Archive for the 'Nursing' Category

NURSES WHO TRAVEL

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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.

WHAT IS THE PATIENT’S STORY?

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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.

Q-TIPs for Stress Management for the LVN/LPN

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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.”

Clinical Instructor

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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.

Our pride!

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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!

Only a few weeks ago, at their graduation walk, our VN students of groups 16 and 17, were shedding tears of happiness during the pinning ceremony. Their voices were shaking, as the class representatives gave their speeches with thanks to the LVN schools, and encouragement to their peers. Friends and family, full of pride and joy, came to support and congratulate the new soon-to-become LVN’s. Now that so many of them have passed their HESI exam, they will be on the way to the real board examination, and we believe, we know, they will not let us down. Our hearts and blessings will be with them as they go on. They are our pride.

We are ahead of the game now!

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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?

LVN/LPN STUDENTS LEARN WHAT TO DO WHEN THE PAITENT SAYS, NO!

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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.

They are watching you!

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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.

The first thing I instruct my students on when they report to clinical is “you will only get out of clinical what you put in.”  They are learning the true meaning behind that saying.  Not only are the students learning their practical skills, the nursing staff is also watching them.  The LVN nursing staff is looking for potential new hires.  The nursing staff has the opportunity to see how the students interact with patients and other staff before they hire them. So remember students, you are not only being watch by your instructor, the staff is evaluating you, too.

LVN/LPN as Leaders

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Yes, it is true that the Licensed Vocational Nurse and Practical Nurse are trained in
LVN/LPN programs to become leaders.  In fact, during the last module or semester of training the LVN/LPN student commonly has the opportunity to become a team leader.  A team leader of a nursing unit is usually in charge of one section of the facility or nursing station.  During the extensive clinical training at both the LVN/LPN school’s clinical lab, and at skilled nursing facilities or hospitals, the student nurse gradually increases their duties, responsibilities and the amount of patients to care for.  Prior to graduation the student becomes a team leader to draw from both their clinical and theory education to manage the care of their patients and delegate nursing duties to their assigned team of student nurses.

While the team leader administers the medication, the team leader delegates to the team members to perform dressing changes, glucose finger sticks, bath care, vital signs, and other nursing duties.  The team leader’s assignment may appear to have the lightest load, but even if the leader has thoroughly planned their day, they still need to allow time for the unexpected.  In fact there is a phrase in nursing, “Always be prepared for the code,” which refers to the unforeseen events that can occur to even the most organized nurse.

Some students refer to the first day of being a team leader as being similar to the experience the first day working in a new job; filled with anxiety and anticipation. Fortunately it doesn’t take long before the student blossoms into a leader.  They not only learn more about the nursing profession, but most importantly learn about themselves as they practice leading a group.  To gain feedback about their leadership qualities, they are evaluated by their clinical instructor, each team member, and complete a self-evaluation.    The evaluations bring out both their strengths and weaknesses, which offers the student nurse valuable information to make adjustments and become a more organized and prepared nurse and leader.

Half-way through

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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.