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.

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.

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.

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).

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.

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.

-by Leora Bar-Din

Vocational nursing programs prepare students to work as LVN’s (Licensed Vocational Nurses.)  An LPN school (LPN training or LPN program) is the same as LVN school (LVN training or LVN program).  The only difference is the state in which you practice.  In California and Texas, these nurses are called licensed vocational nurses or LVN’s.   In all other states they are called licensed practical nurses or LPN’s.

Current Module 1 students—LVN students in Group 13 (AM class) and Group 14 (PM class) are on a steep learning curve.  They have made the transition from the two-day per week LVN prerequisite class to a five-day per week LVN program.  Students have begun to successfully readjust their lives to make room for this program and the time, study and focus it requires.  LVN students in Module 1 are studying Anatomy and Physiology, Clinical Nutrition, Clinical Lab and Fundamentals of Nursing.  All classes are one day per week except Fundamentals of Nursing, which is two days per week.  Anatomy and Physiology is straight-ahead science, and memorization works well as a method of study.  Fundamentals of Nursing and Clinical Nutrition expose LVN students to the way nurses problem-solve: critical thinking.   Recognizing and practicing critical thinking is an intellectually stimulating endeavor!

Current Module 3 students—LVN students in Groups 11 (AM class) and Group 12 (PM class) study Medical Surgical Nursing two-days per week, Pharmacology one-day per week and spend two-days per week at their clinical internship site.  They are studying in depth about each client on the clinical floor, as well as practicing and demonstrating their proficiency in nursing skills and procedures.   Critical thinking is a part of everything these LVN students do, and they are demonstrating increased proficiency in creative problem solving.