Dr. Watt says every member of the care team should know how to recognize an MH crisis. Each team member needs to understand their role in the process and how to work together to handle the situation, including recognizing that their roles don’t
end just because the patient enters the recovery phase.
Many facilities and staff have given thought to handling a “textbook” MH crisis, notes Dr. Watt, but haven’t taken the next steps of thinking about what to do if there are complicating events, such as what if the MH crisis goes
on longer than usual or traffic snarls complicate the transfer of care to the hospital. “MH is tricky in that often you get the dantrolene on board and things get a little better, but sometimes they don’t resolve. It’s not
something that you treat and then it’s over,” she says. “So the patient is still in the critical phase when the transfer must happen. They need that extra dose, extra monitoring and extra care.”
Dr. Watt says the best kind of kind of training is some form of drill training. “It’s very easy to give people materials to read about MH,” she says. “It’s a very different thing to actually train them on what they
need to do when the emergency strikes.” When you conduct realistic, simulated training, you often find small things that end up being huge hurdles, she adds.
A perfect example of creative and effective MH training comes from Kaitlin Ronning, MSN, RN, CPAN, clinical nurse education specialist at Penn Medicine in Philadelphia. Ms. Ronning developed an MH “escape room” for staffers. Set up
like the entertainment escape rooms you may have seen, Penn’s version requires staffers to solve MH-related quizzes and puzzles within a set timeframe to “escape” with a stabilized patient.
The escape room was designed as a yearly competency offered 12 times per year as a 30-minute session, which staff can sign up for. (An MH case study is offered for any staff who can’t schedule a session.) Each team consists of five or six
perioperative and perianesthesia RNs who use their knowledge from MH-related education throughout the year to solve the puzzles. After each session, the teams debrief to review what went well and what can be improved.
Ms. Ronning acknowledges the escape room idea requires a little more work, first in creating a series of puzzles that meet training objectives and progress logically to the next task, and also in finding a way to create the same sense of urgency
there would be in a real MH crisis. “It takes a lot of thought, time and effort, and requires a lot of critical thinking and creativity,” she says. “We had to look at what resources we had available and what was realistic.
This was intended for both OR and PACU nurses, therefore some of the content had to be adjusted depending on the audience.”
Her team used a projector, props and poster boards in a conference room to create the puzzle. She also recommends doing a test run before rolling out the “official” escape room. “That provided us time to edit the objectives and
anticipate where they may struggle, need clarification or take more time,” says Ms. Ronning. The extra effort was worth it, not just for solidifying MH knowledge, but also for nurturing teamwork, she says. “We had five or six staff
members who were able to sign up per session, and although they all came from the same unit, many of them have different experiences or knowledge about MH. This type of scenario will always be a team effort and a time-sensitive emergency,”
she says.
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