Medical Training

Surely you have read ads from people wanting to find the best caretaker for their loved one, but have you ever seen an ad requesting a caretaker for a nurse?  During a recent bout of food poisoning I found myself asking, “Who would I call if I needed a caretaker?”  Fortunately my husband was there to assist me until he realized that maybe it was time to call 911.  In my delirium I pleaded to “tough it out” at home.  Looking back I realize that just because I have the title of a nurse doesn’t mean I can always take care of myself or make wise decisions about my illness.

As the students in a LVN and LPN school train to become a LPN or LVN the focus is on the care of others more than self.  The LVN or LPN job requires that they be prepared for the ultimate “code.” When it comes to you as the nurse, prospective or attending nursing student, who would you call to make decisions about your care?  To prepare in advance, you can fill out a type of Advanced Directive, known as a Living Will or Health Care Directive.  For ease you can fill one out online at legacywriter.com, and make sure you check the current laws about these directives in the state you live in.

These directives pertain more to whether you want artificial life support and some other treatments when you are unable to make those decisions.  I recommend making your own “care plan of action” in advance that lists the people, who you both trust and have medical knowledge when you can not get a hold of your own healthcare provider.  These people might just be in your own neighborhood to assist you before you are on your death-bed.  For myself, I was able to remember my former neighbor’s name, who used to have her own medical practice.  She was able to give us much needed advice, which contributed to my fast recovery and a happy ending.

As we head into the last weeks of the current module, our students are looking forward to a well-earned 2-week summer break.  Students in groups 11 and 12, who are currently in Module 3, have been studying Medical Surgical Nursing and Pharmacology for 22 weeks straight (as there is no break between Module 2 and Module 3), and they are feeling it.  They are also feeling more accomplished and comfortable in their student-nurse role, and all that it entails.  Students in Groups 13 and 14 are finishing up Module 1, and looking forward to beginning the clinical internships at various skilled nursing centers in the Concord area.  They have also made strides in becoming capable student nurses as they continue their education and training at Gurnick Academy.

We are looking forward to our new batch of LVN and PT students scheduled to begin their prerequisite class on July 6th.  The VN/PT prerequisite class, Essential Medical Bioscience, includes an introduction to anatomy and physiology, as well as introductory study of medical terminology and drug calculations.  For those that haven’t practiced math since high school, manipulating fractions, decimals and metric conversions can be challenging.  But through steady practice, most all students are successful in mastering the drug calculation skills necessary for becoming an LVN.

Our students come from a variety of backgrounds when they enter the LVN program.  Some are Certified Nursing Assistants furthering their career in health care.  For these students the practice of patient transfer and general approach to patient care is familiar.  For these students, however, the training and education to become an LVN usually involves “unlearning” their role as a CNA.  The approach to the patient or client as an LVN requires a deeper level of critical thinking and analysis of client data.  Beginning with obtaining vital signs, the CNA turned LVN student recognizes not just abnormalities, but takes the VN student into the realm of, “why is this happening?”  More education in anatomy, physiology and critical thinking enables the CNA turned LVN student to begin to think like a nurse.

While attending and celebrating the 30th American Holistic Nurses Association (AHNA) annual conference with 500 nurses, we also acknowledged both the International Year of the Nurse and the Centennial of Florence Nightingale’s death.  The setting for this momentous occasion was in Colorado Springs, Colorado, which offered views of both flat land to the east and rugged mountains to the west.  This approprié location enhanced the messages from our keynote speakers, Jean Watson, PhD, RN, AHN-BC, FAAN and Janet Quinn, PhD, RN, FAAN as they increased our awareness of how far nurses have come since Nightingale’s influence on nursing.

This year with the coming together of nurses, whether they are a LVN, LPN or RN, we have the support to emerge forward in our profession.  Quinn displayed the stages of the butterfly metamorphosis to depict the stages of our nursing profession.  For years nursing programs, including LVN and LPN programs facilitate the transformation from nursing student to nurse.  Today the veteran-nurses, as well as the new-graduate nurses, are encouraged to transform from the struggle of a 100-year chrysalis stage to unite as emerging butterflies.  Janet used the analogy of butterflies to symbolize nurses, and gardens to symbolize hospitals that support the nurse.

Quinn suggests that instead of buying or transporting more nurses to fill nursing positions in hospitals, build healing habitats within a hospital, similar to building a garden to attract and sustain the life of butterflies.  This is an exciting time to be a nurse, and especially for those entering RN, LVN, or LPN schools to become a part of this year’s AHNA conference theme, “Re-Visioning Environment: Creating a Habitat for Healing.”For more information about the AHNA conference refer to www.ahna.org

Have you heard about the Bodies Revealed exhibit?  This exhibit’s title is aptly named as it reveals not only how the body works beneath the skin, but also stimulates the viewer to see themselves in ways they may never have imagined.  This summer, our LVN program students and their instructors will have the opportunity to learn about various systems of the human body and their interrelated functions as they view two hundred organs and fourteen plasticized human bodies.

Instead of learning about anatomy in a cadaver lab reeking of noxious formaldehyde or limited to the four walls of a LVN classroom, the students will enhance their LVN education with a three-dimensional walking tour to see the effects of disease and unhealthy lifestyles on the body. By witnessing the effects of disease the students will naturally turn inward taking an introspective look at their own life style and choices, and, hopefully, be inspired and motivated to care for their own bodies.  Moreover, if you’re feeling a little uneasy reading about the students examining real dead bodies, imagine the advantage to the student nurse.

Instead the overwhelming feelings that might be stimulated upon experiencing the death of a patient for the first time, the students can begin to address their own feelings about death and dying as they walk through the cell-phone-off corridors of the museum. This will be an experience they will probably never forget.

The rights I am referring to are not professional rights, and not even the “five rights” of medication administration.  Instead a new set of rights are emerging, called the “Five Rights of Humor Administration.”  After reading an article in CE Express by Western Schools 2010 “Infusing Humor Into Healthcare” by Enid A. Schwartz, RN, MS, MC, I suspect students will read about these “rights” in future LVN school textbooks.  Schwartz states that the “rights” of using humor…[include:] the right patient, the right type of humor, the right time, the right amount of humor, and the right route or form of humor.” When checking the “right patient” the author emphasizes the importance of being sensitive and “for some patients, humor is inappropriate or unhelpful.

As a nurse I can not imagine telling a “knock-knock” joke to someone who is just coming out of anesthesia.  Not only would that be the “wrong patient” but also not the “right type” nor “right time” for humor.  The “right amount” of humor might not be as obvious to know.  I guess if you start to sound like a stand-up comic spouting off one-liners you have gone too far.  Then there is the “right route or form;” I recall a pediatric nurse, who instead of telling jokes, was great at imitating voices.  He could give instructions and reassurance as John Wayne or Mickey Mouse and have his patients laughing during what could have been a challenging procedure.  One of the reasons I enjoy being a part of the Gurnick Academy of Medical Arts – LVN program is how we value humor and without knowing it are already utilizing these “five rights.”

What happens to you when someone asks, “Did you hear about …?” Do you reactwith excitement or dread?  If it is dread that you experience, you are probably expecting to hear gossip or be part of what is called, “triangulation.”  Triangulation refers to the triangular shape, as one easily moves outward to one of the 3 points.  In other words, as you listen to your friend speak about someone, you suddenly become connected to the speaker (gossiper). This then triangulates the absent party turning them into the “outsider” or “target. “Whether you are already a LVN in California or a student in a LVN program, you have probably encountered the challenge to both listen to gossip while trying to hold onto your professional values. This scenario sounds like the challenge of riding a donkey while drinking from a crystal goblet, eventually you will only be able to hold onto one, or you will fall off the donkey and break the glass.   By now you might be wondering why people gossip?  According to Anne Katherine, MA, author of “Where to Draw the Line,” she says that gossip can be used to discharge feelings.  Pathetically instead of directly communicating feelings and unmet needs to someone, the suppressed feelings are funneled indirectly with gossip, and leads to mistrust and a fragmented community.  One way to keep your LVN programs or community free from the negative effects of gossip is to stop “the donkey” in its tracks by asking the following:

Will this conversation later be shared directly with the absent party?

Does this conversation bring clarity?

Does this conversation compromise needs such as, mutual respect, trust, or emotional safety?

If your answer to any or all of the questions above is “No,” then protect your “chalice of values” by becoming a compassionate nurse.

What would you do if you were asked to change the way you look at things, not just for a day, but for one whole month?  Would you do it? Today the Modesto faculty at Gurnick Academy of Medical Arts did just that – they took on the challenge to change. Their quest consists of wearing a purple bracelet made by Complaint Free World to remind them that when they gossip or are part of a triangulation, they are to move their bracelet from one wrist to the other.  This bracelet is much more than something colorful; hopefully this new attire will bring more awareness and allow time to change the way they want to look at things.  Awareness is the first step to change.  When we force ourselves to change, we usually meet resistance.

The thirty-day challenge allows for time to integrate this transition.  According to Wayne Dyer, Ph.D., internationally renowned author and speaker in the field of self-development, “If you change the way you look at things, the things you look at change.”  I challenge all faculty of LVN and LPN schools to become models to their LVN/LPN students.  LVN/LPN programs can be the foundation for creating this transformation.  Together we can become a positive contagion to the nursing profession by being a living example of respectful teamwork.

As an instructor for an LVN program, we know how important laughter is, when it comes to learning. Imagine, the first day of class, nervous brand new LVN students are anxiously waiting at their desks to discover what kind of teacher their new instructor will be. Will this be a demanding “prima donna,” or a tyrant and a monster, or perhaps, an easy-going pushover?  Will this instructor burry them under mounds of homework, or will she expect them to absorb and regurgitate every word she speaks, or will she be easy-going, for an “easy A?” …Probably, not.

As the class begins, it starts with a joke, something related to the field of healthcare, or maybe the teacher making fun of herself, making a quick humorous remark at her own expense. And suddenly something magical happens: a smile breaks out on a worried face, and the tense wrinkle between the eyebrows disappears, nervous grimace is replaced by a friendly warmth in the eyes of a student. Now, we are ready to learn.

It is absolutely essential for our LVN students, as well as any other students, to be at ease, when coming to class. Tension is one of the enemies of effective learning. A nervous student is less receptive to new information, less responsive to the learning environment, and more prone to failing. This goes back to the Maslow’s Hierarchy of Needs: the need to feel safe is much more important than the need for learning and self-actualization. The need for our LVN students to feel that they are in a safe place, where they will not be attacked, but rather can express their needs, feelings, and concerns, is vital to successful learning environment.

This is why here, at Gurnick Academy of Medical Arts, we make sure, our students feel exactly this way. This is why on the first day of class, the instructor makes an announcement that the very first course our new students are taking will start with a special event, where everyone has to bring a food item and a joke to share with their new classmates. Laughter is the first thing that can put anyone at ease in an instant. If you can laugh with someone, they momentarily become your buddy, and you are no longer so worried about making friends with complete strangers.

Yes, here, at Gurnick academy, we believe that laughter brings people together, making us closer to each other, helping us learn from each other and get along. After all, this is what we all want: to find our own place in this world and to get along with others. Only then, we can strive for higher heights, and attempt to achieve more. Only then we can truly live, as we laugh, and learn.

F. Gardiner’s Article “Why We Must Change: The Research Evidence” raises a number of very important questions concerning modern college education system.As an LVN program, we provide education to adults with at least high school level of knowledge, and therefore, the level equivalent to college level. In fact, being a degree-granting LVN program, we consider our LVN school as college-level institution. And teaching at this level, we must bring up the appropriate questions about reaching out and getting through to our Nursing students. Do they learn what we teach them?
Apparently, based on the most recent research completed at multiple universities and colleges  on teaching techniques, methods of information delivery, and students’ retention of information, how we teach is not necessarily is how the students learn.

In particular, many teachers employ the method of delivery that requires mere memorization and regurgitation of information. The larger the class size, the less thinking is expected and required of the students, and the more simple recall of information taught. The studies show that students in classes of medium size (20-45 students) are more oriented toward comprehension of the material, and in the small classes (15 students or fewer) the students were able to analyze and integrate the information taught.

Moreover, a very small percent of undergraduate students (only 14%) were ever taught how to study. And when later surveyed on course material retention, in the best cases it was only up to 50%, and in most cases it was as low at 20% of the material taught. So, only one fifth of what we teach, spend so much time and effort on, is retained by our students. Clearly, something needs to change in our education system.If the students retain only one fifth of the lecture, what happens to the rest of the information given to them over the time frame of a course? And why are the retention rates so low?

The answer is simple: the students are not thinking during lecture. What are they doing during lecture, if not thinking? Only about fifty percent of the lecture they are asking or answering questions, or taking notes, the rest of the time, their attention drifts. In fact, science shows that if the student does not stay involved, actively participating in the process of learning, their attention wanders off the subject within 10-15 minutes of the beginning of the lecture, and up to 15 % of the lecture time is spent in day-dreaming!

So, how do we improve the education system for our LVN students? to improve LVN certification. Do we need to change the course curricula or change methods of presentation? Maybe so. However, it is absolutely vital to the process to do everything to retain the attention of the students by keeping them involved in the learning process. Learning is effective only when it is active. The information will be retained, only when thoroughly understood, and it will be understood only if the students come to discover that information on their own.

This coming weekend we are celebrating the National Memorial Day, when we honor all those who did not come back home, giving their lives for our freedom and our chance for a bright future. Along with all those soldiers who never returned, and stayed laying dead on the battlefields, we also remember all the nurses who so selflessly gave up their lives, while saving the lives of others. We are celebrating the heroes who attended the wounded and the dying, risking their own lives. We are celebrating every male and female nurse, who had ever been through the horrors of war from Florence Nightingale, “The Lady with The Lamp,” as she helped sick and wounded soldiers during Crimean War over a century and a half ago to those nurses helping our troops these days in the Middle East and all over the world.

After an exhausting, gory fight, and the flames would die down, a few lone small figures would come out to the battle field, covered with the bodies of the army warriors who had fallen during the attack, to seek out those who are still breathing and alive, trying to save every precious life. At great risk to themselves these brave souls would put the wounded soldiers’ bodies on their fragile petite shoulders to take them to safety and provide necessary medical care. And when a dying soldier’s condition would be beyond medical help, and nothing could be done for the man, a nurse would comfort him by saying a prayer or singing a song, or even writing the last letter to his mother or the girl waiting at home. So many of those brave big hearts in tiny bodies in white gave up their lives while saving the wounded soldiers!

Today, every LVN school in California should remember those nurses, who never came back. We honor those nurses who left behind their loved ones at home: their children, brothers, sisters, husbands, wives, their families. We admire what those nurses did in their time for their country and for their people. And when our time comes, we take that Florence Nightingale’s pledge to help those in need, and to selflessly serve, as all the ones before us did.

As any LVN college, we raise our future LVN nurses to be caring and compassionate persons, going into the future ready not only to fulfill their career goals, but also to fulfill their calling for helping others. We are certain that if there is need, our LVN graduates will go out there and be heroes, just like many hero nurses before them. They will never be forgotten, and we can only hope to live up to them.