For staff members in MIT Medical’s referral office, the morning of Jan. 15 began with Triage Nurse Lynn Forgues entering the office with a life-size dummy in a wheelchair. “This is Maxine,” Forgues told the staff. “Maxine is saying she feels very dizzy, and now she seems to have fainted!”
Adhering to the office’s emergency protocol, Michael Keohane, a clinic assistant, immediately picked up the phone to summon help from the Urgent Care Service, while his colleagues, Meaghan Hubbard and Beverly Rodriguez, rushed to the side of the seemingly unconscious "patient" to prevent her from sliding to the floor.
In the flurry of activity, “Maxine’s” bright blue wig and purple baseball cap tumbled to the floor, revealing the top of her plastic, molded head.
Despite a few nervous giggles, the drill continued: Keohane retrieved an automated external defibrillator (AED), arriving back at the “patient’s” side, just as Nurse Practitioner Jan Puibello arrived from Urgent Care to take charge. Puibello dispatched Keohane to call for a stretcher from the first floor and sent Rodriguez and Hubbard to an adjacent hallway for IV and oxygen supplies.
Once Puibello declared that the “patient” had “regained consciousness” — a few more hair-related mishaps not withstanding — drill participants gathered in a nearby conference room to debrief with Internist Brian Ash, chairman of the department’s Medical Emergency Response Committee (MERC).
“Nobody is comfortable when confronted with a real crisis,” said Forgues, a registered nurse and MERC member who coordinated that day’s drill. “But we want to help people step back from that initial feeling of panic and think clearly about how to get help.”
The Jan.15 drill was the second in a series of mock scenarios planned for all areas of MIT Medical during 2013. The goal, Ash explained, is to have all staff members, including non-clinical staff, participate in at least one scenario per year in their usual work environment, playing the role they might actually play in a real emergency.
“It might be a patient in an exam room who becomes lightheaded, a person who drops to the ground unresponsive and pulseless in a waiting area, an individual who appears to have a seizure just before falling down a flight of stairs, or an employee who develops chest pain while working in our health plans office,” Ash said. “Medical emergencies can occur anywhere and at any time.”
That’s something participants in a previous exercise learned firsthand. “As we were headed to the conference room for debriefing after the first mock scenario of the year,” Ash recounted, “we were called for a real emergency just down the hall. A patient in the Eye Service had just lost consciousness. Our entire group was on scene, equipment in hand, within five seconds. They said, ‘Wow! That’s the fastest response we’ve ever seen!’”
The referral office drill was the first such exercise for Hubbard, Keohane and Rodriguez, who all agreed it was a learning experience. “For me, this exercise really emphasized the need for clear communication,” Keohane said. “Whenever we stopped talking to each other, we got confused about who was doing what.”
Rodriguez concurred. “Even though we knew this drill was happening, I didn’t know what to expect,” she said. “I learned the locations of various supplies that might be needed in a real emergency. Now I feel much more prepared to respond and do my part.”