A Complete Guide for Acing the Swiftriver Nursing Simulation

The swiftriver virtual hospital has provided a useful learning solution for a majority of nursing programs across the world. These programs have embraced the advancement of technology in healthcare training. This goes a long way to enable an easy learning experience. The platform is no different from a real physical scenario in a hospital organization.

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However, due to the sophisticated nature of this technology, most practitioners and students alike find it challenging when navigating through the platform. Therefore, in this article, I will be covering the best way to handle the virtual clinical assessments on the Swiftriver nursing simulation platform.


The swiftriver nursing simulation currently contains different sections, some of them resembling the departments in a hospital. It is regulated by nursing regulatory bodies in assessing the readiness in pre-licensure nursing programs. It provides an alternative to the traditional clinical experience. It is a technique to amplify real experiences with guided ones that replicate the substantial aspects in the real world in a fully interactive manner.

The swiftriver simulation has sections such as; med-pass, medical-surgical, obstetric triage, mental health, math refresher, pediatrics, and emergency room leadership. Soon to come are; medical-surgical manager, community health, health assessment, and nursing administration.

Swiftriver nursing simulation platform aims improves the test taker’s skills in delegation, prioritization, and sequential thinking in different scenarios presented. It has a huge database of case studies from where the simulations come from. It was created by nurses for nurses. It aims at obtaining clinical hours, improving clinical practice, building confidence and skill, and improving NCLEX predictor scores.

Many nursing students, practitioners, and academicians have sung praises for this platform. From a nurse’s perspective, the platform is not very tech-savvy. However, different people have different skills when dealing with virtual simulation. How to handle the virtual clinical has become easier with time and I am here to explain why.

Each session gives a minimum number of scenarios that are needed for completion. There is also a minimum score needed and a minimum number of clinical hours to be achieved to complete the tasks. The tasks are redo-able for any number of times till all the necessary instructions are met and the task moves to the past assignments section. However, using this guide, many students have found it easier to finish the assignments without retrying a couple of times.

Emergency Room Leadership

Prioritization of Patients

This part is for both ER student and staff nurses. Trainees are required to triage over 200 virtual patients with background sound distractors present. As the program starts, the waiting room and emergency rooms are empty and it starts at 0700hrs.

The simulation runs for 24 hours in the emergency room. There are different cadres of nurses listed according to qualifications. The aim is to select the best suited to handle a problem in the ER. When you click the next event button, more patients are admitted and their shortened history or chief complaint is given. As each patient enters, you must read the description and assign an ESI acuity levels from 1 to 5.

Delegation of duties in the ER

You must start with the most critical patients first and assign them 1 or 2 accordingly. The next task is to delegate a nurse qualified to handle that scenario. There are three cadres of nurses starting from the most qualified to deal with limb and life-threatening situations to the least experienced.

You are required to modify staffing when necessary. You will achieve this by delegating these nurses to other patients according to the highest acuity level and the most qualified available nurse. You will then send these patients to a proper room in the emergency room. The patients are sent to the Operating room, holding, step-down, or discharge according to the ESL level of acuity assigned.

When you click the next event, another bunch of patients arrives. The same drill is followed and after some time, things get hectic. The emergency room becomes full. The low acuity patients have to be moved to the patient holding area to create room for admission of others.

The occupied nurses in the trauma and OR can also be freed when the discharge option appears as shown below. This increases the number of available nurses for delegation of new duties. The trainees can also divert appropriately patients when there is no exists. The students are assessed for their ability to properly sequential think with all actions.

As the simulation progresses, the end of the shift finally comes. All the decisions in this simulation are timed and the overall actions will be assessed for accuracy. The time taken is indicated on the upper right corner. The statistics and final scores are shown on the final page. If the instructions were met, the task moves to the past assignments section.

Medicine administration

Patient identification

In this session, you will be required to identify correctly the medications by classification in the swiftriver nursing simulation. A drug index is provided for you for reference. You can type in the name of the drug or the class and all the options available according to preparation and dosage are provided. From your knowledge of pharmacology, these terms used in this session will not be difficult.

The simulation program for the swiftriver med pass sessions starts from 0600 hours and ends at 2200hrs. The med pass answers are in the system and any incorrect answer is flagged immediately using red color. A correct answer is given the green light and the score remains 100 if no mistakes are made.

Identification of Patients

You will need to identify the patients correctly from the biodata on the tablet and the patient in the room. This is done by checking whether the patient’s name, passport picture provided, date of birth, inpatient number, and other information match correctly on the tablet as in the room. If the information does not match, you will need to click the error button. You must show that you were keen and identified the error early enough before administering drugs.

Failure to correctly identify the patient leads to administering of wrong medications to wrong patients. In a real setup, this happens if care is not taken by the nurses. In the swiftriver nursing simulation, you will be penalized some points from the total score. This means that you will not achieve the indicated minimum score which is 100 for the med pass section.

Once the patients have been identified you will enter the room and click on the tab on the patient results. The laboratory results, vital signs results, and pain level need to pop first before proceeding to check the drugs. If this step is skipped, some drugs will decline because they cannot be administered without knowledge of lab results or pain levels.

You will also need to demonstrate safety rights when administering both oral and injectable medications in the swiftriver virtual simulation. Some of the medications have conditions when only they can be administered. Therefore, it is important to note these before clicking the administer button.

For instance, for analgesics such as acetaminophen, they are only administered when the pain level is mild. Similarly, morphine and tramadol are only given when the pain is moderate to severe. You must check for the pain every time you are administering medication. For diabetic patients, the glucose level has to be checked first before giving the appropriate type of antidiabetic and the amount of drug to administer.

Drug Administration

From this point, your knowledge of pharmacology is required. You will be needed to identify when to hold medication based patient assessment. Pain killers need to be held when there is no pain. Some antidiabetics such as insulin glargine must also be held when the patient is hypoglycemic as indicated in the laboratory report. This is particularly important in training practical nurses who can assess the real patient and manage him or her wholesomely and not the textbook.

Choosing the correct medication supply from the pharmacy is essential as not all formulations are always available all the time. A second witness needs to be called upon when administering insulin in diabetic patients.

The correct dosage amount needs to be calculated and given in correct divisions as per the preparation available. Some medications are incorrectly placed in the administration tray and identification is needed to mark the incorrect medication. Some patients are allergic to certain classes of medication. Patient information will indicate his or her allergies and this should be checked first before selecting the specific medication.

For instance, some asthmatic patients are allergic to beta-blockers for cardiovascular disorders. Therefore, administering some drugs such as propranolol may exacerbate their condition. You will be required to demonstrate progress in skills of medication administration through improvement in the time and accuracy of the simulation.

In-built Distractions

There are pop-up interruptions that need to be addressed immediately before proceeding. They present the worst challenge as it is so easy to get an incorrect answer. In med-pass, this leads to failure to get the 100 percent score in the swiftriver med pass assignment. The interruptions are essential to delegate duties to different cadres of nurses appropriately and according to their availability.

For instance, a call light might go off in another room. A nursing assistant if available, the best answer is to assign him/her to go check on that patient. Similarly, a RN or LPN would need to check on a patient who is complaining about feeling pain or headache.

Obstetrical Triage

Mastery of Obstetrical Conditions

Reproductive health is one of the key departments in a hospital. In swiftriver nursing simulation, the basics for passing these obstetrics triage assignments are key. In this section, the simulator has 3 phases. The first phase is to identify 17 basic obstetric definitions according to the presented data. You will be given about 8-10 definition statements where you will be required to choose the condition or procedure.

The list of 17 has obstetrical conditions and procedures. Some of the terms include; contraction stress test, premature labor, placenta praevia, and abruptio placenta just to name a few. Minimal knowledge of obstetrics and gynecology is essential in the swiftriver nursing simulation platform.

The second phase requires you to match terms to patient case scenarios. A detailed history of the patient is given that includes the gestation by date, chief complaints, and recent investigations. These include ultrasonography. You will be required to match the correct term from the drop-down that applies to the scenario.

For instance, Patricia Moore presents with lower back pain that comes in waves with other symptoms that she thought was a yeast infection. She is at 24 weeks and has not had antenatal care. The correct term for her condition is premature labor. Most of the common obstetric conditions are available at the swiftriver nursing simulation.

Triage of Patients

The third phase is where you will need to assign presenting patients to the selected departments in the virtual clinicals. The case studies will detail fully what the patient has presented with and the interventions done before. You will, therefore, triage the patient according to this information and assign the correct department to handle the case.

For instance, a patient who comes with an abruptio placenta and is deteriorating will need to be taken to the theatre for the cesarean section. Similarly, a gestational diabetes patient who has sugar levels under control can be sent for discharge while monitoring is done. A post-term pregnancy will be admitted to the labor and delivery unit for induction of labor.

You will be required to demonstrate progress in skills of obstetrics triage through improvement in time and accuracy of simulation. The scores are determined by the average process time, accurate dose calculation, and accurate triage of patients. An example of a score-sheet as done by myself in the swiftriver nursing simulation is shown in the picture below.

Pediatrics Simulator

The swiftriver pediatrics simulator is unique. It has 5 phases that include; assigning of acuities based on the preliminary assessment on the reported assessment. Different virtual patient case scenarios will be presented on the page. You as the acting nurse will need to select acuity from the drop-down menu as normal or increased. You will select according to that specific need whether educational, pain, health, psychological, or safety. The system will generate a report of whether the selected choices were correct and explain it.

Swiftriver Nursing Simulation

Patient Identification

The next step will assign appropriate rooms according to the level of acuity. The patient with the highest acuity is assigned a room first. The room number selected needs to be the correct one as in the patient name. If it does not match, you need to click the “mark as error” button before you proceed. This is done as alluded earlier in the med-pass section by checking the date of birth and the patient number.

Nursing Diagnoses

Nursing diagnoses according to the patient report will be required in swiftriver nursing simulation. All appropriate nursing concerns based on the history given are indicated by ticking them and leaving the others blank. The system then generates a report of whether the choices selected are true or not with an explanation.

For instance, a newborn patient has concerns such as the risk of impaired gas exchange and hypoglycemia. The next part will be picking patient care scenarios to attend to. The higher numbered acuities are at most risk and therefore need to be attended to first.

The next phase involves given patient scenarios where you will be required to arrange them in order of priority. You will be needed to prioritize pediatric nursing care needed for pediatric patients in the virtual simulation. You ought to demonstrate progress in caring for patients through improvement in the time and accuracy of simulation.

Delegation and prioritization skills are also important here because of the call-light distractors in the swiftriver pediatric simulation. The patient might need help going to the washroom or would like to speak to the person who brings food. Therefore, an appropriate and available staff such as a CNA should be assigned as demonstrated in the picture below.

The correct arrangement of the actions to take according to the priority concern is the hallmark of this phase. In almost all scenarios, assessing the patient comes first and documentation of the report comes last. Always remember that some calls can only be made by the physician, therefore, this step should come first where necessary.

Pediatric Medication

The last phase is the demonstration of safe medication administration for pediatric patients in the virtual clinical environment. The patient information including the medical diagnosis, pain level, lab works, and allergies are indicated before you proceed. You are required to fill the provided in the patients’ 24hr MAR by choosing the select button. If the medication cannot be found or dose is outside the dosing parameters, selecting error would be appropriate.

Simulation of narcotics loaded in the med cart for 24 hours is only meant to demonstrate medication calculation. This is not necessarily according to a health care institution protocol. The drugs can be searched either by category or system in the drug reference provided by swiftriver nursing simulation.

The amount of medications to be placed is selected while paying attention to the route of administration, frequency, and preparation form. Fluids and electrolytes are equally distributed throughout the 24 hours and administered per hour. These drugs after placing in the cart are administered in their correct times and dosages starting from 0600hrs to 2200hrs.

A second witness should be available when administering antidiabetics. Some drugs such as antiemetics, analgesics, and antipyretics are only given when the condition at that time necessitates. Otherwise, they are held.

Medical-surgical Simulation

In this section in swiftriver nursing simulation, you will form a preliminary assessment based on reported assessment data for med-surgical patients in the swiftriver nursing simulation. You will also be needed to assign a correct nursing diagnosis for patients in a medical-surgical environment. Just like in pediatrics, you will need to prioritize the nursing care needed by the sequential arrangement of care in the virtual scenario.

Delegation and prioritization skills with the presence of call-light distractors in the simulation will be essential as described in the other parts of this article. You will need to illustrate progress in caring for these cases by improving in time and accuracy of the simulation. The Med-Surg assignment in the swiftriver nursing simulation is easy to navigate after you are done with pediatrics.

Mental Health

Psychiatric Definitions

In swiftriver nursing simulation, psychiatry is a core aspect of health. You will need to identify correctly a few common psychiatric diagnoses. You then will be required identify correctly a psychiatric nursing diagnosis according to the history and examination report presented. You will show understanding of common drugs for the psychiatric nursing diagnoses presented. This will include will demonstrating knowledge of common medications for presented psychiatric nursing diagnoses.

Prioritization in Psychiatry

In the next phase, you will assess stress levels for a set of patients in the swiftriver nursing simulation. You will show comprehension of appropriate necessary interventions for levels of stress identified in these patients according to priority. Lastly, you will need to display progress in the care of mental illness patients. You will do this by improving in time and accuracy of the process.

Math Refresher

Dosage Calculation

The swiftriver nursing simulation provides for training on the calculation of dosages for patients. In this section, you will accurately solve basic math questions relating to administration of medication. You will also demonstrate proper way to administer medication in a virtual environment. Some calculations involve the calculation of total fluid intake in a patient. These problems present the biggest challenge in the math refresher especially for students who did not grasp nutrition well. However, when you understand how to discern fluids from non-fluids from the list the assignment becomes a walk in the park.

Basically, this guide has come to the rescue of many trainees on the swiftriver nursing simulation platform. Many nurses have given their reviews on this guide and it is encouraging to see more people embracing it. Be a part of the successful trainees who used this platform. Better nurses contribute to better healthcare. Your journey to become the best nurse starts now. Get nursing homework writing service.


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