Medical Training

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.

Here at the Concord campus our vocational nursing students are entering the halfway mark of their module and oh boy, are they happy!  For group 13, this module was their first time in a clinical situation.  Many of the students had never performed real life hands-on care for a patient before.  Over the last five weeks I have seen these students grow with confidence and ability.  Many of the students are finding out that the clinical rotation just doesn’t teach patient care, it also incorporates a good work ethic.  They are learning the value of good communication skills, working with multiple disciplinary teams (physical therapy, dietary, social service, etc) and how to prioritize their assignment.

We are half-way through the module, and it’s time for the six-week evaluations for our LVN students at Gurnick Academy. All faculty and students must participate to follow up on our VN students’ academic progress. This means, the instructors are completing evaluation sheets to establish the academic and practical standing of each student.

What a great idea this is! Each of our nursing students will find out from the teachers, where they are in terms of their grades and overall progress in our LVN program. Some of our students are only at the beginning of their journey, and have a long way ahead of them. This is their first module on the LVN program, and they are trying so hard! Some of the subjects are very new to many of them, but still fun to learn and practice. Practicing using crutches in the Clinical Skills lab, learning about the nursing process in the Fundamentals’ class, and studying for midterms in Anatomy, is not easy, but surely is interesting and involving.  Other students have been on the Nursing program for a while, and now they are half-way through their courses. For these nursing students, it is time to stay focused in their Medical Surgical Nursing and Pharmacology, as well as keep improving their skills in the Clinical Practice rotations.

Half-way through the module, we want to motivate our students to keep up the good work and work on the areas for improvement. This is the time to replenish the connectedness between students and their instructors, and to insure the continuity of high quality education.

Recently I was with a friend who was appalled with he saw someone in scrubs smoking a cigarette.  Since he knew that I taught for a LVN/LPN school, he asked me what type of education a student LVN/LPN receives in regards to the effects of smoking.  Even though a LVN/LPN program includes the effects of smoking and other carcinogens on the cardio-pulmonary and urinary system, education alone is not the only factor in promoting the health of those who want to hold down a LVN/LPN job.  At this point you might be asking, as my friend did, how many nurses do smoke?  According to the 2002 Current Population Survey (CPS) Tobacco Use Supplement, 15% of Registered Nurses smoke; 28% of Licensed Practical Nurses smoke. These are higher rates of smoking than other health care professionals, especially when compared to the rate of physician smokers.

According to the Association of Medical Colleges in the Nursing Times November 26, 2008 article, Health Study Shows Nurses Smoke More than Doctors, 1% of US doctors smoked in 2005.  The good news is that the rate of nurses who smoke is reducing.  In the November 24, 2008 Washington Post article Fewer than 1 in 10 Nurses Now Smoke, The UCLA School of Nursing study found that the rate of smoking among nurses has fallen from 33.2 percent in 1976 to 8.4 percent in 2003.  Unfortunately the November/December edition of Nursing Research states that the death rates of those who presently or those that smoked in the past are still double than that of nonsmokers.

Whether you are thinking about becoming a nurse or already a nurse you become a part of a team of health professionals.  As a team player you can ask for support, especially when it comes to improving your health.   In the Nursing Times November 26, 2008 article, Bob Smith, clinical nurse therapist in smoking cessation at South London and Maudsley NHS Foundation Trust says, “It is absolutely essential that a nurse who is helping a patient quit smoking does not smoke themselves because their help may not appear genuine.” Since stress is a big reason for smoking, student nurses can start on the right track by working together to creatively introduce stress management into their life to promote a healthy life for themselves and their patients.

Eating out at a taco shop can seem mundane until you notice that someone sitting next to you begins to choke and turn blue.  For the lay person without medical training from a LVN/LPN program, the thought of someone choking can be frightening.  One of the many benefits about becoming a LVN/LPN is that all LVN/LPN students must be trained in Cardiopulmonary Resuscitation (CPR).  In addition, healthcare facilities usually require nurses to be recertified in CPR every 2 years to be updated on the latest resuscitation methods.  Just in the last 3 years the amount of chest compressions has increased in ratio to the breaths. Some LVN/LPN schools, such as Gurnick Academy of Medical arts offers CPR training onsite for their nursing students.  Not all CPR courses are the same.  When taking a CPR course find out which CPR guidelines are taught in their program.

To be safe look for CPR certification agencies that follow the recommendations of the American Red Cross and American Heart Association for both CPR and AED techniques.  Just imagine what would happen if in a hospital everyone involved in a “code” received different CPR guidelines; not only that but what if they did not stay current on the latest techniques. Becoming an effective LVN/LPN and working safely in a LVN/LPN job requires receiving the most current information.  This leads us to the next question,“Where does one attend a reputable CPR recertification classes?” It may be tempting to take an online course or a one-hour quick course, but how much will you learn and retain without actually having sufficient practice time doing CPR on mannequins?

Another consideration is to find out if you will be able to practice the Heimlich maneuver, use an automatic external defibrillator (AED), as well as practice CPR on different size mannequins to resemble the adult, child and infant. You might receive training in adult CPR and mistakenly think you are proficient in CPR until you come to the aid of an infant choking or drowning, which requires a different technique.  The BLS Healthcare Provider Course, which is designed to provide the LVN/LPN student and a wide variety of healthcare professionals the ability to provide CPR, use an AED, and relieve choking in a safe, timely and effective manner. Even if you are not yet a nurse, this course can also be taken by nonlicensed healthcare professionals, and can prepare you for a variety of life-threatening emergencies.