As the COVID-19 pandemic swept through the country and universities shifted to online learning, nursing programs needed a new way of providing clinical experiences to students. Taking a cue from longtime online nursing programs like the RN to BSN, universities turned to technology for assistance.
What is a virtual simulation in nursing?
Throughout the years, traditional nursing programs have utilized in-person clinical simulations, which place students in a real-to-life learning experience using interactive mannequins or standardized patients (actors who portray patients), with many variations in between. However, the pandemic changed all of that and nursing programs came to rely on virtual reality simulations in place of their regular clinical simulations to provide meaningful educational opportunities.
Virtual simulations are valuable educational tools that not only provide nurses with practical experiences in a safe environment – they also allow students to effectively apply critical thinking skills and theoretical nursing care principles to better prepare them for a career in a real-world, acute care clinical setting.
Taking a cue from 100% Online RN to BSN programs
Online programs like Ohio University’s RN to BSN program have been using virtual patient platforms such as Shadow Health for years with great success. Shadow Health is included in two of the nine nursing classes required for the OHIO program.
These RN to BSN simulations allow online learners to participate in lifelike, conversational interactions with a wide variety of virtual patients. Learners advance their clinical and communication skills by interviewing, examining and treating virtual patients. According to Dr. Sherleena Buchman, assistant professor in OHIO’s College of Health Sciences and Professions School of Nursing, a variety of technologies can be used for virtual experiences.
VR simulations or vSim in nursing courses
Often universities have clinical simulation programs built directly into their nursing curriculum. Virtual simulations in nursing (vSim) is a platform that more universities embraced during the pandemic to helps to build clinical judgement skills through a realistic virtual environment, according to Dr. Buchman.
Cine-VR, a virtual reality 360 video simulation experience that uses the same principles of clinical simulation is a popular nursing tool. This way, students are able to see and hear a person in need, rather than using a mannequin.
“One example is the administration of NARCAN to a college student who has overdosed in a dorm setting,” said Dr. Buchman. “The learners are immersed in the virtual dorm room, which is viewed through virtual reality goggles, and are able to turn a full 360 degrees and see what is going on all around them. Additional Cine-VR simulations include two other opioid-related scenarios and a three-part experience related to providing care to a patient with Parkinson’s Disease.”
Why is simulation important in nursing?
Simulation is important to nursing because it provides the needed safe learning environment for students. “They are able to ask questions, make mistakes and learn from them without causing harm to a patient,” Dr. Buchman highlights.
“There are many opportunities for virtual and augmented realities to be utilized in nursing education. Our profession as a whole is just beginning to understand the potential for this type of learning,” Dr. Buchman explained. “vSim helps learners to develop confidence in their knowledge, skills and the attitudes of their profession, which is extremely important in the field of nursing.”
Nursing simulated electronic health records (EHR)
A critical part of simulations are electronic health records. Nursing students earning their BSN degree online or in-person can expect to not only learn about electronic health records, but to put that into practice. Nurses must document everything they do on a daily basis.
“There is a famous saying in nursing, ‘If it was not documented then it did not happen.’ As vSim and Cine-VR are realistic nursing scenarios, it is important that learners develop the skills of charting and understanding the electronic health record,” Buchman said.
What to expect from a BSN curriculum
Course requirements for BSN students, whether online or on-campus, are guided by the National Council of State Boards of Nursing, Quality Safety, Education in Nursing, and are built around the American Academy of Colleges of Nursing’s nine BSN Essentials. Ohio University’s RN to BSN degree is designed for working adults and offers 100% online coursework, 5-week sessions, and affordable tuition at less than $7,600 for the program’s nine required nursing courses.
Interested in learning more about an online RN to BSN degree? Visit ohio.edu/rn-to-bsn.
DN: The judge commented that “What I loved about this book is that the authors made complex leadership and business topics accessible and interesting by sharing leaders’ personal stories… Provides actionable and practical strategies students can use to further their own development… Readable and clear, it is sure to be a favorite among students.”
TR: “I love hearing that, by the way. I’m so grateful for the comment about the book. Because you know, when I went into academia, I committed to never writing a book, because I don’t learn particularly well through reading books. It’s just how my brain is wired.
And two, I’ve never, I have never heard anyone say ‘I love a textbook’ before. One thing that I think is missing from all academia is storytelling. So we said, if we’re going to write this book, we’re going to lean heavily on not just our stories, but the stories of people who’ve succeeded and failed at putting these evidence-based innovation leadership and entrepreneurship tactics in the place. And so it’s great to hear that shine through from the reviewer because that’s exactly what we were trying to do: create a type of textbook that students would enjoy, and they can actually be engaging with the content and be able to put that into practice.”
DN: How does the Innovation Studio connect with your book’s study of nursing leadership, innovation, and entrepreneurship?
TR: “I actually teach in our masters of healthcare innovation program and is fully founded on innovation leadership, which adopts what we like to refer to as the entrepreneurial mindset. So if you are in charge of leading people, and that may be in a small capacity to large capacity formally or informally, but you’re always doing a few things.
One new favorite term that I have is building a culture of ambition. And I mean ambition in a way that you’re striving for excellence. So what we teach our team—and what’s in the book—is teaching people to find out what stories resonate most effectively with their co-workers and teammates in the population they engage in, and have that be the driving force that your team unifies around to make significant and substantial change. So by building this culture of ambition, you’re taking on ownership for your actions, you’re taking on ownership for the things that surround you, and the system that you work in.
And that doesn’t mean that you are saying that your system is perfect. But it’s saying that we are in the system, and we’re going to do the best that we can with it. That’s what we’re trying to get people to recognize. And when you come into that with an entrepreneurial mindset, you think about what resources are available to you, what are your key performance indicators, and how you can maximize those, and you let the things that are noise filter out.
So you focus on what’s important, you develop a ‘yes, and’ culture, you empower people to bring their ideas forward, incentivize them, provide them the permission to be innovative, and validate them when they engage in those behaviors. And you build a structure of innovation that lasts beyond your tenure within the organization.
Those are all things that are built into the textbook. And those are all things that we try to get the people engaged in the innovation studio to buy into because we know that if that happens, eventually we’ll find the success that we’re looking for.”
DN: 2020 was a big year for nurse leaders. They’ve been finding innovative ways to cope with shortages, fight burnout, and manage other pain points, and have made a huge impact.
TR: “And you know what, I’m very hopeful. I’m not one of those leaders right now, but I am very hopeful that through the exercises that you just mentioned, people are taking notes and debriefing and finding out what works well.
Because I do think that the exceptional leadership that’s occurring throughout health systems now needs to be the norm. Those things about celebrating our wins, focusing on what’s important today. ‘What’s important now’ — you know, that’s an acronym for ‘win’. How do we win today? What are we going to focus on?
A big component of leadership is making sure that your team is all aligned on the same goals. And, you know, creating the value that you commit to create so that that’s where innovation and leadership all come together.”
Founded in 2017, The Ohio State University Innovation Studio is run by the OSU College of Nursing and Center for Healthcare Innovation and Wellness. In normal times, the Innovation Studio travels the country, encouraging students to create healthcare solutions, and helping them to use technology to develop their ideas into marketable new products.
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How has the pandemic affected the innovation program? DailyNurse spoke to Tim Raderstorf, MSN, RN, the co-founder of the Innovation Studio and Chief Innovation Officer (as well as Clinical Instructor of Practice) at the OSU School of Nursing. Dr. Raderstorf has conducted neurosurgical research on Tethered Spinal Cord Syndrome, but his passion is healthcare innovation.
Before the pandemic, when he wasn’t teaching, Raderstorf traveled the country with OSU’s mobile Innovation Studio. He is also an expert on the role of innovation in nurse leadership and is now an award-winning textbook author. Evidence-Based Leadership, Innovation, and Entrepreneurship in Nursing and Healthcare, the textbook Raderstorf co-wrote with OSU School of Nursing Dean Bernadette Melnyk was an American Journal of Nursing (AJN) Book of the Year, winning first place honors in its category. (In Part Two, he discusses the book and explains why he found the judge’s comments particularly gratifying).
DailyNurse: How have things changed for the Studio during the pandemic?
Tim Raderstorf: “We used to do to makerspaces that would travel. And, you know, it acted as this hub of interaction and engagement and excitement. But when COVID hit, people didn’t want those things [the makerspaces] in their lobbies… and we didn’t want 15 people hanging out in the same location. So, we shut down the traveling innovation studio, which was our original one, and [now we] just run our permanent location, which is right in central campus.”
DN: What did you do when the pandemic hit?
TR: “For the first six months of COVID, because we didn’t open our doors until the students came on campus in September, we ran a virtual makerspace. So Josh Wooten, our shop manager, particularly at the beginning, used our laser cutter and CNC router to make PPE, with our College of Engineering and a variety of public-private partnerships, to get our clinicians the safety equipment they needed to be able to save our communities. We wanted to keep Josh as safe as we possibly could, so we set up a makerspace in his house. He had five 3D printers in his home, and he was printing PPE around the clock with mostly faceshield frames, so that we could hook transparencies or plastic to them. It’d be running day and night, doing work for us while we slept.”
DN: Were the students able to participate at all last year?
TR: “Well, in May [2020], we launched a COVID [Campus Safety] challenge, encouraging everyone to submit their ideas to us virtually. And when students came back to campus, we ran a second virtual challenge asking for ideas that would impact their safety on campus. Things like how to improve mask adherence, social distancing, and the mental health of our student population. We also had pitch days in October and December.
In fact, at that December pitch day, one of the nurses on the unit [came by on her] 15-minute break to pitch her idea to us. And she was wearing PPE, and—unknown to her—it was PPE that we had printed for her.”
DN: Has the pandemic been inspiring nurses to innovate?
TR: “I feel that during the pandemic, some of the acclaim and attention and interest has prompted more nurses to raise their voices in terms of public health and policy, but also to innovate and come up with solutions for the various pain points that you’ve encountered during the pandemic. And I think that’s going to build. I’m very bullish on that. I’m big on systems of innovation and building a structure of innovation, to have a proper culture of innovation that thrives.
Dr. Tim Raderstorf demonstrates an innovation exercise at the Academy of Nurse Leaders.
I’d argue there probably still isn’t much structure for nurses, physicians, pharmacists, whoever is at the frontlines to bring their ideas for [innovations] to most organizations. I do think clinicians have never been more willing and engaged in changing the system. The question is, can systems become engaged and willing and set their clinicians up for success so that they can appropriately drive the changes that need to occur? Particularly as we become cash strapped and healthcare is going through a massive transformation.
I think it there’s going to be a very challenging component to the future of healthcare once the pandemic is over. We have to decide what we refuse to go back to and what we will continue to make changes on.”
DN: Who comes to the pitch days? Students? Faculty?
TR: “We’ve had over 1000 people pitch to us over the last three years. It’s about 55 to 60% students and about 40 to 45% faculty and staff, which is a nice healthy mix, and it’s trending much more towards the students. We are seeing an increase in faculty and staff, but the students are increasing at a much faster rate.”
DN: Are nurses pitching ideas?
TR: “You know, one of my least favorite terms is ‘nursing innovation’. Because there’s no such thing as physician innovation, there’s no such thing as dentist innovation, there’s no such thing as pharmacist innovation. So why do we label ourselves other than just being innovators and really showcasing that we are indeed equals with our peers?
We knew that in order to raise the awareness of the amazing things that nurses do, and create and innovate and invent, that we need to do this alongside our peers, and, you know, almost be humble bragging, as we go along, and said, ‘hey, look, what we’ve created, why don’t you come over here and create something great with us too’.”
DN: When you describe the Studio as “interprofessional,” can you elaborate a bit?
TR: “We encourage people to engage with other individuals who have different backgrounds and professional expertise; [in fact] we require it. If you don’t have an interprofessional team, that is one of the things that disqualify you from being eligible for funding. So if two physicians come up with a great idea, we say, ‘awesome, who are you going to use this on’? And they usually say, ‘well, it’d be an operating room or height’. ‘So who preps your trays? Well, that person needs to be on your team, or you need to be getting insights from the people who are going to be interacting with this tool as well.’”
DN: Are the people who pitch to you mainly aspiring entrepreneurs looking to develop a product that they can sell?
TR: “It’s probably about half and half. A lot of people are interested in developing a new business, a new tool, something along those lines. But [we] also see a lot of people interested in policy change and awareness campaigns. Our most successful commercial effort was a method for preventing addicts from injecting drugs into their system through their IVs at the hospital. We really want to be able to help these people while they’re under our care and give them the resources they need to continue to be successful. So this nurse in the team wanted to find a way to stop people from being able to access the lines without us knowing about it and created a tape that would go over IV ports.
And, you know, it’s now on the market. Her idea has gone from something she drew on a napkin to a tool that is now being used worldwide to help patients.
[The entrepreneurial aspect helps spur change because] there’s nothing that’s free in our health system. That makes it really challenging to scale your ideas without going the commercialization route. If you can’t sell it, it’s really hard to have that mass impact. But really, the key goal of innovation studio is to build a culture of innovation at Ohio State. We really believe that the true impact is in getting our students, faculty, and staff together and creating an atmosphere where great things can happen.
That’s a long game, you have to you have to be patient, and you have to be willing to continue to water the seeds until they’re able to until they’re able to sprout.”
Adopt a Nurse Ohio won’t provide you with an extra mom or dad, but it might connect you with a supportive virtual fairy god-parent. Frontline nurse Sydney Garringer lost her stethoscope and all of her Covid gear when someone broke into her car. Less than 10 hours later, a member of the Adopt a Nurse – Ohio Facebook group, asks, “Sydney, what your favorite color?” —and Sydney replies that most of her stolen equipment has already been replaced. The next morning, another member cheerfully complains, “I never got a chance to choose anything, your [Amazon Wish] list is empty now, are you sure you don’t need anything else?” The 1.9 thousand members of AAN Ohio are ready and waiting to ease the load of the state’s nurses and bring them good cheer.
Patient Care Technician Heather Marie has been treating a growing number of Covid patients, but she’s determinedly positive: “I am continuing my medical dream and going to school to become a paramedic! …. I love what I do and I love knowing I am making a difference in my patient’s life! I work with some of the most wonderful nurses, techs, doctors, respiratory staff, therapists, housekeepers, and dietary staff. That’s one thing that keeps me sane during this time is the teamwork we have!” A group member fancies the dinosaur motif of the scrub hat Heather wears in the photo she posted. Another member sends her a pair of socks festooned with images of little medical clipboards, bandages, and nurse-related images.
April Higgenbotham—who has been an RN for 21 years—posted on the site less than a week before coming down with Covid. A member’s “goodie bag” arrived just in time to raise her spirits while she sat home in isolation from her family.
ICU nurse Brendan McQuown posts a heartfelt pean to his wife: “I am active duty and work in a COVID ICU… My wife of 12 years has been a nurse for 10 years. My hero is my wife. She works, takes care of our basketball team of kids, holds the fort down when I deploy, and still managed to put herself through a MSN program… I don’t know how she does it all.”
And a female RN paid tribute to her ICU nurse spouse: “My name is Paige and I’m an RN, but this post is for my husband Ryan. He is an ICU nurse working in a Covid unit. He would never ask for anything from anyone so that is why I am posting for him! It’s love, I know. What better way than to surprise him to say thank you?! He has been a nurse for 10 years… Recently he was working as a float ICU nurse going to 5 hospitals some over an hour away from home to work in the Covid units. He just started working as a traveler nurse taking assignments in Covid ICUs. He is the hardest worker that I know and is so deserving of receiving special gifts! He works 4-6 days a week, night shift, 12 hour shifts, to provide for our family. We have 2 kids under the age of 2! He never complains and comes home with a smile on his face to greet me and our two boys! Thank you taking the time to read this and thank you for doing this!”
The Adopt A Nurse Ohio group was founded by Heather Stewart, an event coordinator. “I have coordinated everything from weddings, birthdays, funerals, graduations, festivals, etc,” she says.
Adopt a Nurse Ohio is not Heather’s first time up at the Adopt-a rodeo; she has quite a track record! “When Covid [first] hit,” she recalls, “It was our high school seniors who were taking the first blow of missing out on traditions and memories, so I created Adopt a Senior… This was a huge success: we are a small village, but [we were] able to adopt every senior.” Later, when schools started back in session Heather said that she “Noticed a lot of teachers were straining for more supplies, disinfected wipes, masks, etc. So, I then created Adopt a Teacher, I went a little bigger and did this on the county level. Clark County School districts and all teachers/aides/faculty in those schools. This too was a huge success. Hundreds of teachers were adopted.”
Adopt A Nurse Ohio co-founder Heather Stewart taking a break with a friend.
But Heather also has a lot of nurses in her family, including her mother, step mother, brother, and sister in law, “along with a slew of aunts and uncles.” Before long, she felt compelled to do something for nurses too. “Now here we are and our nurses are being hit hard on the frontlines. They are fighting a fight none of us could imagine, or would want to. I went even bigger than local district and county, and went with the state of Ohio. All of our nurses need us. We are all in this together,” Stewart said.
What about the long run? “I do plan on keeping this group going through the pandemic, and after, as long as there is a want for it” says Heather. “All nurses deserve a random act of kindness, regardless of the pandemic.”
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Often universities have clinical simulation programs built directly into their nursing curriculum. Virtual simulations in nursing (vSim) is a platform that more universities embraced during the pandemic to helps to build clinical judgement skills through a realistic virtual environment, according to Dr. Buchman.
