Medical Training

If you haven’t seen the “Very Postmortem: Mummies and Medicine” exhibition at the Legion of Honor Museum in San Francisco, you must go. Gurnick Academy of Medical Arts Licensed Vocational Nurse (LVN) students visited the exhibit on a Saturday in September, 2010 and had a blast! We were able to view the CT scans taken by scientists at Stanford Medical School, which were used to discover what is inside the mummified body of Irethorrou (the Fine Arts Museum’s mummy, which has been on loan since 1944).

Our LVN students had a chance to experience how modern scientific research can provide insight into the way ancient Egyptians lived. The students explored the power of modern technology in three-dimensional imaging of the mummies, accompanied by scientific explanations of the exhibited pieces.

GAMA students can have fun in and outside of classrooms in our LVN program. They get to explore, and experience, science and medicine not only during their regular coursework and attending clinical practice sessions, but also outside of our campus, during field trips such as this one. At Gurnick Academy, we incorporate worthwhile field trips, and educational outings, as part of the curriculum.

People who go to work regularly can often be divided into two categories: those who love their jobs and those who hate their jobs. A job is almost like a marriage; hopefully, you do it for love and not just for the money. Unfortunately, many people work out of necessity, hating what they do and dragging through the days just to get their paychecks. There are the lucky ones who truly enjoy their work and get a full sense of satisfaction. Yet, interestingly, the majority of people fall somewhere in between.  They enjoy what they do, but there is something missing, something that leaves  them unsatisfied.

We all have certain needs to meet in order to feel fulfilled in what we do. Getting a paycheck satisfies our most basic physical needs. However, there is more to what we want and need. That includes satisfying our need for belonging, as well as the need for self-importance, self-esteem, and self-actualization (doing what we were meant to do to feel fulfilled in our lives).

Let’s take, for example, a licensed vocational nurse (LVN) working at a typical skilled nursing hospital. In most cases, an LVN chooses this profession not for a paycheck, but rather to fulfill the need for self-esteem and realization of his or her purpose in life to help others. In most cases, the LVN’s basic needs are met and she enjoys contact with patients, helping them and their families on the way to recovery. Oftentimes, feeling appreciated, or even feeling affection from the patients is quite rewarding.

However, let’s examine what separates an LVN who goes to work with a smile on his or her face looking forward to every shift from the nurse who drags her feet going to work, making it through every shift stressing over the job. The need for self-esteem may be realized in the first case, but not in the second. LVNs or any other workers who are given the power and responsibility to make decisions within their area of expertise and are encouraged to take initiative and practice leadership will feel more confident and satisfied going to work, taking pride in what they do. Workers who are not allowed the opportunity to do these things and who are supervised too closely (that is, micromanaged) will often feel inadequate and powerless.

The key to having a happy worker is to find the golden middle: give just enough direction and boundaries by providing the job duties and responsibilities, and let the worker take ownership for what he or she does by letting them take initiative and responsibility in the assigned tasks. Of course, the level of supervision should be carefully weighed, based on what is appropriate for the level of education and expertise of the worker, as well as the job position. This consideration of management styles results in great benefit to both the employer and the employee, because a happy worker is a good worker.

Gurnick Academy of Medical Arts is  one of the leading LVN schools in California offering LVN nursing courses at campuses in San Mateo, Concord, Fresno and Modesto.

Whether you are considering becoming a RN or a LVN/LPN classes, travel nursing opportunities are abundant.  These temporary nursing positions are a great way to see someplace new, and a way to consider places to later relocate. I once knew of a nurse who wanted to spend her summers near the ocean.  Instead of going through an agency or a nursing recruiter, she asked the hospital of her choice for a summer salary with a housing allotment.  This was a great way for her family of four to spend a summer in her idea of paradise. However if you are looking for simplicity in job placement, it is easy to search on the internet for traveling nurse staffing agencies; make sure you first find out which hospitals and shifts that they are contracted for.

Hospitals generally utilize traveling nurses to cope with the increasing shortage of nurses. If you graduated from a LVN/LPN program and are considering working in another state, first find out the licensure requirements from the state’s board of LVN.  Since each state has different LVN/LPN requirements, it is a good idea to plan ahead.  Another recommendation before signing onto this journey is to first work in one facility for at least one year to develop a foundation and learn as much as you can about nursing.  Sometimes nursing students make the mistake of thinking that all they need to know about nursing will be taught at their LVN/LPN school.

Even though nursing schools, such as Gurnick Academy of Medical Arts offer “real” life situations with simulated mannequins and clinical experience in healthcare facilities, the career of nursing is an ongoing classroom filled with endless opportunities to learn.  In addition, by selecting an area of expertise and becoming certified in that specialty, will place you in even more demand, which can lead to more choices in your job positions.  One last suggestion is to speak directly with a traveling nurse to find out the pros and cons.  If you don’t know of any traveling nurses, you can check out one of the many blogsites written by “real” nurses who have experience in this exciting career.

Have you ever wondered what a patient’s story is prior to admission to a health care facility?  I’ll never forget that question that was asked many years ago by my nursing instructor.  Today I teach LVN students at Gurnick Academy of Medical Arts and encourage them to be curious and find out more than just their patients’ diagnosis and vital data.  Fortunately there is already a program, called My Story, which offers steps in finding out about who the patient really is beyond their room number.  In 2003, Michael Dann became the inspiration to his wife Doreen for starting this program.  After a motor vehicle accident, Michael became just another “John Doe” comatose patient in a trauma unit.

During those last 8 days of life, Doreen Dann, C.O.O. of St. Jude Medical Center in Fullerton, California, created a life-serving tool to bring connection between Michael and his caregivers. The My Story brochure includes questions about the patient’s support system and what they enjoy, such as their favorite pets, hobbies, movies, music, and food.  Depending upon each facility’s policy, these valuable brochures may be filled-out by nurses, volunteers, family, patients, and student nurses. After the brochure is filled-out it is then posted up in the patient’s room, which allows each caregiver, including LVN/LPN students to easily read about their patient prior to administering care.  A DVD is also provided for the caregivers to understand the purpose and story behind the My Story program.

In the DVD Doreen Dann shares her view about how there is healing power in the life story itself.  She explains that when we are able to connect to the life essence, then we can truly become a partner with each other.  With this healing intent, it is no surprise that this program has a history of not only being beneficial to the patient, but also to the caregivers.  For those who enroll in a LVN/LPN program they usually are filled with excitement about their new career.  To keep this spark of enthusiasm, it is important to utilize tools, such as My Story to continue their nursing education even after graduating from a LVN/LPN school.

Everyone probably has heard of Q Tips cotton swabs and their versatile uses from applying and removing makeup, painting, and household cleaning.  The LVN/LPN uses an elongated version of this short household tool for cleaning around the infant’s umbilical cord, wound care, and if needed, come in sterile packages.  Today the acronym Q-TIP can serve the purpose of stress management by redirecting our attention away from stress-filled thoughts.  Every time a nurse uses a cotton-tipped applicator, they can be reminded of the meaning of Q-TIP, which stands for “Quit Taking It Personally.”

These four simple letters can buy the nurse or nursing student the time to make choices on how to respond before they are automatically in a state of reaction to perceived stress.  As the student nurse in a LVN/LPN program takes on more and more responsibility at their clinical sites, it isn’t easy to just let things go, especially when their patient’s condition worsened or their patient’s family vented their anger.  To maintain a caring attitude from the role of student to licensed nurse, it is important to have tools that can quickly get them back on track.  Jill Hare in her TheApple article Five Ways to Quit Taking it Personally” reminds us that “The bad moods of others are more about them than they are about you.” Even though Jill’s article is focused on how teachers can build their confidence without taking on the actions of their students, her tools are very appropriate to improving the nurse/patient relationship.

Hare points that in some careers, such as teachering, they tend to think too much about something and try to fill-in the blanks with words or tone that can magnify our stress-response.  Her solution to this over-active mind is to “Take things at face value. If you don’t understand the point someone is trying to make, ask for clarification. Don’t assume anything.” Kelly Bryson, MFT, Certified Nonviolent Communication Trainer states the following about how to apply Stan Dale’s Q-Tip acronym in his book Don’t Be Nice, Be Real,  “People are never angry or upset with us; they are distressed about an unfulfilled need of their won. I may be the detonator but I am never the dynamite.”  In other words, there is a difference between acknowledging that we can be a trigger to someone’s stress without being the cause.  Nursing students have plenty of opportunities in both the clinical site and the LVN/LPN school to follow the advice from these authors such as Jill Hare who states, “More likely than not, the behavior [of others] is not stemming from something you’ve done, so don’t blame yourself.”

I am one of the clinical instructors for LVN or Licensed Vocational Nurse of Gurnick Academy of Medical Arts. I am currently handling Module IV and we’re having our clinical at Stonebrook Health and Rehab. Stonebrook is located at Concord Blvd in Concord, CA and it is both a short term rehab and long term facility that has 120 bed capacity. I’ve been working at Stonebrook for more than five years and I can say that Stonebrook is one of the best place for clinical site or training ground for SVNs or Student Vocational Nurses.

Module IV students are one step closer in a becoming Licensed Vocational Nurses. That’s why they are practicing or doing actual LVN works or duties. They are doing the actual med pass with 18 to 22 patients. They are the one preparing and giving the medicines to patients but of course with supervision of a licensed staff, either an LVN or RN. They are doing wound care or treatments not only the simple or common wounds but even the complicated ones. They are given the chance not only to observe but to do actual wound vacs themselves. Each student is given their chance to do common bedside procedures like catheterization, suture and staple removal, different types of enemas (fleet and retention enemas), colostomy, G-tube and NG tube care and feeding. They also do actual documentations like nurse’s notes, weekly summaries and care plans. And they also carry out actual doctor’s orders.

This is only the 3rd module that I handled and so far I can say that I really enjoy teaching or handling module IV because this is the last module they need to become Licensed Vocational Nurses. And it gives me a sense of accomplishment knowing that I was able to enrich their knowledge and help them gain the self confidence they need to be effective and efficient nurses in the future.

Have you heard the latest and the most exciting news and Gurnick Academy? Our newest LVN Program graduates, who just finished the post-program review course, completed their first attempt to pass the exit HESI exam last Saturday. The results were unbelievable! 82% passed it the first time! This is the first time in the history of our school, when we have such high passing rates from the first HESI attempt! Thanks to the hard work of all our instructors, staff, administration, and, of course, the students themselves, we are achieving such astonishing results!

An important aspect of LPN training is maternal-child education.  Although many acute hospital units that care for pregnant women i.e. prenatal units do not employ the LPN the understanding of the origin of human life is an essential component of LPN education.  The curriculum generally includes the following:  basic biological principals of the symphony of hormones necessary for conception to take place, the conditions of embryo and fetal gestational growth, complications of pregnancy, labor and delivery, postpartum, the newborn as well as contraceptives.

The role of the LPN during the perinatal period in various health care settings depends mostly on the nursing scope of practice for that state.  Maternal-child health presents many risk factors that require specific assessment skills that are not included in LPN didactic education or skill set training.  In view of that fact the LPN can provide some basic nutritional guidelines, recommended weight gain  education as well as contraceptive alternatives to the expectant families, family planning clinics, physician offices and public health agencies many welcome the LPN as a valued staff member.  Sexually transmitted disease education is often a role for the LPN and some LPN’s have completed certification programs that allow the classification of specialist to be designated following their license initials.

Ninety one percent success rate! Wow! Gurnick Academy of Medical Arts is ahead of many other LVN schools in California! Our most recent graduates’ NCLEX passing results just came in, and the results were astonishing! This was great and exciting news our Chief Academic Officer brought to the latest faculty meeting last Friday. All the instructors in the meeting were happy and proud to hear the news. And as we thought about it, our school deserves to be recognized for one of the strongest VN Programs in California.

Just think about this. Only a few years ago, Gurnick Academy was a small single campus Vocational Nursing program, struggling to compete with other major LVN programs in the Bay Area. And look, where we are now. We are growing stronger than ever, better than ever, more successful than ever.

The journey to success of Gurnick Academy has not been easy. Our Nursing College went through many changes, upgrades, and innovations, which came with much efforts and energy from our school’s executive board, and, of course, all the faculty and staff. This is an example of successful team work, and we do have an amazing team of coordinators, clinical instructors, VN course lecturers, support staff, and of course, our leaders. Without them, who knows, where we would be?

Learning a skill, such as how to take vital signs including blood pressure, temperature, and heart rate, is just one part to the completion of a nursing task.  The other part of completing a nursing skill is to become competent in communication.  As a LVN instructor at Gurnick Academy of Medical Arts, my students are given the opportunity to practice on mannequins and their classmates prior to working with patients at their assigned clinical site.  When working with their classmate I have them both obtain vital signs from an agreeable classmate, and then attempt to complete the same skill with their classmate saying “no” to having their vital signs taken.  As you can probably guess, this classroom scenario quickly leads into a valuable lesson in communication.  Communication can be so simple until the patient replies with the dreaded, “No!”  Since some of our students have been or are parents, they are all too familiar with hearing the word “no” from their children.

As with parenting, a LVN/LPN has the choice to make a request sound like a request, instead of a demand.  The challenge in making requests usually lies in neglecting to connect with the patient to inquire if the patient is hearing the nurse’s requests as a demand.  Marshall Rosenberg, PhD, founder of Nonviolent Communication (NVC) and author of Nonviolent Communication: A Language of Compassion, says the following about hearing someone’s “no” word, “Because of our tendency to read rejection into someone else’s, “no” and “I don’t want to…,” these are important messages for us to be able to empathize with.  If we take them personally, we may feel hurt without understanding what’s actually going on within the other person.”

Rosenberg suggests an alternative to taking the patient’s negative words personally or getting stuck on their “don’t want to” phrases, is to instead hear and empathize with their unspoken, unmet needs.  Early on in the LVN/LPN program the student nurse learns about Abraham Maslow’s hierarchy of needs, which offers a foundation for advancing their communication skills.  In the clinical scenarios and setting, the student nurse is giving the opportunity to apply their theory knowledge by identifying the unmet needs of their patient.  Even though LVN/LPN schools allow for time to practice these skills, the student is responsible to continue practicing these communication skills at home, which will only improve their chances in becoming hired and more competent in a LVN/LPN job.