The flesh-like rubber arms and hands splayed out on a table are very real -- too real, in some cases -- but it’s the artificial blood oozing from a wound that really pulls it all together.
That’s a good thing, at least for the future nurses learning the skills they’ll use regularly at the Nursing Simulator Center at Union College.
The growing center, which just opened a $350,000 expansion in January, gives 100 students the chance to practice hard skills like starting an IV or fitting a central line, and soft skills like teamwork and critical thinking in a setting that resembles a real hospital.
“We want students to come on a shift just like they would at a hospital,” said Tracy Hagele, center coordinator.
Students start in the tasking room, where they learn to find a vein or insert a catheter on the artificial arms and hands fleshy enough to seem real.
If a mistake is made – a missed vein in the arm, for example -- the artificial limbs bleed, which “makes it a little more realistic,” said Rebecca Randa, a clinical instructor at Union College.
Upon mastering those individual skills, students move on to assessing and treating one of the four simulator manikins Union has been using for the better part of the last decade while instructors watch from behind mirrored glass.
“We are behind the glass letting them make decisions,” Randa said. “We can change the situation depending on what they choose to do and they can learn to independently make those choices.”
The curriculum puts students in the simulator lab throughout their education, approximating them closer and closer to what the job will entail as they advance.
The scenarios that play out in the simulator are contoured to Union’s nursing curriculum and written by Hagele based on the expectations of accrediting commissions.
Amy Golter, an adjunct nursing instructor at Union, said students move from single tasks into “multi-level scenarios” focused around collaboration, communication, prioritization and delegation.
“We use simulation in all of our classes,” Golter said. “We’ve incorporated it into our clinical hours, so students get training on it immediately when they come into the nursing program and we build as we go.”
In addition to the manikins -- which can breathe, blink, bleed and respond to treatments -- Union also relies on volunteers, including alumni, other nursing students or Union students with a passion for acting to portray patients so the students can work on their bedside manner.
“With most of our unit-based scenarios, we have simulators and live patients in the bed and a family member sitting at the bedside,” said Golter. “They can interact with the manikin to do things like give medications, do procedures that we wouldn’t want to be doing on a live person.
“But on the person, they can do things like communication and the actual human interaction.”
One of the higher level scenarios Union puts students through calls on them to prioritize patients to clear space for others being admitted to a hospital after an emergency.
In between the patient rooms are control rooms where instructors can monitor students, record their work for playback, or flip the switch on a new scenario.
A classroom in the middle of the center allows for students to monitor a simulation in real-time or watch a recorded simulation to debrief over what worked and what can be done better.
The simulation center, coupled with regular classwork is putting Union College’s nursing students on a fast track of success, according to test results from the National Council Licensure Examination for nurses.
More than 94 percent of Union College nursing graduates passed the board exam on the first try in 2015 -- the highest in the state -- compared to about 87 percent of students at other nursing schools around the state.
Last year, the number of students who passed on the first try rose to 97 percent. Results from around the state will be released at the end of the month.
About 60 percent of Union College’s nurses will get jobs in Nebraska upon graduation, said Nicole Orian, chair of the Division of Nursing. Many are hired before graduating.
Ava White, a recent Union College graduate and nurse at CHI-St. Elizabeth, said she wanted to attend one of the high-tech simulation centers she saw friends sharing on social media where she could learn to treat cardiac arrest, seizures or hemorrhages in a safe learning environment.
“Lo and behold, here in Lincoln, Nebraska, there was a simulation center,” White said. “It drew me in because I was able to practice even more so than just in the hospital with clinicals.”