Scenario Development Tips and Tricks

Work in groups of 4 to develop a scenario that you feel would challenge your classmates.  Choose a topic of interest to you (cardiac, emergency, respiratory, women’s health, pediatrics, etc.) and design a scenario similar to our weekly scenarios.  The “most challenging scenario,” will be selected as the “Champion Scenario” and will be presented and solved by your classmates on the last day of class.  Please note:  This is a friendly competition for bragging rights of “THE CHAMPION SCENARIO.”  Have fun with this assignment!

The scenario must contain the following:

Topic: 

Chose an area of nursing that as a group you are interested in.  Your topic/scenario should be focused, reality-based, relevant and reflective of best practices in nursing. 

Planning your scenario:   

This is step critical as it is the foundation for your scenario.  You will not be turning this in to me.  This step will assist you in identifying the expectations that you have for your classmates, and will help you expedite this assignment.

Write at least 6 objectives or outcomes that reflect what can be learned from your scenario.  Example

After the conclusion of this scenario, my classmates will be able to: 

1.       Define or identify……. Identify common Pharmacological approaches to the treatment of XYZ- NAUSEA, POST-OP PAIN, HYPERLIPIDEMIA

2.       Describe the Pathophysiology of XYZ—CAROTID ENDARTERECTOMY, HYPERLIPIDEMIA

3.       Interpret…. Interpret the lab values associated with XYZ

4.       Choose or examine…….Choose the appropriate safety measures to implement with XYZ- ER PATIENT- 1 DAY POST OP, HX HYPERLIPIDEMIA

5.       Differentiate….Differentiate between A and B-

6.       Explain…… HOW LEADERSHIP CREATES COLLABORATION AND TEAMWORK IN COUNTRY ER

7.       Respond…Respond to ABC, a complication commonly seen in XYZ- VICADIN, FENERGEN, MAN GOING INTO HYPOVOLEMIC SHOCK,  

8.       Identify…..Identify characteristic behaviors commonly presented in XYZ

9.       Critique….What could you have done that would have…SMALL COUNTY HOSPITAL, NO VASCULAR SURGEON ON CALL, SUPPORT FOR WIFE

Develop an Introduction:

Write one or two opening paragraphs that set the stage for your scenario.  Within this introduction you will identify background information, the patient, symptoms, and related circumstances of the situation (events leading up to the scenario).  Remember to incorporate subjective and objective data. 

Terry, RN works in a small county ER, one of the most challenging places to be a nurse.  This evening there is an incredible storm occurring outside.  The nurses in the ER are getting ramped up and are preparing for an influx of “customers” related to crashes and accidents due to the storm when a woman and her husband who is post-op day #1, having had a carotid endarterectomy.  The young man is vomiting and sweating.  Another nurse in the room places and IV into the man’s arm.  He has been taking Vicodin since returning home from surgery.  He tells Terry that his stomach is queasy.  Terry immediately asks the physician, who is just across the room from him, what he can give this man for his nausea.  The physician replies, “Phenergan.”  Terry administers Phenergan and leaves to handle an emergency in another room.  Suddenly, there is a scream in the room of the man who came in with nausea and vomiting, due to recovery from a previous surgery; his vomiting caused the incision to rupture.  Terry, RN rushes to the scene and sees blood squirting 2 feet into the air from the man’s neck.  The IV that the nurse put in was also lost; therefore, she needed to restart another IV in the other arm.  The man’s BP is dropping and his HR is increasing.  He is losing blood fast and there is no surgeon on call.  What measures are taken to keep the client safe?  What measures can be taken to create team in this small county ER?  Hint…really think outside the box!!     

Add another paragraph and provide pertinent family and social history.  In addition, you can expand on the introduction by clarifying specific areas, and expanding on the background information, if you choose. 

Physical Examination/Assessment Findings:  This information may be found throughout your scenario

The only pertinent information the ER nurse and physician have is that the client is post-op day #1 from a carotid endarterectomy with a history of hyperlipidemia.  He is currently taking Vicodin.

Course of Care:  Plan/Treat/Evaluate:

This is the bulk of your scenario.  You decided the turn of events and the monitoring and execution needed.   Formulate your questions around this information.  When monitoring think about: the parameters for efficacy and safety, the likely chain of events, and any interruptions and/or change of course events that could possibly occur in a realistic scenario. You are free to add any additional drama to your scenario i.e. Crime scene.

Question Development:

1.       Define or identify……. Identify common Pharmacological approaches to the treatment of XYZ- NAUSEA, POST-OP PAIN, HYPERLIPIDEMIA

2.       Describe the Pathophysiology of XYZ—CAROTID ENDARTERECTOMY, HYPERLIPIDEMIA

3.       Choose or examine…….Choose the appropriate safety measures to implement with XYZ- ER PATIENT- 1 DAY POST OP, HX HYPERLIPIDEMIA

4.       Explain…… HOW LEADERSHIP CREATES COLLABORATION AND TEAMWORK IN COUNTRY ER

5.       Respond…Respond to ABC, a complication commonly seen in XYZ- VICADIN, FENERGEN, MAN GOING INTO HYPOVOLEMIC SHOCK,

6.       Critique….What could you have done that would have…SMALL COUNTY HOSPITAL, NO VASCULAR SURGEON ON CALL, SUPPORT FOR WIFE

Final Outcome: 

This is completely your call on what happens to your client (ie. Transferred elsewhere, discharged to home, etc.)