I'm an educator for a pediatric home care organization, and for the last several years we have incorporated high-fidelity simulation training into our educational programs. "Replicating Real Life: Simulation in Nursing Education and Practice" (AJN Reports, May) discusses the use of simulation in nursing school when faculty are having difficulty providing enough meaningful clinical training. Our pediatric nurses are caring for technology-dependent, medically fragile children in their homes. Fortunately, emergencies happen infrequently in the home. However, to ensure the safety of our patients, we as nurse leaders and educators have a professional obligation to ensure that our nurses are prepared to handle an emergency if one should occur.1

Previously we required our new nurses to work with a preceptor in the client's home, but we found that many times the client was stable during precepting hours and the new learner was unable to experience or practice critical-thinking skills and emergency preparedness. We, like the nursing schools mentioned in this article, are moving toward replacing approximately 50% of the required precepting hours with simulation. We have developed scenarios that require our nurses to use both clinical skills and critical-thinking skills, including oxygen desaturation, seizure activity, tracheostomy decannulation, and mechanical ventilation. I look forward to further discussion and studies on the use of simulation in the home care setting.

Virginia Savarese, BSN, RN, CPN

Birdsboro, PA

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