Two Sides to the Story: Utilizing Simulation to Improve Communication (RD)

Nursing staff surveys revealed that there was a need to improve communication about our medically acute patients with our Hospitalists in the Psychiatric setting. Communication between nursing and hospitalists did not meet collaborative communication needs of the healthcare team or the needs of the medically acute patient. Nursing staff, not being continuously immersed in the medical environment, lacked a communication structure concentrated on the detailed needs of the patient. On the other hand, the hospitalists did not recognize the limitations of a locked inpatient psychiatric unit in relation to patient assessment and available interventions, leaving both parties frustrated. There were boundaries in the aptitude to efficiently communicate about the psychiatric patient with medical needs due to nursing not being immersed continuously in the medically acute environment resulting in frustrated nurses as well as medical providers. The Virtual Education and Simulation Training lab, Behavioral Health nursing staff, and Hospitalists arranged to simulate medical emergencies in order to assess both sides of communication. Simulation scenarios were developed for the nurses to assess a decompensating medically acute psychiatric patient and communicate their findings with the hospitalist behind the scenes who was unaware of the situation. Both parties were then debriefed in the same room after the exercise and discussed areas of strengths as well as room for improvements as seen from either side. A pre and post implementation survey was conducted among nursing staff and the hospitalists. Physicians reported a vastly better understanding of the limitations nurses face on a locked psychiatric unit while nurses subsequently reported an improved understanding in regards to the limitations of the hospitalists. Both nurses and physicians agreed that since training, there has been improved communications in regards to the medically acute psychiatric patient. The goal of improving communication and partnership between members of the medical team as well as Behavioral Health Nurses was met with the utilization of a simulated setting.