Office of Public Affairs

USM's School of Nursing tackling workforce challenge

In the USM School of Nursing Simulation Lab, only the care is real.

The rest — the illnesses, medicines and even the patients — are unreal. Machines imitate the beeps of heart monitors while high-tech mannequins blink, breathe and bleed.

Scenarios here in the hospital-like lab on the Portland campus can be so convincing that instructors rarely allow the mannequins to approximate the end of life.

“We don’t often let our students make such critical errors,” said Krista Meinersmann, PhD, RN, the director of the USM School of Nursing. Allowing even a simulated patient to die can be “challenging” to students, she said.

“Our students learn in a safe environment, so that when they go into the hospital, they’re not overwhelmed. They’re able to easily go in and say, ‘I have done this on a mannequin. I can reproduce it safely on a live patient.’”

It’s a key setting part of the nursing education, which begins in the classroom, proceeds into the simulation lab and evolves into real-life clinical experiences in hospitals and healthcare facilities throughout the region.

And it’s working.

The USM School of Nursing produces more nursing degree graduates than any other school in Maine. Of the roughly 500 students enrolled in undergraduate and graduate programs, more than 350 work in area hospitals.

While the largest group of students are enrolled in the traditional four-year nursing program, many transfer in from two-year programs at Southern Maine Community College and elsewhere. USM also offers a 15-month accelerated program for people who have earned a bachelor's degree in another discipline but want to be a nurse.

There are also several graduate programs, including nurse practitioners with concentrations in Primary Care Adult Gerontology, Acute Care Adult Gerontology, Psychiatric-Mental Health, Education and Family Nurse. A doctor of nursing practice is also offered.

It's not enough. A workforce cliff is coming.

By 2025, Maine is projected to need 3,200 nursing professionals unless schools can increase the number of new licensed nurses by 400 each year, according to a report by the Maine Nursing Action Coalition.

The University of Maine System is is working on a plan to double nursing enrollment and bring nursing education into high-need, rural Maine communities.

USM's School of Nursing is currently at capacity, Meinersmann said. But with more faculty and an expanded simulation lab, the school could accept more students into the program.

The School of Nursing is working on hiring more faculty. Meanwhile, a bond facing Maine voters on Nov. 6 — Question 4 — would include money to double the size of the Portland lab.

The facility is in constant use, said Scott Cook, the learning resource and simulation center manager. He schedules the lab and maintains its equipment, which includes the mannequins, high-tech tools and the control rooms overlooking each of the four hospital-like rooms. The individual mannequins vary widely in price and can cost tens of thousands of dollars, he said.

Every undergraduate nursing student must take at least three classes within the lab.

Students wear uniforms and practice the habits of hand-washing that are part of infection control.

At first, they run through skills training, learning to start an IV, change a dressing or insert a tracheal tube in the lab.

Over time, the skills build into scenarios. From the two most advanced control rooms, faculty can simulated a variety of medical problems, even speaking through the mannequin to talk with the students and describe how they feel.

“In the lab, we're putting people in challenging situations faster than they would in real life," Meinersmann said. “The simulated patients come in with presenting symptoms. If you do the right thing, the respiratory rate slows down and they start to improve.”

All of it is aimed at having more experienced students — critical thinkers and safe providers — when they start working with patients in real, clinical settings.

This fall, facilities hosting USM nursing students include Maine Medical Center and Mercy Hospital in Portland, Central Maine Medical Center and St. Mary's Regional Medical Center in Lewiston, SMHC Medical Center in Biddeford, Spring Harbor Hospital in Westbrook and Mid Coast Hospital in Brunswick.

“We so value our partnership with the University of Southern Maine School of Nursing,” said Lois Skillings, Mid Coast's president and chief executive officer.

“Through the years, hundreds of well-educated nurse and nurse practitioner graduates have joined the team at Mid Coast Hospital providing expert, compassionate care to patients in our community.," Skillings said. “USM nursing faculty and leaders have a proactive and innovative way of keeping ahead of the curve. We are truly fortunate to have this gem of a program in Maine.“

Story by Daniel Hartill and photos by Alan Bennett, USM Office of Public Affairs