Skills stations: Community health work

Facilitator:
Patients:
Time: 15 mins; 1150-1205
Actual time:
Learning Objectives:
Materials: Make-up.

Sophia's Skill Stations

Note to trainers:

Use elements from Sophia's Skill Stations and elements from Community Health Scenario to build these skills stations.

10 stations, no scene. Try to set this up as linear as possible -- e.g., patients around the perimeter of the room at even spaces. If there are more medics than patients, add a card saying "break" at a station.

Tell patients:

If a question comes up that you cannot answer, say, "I don't know," or, "No."

Patients

Little kid (can be wearing a sign) who is confused and crying. Nothing else wrong. Mother is not in sight.
This patient has a scrape on the leg after a scuffle near the cops broke out. The patient is angry and wants to tell the medics all about it, rather than discuss the injury. Dirty wound, small amount of blood. The patient says s/he cannot put weight on the ankle, says it was "twisted" in the scuffle. Patient has no allergies, no current medications, recent history of an infected wound that required some drug therapy ("that was much worse than this one -- I don't care about this one...").
Someone threw a glass bottle at a cop but hit this person instead. The patient is screaming bloody murder because the bottle broke on impact with their hand and a piece of it lodged into the palm, which is scary and hurts a lot. The person thinks their hand is broken and really wants it looked at right now. The patient also has a problem trusting other protestors since it was protestors who hurt him/her. The patient is a little defensive and combative. A&Ox3, no head trauma.
This person is afflicted with a bone disorder that the medics have never heard of (use "osteomalacia" or "paget's disease"). This person complains of being cold and hungry. S/he has no apparent injury, and state that s/he is not injured or ill. However, if the medics do SAMPLE, they find that this person is on 14 medications and has a long and complex medical history that they want to recount (person should just ramble about things endlessly and randomly until stopped). This person is a whiner and rejects offers of help.
This bystander is not injured, but is creating problems for medics by trying to interfere and "help." The person feels that s/he does not have to answer to medics and that s/he can do what s/he wants to assist people. S/he will start yelling at medics (either insisting s/he does not have to leave or yelling at them to do specific tasks "to help the patient") if the medics do not successfully route her/him away from the patient's side.
Bruise on ankle with much pain. Ankle cannot bear weight. The patient just tripped on the curb. Feeling really embarrassed. Vital signs are normal and SAMPLE turns up nothing big. The patient wants an ice pack and then they will just leave because this is "no big thing." If pressed, this patient insists unconvincingly that they will pursue medical care on his/her own.
This patient came down the wall and is badly emotionally traumatized by this incident. S/he has no obvious injuries but is so scared s/he are not being reasonable. The anxiety is such that the person appears to not be A&Ox3, but may actually be fine. S/he wants an escort to a personal safe space (not the wellness space). This patient may not be eighteen years old.
This patient is a Muslim woman who fainted. She objects to having men touch her, and will reject medical care initially because she does not like having too much attention on her. She also is bothered by onlooking protestors (if present). She cannot speak English fluently, and this is embarrassing. She has no symptoms of injury, and no apparent major illness. She fainted after a few hours of standing around at a rally. Has not eaten today, and feels thirsty. She will not accept care until there is privacy/safe space and a female medic is treating. This patient freaks out if medics put alcohol-based tincture (such as Rescue Remedy) on her. She is also hot to the touch, and says she is not thirsty but is very weak and dizzy, with some nausea but no vomiting. She freaks out again if medics attempt to remove her head scarf. At the same station:
This patient has a sprain to the wrist. After treatment, or if left untreated, this person wanders around interfering with other patients and causing trouble generally. Stares at Muslim woman like she is from outer space.
This guy got in a fight last night at the bar and now has extreme stomach pains at his right upper quadrant. He is nauseous and confused. Has a long, complex, and contradictory story about what occurred that injured him. His pulse is fast and his breathing is a little shallow and thus quicker than normal. The patient says he was not injured at the protest, but now wants to leave and will accept medics arranging this. The patient is most comfortable seated with legs partly bent and complains loudly when the medics press the affected area. The patient is in too much pain to walk out on his own.
This freelance reporter genuinely thinks that recording and interviewing a patient is helpful -- and s/he is so convinced of this that s/he will do it without asking medics first. If told to leave, the Indymedia person is hurt and offended that the medics don't agree with his/her decision. # This person faints after seeing her/his friend get injured. When s/he comes to, she tells the medics that s/he has not eaten today and has not had water in six or seven hours. She is woozy and freaked out about her friend who is injured. If the medics give this person alcohol in the form of an herbal medication, s/he responds emotionally because s/he is straight edge/religious/in addiction recovery and does not want alcohol.
This person is crying so hysterically that s/he cannot explain what is going on. The person does not get better or calm down, but may stop crying a little and begin to act incredibly paranoid and fearful to the point of not speaking to anyone. The freak out goes up a notch if anyone touches the actor. No one can explain what is happening. The medics do not make any gains through any action with this person without strenuous effort. If they try long enough, he/she calms down and becomes quiet, although a story about what is happening is never forthcoming.
This counter-protestor has become trapped in an area of the protest where cops corral everyone and are making slow, methodical arrests of the entire group. The counter protestor asks for care for a blister. Nothing else is wrong. However, the aid given to him prompts someone else to confront the medics and the counter protestor both, and a fight breaks out. The other person's problem is something about corporate medicine that quickly becomes incoherent and is obviously just a rouse for this person, who is freaked out, to express their discontent at their situation. The medics are put in a situation where they may be endangered and are the cause of a major problem.
Woman is cutting collected tree branches into burnable sizes with hand saw next to BBQ. Attempting to hold down branch by placing it on folding chair and sitting on the branch for stability. Branch breaks and saw goes into woman's thigh cutting her jeans and small but ragged cut on leg. She stands up startled and places palm on hand on hot BBQ for stability and burns hand. Undocumented and is fearful of going to hospital. She is with the next person:
Protester from out of town is 5 months pregnant. Her partner is the woman who cut her leg and got a burn at the BBQ. She is going into a panic attack and begins to have severe cramping and throws panic attack into full swing. Hard time breathing and over reacting. Thinks everyone is trying to hurt her and her partner. Does not want to go to hospital without partner (who is undocumented and afraid to go to the hospital herself).