Archive for the tag: LPN Certification

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.

An important aspect of LPN training

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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.

Nutrition in the LVN/LPN program

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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.

For instance, a pregnant woman’s food intake varies throughout her pregnancy as she typically gains a total of 25-35 pounds.  It is recommended that during the first trimester the new mother is to eat an additional 150 calories more per day, and then increase an additional 350 calories per day in the second and third trimesters of pregnancy. In contrast an infant under 6 months only needs approximately 438-645 total calories for the whole day.  On the other end of the age-spectrum, is the older adult who needs less calories because their body muscle mass usually decreases with age.  According to the Dietary Guidelines For Americans 2005, a sedentary woman over 51 years of age only needs 1,600 calories per day. With diabetes and obesity on the rise in the U.S., nurses more than ever play an important role in educating the public about healthy food choices.

STANDING OUT WITH NURSING CERTIFICATES

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Have you ever read a nurse’s name badge followed by the initials “CHPLN” or “CMCN”?  These initials, along with several others, signify different types of certifications.  Even though most nursing certifications require a Registered Nurse license, there are several listed below to enhance both the opportunities of employment and the role as a LVN or LPN.  Probably the most common certification for the new LVN graduate is the Intravenous and Blood Withdrawal certificate, which in California permits the LVN to start IVs, hang certain IV fluids & blood products, and withdraw blood.

This certification requires minimal training after graduation from a LVN or LPN school. The following are certifications that can be earned by fulfilling a specified amount of nursing hours after graduating from a LVN or LPN program. To be able to apply for one of the subsequent certification board examinations, a nurse must also meet the following requirements for the specialty listed in the 2007 Career Guide from the American Journal of Nursing (http://www.nursingcenter.com/pdf.asp?AID=688269):

1) The National Board for Certification of Hospice and Palliative Nurses (www.hpna.org) offers a certification as a Certified Hospice and Palliative Nurse (CHPLN) for LVNs and LPNs that have at least 2 years of experience with Hospice and Palliative care.
2) The American Board of Managed Care Nursing (www.abmcn.org) offers a certificate as a Certified Managed Care Nurse (CMCN), which requires a current LVN or LPN license, and 1 year of full-time employment as a LVN or LPN in areas of managed care, or 2 years as an LVN or LPN  “…providing direct or indirect care in an acute care, outpatient, skilled nursing, or mental health facility or other health care organization, or as an educator or consultant; or 1 year of acceptable case management employment experience…”
3) The Certification Board for Urologic Nurses and Associates (www.suna.org) has a certificate for the LVN or LPN after 1 year of urology experience.
4) The National Certification Corporation for the Obstetric, Gynecological, and Neonatal
Nursing Specialties (www.nccnet.org) has a certificate as a Menopause Educator (ME) for currently employed and licensed LVNs and LPNs.
The National Association for Practical Nurse Education & Service, Inc. (NAPNES) (http://napnes.org/certifications/index.html) offers the following online certification examination:
The title as a Certified Long-Term Care (CLTC) “…can be obtained for those that
hold a current LP/VN license in good standing and has documentation of 2000 hours of long-term care practice within the previous three years.”

The following are certifications for Licensed Vocational Nurses who lack work experience as a licensed nurse:
1) The NAPNES Pharmacology Certificate (NCP) is not only available to currently licensed LVNs or LPNs, but also for new graduates waiting to take the NCLEX licensure examination for LP/VNs and have their LVN/LPN school program director signature on the certification application.
2) The International Board Certified Lactation Consultants (IBCLC) certificate is offered by the International Board of Lactation Consultant Examiners (IBLCE) (http://americas.iblce.org/announcing-future-requirements) According to the IBLCE, “Beginning in 2012, all first-time candidates [to be certified as a lactation consultant] will be required to have completed the following education and clinical practice experience prior to applying for the exam: 90 hours of pre-exam education in human lactation and breastfeeding and …be a [LVN]…Or have completed both of the following general education requirements:8 general education courses of one semester, or equivalent, in length [and] 6 additional continuing education subjects, and Clinical breastfeeding practice hours.”
3) The National Commission on Correctional Health Care (www.ncchc.org) offers the Certified Correctional Health Professional (CCHP) certificate for health professionals working in correctional settings
By earning one or more of these certificates the nurse will increase their opportunity to “stand out” as the one who has gone the “extra mile” to improve the standard of care in nursing today.

CLOWNS WHO CARE

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Recently while attending a nursing conference, I met a nurse, who was also a clown who enjoys visiting patients in hospitals and Long Term Care facilities.  Her “clowning around,” which is not commonly taught in nursing programs, such as a LPN program, is called “Spiritual Clowning.” Even though clowning is not a required objective in LPN schools, nurses can add to their repertoire of caring techniques by learning about the art of “clowning” in hospital settings… To my amazement there are different variations of these clowns called “Caring Clowns” and “Hospital Clowns.”

There is even an online newsletter, Hospital Clown: The Gentle Art of the Caring Clown, which has been online for the past 6 years posting articles about this growing craft.  This newsletter’s editor and publisher Shobhana Schwebke “Shobi Dobi” vividly describes her caring vocation in her article The Hospital Clown, “[As a vulnerable clown] I listen with all my heart. I call it Open Heart Listening. I hold the hands of comatose patients and hug those grieving. I have therapy sessions between a puppet and an angry child. All of it is spontaneous and in the clown’s tradition of unconditional love. When my heart is open, the whole hospital becomes one grand improvisational play.”

There is also an association called the American Association for Therapeutic Humor (AATH) that educates medical and non-medical professionals about clowning and other therapeutic-humor methods.  In the AATH June 1999 newsletter Shobi describes clowning as a calling in her article Beyond Goofy, “There is a calling to be a clown – an inner calling not unlike the priest or nun, actor or musician. It is a strong inner connection to a spirit of joy.”  Some refer to the profession of nursing or becoming a LVN/LPN as a calling.  There are many similarities between nursing and clowning with “caring” probably being the most meaningful component of both professions.

DENTAL WELLNESS FOR MENTAL ILLNESS

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A major area in nursing is addressing wellness for both the physical and mental health of patients.  Unfortunately attending to one’s mental health can be very challenging not only the patient, but also for the LVN/LPN.  Fortunately nurses, patients, and their family have a resource called the National Alliance on Mental Illness (NAMI), which addresses mental health, and has expanded by promoting health for the whole person with mental illness.NAMI has a Wellness Center at their National Convention that promotes healthy living.

The Wellness Center offers activities, advice and information including topics such as: medications, nutrition, blood pressure, smoking cessation, and dental hygiene. According to the NAMI website at www.nami.org, many people with mental illness have challenges with their teeth. Other than dental health professionals, most medical courses, such as the objectives in a LPN program are not required to have extensive dental training.  Knowing the need for further dental health education, Lisa Knapp Stillman and her sister started the Dental Voice for Mental Health.

Since 2008 Lisa and her sister represent their project with a booth at the NAMI convention’s Wellness Center. Lisa, who is both a dental hygienist and a mother of a son with severe mental illness, knows first hand how the medications that treat mental illness can deteriorate teeth.  In The Dental Voice for Mental Health in the summer 2010 issue of NAMI Voice, Stillman states that there are over 700 medications that can cause the side effect, xerostomia (dry-mouth).

Stillman describes how dry mouth impacts the whole person, “Without saliva and its emollients, a person cannot move their food around, chew or taste their food.  Saliva is essential for fighting infection and maintaining the integrity of a healthy tooth.”
Instead of using water to lubricate the mouth, Lisa recommends applying over-the-counter emollients to the mucus membranes in the mouth. Lisa hopes to take this much-needed information out to mental health care professionals.  Hopefully she will include venues, such as a LVN or LPN school to collaborate with nursing students to facilitate awareness about the Dental Voice for Mental Health to the medical community.

WHERE ARE ALL THE MEN?

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If you have ever been a patient in a hospital, you might have asked where are the male nurses?  You also may be surprised to know that the career for paid nurses started not with female, but with male nurses, and the first nursing school, which opened in India during 250 BC, only accepted male nursing students.  During the era of Hippocrates (460-370 BC), who was the father medicine, nursing care was delivered by men.  In the December 2009 article 10 Most Famous Male Nurses in History posted on Nursetini, Walt Whitman (1819-1892) is listed as one of the 10 most famous male nurses.  Whitman is famous for being a writer and poet, but it turns out that after his brother was wounded in the American Civil War, Whitman devoted both time as a volunteer nurse and writings about the need for nursing care for the soldiers.

According to the Winter 2009 AHNA Beginnings article, “Why Aren’t There More Men in Nursing?” editor Lynne Nemeth states that the Reformation era (1550-1850), which was referred to by some as the dark ages of nursing, more women were becoming hospital nurses and medical care deteriorated allowing prisoners work as nurses “…in lieu of prison terms.”  With the Industrial Revolution, which took place in mid 17th and 18th centuries, men took advantage of higher paid jobs, which excluded low-paid nursing positions.  Nemeth refers to how “Ironically it is Florence Nightingale, considered to be the founder of modern nursing, who is credited with the demise of men in nursing.”

In 1867 Nightingale wrote about how she wanted the female head nurse to have the power over nursing and not the male nurse. Despite all the positive contributions to nursing, it wasn’t until 1955 when Edward L.T. Lyon became the first male nurse in the military. According to a 2005 Men in Nursing Study by Bernard Hodes Group, men only make up between 5-6 percent of registered nurses.  Fortunately there are both men and women working together to support and educate men into the career of nursing.  If you are presently in a LVN or LPN program and want to join a nursing organization that supports male nurses, the American Holistic Nurses Association (AHNA) has a history of supporting and honoring both male and female nurses.  In 2008, the AHNA named Richard Cowling, III, RN, PHD, APRN-BC, AHN-BC the Holistic Nurse of the Year. Unlike the AHNA, the American Nurses Association (ANA) did not allow men to become members until 1940.

Whether you are thinking about becoming a male LVN, LPN, or registered nurse, read about the many resources such as the free online Male Nurse Magazine at www.malenursemagazine.com. Today there are several LVN & LPN schools, such as Gurnick Academy of Medical Arts that encourage the presence of men in nursing, and have male faculty role models.

Looking Forward to Clinical at Antioch Convalescent

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At the first meeting on the clinical site the instructor will review with you what to expect during clinical time.  I happen to know the Antioch staff is wonderful.  You will get a lot of great experience during this rotation.   The staff there has many strengths and is always helpful.  They show compassion, integrity, and teamwork.  We will be doing hands on patient care.  I love clinical nursing.  To me, being at the bedside and working with the patients is the most rewarding.  To be a good LVN clinical nurse (or LPN Licensed Practical Nurse) you have to be multi-talented.  You have you learn the best approach for each of your patients as they all have different personalities and needs.  You’ll learn about different cultures, values, and beliefs, which can be very exciting.  For example, you’re likely to encounter different languages, lifestyles, and social roles.  You will be doing patient assessments daily.  We will be reviewing clinical LVN skills (and LPN nursing) in the lab at Gurnick.  The students usually love this.  This is a great time to ask me any questions you may have.  Yes, you are to be dressed in scrubs with your hair up and ready to take notes.

At Antioch we will be doing vital signs on the patients.  We will be getting the patients out of bed, to eat dinner or go to the dining area.  The patients love to get student nurses.  You are the ones who can sit and visit with them.  Listen to their wisdom and stories of their life.  You will get to form a professional bond with your patients and their families.  This is always an honor.  As the weeks pass, you will witness progression with all your patients.  This is exciting and hopeful for everyone.
You will also be working with patient’s charts.  You will learn about the different parts of a chart.  We will be talking about the patient’s medications and lab work.  You will learn the why’s….why did the doctor order this or not order that?  What is he/she looking for?  LVN Clinical nursing and LVN courses are fun and exciting because you get to use the nursing process and learn critical thinking.

SHIFT NURSING with the CARING THEORY

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In June 2010 the American Holistic Nurses Association was blessed with having Jean Watson, PhD, RN, AHN-BC, FAAN as keynote speaker.  Mrs. Watson’s extensive biography includes her published theory of nursing “The philosophy and science of caring.”  Nursing theories are important for the student LVN or LPN to guide the way in development as a licensed nurse.  In the Spring 2010 AHNA Beginnings publication, Watson lists examples of how to implement the Caring Theory in her article Caring Science and the Next Decade of Holistic Healing: Transforming Self and System from the inside Out.  She states, “When systems begin to authentically embrace Caring Theory and its role in healing, and thus creating biogenic practices, the foundation for professional nursing shifts.

Within this article, she acknowledges the participants of International Caritas Consortium (ICC, www.cartiasconstortiu.org) for their efforts toward this nursing shift.  One of the simple examples that can be practiced not only by the ICC participants, but also in LPN schools and hospitals is hand washing.  Hand washing is not just used for cleaning our hands, but according to Watson this ritual can somehow “…energetically cleanse oneself…” which allows for “…pausing to set intention before entering a patient’s room.”

Another one of Watson’s simple, yet profound suggestions is to have magnets with positive affirmations and messages on patients’ doors.  This affirmative idea can be easily initiated by student nurses in any nursing program, including the LVN or LPN program.  One of the most intimate of Watson’s practices is to be “seeking” as we nurses look and connect to the “spirit-filled” person that might be hiding behind their diagnosis.   For more information about Jean Watson caring philosophy visit www.watsoncaringscience.org