Medical Training

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 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.

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.

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.

Each student at a LVN or LPN school learns about nursing care for all stages of life including childbirth and infancy.  During this phase of life, some nurses have a credential to provide greater assistance for the lactating mother and baby.  There is even an association, The International Lactation Consultant Association (ILCA), which has over 5,000 members in 50 nations for the International Board Certified Lactation Consultants (IBCLCs). Nurses, midwives, and physicians are not the only health professionals allowed to become certified as a Lactation Consultants.

This specialty also encourages childbirth educators, dietitians, and other health professionals to apply for certification.  The role of a lactation consultant is far more in-depth than just helping the new mother breastfeed.  According to Valerie Banarie, RN, BSN, CLC from Breastingfeeding.com, Lactation Consultants can address the following breast-feeding challenges: infant latch-on problems, sore nipples, infant’s rapid weight loss or slow weight gain, insufficient breast- milk, and twin infants.

If a LVN or LPN wants to specialize in the clinical management of breastfeeding there are several health care settings that can utilize their expertise.  According to the ILCA (www.ilca.org), Lactation Consultants can work in “…hospitals, pediatric offices, public health clinics, and private practice.” For those that want to address global health, the ILCA with UNICEF and the World Health Organization (WHO), provides representatives to organizations including the World Health Assembly and United Nations.

Have you heard about first lady Michelle Obama’s campaign Let’s Move to solve the epidemic of childhood obesity within a generation?  The Let’s Move website states, “…only a third of high school students get the recommended levels of physical activity.” According to the Centers for Disease and Prevention, “Aerobic activity should make up most of your child’s 60 or more minutes of physical activity each day. This can include either moderate-intensity aerobic activity, such as brisk walking, or vigorous-intensity activity, such as running [at least 3 times per week].”  One of the ways to make exercise a part of your life at any age is to sign up for the Active Lifestyle Program.

This program site is located at www.presidentschallenge.org and is a part of the President’s Council on Fitness, Sports and Nutrition (PCFSN). The PCFSN’s mission is to engage, educate and empower all Americans across the lifespan to adopt a healthy lifestyle that includes both regular physical activity and good nutrition.  The Active Lifestyle Program can be a helpful tool for nurses, especially since the LVN / LPN already assists with setting realistic goals and encouraging fitness in their patient’s lifestyle plan.

Nursing students learn about the importance of movement at any age, including the curriculum taught in LPN programs.  Nursing schools, such as a LPN school addresses the concerns for physical movement with their patients to facilitate the body to heal and prevent further complications, such as blood clots and respiratory infections.  Check out www.letsmove.gov for more information about the importance of exercise and how to promote exercise toward a healthier life.

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.