One Smart Dummy

Risk-free medical practice for a safer tomorrow

Story by Ashlie Doran

'Am I safe?' 'Has my doctor, nurse or health practitioner taken the right course of action to treat my needs?' 'Has he/she made a mistake?'

Most people would find it unfortunate to know any patient having these questions. And yet, it happens.

The Institute of Medicine (IOM) located in Washington, D.C. estimated there are 44,000 to 98,000 preventable hospital deaths per year in their 1999 report, To err is Human: Building a Safer Health System.

Since its publication, IOM's statistics have been a topic of controversy. Some published reports assert the figures are exaggerated, while others find them to be adequate or insufficient. Two extensive studies were performed to calculate these estimations, but the methodology is debated over. For example, there are difficulties defining and measuring medical errors, particularly in hospitals where separating a patient's level of fragility and sickness from error on the provider's part is difficult.

"All agree that even the lowest plausible number would be unacceptably high," said Dr. John R. Clarke in his report, "Making surgery safer."

There is consensus, furthermore, that the effectiveness of medical care needs to be improved. Carolyn M. Clancy, M.D., director of the Agency for Healthcare Research and Quality (AHRQ) spoke at the "Remaking American Medicine Symposium" in Washington, D.C. on September 27, 2006. On behalf of the Kaiser Family Foundation, an independent national health philanthropic information provider and analyzer, and AHRQ, she said a 2006 survey found 51 percent of Americans are dissatisfied with the quality of health care they receive. The IOM states the greater issue is not individual, undeniable error, but a system lacking effective patient care. Effective health care provides the services, procedures, and actions required to keep the patient alive.

"I feel more prepared to be a nurse because of SimMan."

Now, these services, routines, and procedures are practiced by nursing majors at Plattsburgh State University College (PSUC) risk-free because of the generosity of Virginia Sturrock Damianos, and on behalf of her deceased husband, Dr. Xenophon Damianos, who donated a nearly $40,000 computer-operated patient simulator, called SimMan. As alumni of PSUC, they have donated generously to the college.

"It was a loving and wise choice made from the heart," Virginia said of the decision to give back to her and her husband's alma mater. "I've always been very fond of Plattsburgh."

The Damianos recently donated a five foot five inch SimMan that weighs 75 pounds and has many skills for a dummy. SimMan, a patient simulator, provides hands-on practical training because unlike mannequins he can manipulate vital signs, make vocal noises, be given intravenous (IV) therapy, and shots. It can mimic breathing and pulse rates, as well.

"It allows students to develop the ability to provide care in a consequence-free environment."

SimMan arrived on campus straight from the makers during the fall 2006 semester. Since its arrival, the professors and lab technicians have been learning, and training continually to successfully integrate the technology into the nursing lab program. Two solid days of training, coordinated by PSUC Associate Professor of Nursing Dr. JoAnn Gleeson-Kreig, were dedicated towards training faculty involved with SimMan. Use of the medical technology began at the start of the spring 2007 semester.

"I'm pleased with how the teachers have taken to it," Dr. Zoanne Burgess Schnell, professor and chair of the nursing department at PSUC, said. "We'll do anything we can to benefit the students and their future patients."

During lab groups of four nursing majors take different roles and act out a medical scene as if SimMan were a real person. One individual plays the head nurse at the service station. The second plays the staff nurse and another plays the nurse's aid. The last individual pretends to be SimMan's relative. They go through the regular procedures by talking to the dummy and asking the individual playing a family member what they think is wrong. Then, from the observable symptoms, from what the family member is telling them, and their own assessment, they must come up with the proper treatment.

"It allows students to develop the ability to provide care in a consequence-free environment," Gleeson-Kreig said.

SimMan helps the nursing majors practice vital skills, and helps improve the quality of their education by easily showing the professors what areas the students need more practice in. So, while the students hone their assessment skills during a medical emergency, the lab faculty critiques the students. Video recordings are taken of each scene so students can receive constructive criticism, and review their actions themselves.

Each lab focuses on a certain type of medical ailment. For example, the students can be tested on their ability to identify and treat symptoms associated with hypoglycemia or low blood sugar.

A unique request by Virginia asked for SimMan to be called Dr. Jim when it's dressed as a guy and Miss Jinny when it's dressed as a girl, depending on the medical issue. Jinny is Virginia's nickname, and Dr. Jim is her husband's nickname.

Not only are the professors proud of the implementation of SimMan into the nursing program, but the students seem to find it to be an asset to their future careers.

"I feel more prepared to be a nurse because of SimMan," said Colleen Root, a nursing major at PSUC.

One nursing major believes the new medical technology may improve the quality of care given by nurses by preparing them more effectively.

"If my mom was in the hospital and I knew that the nurses caring for her had practiced on SimMan during [his/her] training, I would feel more comfortable with the care they would provide for her," said Lena Kohlmaier, a PSUC nursing major.

The new medical tool isn't only good news for nursing majors. Gleeson-Kreig stated it was possible CVPH may utilize SimMan for training purposes in the future. Advanced and further training to promote the execution of proper diagnosis can be fostered practicing with SimMan. It is seen by many as a viable instructive tool for all professionals involved with the public's well-being.

Although, there are no definitive, empirical studies that show the number of preventable hospital deaths due to error will decrease, the use of SimMan is seen by many as a positive action.

How do you feel about the American medical system?

Meet Virginia Sturrock Damianos and Dr. Xenophon Damianos

Virginia, originally from Attica, New York, a small town in Western New York, started at Plattsburgh State University College in 1946 to become a nurse. Both of her parents worked in health-related fields. Her father was a veterinarian, and her mother was a pharmacist.

She spent her freshmen and senior year on campus. Her sophomore and junior years were spent in Albany, which was customary for nursing majors then.

In the summer of 1949, she took some nursing classes at Plattsburgh. She met her future husband and father of her six children at a varsity snack bar that used to be next to the president's home.

"I was living at the Physician's hospital [now CVPH]. So, I went into the snack bar, and he was behind the counter making the food. And that was it. Love at first sight," Virginia said.

Virginia graduated in 1950, and her husband, Xenophon Damianos whose nickname is Jim, graduated in 1951. After graduation, Jim, the son of two immigrants who resided in the Bronx, moved to Italy with Virginia so he could pursue his dream to become a doctor. They lived in Italy for five years from 1956 to 1961.

Returning to the U.S., the couple moved to Stony Brook, Long Island. Dr. Jim set up a private, family practice in Stony Brook in 1965. Virginia worked as a school nurse at a nearby high school. They always stayed connected with PSUC. She served on the Alumni Board for over 40 years. He was a part of the College Foundation. The couple went to every homecoming event they could. Jointly, the couple has provided scholarships for nursing majors through the years, as well.

In 1971, Jim was honored as a distinguished alumnus. In 1995, the couple was recognized with the distinguished alumni award in May. The nursing skills lab was dedicated to them, and they were grand marshals of the parade. The plaque outside the nursing lab describes the couple as the embodiment of the spirit of PSUC and an example of its highest ideas.

"We were thrilled to pieces," Virginia said.

They were happily married for 53 years. Jim is recently deceased. The couple has six children, three girls and three boys, and 13 grandchildren. Jim started up a realty company his sons now carry on named Damianos Realty. The company mainly renovates medical buildings for doctors in Stony Brook.

To this day, Virginia continues to love and support Plattsburgh.

About the Institute of Medicine:

IOM was chartered in 1970 as part of the National Academy of Sciences. It is a non-governmental, non-profit organization. Mostly at the request of the government, a group of the best national and international scientists donate their time to study an issue of national significance. They state they are not funded by the government in any "direct federal appropriations" on their homepage.

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