Rutgers Nursing Magazine - Summer 2020

R U T G E R S N U R S I N G / S U M M E R 2 0 2 0 20 / 21 A C A D E M I C E X C E L L E N C E Open the cabinet in Tita Viray’s office at the Center for Clinical Learning (CCL) and you may be surprised at the contents— among them vinegar, coffee, canned cher- ries, gelatin, and other apparently unre- lated grocery items, all of which Viray (BSN, RN) uses in concoctions that help bring to life the physical manifestations of human suffering. Presiding over what she calls the “sim cen- ter” (“sim” for “simulation”) at Rutgers School of Nursing, Viray, whose title is clin- ical learning coordinator, is responsible for moulage, an educational tool, dating back to the Renaissance, used to simulate the appearance of illness and injury through makeup applied to mannequins or live humans. Today, it’s employed to train nurs- ing students and other health care workers. Unlike textbook descriptions and photo- graphs, moulage offers students the oppor- tunity to experience a lesson in three dimensions. “The authenticity of moulage,” Viray says, “gets students immersed in the situation.” And while requisite clinical rota- tions offer real-life lessons, not every student is likely to encounter rare events like an impalement or a postpartum hemorrhage. Kits of readymade latex moulages are pricey, so Viray often mixes commercial moulages with her own creations. When crushed, those canned cherries become blood clots. To simulate vernix caseosa— the protective substance that coats the skin of newborns—Viray uses cottage cheese mixed with faux blood. To re-create the look and feel of a deep vein thrombosis— a blood clot, often in the leg, that tends to feel warm to the touch—she heats up the area with a hand-warmer. Like a director, Viray instructs her volunteers how to act as if they’re in pain: to move gin- gerly or moan in distress. Because the sim- ulations are so lifelike, students tend to respond viscerally and automatically. If they see blood, for instance, they’ll im- mediately glove up. “We want to develop those safe habits in them,” Viray notes. Her simulations are in great demand, but Viray can’t satisfy every professor’s request. “Our greatest challenge is time,” says Debora Tracey (DNP, RN, CNE), assistant professor and the CCL’s assistant dean. Simulations can take more than two hours to set up. Students have the opportunity to experi- ence a wide variety of simulations at the annual Hospital of Horrors, which features 10 “patients” in varying states of distress, from a construction worker with an im- paled leg to a newborn with jaundice. It can sound a little gruesome, but for Viray, a successful simulation isn’t about shock value but what the students take away from her creations. “At the end of the event,” she says, “my reward is that ‘wow’ reaction I in- spired and seeing just how much the stu- dents have learned.” n Keeping it Real I N T H E HANDS O F AN E X P E R T, T H E T E CHN I QU E KNOWN A S MOU L A G E I S A POWE R F U L T E A CH I NG T OO L . Viray applies makeup to volunteer Gus Filippelli during a disaster nursing simulation.