End of Life: Pediatric Simulation

Another wonderful opportunity I was able to take part in was the

Pediatric End of Life simulation. In this simulation, students from the
School of Medicine and School of Nursing collaborated to preform a skit
that portrayed how different members of the health profession dealt
with a parents decision to end their childs life. Also because each
student had a different profession to portray we were able to work
interprofessionally during resuscitation efforts until the parents gave
their last decision. Although the experience was a play for the
audience it left a lasting impression on those that participated. It let us
understand that death not only affects the family but also every person
directly involved with the patient.
In this simulation each student was able to choose which health
profession they wished to portray during the play. This included the
many different professions involved in critical areas and the crash
team. The roles consisted of Respiratory Therapists, Faculty Doctor,
Resident, Intensive Care Nurse, Chaplin, Pediatrician, and many others.
I personally was not an actor but a coordinator and assistant to those
who were having trouble developing their characters. Each person had
the ability to create their characters past experience with having
children, hospital experience, and death. Once everyone developed
their characters we discussed how each of the professions personal
situations could be affected by the loss of an 8-month-old patient.

Although it was only a discussion it was impactful to see that even

personalities can be affected. For instance the student that portrayed
the mother decided not to peruse resuscitation efforts, which conflicted
with the new Residents desire to save every patient. As a group we had
to work interprofessioally to be able to portray every character while
still convicting the struggles the family and personnel working with the
family.
In the play itself the audience was able to see how the
professions worked together to resuscitate the child. The play starts
with the child, a few hours out of surgery, recovering in his incubator
with the parents by his side. The childs vital signs drop causing
concern for the parents who automatically call the nurse. In this
situation the nurse does what she can before the stats drop drastically
and she calls a Code Blue. At that moment the crash team walks in
causing the mother and father to become hysterical and pushing
people out of their way. During these types of situations the code team
and primary nurse are so concerned with saving the child that they
need upmost concentration to insure everything goes well. Assessing
the situation the Pediatrician takes both parents aside and explains
what is happening. He explains that respiratory is ventilating the child,
while the ICU nurse is pushing Epinephrine to help restart the heart as
ordered by the resident. In this type of situation it is essential to work
interprofessioally to ensure that the child is getting the best care

possible while also taking care of the parents. Everything happened

quickly making communication key to success. Unfortunately for this
situation the mother decided not to intubate her child and stop
resuscitation efforts causing the child to pass away. To the mother she
was stopping her child from experiencing further pain while the
resident was in distress with taking someones life. However
regardless of the point of view the parents received support from
everyone involved while the resident spoke to her faculty to express
how she was feeling.
The key to working as an interprofessional group is
communication and none was more evident than us portraying
interprofessional resuscitation and interpofessionally putting a play
together. Both required communication and assessment of the
situation in order to understand how to proceed.