There was nothing mechanical about the way Fort Sanders Regional Medical Center nurses handled several deliveries in the conference room of the hospital's labor and delivery department Wednesday.
The nurses, all shift leaders, delivered with expertise and humor when the umbilical cord was wrapped around the baby, when the baby's shoulders were stuck, when the placenta was blocking the cervix, when the mother's blood pressure spiked and caused her to have seizures, and in spite of a number of other dangers.
But the patient, "Noelle," was in no position to appreciate the nurses' work. Noelle is a robot - a mannequin birthing simulator that can be programmed to deliver her "baby" with just about any kind of labor and delivery complication.
Fort Sanders Regional got Noelle and her infant companion, "Hal," a newborn that can simulate post-birth complications, about a month ago, but Wednesday was the first time nurses had trained on the robots. A representative from Noelle's maker, Gaumard Scientific Co., was on hand to help nurses learn to run the simulations.
Noelle can have a breech delivery, or a vacuum or forceps delivery, or even a Caesarean section. She can be set up with a dilating cervix in one of four sizes, and any of three vulva for postpartum stitching. She can be given an IV or intubated, and nurses can monitor hers and the fetus's heart rates, blood pressure and pulse oxygenation. She even talks (and sometimes moans, grunts and screams).
"She is fantastic," said Cathy Fry, nurse educator and clinical practice specialist. "She does more than I'd even hoped for."
Fry co-presented a grant proposal that convinced the Fort Sanders Foundation to unanimously vote to purchase the $34,000 system for the hospital's maternity department. For the past five years, Fort Sanders Regional has delivered the most babies of any Knoxville hospital; last year, 3,059 babies were born there.
Previously, nurses conducted monthly "high-risk" birth scenario drills using inanimate models. But Noelle is the first interactive device they've used during a birth scenario. And while other hospitals in the area have used birth simulators, Fry said, Noelle is currently the most advanced. She's wireless, has an internal motor and can be used in or controlled from any area of the hospital.
"These drills are usually held for situations that don't happen very often but are very serious when they do happen," Fry said. "The nurses need to be able to act automatically."
Although Noelle comes with some pre-set scenarios, Fry said, they can also be modified. Nurses can even duplicate real hospital cases to use for training.
Fry said all maternity nurses - including labor and delivery, postpartum and nursery nurses - will train with Noelle and Hal. The full-size infant simulator (which is not the plastic model baby Noelle "gives birth" to) has an umbilical stump and pulsates as a real infant does. Using internal colored lights, it even turns "blue" if it's not getting enough oxygen.
Karin Gamble, a labor and delivery nurse for 34 years, said the simulators will help not only new nurses, but old hands like herself.
"You get to actually practice in a controlled environment" to be ready for the complex case when it involves an actual patient, she said.