A doll that gives birth could revolutionise the way maternity doctors and nurses are trained.
The birthing simulator is a life-size dummy which replicates a mother in labour and allows the maternity staff to get the ‘hands on’ training they need, without putting patients at risk.
The mannequin is part of a new approach
to training adopted by St. Paul’s hospital in Vancouver, Canada.
Newly qualified medical staff may know what to expect, but they have not experienced what it is like to be responsible for the outcome of a live birth.
This helps to break them into their roles without a real patient.
“She kept saying that she needed something for the pain and she was moaning and my own reaction as a nurse is I want to help her, I want to fix that pain, so hearing it was actually really good because it made it more of an emotional connection, rather than her just being this plastic doll,” says Nurse Nicole Lavoie.
Emergency drills are in place, designed to simulate a birthing emergency known as code pink.
The drills involve the actual sequence of events that take place during a real delivery.
Adrenalin starts pumping as the nurses assess the labour, monitoring the baby’s heart rate and checking for vital signs that all is going to plan.
One of the team takes the role of the patient, speaking in place of the mannequin, so that the nurses and doctors can communicate verbally.
To keep things realistic the mannequin has a name and history which can mean there are complications for the staff to overcome. As this labour progresses it becomes clear something is wrong and the nurses call for backup.
As staff start checking all the signs time becomes critical, just as it would in a real birthing situation.
The simulator, or ‘sim mom’ as she is known, is no ordinary doll.
This one at St. Paul’s Hospital in Vancouver has state of the art functions.
They include a full body-birthing simulator with a pulse, realistic body parts and fully functioning anatomy.
These nurses act out a scenario involving a cord prolapse and, as with a real life emergency, there is no room for error.
With an immediate response being essential the medical team has no time to hesitate. They feel the same pressures as they experience in real life.
Here the nurses have to get the patient from the maternity ward to the operating room for an emergency c-section.
No details are overlooked and to ensure it is as realistic as possible, the team run to the same operating suite where obstetric surgery is always performed.
Surgeons are already in place after getting scrubbed up and not a moment is wasted.
“I think it just makes it quicker because time is of the essence, so really if it’s half an hour to deliver or ten minutes, then that could mean a baby making it or not,” says Surgeon Andrea Massey.
All this is not just about gaining experience, it also vital to maximise operational efficiency.
Much can be learned about how things go wrong, the situations which lead to them going wrong and how best to prevent them happening to a real patient.
The speed at which the team identifies problems and decides on a course of action like surgery can make the difference between survival, or death of the mother and her baby.Getting the emergency room full of doctors and nurses together takes weeks of planning which adds to the tension.
Numerous complications can arise during childbirth, including problems with the placenta, the cord wrapped around the baby’s neck or the baby being stressed by the contractions.
As well as these foetal risk factors mothers are at risk of hypertension and other complications, such as chronic diseases like diabetes, or heart conditions.
Everyone here is relieved this is role-play and not a scenario involving a real patient.
This is the only the fifth drill the hospital has organised. Each one presents new challenges. All of them are based on real events nurses have experienced on maternity wards.
Experienced staff watch closely and take notes including Anaesthetist Dr Laine Bosma.
Bosma believes the drills also improve communication and teamwork and can act as a catalyst to necessary policy or procedural changes.
“This exercise doesn’t necessarily make us better at those physical skills. This exercise makes us better at making sure that everything is set up, that the process is well organized and if we have a well organized process, we get the information we need for us to make good, solid decisions,” she says.
The mannequin is an expensive piece of kit costing more than 26,000 euros, but if it saves lives it will be worth every penny.