Simulations sound like a brilliant idea at first. To the newbs. You think, "It'll be great. A safe place to make mistakes. A positive learning environment. Kumbaya."
Horse shit.
It's a dark dungeon, controlled by a sadistic revolting beast. The sight of it sickens me. She's Bruce Vilanch's doppelganger. You can smell its rotting flesh as soon as you exit the elevator. Its coffee breath is so putrid it could have done more damage than the A bomb on Hiroshima. I hear a sinister laugh from behind the closed door as it sets up my simulation. My fists clench, my eyebrows furrow, I am ready to take on this vile demon.
A classmate exits the room, crying. She doesn't even look at me.
"You may enter," hissed the voice of Diablo.
I approached the Beast. I had my prep worksheet completed. I included as much information as I could to satisfy its needs.
"You have not included the Furosemide in your write up. Nor the mechanism of action for Digoxin," it snarled. A wicked grin spread across its unholy face. It thought it had me. I could practically see it salivating. If it had, I would not be allowed to continue onward. My future as a student would be in jeopardy.
"I- I- Furosemide wasn't prescribed," I exclaimed, finally finding my voice. "And digoxin has an unclear mechanism of action. It's a positive inotrop. It increases contractility. Furosemide can be given in an IV bolus over 1-2 minutes. It's a loop diuretic."
The Beast stopped salivating. It thought for a moment. It flung its arm in the air, "Fine. We'll get started." The revolting smell emanated from it's unkempt body. The odor threatened to singe my eyebrows. "Wait outside for me to call you in."
I never know when it's time for me to come in. There is no call light outside of its dungeon.
Another thing unlike a REAL hospital, I thought. I hear a lot of coughing from behind the door.
Is that my que? I don't know. I enter the room.
"NURSE, NURSE, NURSE! I'm DYING! Can't you see I'm DROWNING?!"
The Beast is controlling the voice and movements of the doll. I can't see it. But I know its there behind the mirror. Watching me. Judging me. Hating me.
"What are you doing? Why aren't you helping me? Do you not know what to do?!?!" The doll sounds panicked.
I give a cold stare to the mirror. It has a flare for the dramatics.
"It's alright, Mr. Jones. My name is Sally. I'll be your nurse for the day. I see that you were admitted last night. You have heart failure and it looks like fluid may be backing up." I touch the lifeless hand of the plastic doll. I cross check the wristband and confirm it with the ID on the computer. "I'm just going to take your vitals real quick and then I'll see if there are some medications I can give you so you'll feel better."
"YOU'RE GOING TO TAKE MY WHAT?!?!"
Restraining an eye roll, I explain in a calm voice, "Silly me. I mean I will MEASURE your vital signs. I won't be taking anything today, Mr. Jones." I listen to the heart; clear. I listen to the lungs; crackles, as suspected. I'm inclined to drop the 100,000 dollar plastic doll on it's back but I'm sure that will get me expelled. I go to assess the edema in the feet. "Assessing for edema," I say out loud.
The Beast remains silent.
I clear my throat, "Assessing for edema," I say again.
Nothing.
"A-hem. Edema!"
"2+!" the Beast's diabolical voice boomed above me from the speaker.
"Thanks."
I report my vitals to the mirror and turn back to the fake patient. "Mr. Jones, I'm going to call the doctor to see about switching your thiazide diuretic to a loop diuretic. It will work faster and hopefully have you feeling better quicker."
"Will it work instantly?" the Beast loves to mess with me.
"No, sir. It will work fast, but not instantly."
"Will it work instantly?" again, the Beast knows I'm annoyed. I can't help my face. It betrays me everytime.
I compose myself. "No. It won't be instant, but it will be faster. I'll be right back," I force a smile to the doll. I walk over to the phone and punch in the fake number to the fake doctor. "I'm calling the doctor," I announce loudly to the empty room so the Beast knows who it needs to pretend to be.
"Hello! Who is this?!" it didn't buy my fake smile apparently.
Tenderly, I say into the receiver, "This is Nurse Sally. I'm calling about a patient, Mr. Jones, that I have received this morning. I would like to see if we could change his prescription from a thiazide diuretic to a loop?"
"What hospital are you at?!"
Fuck! I don't know what the fuck to call this place? It isn't real. "I'm at the ABC hospital," I make up.
"I don't work there."
Click.
You've got to be kidding me. I dial out again. "Calling the doctor!" I exclaim to the empty room.
"Hello?!"
"Hi, it's Nurse Sally again. How silly of me. I meant to say that I work at the Simulation Hospital," I say far too cheery. I can almost hear my own teeth break as I grind them in my smile.
"Ah, yes. Now I DO work there. What was the question again?"
I repeat my request.
"Nurse. NURSE! NURSE!!!" I turn to face the fake patient. The Beast put on a soundtrack of him coughing violently. "Am I going to die!? Why haven't you gotten my meds yet? Are you competent?" I can picture that same wicked smile spread across the Beast's face. My eyes water as I remember the smell of its rancid breath.
"I'm on the phone with your doctor right now," I respond sincerely.
"Hello?!" The shouting through the phone nearly blows my ear drum. "If you're not paying attention to me I'm just going to hang up. I don't have time for this foolishness."
Click.
I take a few deep breaths and try to remain calm. My heart has shifted from my normal bradycardic rhythms to tachycardia. I glance at the clock. Only 10 more minutes left. If the Beast holds me over it will put it behind on the its entire afternoon schedule. "Calling the doctor," I call out so the Beast behind the mirror can hear me.
"WHAT?!" The fake doctor screams into the receiver.
"It's Nurse Sally again, sir. I'm sorry I wasn't giving you my full attention earlier. May we try this again.?"
**Cough** **Cough** **Cough**
I ignore the plastic doll's coughing fit. I need to get this fake medication into my fake patient so he doesn't fake die, but I can't do that until after I get a new order from the fake doctor.
"Ok. I'll write up a new prescription,"
"Thank you, doctor."
Click.
I stand around for a few minutes waiting for the new order to pop up from the fake doctor. Really, Beast, what ARE you doing in there? Just watching me? I try to make use of my time and document the fake vitals of my fake patient on the fake hospital's fake computer program. The new order pops up.
**Cough** **Cough** **Cough**
I rush to the imitation medicine cabinet. I log onto the two mock-up computers so that I can retrieve the medicine. SHIT! The Beast has pulled another one on me. The order is in the system wrong. One computer says one thing. The other computer says something completely different. Fuck off.
It's hard to hide my anger. My pulse is loud enough I can hear it in my ears. I'm shaking. I'm on the verge of cracking.
"Simulation terminated," booms the Beast's voice overhead once more.
It slithers out of the room from behind the mirror. That evil grin is on its face. There's a glint in its eye. I think this is what it looks like when it's happy. If it is even capable of experiencing the feeling of happiness.
"Looks like you didn't know what to do about the mismatched orders," it snickers.
I knew it! It is happy! My face grows red.
"I guess this means that you haven't been looking at my powerpoints?"
"I always look at the powerpoints everytime before a simulation," I answer, slowly. They never change. It's nothing knew, but I always review it just in case. "There wasn't anything on there that told me how to override it!" I can't hold back the anger in my tone. I try hard, but it seeps through.
Cracking another smile, "You would've known if you'd looked at those presentations. Clearly you have not." It's licking its lips again. I can see the saliva collecting in its mouth getting trapped in the corner of its lips.
Gross.
I try hard to maintain my composure.
I pause for a moment to collect my thoughts. How could I prove my point? It hits me!
I look at the beast as if it's an adorable puppy instead of the grotesque monster that it is.
"You are the worst student I've ever had. The worst of the worst. You shouldn't be allowed to look after a worm! YOU WILL NEVER SURVIVE THIS PROGRAM!" The Beast is drawing itself up to full height, sticking out its chest.
I smile and think to myself....
I knew I had the Beast. I just knew I did. I place my hand over my name badge. "What's my last name?" I ask politely.
"What?" it hisses back.
"What's my last name?" I ask cocking my head back slightly.
"WHAT?!"
I suppress my inner Samuel L. Jackson.
Say what one more time...
"What's my last name?" I ask one last time.
"I don't know," the Beast admits.
I smile. I know I've just won. "You read my last name every single week that I come in here, and yet you don't remember it. Not that I would expect you to. And trust me I don't mind. You see, that's only one word for you to learn and be an expert on. I have ten powerpoints, and 30 minutes of videos to be an expert on, on top of an extremely ambitious workload already."
"YOU ARE DISMISSED!!!!!" The Beast shoots fire through its eyes. I duck down as to not have my hair burned.
And that's how I almost got kicked out of school.