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!

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.

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.

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.

As my LVN students study and fill their mind with new facts and data, they are also being taught how to become more sensitive to their patient during the physical tasks of lifting & transferring patients from a bed to wheelchair and stretcher, as well as pushing wheelchairs and stretchers.  Inside the LVN/LPN schools skill lab the students practice these skills and more while using their classmate and mannequins to substitute as a patient. One of the skills to master is “breaking the patient’s fall.”  The word “break” may sound as if they are breaking their own back to protect the patient, but rest assure that this is a safe technique that the students learn to allow their patient to slide down the student nurse’s leg to the floor, instead of a fatal fall to the floor.

The LVN Nursing students have both clinical instructor and their illustrated textbook with detailed steps to guide them down the safe path.  Along with practicing these steps, they themselves get to experience being a patient who is dependent upon someone else for transferring from one place to another.  Instead of choosing when and having the ability to jump out of bed, sit on a toilet, and freely ambulate down the hallway, the students sit in wheelchair waiting for another student nurse to push them through the handicapped-bathroom doorway and then transfer them onto the toilet.  Don’t worry, even though we want our nursing students to experience being a hospital patient the students keep their clothes on.

Soon after a student nurse experienced being a patient in a wheelchair she stated, “It’s the little things that matter.” She was referring to her classmate’s attentiveness to her as he pushed her in a wheelchair outside and avoided the hot sun, kept an even pace, and not once jeopardized injury to her limbs.  This was her positive experience after she had pushed him around in the wheelchair.  Another example of how valuable being the patient is to learning a skill is when students take turns being lifted/transferred from one hospital bed to another.  I can always tell who has never experienced being the patient before, as their eyes get big and sometimes even let out a scream as they are temporarily air-born during their transfer from one bed to another.  These valuable lessons that heighten one’s awareness require first-hand experience as they cannot be fully taught by a textbook or lecture alone.  Hopefully memories of being the “patient” will carry over to their LVN/LPN job to remind them of the importance of being sensitive to their patient.

Parts of the LVN clinical training in Module 4 is that LPN licensed practical nursing students are scheduled to participate in various field trips throughout the Bay Area.  There are scheduled field trips to HeadStart, Martin Luther King, Jr. Preschool, Lynn Center, California Medical Facility in Vacaville, John Muir Medical Center and Sonoma Developmental Center.  These scheduled field trips during LVN courses are done to enhance the knowledge and experience of our students and thus better prepare them to be the best nurses they can be.  One of our field trips for Group 11 was to go to the Napa Coroner’s Office to observe an autopsy.

On July 16th Group 11 drove to the Napa Valley eager to have a life altering experience.  Students were anxious with cold, sweaty palms but also excited to experience the unknown.  We were welcomed by the Deputy Sheriff who gave us a nice tour of the facility and told us that there were two autopsies scheduled for that morning: a 25 year-old male and a 58 year-old female.  The Deputy Sheriff was explained that these two cases will be good experience for the students, as they will be able to see a variety of cases in one day.  We were briefed by the Deputy Sheriff as to what to expect and what was expected of us, but nothing could really prepare us for what we saw.

Our Clinical Coordinator, Nancye Maffei, handed out the Personal Protective Equipment (PPE) and instructed us to put it on.   As we put it on, we began to wonder why we needed this level of protection to observe an autopsy.  Nancye told us that during previous autopsies the pathologist allowed students to touch and hold human organs.  Experience from previous classes also taught us that there is the risk of exposure to clothing and skin.

We were told if we could not stand the smell or being that close to a dead body we could always stand behind the glass window in the other room.  As we were guided inside the coroner’s laboratory you could feel the cool breeze and the absolute absence of noise.  As the metal gurney was wheeled in with a closed body bag, reality started to kick in.  When the pathologist opened the zipper of the body bag we could feel the anxious, tense feelings of the students in the room.

The Pathologist (as well as all of the staff) was very accommodating to the Gurnick Academy of Medical Arts LVN students.  As he proceeded the pathologist told us exactly what he was doing.  The experience was very overwhelming to the students but it definitely taught them a lot about human anatomy and physiology.  For most LVN students it was the first time they had seen a human brain, heart, lungs, larynx, stomach, kidney, liver, thyroid, spleen and other organs.  It was an experience we will remember.