Medical Training

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?

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.

Today, I had a great opportunity to meet with the Concord campus faculty of Gurnick Academy of Medical Arts. What a wonderful group they are! I was invited to give a presentation on the effective teaching methods for the didactic and clinical instructors. The meeting was very interactive, as the faculty members started asking questions and making comments, and the excitement of the event was present in the air.

As I was standing in front of this lively, intelligent group, I thought to myself: “What a wonderful idea to have faculty of different campuses interact with each other like this!” If anyone benefits from such interaction, it is our LVN students! It’s true! When working with an accelerated LVN programs, instructors have to work together, presenting a united front, when it comes to developing successful teaching methods and training techniques. Not only we get to “vent” about our problems in teaching, but we also find out the approaches of other teachers to certain challenges. And sometimes, we get to learn something completely unexpected and refreshing, leading to “Aha!” moments of our own, when we move outside of our comfortable boxes and look at what other instructors are doing.

I am proud to be a part of Gurnick Academy, who is promoting such interaction between the VN School faculties. Instructors get to learn from each other, share their concerns, experiences, and expertise with each other, making our LVN school stronger and more successful.

Years ago when I became a LVN, I was pleasantly surprised to know that nutrition was one of the required courses to become a LVN/LPN.  Fortunately nutrition is still being taught in LVN/LPN schools with a minimum requirement of 32 theory hours in California.  The significance of good nutrition and health was even conveyed back in the days of Hippocrates (460-370 BC) who was the father of medicine known to say, “Let thy food be thy medicine, and thy medicine be thy food.” Today LVN/LPN students learn about the basic principles of nutrition to create a foundation for learning about the functions of protein, carbohydrates, fats and water.

With this knowledge the LVN/LPN may be the first one to notice that their patient is not eating adequate amounts of protein, which is essential for their patient’s wounds to heal and tissue to grow.  In addition, carbohydrates, such as glucose is essential for the brain to function, as this is the brain’s fuel.  Patients are sometimes not permitted to eat food prior to diagnostic tests and surgery.   This time of fasting can be very dangerous when the lack of food disrupts the blood sugar level and nutrients.  A patient may become disoriented and confused by having their diet withheld too long.  Fortunately for the patient, the nurse acts as a detective by keeping an eye out for all contributing factors that can be managed to prevent further problems with their patient.  Nutritional needs not only vary with different diagnosis, but also throughout the lifespan.

So you finished going to an LVN school in California and you are wondering, “That was a lot of work, but what can I do with this LVN certification?” Well, first of all, think back to when you made the decision to become a nurse in the first place. Did you want to help people? If so, in what way?  Maybe you took care of a family member who was sick at home and you thought that was something you could do as a career.  Maybe it’s a career change because you wanted to be an advocate for people who are disabled or in capacitated due to illness.  Once you remember the initial reason for your becoming an LVN, you can explore possibilities and options available.  If you like children, look into hospitals, clinics, home health care, pediatric hospice, or maybe school nursing.  You liked the technology and machines, look into the companies who made them and give them a call.  They use nurses to help teach others how to use them and to sell them.  This could be a lot of fun.  If you happen to like the excitement and the adrenaline rush of thinking on your feet and acting quickly and yet not get too emotionally involved with the patient, then maybe emergency room nursing is for you.  It’s a very fast paced area to work.  If you do like working with people, the patients and other health care providers, then bedside nursing is great.  You have 8 or 10 or 12 hour shifts where you will see the patient throughout those hours.  And within that area are several specialties, such as geriatrics, that is working with the elderly.  You could work at skilled nursing facilities, rehabilitation centers, day care facilities, or some retirement homes have need of nurses. Sometimes you have to think outside of the box when considering where to work. Large manufacturing companies often have on-site nurses, sporting facilities where professional athletes play, camp nursing would allow one to be outside and work with either healthy or special populations (asthmatics, cancer patients, etc), and working in the prison system.  Prisoners get sick or already were, so there is another special area of care.

Do you enjoy seeing other parts of the country or even the world?  Travel nursing is an exciting field.  Many nursing magazines have advertisements for travel nurses.  You get to experience living in another part of the country, learning about their culture and beliefs, maybe even a different language.

Registry nursing is a challenging area to be.  Here you would work within a company who would send you out to appropriate places to work.  It could be one-to-one nursing in someone’s home, or possibly working in a hospital, or even giving out flu shots at the local drug store, constantly changing environments with new people.

LVN’s also can become instructors and teach other students to become LVNs.  But, with all these areas of nursing, you have to do research and find out more about it.  Some areas will only accept registered nurses; that is why you have to ask more questions. Sometimes you have to explore further from the cities to find where an LVN can work, but the jobs are out there.