Impact: Part 3 of the Series From Nursing Student to Patient and Back Again

In this three-part Ask the Expert Series, we feature Bhavana Aitha, a senior nursing student at the University of Delaware who explores the reciprocal benefits of working as a simulated patient while helping her university use simulated patients. In this third part of the series, Bhavana talks about the impact of nurses.

By: Bhavana Aitha

Every day nurses impact the lives of patients. It’s a simple truth. When people are asked about their hospital stay, they almost always will say, “Oh yes, they treated me well. I had a really good nurse.” Most people admitted to a hospital are going through a tough time, one of toughest of their lives. Besides having physical pain, the hospital experience itself tends to make people feel helpless and weak.

As providers, it is part of our job to enlist hope. We have a strong influence on how our patients feel about themselves. And for that reason, they will remember us for years to come.

I didn’t realize the impact we have as nurses until a simulation experience changed my life. It was the beginning of April, and we were preparing as patient actors to do a simulation for DNP graduate nursing students. It had been a couple of months since my trip to Tanzania and South Africa, a nursing study abroad experience with my maternity professor to provide care for laboring women. In clinics in Africa, women are alone in the delivery room. No family or friends are allowed to stay with the patient because they are said to disrupt the birthing process. This is why, when caring for laboring patients, my classmates and I set out to help them through contractions and during pushing. We provided comfort care to our mothers in a way that their families could not. Because of the lack of resources and the shortage of health care providers in all the hospitals we visited, I couldn’t help but feel that there was something more that needed to be done. When one of our patients who was having a hard and stressful delivery needed an episiotomy, my classmate and I made sure to help hold her legs and use therapeutic touch to guide her through this strenuous time. The midwife working with the patient left her on the operating table for at least two hours after her delivery, writhing in pain, waiting to be stitched up. To say the least, it was grueling to watch. We advocated for our patient and tried to find the midwife to urge him to finish the procedure. Unable to reach him, we stayed with our patient and her newborn to make sure they were okay. Like our patient, my classmate and I felt helpless and vulnerable.

I carried feelings of guilt back with me to the States. For months, I asked myself what else I could have done to change the situation. I didn’t want my patient to have only traumatic memories of her special day, which should have been a day of celebration for the birth of her first child. It is the duty of medical professionals to be educators, supporters, and, most importantly, empathizers for patients. I was angry at the midwife for not fulfilling his duty and angry at myself for being unable to fulfill mine.

For my simulation with the graduate nursing students, I played a victim of domestic abuse, 14 weeks pregnant. My boyfriend had “slapped me around” on several occasions, even “accidentally dragging me by his truck” during an argument. He had slammed the driver’s door, started the truck, and put it in gear, reportedly without realizing that my dress was caught in the car door. I was coming in to discuss prenatal care and the possibility of future OBGYN appointments. The goal of this simulation was to get the graduate nursing students to ask difficult questions about physical abuse and discuss the possibility of my moving to a domestic violence shelter.

While playing this pregnant woman, I felt a rush of vulnerability and worthlessness. I wanted so badly to get out of my situation, but I couldn’t because I felt hopeless. All I wanted was for someone to tell me that I had options and to know that there was someone who would do everything in her power to help me. I wanted to hear that someone cared. One student told me what I needed to hear, that she was incredibly sorry I was going through such a difficult time and she would do everything to try and get me out of this horrible situation. She said the words (and I remember them distinctly), “You are not alone.” I immediately felt a sense of hope and the possibility of a bright future for my baby. Just having someone’s presence, knowing that she cared, made me feel much less vulnerable than I did before.

This simulation made me think back to the woman my classmate and I cared for in Africa. I realized that even though we were not able to physically help our patient, we were there for her in a way that no one else was. I started to feel less guilty about not being able to do much because I realized that we had been able to do something. My classmate and I gave her the sense that she was not alone. Sometimes that is all that patients need to know to ultimately feel cared for. It was because of this simulation experience that I was able to realize this in such an effective way.

Our care is specialized. With every decision we make, we affect our patients in one way or another. This is often forgotten as we tend to neglect to realize how much of a difference we can make in our patients’ lives. The beauty of this career is the time we get to spend with our patients. Doctors, pharmacists, physician assistants, social workers, and other providers don’t spend nearly as much time at the bedside as we do.  They rely on our patient-provider connection beyond all other assessments and data measurements to create a comprehensive plan of care. We are the ones who bring the patient’s voice to the process of decision-making by the health care team. We matter. And most of all, we matter for our patients. They rely on our help to feel less vulnerable. Even though it sometimes may seem as if we can’t do much for our patients, our sincere presence counts. If our patients know that they are in our thoughts, that is a step forward in the right direction.

I am so beyond grateful for all of the simulation experiences I have had as a nursing student and patient actor. They have taught me many important lessons beyond the textbook definitions of communication and empathy. They have taught me the importance of empathy, how little things can make a huge difference, and the great impact we have as nurses in the field of medicine. The future of simulation education is bright. I hope that we can move toward a more interactive experience for nursing students, so that they can touch, feel, and think everything that their future patients will touch, feel, and think. After all, putting yourself in someone else’s shoes is the best way to learn. Being a patient actor has definitely helped me become a better nurse. I feel better prepared for my future and only hope the same for graduate and undergraduate nursing students to come.

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Bhavana Aitha is currently a fourth-year nursing student at the University of Delaware. She is pursuing an honors degree in hopes to become a future labor and delivery nurse. She has had many simulation experiences as a student and patient actor throughout her education and intends to expose her knowledge to the nursing education community in order to better advance teaching and learning for subsequent student nurses. The standing vice president of the Multicultural Student Nurses Organization, she spends her spare time volunteering for a nonprofit organization called Lori’s Hands in efforts to provide assistive care for people with chronic illnesses in her community.