHAT I'D LIKE TO SAY IS I 1228 00:46:10,634 --> 00:46:12,870 LIKE TO BRING THE HEART AND 1229 00:46:12,936 --> 00:46:16,907 BRAIN TOGETHER. 1230 00:46:16,974 --> 00:46:27,518 I ALWAYS HAVE I LIKE TO BRING HE 1231 00:46:28,452 --> 00:46:29,319 HEART AND BRAIN TOGETHER BECAUSE 1232 00:46:29,386 --> 00:46:33,624 I THINK THE BRAIN'S MORE 1233 00:46:33,690 --> 00:46:33,891 IMPORTANT. 1234 00:46:33,957 --> 00:46:35,626 DR. GOMEZ THINKS THE HEART'S 1235 00:46:35,692 --> 00:46:37,327 MORE IMPORTANT SO WE COME 1236 00:46:37,394 --> 00:46:43,734 TOGETHER AND WE WANT TO ADVANCE 1237 00:46:43,800 --> 00:46:44,334 NEUROLOGICAL ASSESSMENT. 1238 00:46:44,401 --> 00:46:47,404 AT THE CLINICAL CENTER WE WANTED 1239 00:46:47,471 --> 00:46:50,541 TO BRING THE MEANING BEHIND THE 1240 00:46:50,607 --> 00:46:51,408 NEUROLOGICAL ASSESSMENT AND 1241 00:46:51,475 --> 00:46:53,377 CONNECT THE CRITICAL THINKING 1242 00:46:53,443 --> 00:46:56,213 TRANSLATE TO BEDSIDE AND 1243 00:46:56,280 --> 00:46:59,383 INTEGRATE THE NEUROLOGICAL 1244 00:46:59,449 --> 00:46:59,683 EMERGENCIES. 1245 00:46:59,750 --> 00:47:02,486 THIS IS INTERESTING BECAUSE WE 1246 00:47:02,553 --> 00:47:05,889 HAD STAKEHOLDERS AND OUR NURSING 1247 00:47:05,956 --> 00:47:06,523 EXECUTIVE AND CLINICAL CENTER 1248 00:47:06,590 --> 00:47:07,424 EXECUTIVE TEAM SUPPORTED THIS 1249 00:47:07,491 --> 00:47:17,634 MISSION. 1250 00:47:30,047 --> 00:47:32,216 WE DO PROTOCOLS AND CREATE A 1251 00:47:32,282 --> 00:47:34,051 COMMON GROUND OR COLLECTIVE 1252 00:47:34,117 --> 00:47:35,385 INTELLIGENCE AS DR. GOMEZ SAID 1253 00:47:35,452 --> 00:47:38,021 AND SHARE THE SAME MENTAL MODEL. 1254 00:47:38,088 --> 00:47:38,622 WE WANTED TO UNDERSTAND AND 1255 00:47:38,689 --> 00:47:40,724 SPEAK THE SAME LANGUAGE FROM 1256 00:47:40,791 --> 00:47:42,726 NURSING TO PROVIDERS AND TO DO 1257 00:47:42,793 --> 00:47:45,295 THAT WE WANTED TO MAKE SURE THAT 1258 00:47:45,362 --> 00:47:47,397 WE HAD SOMETHING MEANINGFUL. 1259 00:47:47,464 --> 00:47:48,732 AND OVER ALL WE WANTED TO KEEP 1260 00:47:48,799 --> 00:47:49,666 IT SIMPLE. 1261 00:47:49,733 --> 00:47:51,268 ONE OF THE THINGS I LIKE TO SAY 1262 00:47:51,335 --> 00:47:53,270 IS KEEP IT SIMPLE AND AS A 1263 00:47:53,337 --> 00:47:55,239 BEDSIDE NURSE FOR A VERY LONG 1264 00:47:55,305 --> 00:47:56,840 TIME ONE OF MY POST POPULAR 1265 00:47:56,907 --> 00:47:58,542 SAYING TO SAY IS I DON'T HAVE 1266 00:47:58,609 --> 00:47:59,343 TIME FOR THAT. 1267 00:47:59,409 --> 00:48:00,377 SO EVERYBODY CAN SAY, I DON'T 1268 00:48:00,444 --> 00:48:01,478 HAVE TIME FOR THAT. 1269 00:48:01,545 --> 00:48:03,347 I HAVE TO INTEGRATE WHATEVER I'M 1270 00:48:03,413 --> 00:48:05,215 GOING TO BE DOING INTO MY DAILY 1271 00:48:05,282 --> 00:48:07,451 CARE BECAUSE I REALLY DON'T HAVE 1272 00:48:07,517 --> 00:48:13,724 TIME TO DO MORE EDUCATION OR 1273 00:48:13,790 --> 00:48:14,424 TRAINING. 1274 00:48:14,491 --> 00:48:15,592 SO THAT TRUST WAS IMPORTANT TO 1275 00:48:15,659 --> 00:48:19,696 FIGURE OUT WHAT TO DO NEXT. 1276 00:48:19,763 --> 00:48:21,465 THIS LED ME TO A QUOTE WHEN I 1277 00:48:21,531 --> 00:48:26,536 START THE THISSOUS -- THIS OUT 1278 00:48:26,603 --> 00:48:27,104 THAT RESONATED. 1279 00:48:27,170 --> 00:48:30,107 NIL I FORGET AND TEACH ME I 1280 00:48:30,173 --> 00:48:32,342 REMEMBER AND INVOLVE ME AND I 1281 00:48:32,409 --> 00:48:33,110 LEARN. 1282 00:48:33,176 --> 00:48:34,778 I'M ABOUT GIVING FISHING POLES 1283 00:48:34,845 --> 00:48:35,779 AND NOT FISH. 1284 00:48:35,846 --> 00:48:39,383 I WANTED TO MAKE A LONG LASTING 1285 00:48:39,449 --> 00:48:43,854 IMPACT AND I EMBRACE THE THEORY 1286 00:48:43,920 --> 00:48:45,589 AND THOUGHT PROCESS BEHIND 1287 00:48:45,656 --> 00:48:48,425 SIMULATION BUT IT'S NEW FOR 1288 00:48:48,492 --> 00:48:50,527 NURSING. 1289 00:48:50,594 --> 00:48:54,965 WHY DON'T WE USE THE 1290 00:48:55,032 --> 00:48:56,366 NEUROEDUCATION SERIES TO SEE HOW 1291 00:48:56,433 --> 00:48:57,100 IT WILL WORK OUT? 1292 00:48:57,167 --> 00:48:57,968 THIS WAS ROBUST. 1293 00:48:58,035 --> 00:49:00,203 LOOK AT THE TIME LINE. 1294 00:49:00,270 --> 00:49:02,205 I LIKE TO SEE THE SUCCESS. 1295 00:49:02,272 --> 00:49:05,342 BETWEEN SUMMERS OF 2020 AND 2022 1296 00:49:05,409 --> 00:49:09,046 WE EXPERIENCED MANY DRY RUNS. 1297 00:49:09,112 --> 00:49:11,315 WHO HERE LOVE NEURO? 1298 00:49:11,381 --> 00:49:15,385 I KNOW YOU'LL ALL RACE -- RAISE 1299 00:49:15,452 --> 00:49:17,954 YOUR HAND AND AS WELL. 1300 00:49:18,021 --> 00:49:26,396 IT HAS A STIGMA. 1301 00:49:26,463 --> 00:49:27,431 DOES EVERYBODY HAVE A BRAIN AND 1302 00:49:27,497 --> 00:49:27,931 SPINAL CORD? 1303 00:49:27,998 --> 00:49:30,934 I HOPE SO. 1304 00:49:31,001 --> 00:49:33,103 IT'S VITAL TO OUR DAILY PRACTICE 1305 00:49:33,170 --> 00:49:35,205 AS NURSES AND PRACTITIONERS. 1306 00:49:35,272 --> 00:49:37,207 WHEN WE LOOK AT THE MILESTONE 1307 00:49:37,274 --> 00:49:38,508 AND PHASES WE WENT THROUGH THE 1308 00:49:38,575 --> 00:49:40,644 INITIAL CALL TO ACTION WAS IN 1309 00:49:40,711 --> 00:49:42,145 SUMMER OF 2020. 1310 00:49:42,212 --> 00:49:43,347 NOT A GREAT TIME TO INITIATE A 1311 00:49:43,413 --> 00:49:45,015 PROGRAM. 1312 00:49:45,082 --> 00:49:45,882 I DON'T KNOW. 1313 00:49:45,949 --> 00:49:47,150 THERE WAS SOMETHING GOING ON 1314 00:49:47,217 --> 00:49:48,418 ABOUT THAT TIME. 1315 00:49:48,485 --> 00:49:50,587 I'M NOT SURE WHAT IT WAS BUT 1316 00:49:50,654 --> 00:49:58,395 PRETTY WE GOT THROUGH IT. 1317 00:49:58,462 --> 00:50:00,964 WE LAD TO RETHINK AND WITH 1318 00:50:01,031 --> 00:50:02,833 DR. GOMEZ WE DID TRIAL RUNS AND 1319 00:50:02,899 --> 00:50:04,668 SOME SUCCESS AND SOME FAILS. 1320 00:50:04,735 --> 00:50:06,770 WE WANTED TO DEVELOP SOMETHING 1321 00:50:06,837 --> 00:50:16,179 THAT WAS MEANINGFUL AND NEW. 1322 00:50:16,246 --> 00:50:22,185 WE WENT FROM THE BASEMENT OF 1323 00:50:22,252 --> 00:50:24,588 FAES AND DR. GOMEZ WAS CARRYING 1324 00:50:24,654 --> 00:50:26,556 A MANNEQUIN WHICH WAS HEAVY AND 1325 00:50:26,623 --> 00:50:28,258 WE WERE TRYING TO GET IT TO WORK 1326 00:50:28,325 --> 00:50:29,426 BUT TIME WASN'T ON OUR SIDE. 1327 00:50:29,493 --> 00:50:31,795 WE HAD TO RETHINK IT. 1328 00:50:31,862 --> 00:50:33,964 THEN WE HAD TO FIGURE OUT WHAT 1329 00:50:34,030 --> 00:50:36,666 WE WERE GOING TO TEACH. 1330 00:50:36,733 --> 00:50:38,535 WELL, AGAIN, EVERYBODY SAY I 1331 00:50:38,602 --> 00:50:44,474 DON'T THERE TIME TO DO THAT OR A 1332 00:50:44,541 --> 00:50:45,242 30 MINUTE NEURAL ASSESSMENT. 1333 00:50:45,308 --> 00:50:47,010 SO WHAT WE WERE GOING TO TEACH? 1334 00:50:47,077 --> 00:50:51,581 IN FALL OF 2021, IN THE MIDST OF 1335 00:50:51,648 --> 00:50:53,850 COVID TIMES WE WERE ABLE TO HAVE 1336 00:50:53,917 --> 00:50:56,286 AN APPROVED ONLINE COURSE TO 1337 00:50:56,353 --> 00:50:57,988 LAUNCH FIRST AND THEN THE IN 1338 00:50:58,054 --> 00:50:58,989 PERSON SESSIONS WHEN IT WAS SAFE 1339 00:50:59,055 --> 00:51:00,424 TO DO SO. 1340 00:51:00,490 --> 00:51:02,092 SO I'M GOING TO TAKE YOU THROUGH 1341 00:51:02,159 --> 00:51:03,093 THAT STORY AND JOURNEY. 1342 00:51:03,160 --> 00:51:09,499 IT'S REALLY EXCITING. 1343 00:51:09,566 --> 00:51:10,367 FIRST LET'S TALK ABOUT THE 1344 00:51:10,434 --> 00:51:11,067 COMMON GROUND. 1345 00:51:11,134 --> 00:51:13,036 SO WHEN WE TALK ABOUT THE COMMON 1346 00:51:13,103 --> 00:51:17,441 GROUND, IT'S LIKE WHY ARE WE 1347 00:51:17,507 --> 00:51:18,308 DOING THIS? 1348 00:51:18,375 --> 00:51:20,744 I THINK ABOUT THAT SHARED MENTAL 1349 00:51:20,811 --> 00:51:23,880 MODEL AND WE ALL WANT TO WORK IN 1350 00:51:23,947 --> 00:51:25,148 A VACUUM. 1351 00:51:25,215 --> 00:51:28,151 I'M AN ONCOLOGY NURSE AND 1352 00:51:28,218 --> 00:51:29,986 ONCOLOGIST AND NEURAL NURSE AND 1353 00:51:30,053 --> 00:51:30,287 ICU NURSE. 1354 00:51:30,353 --> 00:51:35,125 WE ALL HAVE A BRAIN AND SPINAL 1355 00:51:35,192 --> 00:51:38,128 CORD AND SO LET'S USE THEM AND 1356 00:51:38,195 --> 00:51:39,196 HEART OF COURSE. 1357 00:51:39,262 --> 00:51:42,332 WE STRIVE TO SPEAK THE SAME 1358 00:51:42,399 --> 00:51:42,899 CLINICAL LANGUAGE. 1359 00:51:42,966 --> 00:51:44,201 WE BELIEVE BY COLLABORATING AND 1360 00:51:44,267 --> 00:51:45,902 SUPPORTING EACH OTHER WE CAN 1361 00:51:45,969 --> 00:51:47,637 PROVIDE THE BEST EVIDENCE-BASED 1362 00:51:47,704 --> 00:51:49,206 PRACTICE CARE FOR OUR CLINICAL 1363 00:51:49,272 --> 00:51:52,309 RESEARCH CENTERS AT THE NIH 1364 00:51:52,375 --> 00:51:53,477 CLINICAL CENTER AND RECOGNIZE 1365 00:51:53,543 --> 00:51:54,845 NEUROLOGICAL EMERGENCY. 1366 00:51:54,911 --> 00:51:56,847 SEE THAT RECOGNITION OF THOSE 1367 00:51:56,913 --> 00:51:58,148 OVER AND OVER AGAIN BECAUSE THAT 1368 00:51:58,215 --> 00:52:02,385 IS WHAT WAS IMPORTANT AND THE 1369 00:52:02,452 --> 00:52:04,287 SHARE MENTAL MODEL THE 1370 00:52:04,354 --> 00:52:05,255 COLLECTIVE INTELLIGENCE. 1371 00:52:05,322 --> 00:52:07,824 NO MATTER WHERE WE'RE COMING 1372 00:52:07,891 --> 00:52:10,627 FR 1373 00:52:10,694 --> 00:52:12,529 FROM, WE NEED TO SPEAK THE SAME 1374 00:52:12,596 --> 00:52:13,897 LANGUAGE AND DO THE SHARED 1375 00:52:13,964 --> 00:52:15,131 MENTAL MODEL. 1376 00:52:15,198 --> 00:52:16,399 INITIALLY, WE WERE LOOKING AT 1377 00:52:16,466 --> 00:52:19,736 WHAT WAS GOING ON HERE. 1378 00:52:19,803 --> 00:52:22,305 SO AS PART OF EVIDENCE-BASED 1379 00:52:22,372 --> 00:52:23,206 PRACTICE WE LET THE EVIDENCE 1380 00:52:23,273 --> 00:52:24,741 GUIDE US TO THE ANSWERS. 1381 00:52:24,808 --> 00:52:25,909 WHAT IS GOING ON IN THE 1382 00:52:25,976 --> 00:52:29,546 LITERATURE AND GOING ON HERE. 1383 00:52:29,613 --> 00:52:31,147 WE WERE AS UNIQUE AS WE THOUGHT 1384 00:52:31,214 --> 00:52:32,516 WE WERE. 1385 00:52:32,582 --> 00:52:35,552 FOR A NON-NEUROLOGICAL 1386 00:52:35,619 --> 00:52:38,655 POPULATIONS THE MOST COMMON 1387 00:52:38,722 --> 00:52:40,924 PRIMARY DIAGNOSIS WERE ONCOLOGY 1388 00:52:40,991 --> 00:52:41,191 PATIENTS. 1389 00:52:41,258 --> 00:52:47,397 THAT'S NOT PRIZE SURPRISING AND 1390 00:52:47,464 --> 00:52:50,901 WE SAW SOLID TUMORS AND 1391 00:52:50,967 --> 00:52:54,771 LYMPHOMAS AND WHAT WE SAW FOR 1392 00:52:54,838 --> 00:52:59,743 CONSULTS WAS STROKE LIKE AND 1393 00:52:59,809 --> 00:53:02,712 SEIZURE LIKE SYSTEMS AND ACUTE 1394 00:53:02,779 --> 00:53:03,713 DECLINE AND ACUTE STATUS AND 1395 00:53:03,780 --> 00:53:05,649 WE'VE SEEN THAT IN OUR 1396 00:53:05,715 --> 00:53:09,252 PRAGMATICS. 1397 00:53:09,319 --> 00:53:13,223 -- PRACTICE. 1398 00:53:13,290 --> 00:53:15,125 WHEN I LOOK AT NURSING 1399 00:53:15,191 --> 00:53:16,626 DOCUMENTATION, WHAT WAS LACK ON 1400 00:53:16,693 --> 00:53:17,460 THE ACCURACY? 1401 00:53:17,527 --> 00:53:21,164 IT WAS CONFUSING TO LOOK AT THE 1402 00:53:21,231 --> 00:53:24,901 DOCUMENTATION ITSELF AND LOOK AT 1403 00:53:24,968 --> 00:53:28,505 THE ASSESSMENT IN ITS ENTIRETY 1404 00:53:28,572 --> 00:53:30,440 AS FROM THE NEURAL PERSPECTIVE 1405 00:53:30,507 --> 00:53:32,275 OUTSIDE THE NEUROLOGICAL UNIT. 1406 00:53:32,342 --> 00:53:34,444 WE THEN DO NOT USE THE NIH 1407 00:53:34,511 --> 00:53:38,548 STROKE SKILL. 1408 00:53:38,615 --> 00:53:41,851 I KNOW THAT'S SHOCK BUT I DON'T 1409 00:53:41,918 --> 00:53:43,787 HAVE A SCALE TO LOOK AT THE 1410 00:53:43,853 --> 00:53:44,487 PRACTS. 1411 00:53:44,554 --> 00:53:45,956 WHAT WAS MISSING IS SENSORY, 1412 00:53:46,022 --> 00:53:48,491 VISUAL FIELDS AND INACCURATE 1413 00:53:48,558 --> 00:53:51,394 PUPIL CHECKS, PARAMETERS, WHOLE 1414 00:53:51,461 --> 00:53:52,762 MISSING PARAMETERS IN 1415 00:53:52,829 --> 00:53:55,065 DOCUMENTATION LIKE SEIZURES, 1416 00:53:55,131 --> 00:53:57,067 GAIT AND NO BASELINE 1417 00:53:57,133 --> 00:53:59,402 NEUROLOGICAL ASSESSMENTS A LOT 1418 00:53:59,469 --> 00:54:00,704 OF TIMES. 1419 00:54:00,770 --> 00:54:01,871 AND NOW THAT IS NOT DIFFERENT 1420 00:54:01,938 --> 00:54:03,406 FROM WHAT WE SEE IN THE OUTSIDE 1421 00:54:03,473 --> 00:54:09,813 POPULATION. 1422 00:54:09,879 --> 00:54:11,147 TO TAKE THE SUMMARY OF THE CLIN 1423 00:54:11,214 --> 00:54:13,416 ISSUES I WANTED TO PUT THEM IN 1424 00:54:13,483 --> 00:54:14,951 FOUR DOMAINS TO THINK ABOUT THE 1425 00:54:15,018 --> 00:54:15,385 SO WHAT. 1426 00:54:15,452 --> 00:54:16,086 SO WHAT. 1427 00:54:16,152 --> 00:54:17,921 SO I FOUND OUT WHAT WE'RE 1428 00:54:17,988 --> 00:54:19,389 MISSING. 1429 00:54:19,456 --> 00:54:21,791 I FOUND OUT WHAT WAS IN THE 1430 00:54:21,858 --> 00:54:24,461 LITERATURE AND WHAT STRATEGIES 1431 00:54:24,527 --> 00:54:28,331 I'M GOING LOOK AND ONE GOAL BY 1432 00:54:28,398 --> 00:54:29,966 DEVELOPING THE NEURAL EDUCATION 1433 00:54:30,033 --> 00:54:30,867 SERIES? 1434 00:54:30,934 --> 00:54:33,870 WELL, OBVIOUSLY THE TRIGGER AT 1435 00:54:33,937 --> 00:54:39,309 THE BEGINNING, IMPROVED 1436 00:54:39,376 --> 00:54:41,011 NEUROLOGICAL NURSING DOCUMENT 1437 00:54:41,077 --> 00:54:43,413 AND IMPROVE THE COMPETENCY AND 1438 00:54:43,480 --> 00:54:45,248 JUDGMENT WITH NEUROLOGICAL 1439 00:54:45,315 --> 00:54:45,949 ASSESSMENT. 1440 00:54:46,016 --> 00:54:47,951 THESE WERE VERY IMPORTANT AS THE 1441 00:54:48,018 --> 00:54:49,519 FOUNDATION AND STRUCTURE AS A 1442 00:54:49,586 --> 00:54:54,491 LOOK AT THE CLINICAL ISSUES. 1443 00:54:54,557 --> 00:54:57,193 SO YOU SAW A LOT OF THEORY AND I 1444 00:54:57,260 --> 00:55:00,864 KNOW PEOPLE LOVE THEORY -- MAYBE 1445 00:55:00,930 --> 00:55:01,598 NOT. 1446 00:55:01,665 --> 00:55:03,299 THAT MAKES PEOPLE A LITTLE DIZZY 1447 00:55:03,366 --> 00:55:07,003 BUT IT'S A GREAT THEORY AND MY 1448 00:55:07,070 --> 00:55:09,172 MENTORS MENTIONED TO ME WHEN I 1449 00:55:09,239 --> 00:55:10,573 CAN LINK THEORY AND SCIENCE YOU 1450 00:55:10,640 --> 00:55:13,677 HAVE MAGIC. 1451 00:55:13,743 --> 00:55:17,814 SO THIS IS THE TANNER CLINICAL 1452 00:55:17,881 --> 00:55:18,848 JUDGMENT MODEL DEVELOPED BY 1453 00:55:18,915 --> 00:55:20,517 TANNER AND WROTE AN ARTICLE THAT 1454 00:55:20,583 --> 00:55:21,785 SAID THINK LIKE A NURSE. 1455 00:55:21,851 --> 00:55:24,387 NOW, THINKING LIKE A NURSE IS 1456 00:55:24,454 --> 00:55:25,789 INTERESTING BECAUSE IN NURSING 1457 00:55:25,855 --> 00:55:27,891 WHEN IS DIFFERENT THAN MEDICINE 1458 00:55:27,957 --> 00:55:29,893 IS WE LOOK AT SYMPTOMS AND 1459 00:55:29,959 --> 00:55:30,927 PATTERN RECOGNITION AN NOTIFY 1460 00:55:30,994 --> 00:55:33,430 WHEN WE NEED TO ESCALATE CARE. 1461 00:55:33,496 --> 00:55:37,834 SO WE LOOK AT ALL THESE 1462 00:55:37,901 --> 00:55:40,704 ASSESSMENTS AND DESCRIBE THINGS 1463 00:55:40,770 --> 00:55:46,109 TO THE ENDTH DEGREE AND WHAT I 1464 00:55:46,176 --> 00:55:49,145 DID OR WE DID WAS LOOKED AT 1465 00:55:49,212 --> 00:55:51,147 NOTICE AND WHAT DO WE NOTICE 1466 00:55:51,214 --> 00:55:51,781 WHEN WE ASSESS? 1467 00:55:51,848 --> 00:55:55,385 AND HOW DO WE INTERPRET THIS? 1468 00:55:55,452 --> 00:55:56,619 WHAT DO WE THINK OF? 1469 00:55:56,686 --> 00:55:58,054 HOW DO WE UNDERSTAND? 1470 00:55:58,121 --> 00:56:00,757 WHAT IS INTUITIVE AND WHAT IS 1471 00:56:00,824 --> 00:56:02,358 OUR EXPERIENCE ALLOWED AND HOW 1472 00:56:02,425 --> 00:56:03,126 TO RESPOND. 1473 00:56:03,193 --> 00:56:04,327 AGAIN, I DON'T HAVE TIME FOR 1474 00:56:04,394 --> 00:56:08,998 THIS AND KEEPING IT SIMPLE, WHAT 1475 00:56:09,065 --> 00:56:10,400 ARE THE TWO THINGS I CAN DO. 1476 00:56:10,467 --> 00:56:12,268 DO I ACT OR NOT ACT? 1477 00:56:12,335 --> 00:56:14,437 AND AS NURSES, WE'RE ALWAYS AT 1478 00:56:14,504 --> 00:56:15,538 THE BEDSIDE. 1479 00:56:15,605 --> 00:56:17,674 SO THAT'S EXACTLY WHAT WE DO. 1480 00:56:17,741 --> 00:56:20,076 DO WE ACT AND CALL OUR 1481 00:56:20,143 --> 00:56:20,343 PROVIDERS? 1482 00:56:20,410 --> 00:56:23,079 DO WE GIVE MEDICATIONS. 1483 00:56:23,146 --> 00:56:24,781 WHAT IS THE INTERVENTION. 1484 00:56:24,848 --> 00:56:26,783 AS NURSES AND NOT WITHIN OUR 1485 00:56:26,850 --> 00:56:28,218 SCOPE OF PRACTICE DO WE 1486 00:56:28,284 --> 00:56:29,319 DIAGNOSE. 1487 00:56:29,385 --> 00:56:31,921 WE NEED TO IDENTIFY WHAT IS 1488 00:56:31,988 --> 00:56:36,292 EMERGENT AND HOW TO ESCALATE. 1489 00:56:36,359 --> 00:56:38,995 THEN, WE COME BACK AND WE 1490 00:56:39,062 --> 00:56:39,896 RECOGNIZE FINDINGS AND CAN 1491 00:56:39,963 --> 00:56:40,997 REFLECT ON THE ACTION. 1492 00:56:41,064 --> 00:56:42,599 DO YOU SEE HOW THIS CAN REALLY 1493 00:56:42,665 --> 00:56:43,066 INTEGRATE ITSELF INTO 1494 00:56:43,133 --> 00:56:45,535 SIMULATION? 1495 00:56:45,602 --> 00:56:47,971 SO THIS ACTUALLY BROUGHT TO WHAT 1496 00:56:48,037 --> 00:56:48,571 AM I GOING TEACH? 1497 00:56:48,638 --> 00:56:52,075 NO ONE HAS TIME TO DO A FULL 1498 00:56:52,142 --> 00:56:53,943 NEURAL ASSESSMENT. 1499 00:56:54,010 --> 00:56:55,378 A NEUROLOGIST WILL SAY IT TAKES 1500 00:56:55,445 --> 00:56:56,913 30 MINUTES AND THE EXPERTISE OF 1501 00:56:56,980 --> 00:56:57,347 THAT. 1502 00:56:57,413 --> 00:57:00,183 I'M NOT ASKING ANYBODY TO PULL 1503 00:57:00,250 --> 00:57:01,518 OUT THEIR TRAINING FORKS OR 1504 00:57:01,584 --> 00:57:03,052 REFLEX HAMMERS. 1505 00:57:03,119 --> 00:57:04,187 BUT THOSE AWAY. 1506 00:57:04,254 --> 00:57:10,059 NEED A PEN AND HERE WE GO. 1507 00:57:10,126 --> 00:57:12,162 WE DID PRELIMINARY VALIDATION ON 1508 00:57:12,228 --> 00:57:14,430 THE NEUROLOGICAL PRECISION AID 1509 00:57:14,497 --> 00:57:15,131 TOOL. 1510 00:57:15,198 --> 00:57:16,699 WHAT'S IT'S NOT IS AN ALGORITHM. 1511 00:57:16,766 --> 00:57:18,968 IT'S A GUIDE TO HELP YOU GO 1512 00:57:19,035 --> 00:57:20,804 TOWARDS THE NEXT CLINICAL 1513 00:57:20,870 --> 00:57:21,070 DECISION. 1514 00:57:21,137 --> 00:57:29,913 AS YOU CAN SEE, HERE YOU HAVE 1515 00:57:29,979 --> 00:57:33,616 TEST, CONNECT AND RESPOND WHICH 1516 00:57:33,683 --> 00:57:35,385 COINCIDES WITH NOTICE, RECOGNIZE 1517 00:57:35,451 --> 00:57:36,319 AND ACTION. 1518 00:57:36,386 --> 00:57:39,722 SO HOW WE DO THIS IS WE TAKE THE 1519 00:57:39,789 --> 00:57:43,059 FOUR MAJOR NEURO DOMAINS WE'RE 1520 00:57:43,126 --> 00:57:44,727 OFTEN MISSING BECAUSE PEOPLE 1521 00:57:44,794 --> 00:57:45,461 DIDN'T UNDERSTAND IN GENERAL 1522 00:57:45,528 --> 00:57:48,731 WHAT WAS INCLUDED IN A 1523 00:57:48,798 --> 00:57:49,265 NEUROLOGICAL ASSESSMENT. 1524 00:57:49,332 --> 00:57:51,000 YOU NEEDED ALL THESE TO BE 1525 00:57:51,067 --> 00:57:52,669 INCLUDED IN NEUROLOGICAL 1526 00:57:52,735 --> 00:57:54,137 ASSESSMENT WITHIN THE LITERATURE 1527 00:57:54,204 --> 00:57:56,506 AND THE EVIDENCE WE FOUND WHAT 1528 00:57:56,573 --> 00:57:57,674 WILL LEAD YOU TO EMERGENCY AND 1529 00:57:57,740 --> 00:58:01,477 WE SIMPLIFIED IT BY MAKING THE 1530 00:58:01,544 --> 00:58:02,212 ACTIONS BINARY. 1531 00:58:02,278 --> 00:58:03,613 IT'S EITHER YES OR NO. 1532 00:58:03,680 --> 00:58:05,915 WILL IT LEAD YOU TO A CAUTION 1533 00:58:05,982 --> 00:58:09,452 WHERE YOU'LL HAVE A HIGHER ALERT 1534 00:58:09,519 --> 00:58:10,453 RESPONSE OR COMPLETE RED FLAG? 1535 00:58:10,520 --> 00:58:15,391 THIS ALLOWED US TO DEMYSTIFY THE 1536 00:58:15,458 --> 00:58:21,297 NEURO ASSESSMENT AND HAVE A 1537 00:58:21,364 --> 00:58:25,368 TANGIBLE TOOL AND COINED IT THE 1538 00:58:25,435 --> 00:58:26,669 HIGH YIELD NEURAL ASSESSMENT. 1539 00:58:26,736 --> 00:58:29,505 MOVING ALONG, WE'RE GOING TWO 1540 00:58:29,572 --> 00:58:31,241 PHASE 3 OUR MILESTONE. 1541 00:58:31,307 --> 00:58:33,776 SO WE HAVE -- WE KNOW WHAT WE'RE 1542 00:58:33,843 --> 00:58:35,945 TESTING, CHECK, AND NOW WE HAVE 1543 00:58:36,012 --> 00:58:37,046 TO TEACH IT. 1544 00:58:37,113 --> 00:58:39,616 HOW ARE WE GOING DO THAT? 1545 00:58:39,682 --> 00:58:41,751 EVERYBODY LIKES TO SAY 1546 00:58:41,818 --> 00:58:43,720 EDUCATION, EDUCATION, EDUCATION. 1547 00:58:43,786 --> 00:58:46,589 WE AN ISSUE, WE NEED TO TRAIN. 1548 00:58:46,656 --> 00:58:50,827 WE HAVE AN ISSUE, WE NEED TO 1549 00:58:50,894 --> 00:58:51,094 TRAIN. 1550 00:58:51,160 --> 00:58:52,929 AND YOU NEED TO HAVE MEANING 1551 00:58:52,996 --> 00:58:55,398 BEHIND IT AND ONCE AGAIN 1552 00:58:55,465 --> 00:58:56,833 CREATING THEORY BEHIND OUR 1553 00:58:56,900 --> 00:58:59,435 INTERVENTION WE ADDED THE 1554 00:58:59,502 --> 00:59:01,771 KNOWLEDGE SKILL ATTITUDE. 1555 00:59:01,838 --> 00:59:03,206 KNOWLEDGE BY INCLUDING THE 1556 00:59:03,273 --> 00:59:06,342 FOUR-HOUR ONLINE MODULE HELPED 1557 00:59:06,409 --> 00:59:06,910 BY INCLUDING CONTINUING 1558 00:59:06,976 --> 00:59:08,745 EDUCATION CREDITS. 1559 00:59:08,811 --> 00:59:14,183 NEXT WAS DEMONSTRATING THE 1560 00:59:14,250 --> 00:59:17,420 SKILLS AND REPEATING THIRD WAS 1561 00:59:17,487 --> 00:59:20,723 HOW TO CHANGE THE ATTITUDE OR 1562 00:59:20,790 --> 00:59:22,458 RESPONSE TO IT. 1563 00:59:22,525 --> 00:59:24,827 IT WAS A BEAUTIFUL THING FOR 1564 00:59:24,894 --> 00:59:25,228 NOTED. 1565 00:59:25,295 --> 00:59:27,697 PEOPLE THOUGHT NURSES KNEW HOW 1566 00:59:27,764 --> 00:59:29,532 TO DO AN ASSESSMENT. 1567 00:59:29,599 --> 00:59:31,134 AND SOMETHING AS SIMPLE AND 1568 00:59:31,200 --> 00:59:33,503 BASIC AS NEUROLOGICAL ASSESSMENT 1569 00:59:33,569 --> 00:59:35,505 WAS NOT DONE THE SAME WAY. 1570 00:59:35,571 --> 00:59:37,807 OR WASN'T DONE AT ALL. 1571 00:59:37,874 --> 00:59:39,776 SO HOW DID WE DO? 1572 00:59:39,842 --> 00:59:43,379 YOU GUYS READY? 1573 00:59:43,446 --> 00:59:44,747 I'M EXCITED. 1574 00:59:44,814 --> 00:59:46,649 THIS IS JUST A DISCLOSURE THIS 1575 00:59:46,716 --> 00:59:53,489 WAS ALL ANONYMOUS AND OUR 1576 00:59:53,556 --> 00:59:56,960 STRATEGY TO PROVE EFFECTIVENESS 1577 00:59:57,026 --> 00:59:59,529 WAS DONE ON THE THREE METRICS. 1578 00:59:59,595 --> 01:00:03,166 MY MENTORS HELPED ME IDENTIFY 1579 01:00:03,232 --> 01:00:04,801 WHAT TO MEASURE. 1580 01:00:04,867 --> 01:00:06,803 WE'RE LOOKING AT BRAIN CODES AND 1581 01:00:06,869 --> 01:00:11,407 INTERMEDIATE CONSULTS AND ADD 1582 01:00:11,474 --> 01:00:20,450 SERVICE EVENTS PRE AND POST 1583 01:00:20,516 --> 01:00:28,891 KNOWLEDGE AND THE EFFECTS MUCH 1584 01:00:28,958 --> 01:00:38,634 THE EDUCATION TRAINING. 1585 01:00:38,701 --> 01:00:45,141 WE HAD OUR NURSING INTRAMURAL 1586 01:00:45,208 --> 01:00:47,343 SCIENCE AND PRIOR TO AUDITING 1587 01:00:47,410 --> 01:00:50,446 THE DOCUMENTATION. 1588 01:00:50,513 --> 01:00:54,017 WE AUDIT A LOT OF CHARTS. 1589 01:00:54,083 --> 01:00:55,685 WE HAD TO LOOK AT WHAT WE WERE 1590 01:00:55,752 --> 01:00:56,953 GOING TO BE DOCUMENTING. 1591 01:00:57,020 --> 01:00:58,855 WHAT WOULD LEAD TO NEUROLOGICAL 1592 01:00:58,921 --> 01:00:59,489 EMERGENCIES AND WHAT WE WERE 1593 01:00:59,555 --> 01:01:08,931 GOING TO AUDIT. 1594 01:01:08,998 --> 01:01:09,866 SOME COMPONENTS WERE IN THE 1595 01:01:09,932 --> 01:01:12,902 MIDDLE AND WE DIDN'T HAVE AN 1596 01:01:12,969 --> 01:01:14,203 EXACT MEASUREMENT. 1597 01:01:14,270 --> 01:01:16,539 PAINSTAKINGLY I HAD TO GO 1598 01:01:16,606 --> 01:01:17,874 THROUGH ALL THE DOCUMENTATION TO 1599 01:01:17,940 --> 01:01:19,008 SEE WHAT WAS IMPROVEMENT. 1600 01:01:19,075 --> 01:01:22,712 I DID THIS TO ELIMINATE BIAS BY 1601 01:01:22,779 --> 01:01:24,580 CREATING A RUBRIC. 1602 01:01:24,647 --> 01:01:28,317 HERE IS A QUICK SNAPSHOT OF PRE 1603 01:01:28,384 --> 01:01:30,253 AND POST NEURAL EDUCATION 1604 01:01:30,319 --> 01:01:30,520 SERIES. 1605 01:01:30,586 --> 01:01:33,089 THE FIRST PART OF IT WAS THE 1606 01:01:33,156 --> 01:01:33,656 FOURTH QUARTER. 1607 01:01:33,723 --> 01:01:35,291 WE DIDN'T HAVE THAT MUCH DATA 1608 01:01:35,358 --> 01:01:37,226 THERE BUT HAD A NUMBER OF BRAIN 1609 01:01:37,293 --> 01:01:38,795 CODES AND YOU CAN SEE IT 1610 01:01:38,861 --> 01:01:39,062 DECREASED. 1611 01:01:39,128 --> 01:01:43,399 I CAN'T TELL YOU IF THAT WAS 1612 01:01:43,466 --> 01:01:44,033 BETTER OR WORSE. 1613 01:01:44,100 --> 01:01:45,935 YOU CAN ARGUE EITHER WAY. 1614 01:01:46,002 --> 01:01:51,307 THE NUMBER OF REQUIRED HE IS 1615 01:01:51,374 --> 01:01:51,641 SC 1616 01:01:51,707 --> 01:01:53,076 CALATION OF CARE AND -- 1617 01:01:53,142 --> 01:01:54,210 ESCALATION OF CARE AND ABSENCE 1618 01:01:54,277 --> 01:01:55,878 OF BASELINE, EVERYBODY DID A 1619 01:01:55,945 --> 01:01:57,780 BASELINE ASSESSMENT I NOTED ON 1620 01:01:57,847 --> 01:01:59,048 MY DOCUMENTATION AND ALL BRAIN 1621 01:01:59,115 --> 01:02:02,552 CODES. 1622 01:02:02,618 --> 01:02:04,420 NURSING DOCUMENTATION MEASURED 1623 01:02:04,487 --> 01:02:07,256 BY 12 INDICATORS AT 100% OF THE 1624 01:02:07,323 --> 01:02:10,059 CRITERIA DONE BY THE RUBRIC. 1625 01:02:10,126 --> 01:02:14,063 AND NOW THE ACTUAL SIMULATION 1626 01:02:14,130 --> 01:02:14,297 COURSE. 1627 01:02:14,363 --> 01:02:16,899 NOW, 80% OF STAFF SUCCESSFULLY 1628 01:02:16,966 --> 01:02:17,800 COMPLETED THE EDUCATION PROGRAM 1629 01:02:17,867 --> 01:02:18,768 BY MARCH 2023. 1630 01:02:18,835 --> 01:02:20,369 THAT WAS BASED ON THE NUMBER 1631 01:02:20,436 --> 01:02:21,537 WHEN WE STARTED THE PROGRAM AND 1632 01:02:21,604 --> 01:02:23,306 NUMBER OF NURSES. 1633 01:02:23,372 --> 01:02:26,876 SO WE HAD A GREAT OUTPUT. 1634 01:02:26,943 --> 01:02:27,610 RESULTS FROM THE IN PERSON 1635 01:02:27,677 --> 01:02:30,546 SKILLS AND SIMULATION WAS ALSO 1636 01:02:30,613 --> 01:02:30,813 FANTASTIC. 1637 01:02:30,880 --> 01:02:33,549 WE HAD 100% COMPLIANCE OF PEOPLE 1638 01:02:33,616 --> 01:02:35,284 LOOKING AT COMPLETING THE 1639 01:02:35,351 --> 01:02:37,220 SIMULATION AND GIVING RESULTS. 1640 01:02:37,286 --> 01:02:40,823 APPROXIMATELY 362 NURSES 1641 01:02:40,890 --> 01:02:41,924 COMPLETED THE EXPERIENCE. 1642 01:02:41,991 --> 01:02:44,527 AND OVER 99% STATED THAT THE 1643 01:02:44,594 --> 01:02:46,762 EXPERIENCE WAS EXCELLENT. 1644 01:02:46,829 --> 01:02:48,364 THEY STRONGLY AGREED POSITIVELY 1645 01:02:48,431 --> 01:02:50,333 AND OVER ALL GAVE A POSITIVE 1646 01:02:50,399 --> 01:02:52,768 IMPACT AND IMPACTED THEIR 1647 01:02:52,835 --> 01:02:54,570 CLINICAL PRACTICE. 1648 01:02:54,637 --> 01:02:56,772 WHAT WAS MEANINGFUL WAS THE 1649 01:02:56,839 --> 01:02:57,206 THEMATIC ANALYSIS. 1650 01:02:57,273 --> 01:02:59,408 THE MAJORITY OF RESPONSES 1651 01:02:59,475 --> 01:03:03,146 INCLUDED RESPONSES AND FEEDBACK 1652 01:03:03,212 --> 01:03:06,849 AND SOME OF THE COMMENTS WERE 1653 01:03:06,916 --> 01:03:09,652 WELL DONE, LOVED, EXCELLENT, 1654 01:03:09,719 --> 01:03:09,919 ENJOYABLE. 1655 01:03:09,986 --> 01:03:15,224 THE PRIMARY POPULATION WAS 1656 01:03:15,291 --> 01:03:15,658 ONCOLOGY. 1657 01:03:15,725 --> 01:03:17,493 WHAT WAS MORE MEANINGFUL THEY 1658 01:03:17,560 --> 01:03:18,928 RECOGNIZED WAS THAT NURSES WOULD 1659 01:03:18,995 --> 01:03:19,862 STOP ME AND STAY I LOVE THAT 1660 01:03:19,929 --> 01:03:22,598 COURSE. 1661 01:03:22,665 --> 01:03:24,767 OR THEY WOULD SEND E-MAILS 1662 01:03:24,834 --> 01:03:27,036 SAYING I CAUGHT SOMETHING EARLY. 1663 01:03:27,103 --> 01:03:30,573 THAT WAS IMPACTFUL. 1664 01:03:30,640 --> 01:03:32,608 WE CAN'T ALWAYS MEASURE THAT 1665 01:03:32,675 --> 01:03:34,677 BECAUSE THAT'S WITH OUR HEART, 1666 01:03:34,744 --> 01:03:37,813 RIGHT, BUT IT WAS MORE IMPACTFUL 1667 01:03:37,880 --> 01:03:40,149 EVERY DAY WHEN PEOPLE WANTED TO 1668 01:03:40,216 --> 01:03:43,252 TAKE THAT CLASS. 1669 01:03:43,319 --> 01:03:44,287 UNFORTUNATELY, FORTUNATELY IT 1670 01:03:44,353 --> 01:03:45,955 WAS OFTEN OVERBOOKED BECAUSE WE 1671 01:03:46,022 --> 01:03:51,394 DIDN'T HAVE AS MANY SPACES 1672 01:03:51,460 --> 01:03:55,031 AVAILABLE HOWEVER PEOPLE WERE 1673 01:03:55,097 --> 01:03:56,032 ABLE TO ENJOY THE EXPERIENCE. 1674 01:03:56,098 --> 01:03:57,466 WHAT DID WE LEARN? 1675 01:03:57,533 --> 01:03:59,001 QUALITY TAKES TIME. 1676 01:03:59,068 --> 01:03:59,869 THOUGH WE WERE SUCCESSFUL. 1677 01:03:59,936 --> 01:04:02,038 I'M SURPRISED WE WERE ABLE TO DO 1678 01:04:02,104 --> 01:04:02,905 THIS FOR THREE YEARS IN THE 1679 01:04:02,972 --> 01:04:07,443 MIDST OF COVID. 1680 01:04:07,510 --> 01:04:08,811 TO RELY ON SUBJECT MATTER 1681 01:04:08,878 --> 01:04:18,487 EXPERTS AND CREATE STRUCTURE. 1682 01:04:18,554 --> 01:04:20,790 IT'S HARD AND SHOULD NOT BE 1683 01:04:20,856 --> 01:04:21,257 TAKEN LIGHTLY. 1684 01:04:21,324 --> 01:04:24,327 WHEN I SEE DEBRIEFING DONE ON A 1685 01:04:24,393 --> 01:04:26,062 WHIM IT'S DANGEROUS IN A WAY 1686 01:04:26,128 --> 01:04:28,497 BECAUSE WE'RE ASKING PEOPLE TO 1687 01:04:28,564 --> 01:04:30,633 BE SENSITIVE AND WE HAVE TO 1688 01:04:30,700 --> 01:04:32,168 PROVIDE THE SAFE ENVIRONMENT. 1689 01:04:32,235 --> 01:04:35,371 THE WAY WE TALK AN WAY WE 1690 01:04:35,438 --> 01:04:39,208 EXPERIENCE SOME REALLY 1691 01:04:39,275 --> 01:04:41,110 HIGH-LEVEL SITUATIONS IS 1692 01:04:41,177 --> 01:04:42,111 IMPORTANT. 1693 01:04:42,178 --> 01:04:42,979 SIMULATION IS NOT JUST 1694 01:04:43,045 --> 01:04:48,384 EDUCATION, AND I LEARNED THAT 1695 01:04:48,451 --> 01:04:50,820 FROM OUR ORIGINAL DIRECTOR. 1696 01:04:50,886 --> 01:04:52,321 SHE REALLY WAS ABLE TO HONE THAT 1697 01:04:52,388 --> 01:04:54,924 IN AND BRING IN THAT EDUCATION 1698 01:04:54,991 --> 01:04:57,226 PIECE AND HELP THAT OUT AND 1699 01:04:57,293 --> 01:05:01,297 REALLY HELP LINK THAT SIMULATION 1700 01:05:01,364 --> 01:05:03,232 WITH DR. GOMEZ AND LATER 1701 01:05:03,299 --> 01:05:04,433 DR. JABARA. 1702 01:05:04,500 --> 01:05:05,134 INTERDISCIPLINARY COLLABORATIVE 1703 01:05:05,201 --> 01:05:07,003 IS EFFECTIVE. 1704 01:05:07,069 --> 01:05:09,138 EVERYBODY HAS A DIFFERENT POINT 1705 01:05:09,205 --> 01:05:11,374 OF VIEW. 1706 01:05:11,440 --> 01:05:12,408 EVERYBODY HE SEES THINGS 1707 01:05:12,475 --> 01:05:12,808 DIFFERENTLY. 1708 01:05:12,875 --> 01:05:15,077 SHE MIGHT LOOK AT THE HEART 1709 01:05:15,144 --> 01:05:16,846 RATE, I'M GOING TO LOOK AT THE 1710 01:05:16,912 --> 01:05:17,847 NEURO ASSESSMENT BECAUSE THAT'S 1711 01:05:17,913 --> 01:05:20,082 WHAT I'M COMFORTABLE WITH. 1712 01:05:20,149 --> 01:05:21,917 UNDERSTANDING THE CONCEPT WAS 1713 01:05:21,984 --> 01:05:23,786 IMPORTANT AS WE DEBRIEFED AND 1714 01:05:23,853 --> 01:05:26,322 LOOKED AT THE PROGRAM. 1715 01:05:26,389 --> 01:05:28,057 SO OUR FUTURE, WE'RE GOING TO 1716 01:05:28,124 --> 01:05:30,593 CONTINUE TO MONITOR METRICS 1717 01:05:30,660 --> 01:05:35,364 BECAUSE WE LOVE TO AUDIT CHARTS. 1718 01:05:35,431 --> 01:05:37,433 THAT'S SARCASM BY THE WAY. 1719 01:05:37,500 --> 01:05:38,434 INTERDISCIPLINARY NEURO 1720 01:05:38,501 --> 01:05:39,302 SIMULATION. 1721 01:05:39,368 --> 01:05:42,538 WE'LL TRY DO MORE AND MORE 1722 01:05:42,605 --> 01:05:45,207 PRIORITIZE TO THE POPULATIONS 1723 01:05:45,274 --> 01:05:50,012 AND INCREASED BRIEF NEURO 1724 01:05:50,079 --> 01:05:51,213 ASSESSMENT DOCUMENTATION WHICH 1725 01:05:51,280 --> 01:05:53,616 IS A BARRIER TO E.H.R. IN 1726 01:05:53,683 --> 01:05:54,317 GENERAL FOR EVERY ORGANIZATION. 1727 01:05:54,383 --> 01:05:55,785 THAT'S WHAT WE WERE GOING TO DO 1728 01:05:55,851 --> 01:06:01,190 TO HAVE ACTUAL REPORTS. 1729 01:06:01,257 --> 01:06:03,492 SO I'D LIKE TO GIVE SPECIAL 1730 01:06:03,559 --> 01:06:05,294 THANKS TO THESE PEOPLE WHO 1731 01:06:05,361 --> 01:06:05,728 HELPED. 1732 01:06:05,795 --> 01:06:07,430 AND ALL THESE PEOPLE THAT HELPED 1733 01:06:07,496 --> 01:06:12,134 US DEBRIEF. 1734 01:06:12,201 --> 01:06:13,703 HERE'S OUR CONTACT INFORMATION. 1735 01:06:13,769 --> 01:06:15,571 AND OUR LOVELY PICTURES. 1736 01:06:15,638 --> 01:06:20,810 IF YOU WANT TO CONTACT US FOR 1737 01:06:20,876 --> 01:06:23,412 ANY TIME PLEASE MAKE SURE IT'S 1738 01:06:23,479 --> 01:06:25,514 SIMULATION AND THANK YOU TO ALL 1739 01:06:25,581 --> 01:06:27,383 THE NIH CLINICAL CENTER AND 1740 01:06:27,450 --> 01:06:29,385 NURSING DEPARTMENT AND THE NIH 1741 01:06:29,452 --> 01:06:31,787 CLINICAL CENTER SIMULATION TEAM 1742 01:06:31,854 --> 01:06:33,489 AND STAKEHOLDERS AND THE 1743 01:06:33,556 --> 01:06:35,157 PARTICIPANTS WHO INSPIRE OUR 1744 01:06:35,224 --> 01:06:37,760 WORK AND WERE THERE TO BE THE 1745 01:06:37,827 --> 01:06:39,628 GUINEA PIGS SOMETIMES OF WHAT WE 1746 01:06:39,695 --> 01:06:40,396 WERE TRYING TO DO AND 1747 01:06:40,463 --> 01:06:40,696 ACCOMPLISH. 1748 01:06:40,763 --> 01:06:50,940 QUESTIONS? 1749 01:06:51,374 --> 01:06:59,382 >> I WANT TO WRAP UP AND THANK 1750 01:06:59,448 --> 01:07:00,649 FOUR EXCELLENT SPEAKERS. 1751 01:07:00,716 --> 01:07:04,520 GREAT TRENGS PRESENTATIONS AND 1752 01:07:04,587 --> 01:07:06,055 LIKE ANY GOOD PRESENTATION EN 1753 01:07:06,122 --> 01:07:07,423 GENDERS US TO CREATE NOR 1754 01:07:07,490 --> 01:07:09,592 QUESTIONS AND BE REFLECTIVE AND 1755 01:07:09,658 --> 01:07:10,459 SEE WHAT OPPORTUNITIES ARE. 1756 01:07:10,526 --> 01:07:11,894 THANK YOU FOR TAKING US THROUGH 1757 01:07:11,961 --> 01:07:14,697 THE JOURNEY AND THE HISTORY OF 1758 01:07:14,764 --> 01:07:24,507 THE PRACTICE AND IMPACT FOR 1759 01:07:24,573 --> 01:07:26,208 SIMULATION AND WE'RE OUT OF TIME 1760 01:07:26,275 --> 01:07:31,380 SO I INVITE YOU TO COME DOWN AND 1761 01:07:31,447 --> 01:07:33,816 SPEAK TO SPEAKERS AND FOR THOSE 1762 01:07:33,883 --> 01:07:38,788 ON VIDEOCAST WE WILL FORWARD 1763 01:07:38,854 --> 01:07:40,156 YOUR QUESTIONS TO THE SPEAKERS. 1764 01:07:40,222 --> 01:07:42,024 I WANT TO SAY THANK YOU FOR WHAT 1765 01:07:42,091 --> 01:07:43,626 YOU'RE DOING AND FOR WHAT YOU DO 1766 01:07:43,692 --> 01:07:46,562 EVER DAY. 1767 01:07:46,629 --> 01:07:47,830 -- EVERY DAY. 1768 01:07:47,897 --> 01:07:50,099 11 YEARS AGO AND 10 MONTHS OR 11 1769 01:07:50,166 --> 01:07:52,435 YEARS AGO THIS MONTH, EXCUSE ME, 1770 01:07:52,501 --> 01:07:56,472 I FOUND MYSELF ON THE WRONG SIDE 1771 01:07:56,539 --> 01:07:58,507 OF THE BED RAIL AND WITH IT I 1772 01:07:58,574 --> 01:08:02,044 THINK WE HEAR EVERY DAY WHAT 1773 01:08:02,111 --> 01:08:04,647 NURSES DO BUT I THINK THAT MY 1774 01:08:04,713 --> 01:08:09,185 OWN JOURNEY WAS THAT NURSES 1775 01:08:09,251 --> 01:08:11,454 ALLOW A PERSON TO MAINTAIN THEIR 1776 01:08:11,520 --> 01:08:15,024 HUMAN DIGNITY AND OFTEN WHAT IS 1777 01:08:15,090 --> 01:08:16,592 OFTEN THE MOST UNDIGNIFIED YOU 1778 01:08:16,659 --> 01:08:18,260 CAN FIND YOURSELF IN. 1779 01:08:18,327 --> 01:08:19,528 FOR THAT I WANT TO SAY THANK YOU 1780 01:08:19,595 --> 01:08:22,731 FOR WHAT YOU DO EVERY DAY AND I 1781 01:08:22,798 --> 01:08:27,303 HOPE THIS PRODUCTIVE AND 1782 01:08:27,369 --> 01:08:27,903 ENRICHING NURSES GRAND ROUND. 1783 01:08:27,970 THANK YOU VERY MUCH.