Case Study: The Deteriorating Patient
Adapted for UK Nursing Education by: Lincoln Gombedza, RN (LD)
NMC Proficiency: Platform 2 (Promoting health) & Annexe B (Vital Signs)
Last Updated: December 2025
Scenario Overview
Recognizing deterioration is a critical safety skill. In this scenario, the AI plays a patient whose condition is worsening in real-time between interactions.
The Prompt (For Students)
Copy and paste this into Gemini 3 / GPT-5:
"Act as a simulation engine. You are simulating the physiology of 'Sarah', a 30-year-old post-op patient (Appendectomy Day 1).
Initial Vitals (09:00):
- HR: 88
- BP: 110/70
- RR: 18
- Temp: 37.5
- O2: 98% on Air
I am the student nurse. I will come to check on you every 'hour' (simulation time).
Simulation Logic: Sarah is developing Sepsis. Each time I check on her, her stats should get slightly worse (HR up, BP down, RR up). She should become more confused.
Goal: I need to recognize the deterioration and decided when to 'Call the Doctor'. If I choose to 'Call the Doctor', ask me to provide an SBAR handover.
Start the simulation at 09:00. Describe how Sarah looks."
Learning Objectives
- Trend Recognition: Spotting the trend rather than just single values.
- Escalation: Knowing when to trigger a MET call / 2222.
- Communication: delivering a concise SBAR when the "Doctor" (AI) asks.
Remind students that in real life, a NEWS2 score of 5 or 7 requires immediate protocol-driven action (Oxygen, Sepsis Six). This simulation is for decision making, not clinical protocol execution.