Sphygmomanometers came in different sizes to accommodate patients’ body shapes. They ranged from tiny, doll-like cuffs for infants, small and narrow ones for children, standard width cuffs for adults, and extra-wide/extra-long sizes for obese patients. Using my partner, Judy, as a model Mrs. Peak wrapped the cuff around Judy’s upper arm just above the elbow, inserted the stethoscope’s ear pieces into her ears, and slid the round, flat metal end of the stethoscope under the cuff at the site of the vein on the inside aspect of the elbow. As Judy grumbled in discomfort, Mrs. Peak pumped the cuff up to just over 200 mg mercury to obliterate the sound of blood pumping in that vein. Slowly allowing the cuff to deflate, the needle on the attached dial began flicking just before the first heart beat sounded. It was at this point, Mrs. Peak said, that the number the needle pointed to on the dial was the upper (systolic) blood pressure reading. Allowing the cuff to continue deflating, the lower blood pressure (diastolic) reading was obtained when the pounding of the pulse was no longer audible.
Once we had mastered vital signs, our training progressed to the nursing skills needed to physically care for a patient. Our clinical training in the classroom followed a hands-on training approach using a role playing technique. We student nurses paired up: one played the part of a patient while the other acted as the nurse. In one of our first role play skills training classes, the ‘patient’ was given a bed bath by the Student Nurse. Our Instructors guided us in techniques which would protect the ‘patient’s’ privacy and dignity. In the attached photo, while dressed in a floral housecoat, I am ready to take my turn at playing ‘patient’. I have already demonstrated my proficiency at the physical care skill by having bathed Judy, my bed-ridden ‘patient,’ and I’m in the process of assisting her to clean her teeth. In the next session of the day’s class, I’ll assume the role of ‘patient’ and Judy will demonstrate her skills to Mrs. Peak. Other photos show several students wearing blindfolds while seated at a dining table. The non-blindfolded students assume the role of ‘nurse’ to a visually impaired ‘patient’ who requires assistance to feed him/herself.
Student Nurse Barbara Tiessen during role play skills training
More role play training: assisting ‘impaired patients’ with eating
In Semester Two, the nursing skills incorporated into the Medical Surgical Nursing course required competence in giving an injection into the deltoid and/or buttock muscle of the ‘patient’. None of us looked forward to being the ‘patient’ in that exercise, so we first practiced injecting oranges with sterile water until the Instructors felt we were ready to inject each other. Through this and all our other role play experiences, we learned what it felt like to be the recipient of many unpleasant interventions. This then fostered in us the development of empathy, one of the defining characteristics of a Registered Nurse. In the picture below, Mrs. Hitz gets an injection from our classmate, Karen. We all considered Mrs. Hitz a very brave woman and we were all grateful that Karen was the one chosen to perform this skill on an Instructor.