Date and Time: Shows the current date and time within the simulation. The date refers to the "Case Day". So the first day which you care for the patient is Day 1, etc. Time passes within the simulation only when you take some action. When you check the patient's vital signs, administer medications, or perform other actions that take time, some simulation time will pass and the Date and Time display will change accordingly. To pass larger amounts of time, use the Wait icon described in Control Buttons below or the Wait menu item described under the Intervention Menu.

Control Buttons: The buttons in the lower right part of the screen are shortcuts to frequently-used menu items. They behave in the same way as the matching menu options.

Take Vital Signs:

Assess Pain Level: You ask the patient to represent his/her pain on a scale from 0 to 10, where 0 is no pain and 10 is severe pain. The patient's response is printed to the Feedback Box.

Wait: Waits one hour (allows one hour of simulation time to pass). This simulates the nurse doing rounds, checking on other patients, etc.

Administer Medications: This button brings up the Administer Medications dialog box, as described below in the Menus section.

Request Consultation: This button allows you to consult with the Supervising Nurse, as described in below in the Menus section.

Menus

The Menu Bar at the top of the Painless applet window provides you with access to all of the applet's controls. Each menu is described in detail below:

Case Menu

End Case: Ends the case prematurely. This option will score the case for as long as it has been run, but the report will note that the case was ended before completion.

Restart Case: Restarts the present case.

Quit: Quits the applet. Note that this quits only the applet, not the browser.
Assessment Menu

Vital Signs: Takes the patient's vital signs, printing them to the Feedback Box.

Pain Level: You ask the patient to represent his/her pain on a scale from 0 to 10, where 0 is no pain and 10 is severe pain. The patient's response is printed to the Feedback Box.

Query Patient: This menu allows you to ask a variety of questions of the patient. You may choose any of the listed questions, and the patient's response will be printed to the Feedback Box.
Intervention Menu

Wait: This menu item allows you to wait for a specified period of time (15 minutes to 24 hours). While you are "waiting," simulation time will be passing, but you will be unable to affect what is going on.

Give Med: This menu item brings up the Administer Medications dialog box. You will see a list of the medications currently prescribed for the patient. When you select a medication, a list of appropriate routes appears below the list of medications. When you select a route, the popup menu for dosage will become active and you can select the dosage. Choose Adminsiter to administer the medication, or Cancel to cancel your selections without administering any medications.

PCA Pump: This menu item allows you to access the PCA Pump while it is running. It will bring up the PCA control window from which you can change the PCA controls, view the patient's PCA history, or stop the pump altogether. When the PCA Pump is not running this menu item will be greyed out. (To activate the PCA Pump, go to the Administer Medications dialog, select the drug to use in the PCA Pump and select the option "PCA Pump.")

Patient Teaching: This menu item allows you to teach the patient about the drugs they are being given. Selecting the drug or drugclass from the sub menu will bring up a teaching dialog box with a list of topics which you can teach. Select one or more topics to teach and press the Teach button to teach the topic(s) or the Cancel button to exit the dialog without teaching. The Feedback Box will display what you have told the patient.
Consultation Menu

Supervising Nurse: When you consult the Supervising Nurse, you will see advice in the Feedback Box. The advice often relates directly to the case and to the current state of the patient.
Help Menu

Technical Help: Brings up this file in a new browser window.

Equipment & Terms: Displays help on terms and equipment used within the simulation in a separate browser window.

Medications

Medications Dialog Box

To administer medications, you may either select the menu item "Administer Meds" (Intervention Menu), or click the Meds button (identified by the syringe). You will see the Administer Medications dialog box (pictured to the left).

Notice that at first, only the medications are listed. When you select a certain medication, a list of the available routes for that medication will appear at the bottom of the box (see illustration below, "Choosing Route/Dosage").

Once you have chosen both medication and a route, the dosage pop-up menu for the chosen route and that route only will become active. You may not select a dosage before selecting a route. Once you have chosen the route, you may choose the dosage from the pop-up menu beside it.

If you change your mind about the medication before clicking the "Administer" button, you may change the dose, route, or medication as follows:

To change the dose, simply make another selection from the pop-up menu. Note that this will negate the previous dose selection.
To change the route, choose another route by clicking its button in the bottom list. Note that this will negate the previous route selection.
To change the medication, choose another medication by clicking its button in the top list. Note that this will negate the previous medication selection.

Choosing Route/Dosage

You may only administer one medication, route and dose at a time. When you have made your selection, click "Administer" to give it to the patient. If you change your mind completely and do not wish to administer medication at this time, click "Cancel" instead. If you click "Cancel," no medication will be administered regardless of the current settings in the dialog box.

The Case Score Screen

After the simulation is completed, a score screen will appear which includes scores for pain relief, side effect management, patient teaching, and total patient satisfaction. A full report may be exported to a web page, which may then be printed out or saved.