Special to UM News
MIAMI, Fla. (December 12, 2016) — The Gordon Center for Research in Medical Education doesn’t usually take care of patients, but on one recent Saturday it served as a makeshift hospital for M.D./M.P.H. and nursing students working together on a complicated, frightening possibility: How would they respond to a terrorist attack at Marlins Park?
Triage for the disaster drill was in the lobby, a large emergency department was set up downstairs, and other areas included a medical/surgical floor, pediatrics, an intensive care unit, and OB/GYN.
“We ran two scenarios so that each student had the opportunity to play both a provider and a victim role,” said Ivette Motola, M.D., M.P.H., director of the Division of Prehospital and Emergency Healthcare and assistant director of the Gordon Center at the University of Miami Miller School of Medicine. “In the first scenario — a bombing and active shooter at the stadium — every area in the hospital had to figure out how to get the patients in, how to treat them, whether to send them home — the same thing that happened at the Boston Marathon bombing. The students who weren’t health care providers in the first scenario were the victims or family members, and then in between we flipped them.”
In the second scenario, the active shooter came to the hospital, Motola said. “The students had to manage sheltering in place, and some were given the role of incident commander and public information officer. We were a little concerned about the level of the challenge and having them all have active roles, but it came together beautifully.”
Casey McGillicuddy, a second-year M.D./M.P.H. student who wants to pursue a career in disaster medicine, shared Motola’s enthusiasm for the experience. “This was a great opportunity to take away the silos between medical and nursing students,” she said. “Nurses will be such a huge part of the rest of my career – it was great to learn from each other.”
Directing the exercise from the School of Nursing and Health Studies was Susana Barroso-Fernandez, Ph.D., R.N., director of simulation operations for the school’s International Academy for Clinical Simulation and Research.
“Nurses are the largest body of first responders in any disaster,” Barroso-Fernandez said. “When you look at a situation of this magnitude, you can pick up a nursing journal or read an article or watch the news, but unless we give them the experience of the front line and put them in that situation, they graduate not knowing what it feels like.
“In this day and age, unfortunately, it’s not a matter of if something happens, it’s when.”
The exercise was McGillicuddy’s capstone project, so she was involved in planning from the beginning. “After the Orlando massacre and the Boston Marathon, we were interested in doing an active-shooter exercise,” she said. “The roles had to be very carefully planned — for example, ‘You are a gunshot victim, right lower leg, and are experiencing shock.’ ”
Thinking about the unthinkable is critical for medical and nursing students, Motola said. “Because disasters don’t happen very often it’s hard to get people to focus on preparing for it, but the idea is to have health care providers who have thought about it and are prepared for it.”
Emergency management professionals who participated in the exercise stressed that message, McGillicuddy said. “They said some of our decisions weren’t necessarily right or wrong, but should it occur in real life we’ll be ready, and we won’t be panicking. It’s always better to have action than inaction.”
“Nursing school is an amazing experience,” Barroso-Fernandez said. “This exercise gives you an opportunity to step back. Because even if you’re working at a hospital during a disaster, it’s a different experience than coming in for your regular shift.”
Many of the nursing students will qualify to join the Medical Reserve Corps after graduation and be available for assignment during a disaster. Building relationships with the M.D./M.P.H. students was valuable preparation for those and other experiences, Barroso-Fernandez said. “At the end of the day what we all want is to enhance patient care and improve patient safety, whatever the scenario.”