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.

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.

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.

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.

When we, the faculty at Gurnick Academy of Medical Arts, tell our students “we are here for you,” we actually mean it. Yes, it’s true, our LVN students have to work very hard toward their degree, and no, we do not “sell” the diplomas for the tuition fees. Our nursing students have to put a lot of work and their time into their studies to get the right to become a Licensed Vocational Nurse. However, when it comes to helping our students achieve their goal in education and becoming a healthcare professional, we stand behind them one hundred percent.

So, when LVN program students express their opinion on assignments given in class and at home, we listen to what they have to say. Everyone has a voice and deserves to be heard and considered. We do want to know, what works for our students, what learning techniques are the most useful in achieving maximum results, and which methods may need to be retired. This way, we get maximum student satisfaction, and yet the highest results in academic success. It is possible to get both: high students satisfaction scores for our school, and high NCLEX scores from our graduates. We push them hard, but we push them wisely. After all, we are here for them primarily. So whatever they have to say, we do listen , and we to hear.

Well we are back to school and it’s time to buckle up, study hard and enjoy the now. And I do mean enjoy the now. This time for knowledge, learned by both LVN courses and practical hands-on experience, is an important leap towards furthering your education and ultimately holding that coveted license as a Vocational Nurse (LPN Licensed Practical Nurse.

For my clinical students this is their first time for what we term as patient care with “real patients.”  The students are now interacting with real time and place situations in the process of becoming a fluent and valuable LVN of the future.  Here are a few of the skills which you must acquire during this critical and fulfilling portion of your clinical studies:

Patient Care:
A. Vital Signs
B. Wound care and treatments
C. Foley care and insertion
D. Collection of urine specimens
E. Removal of surgical staples
F. Develop critical thinking
G. Develop leadership skills

These skills must be obtained and made ready for the call of your new sought-after profession as a Licensed Vocational Nurse.  Be proud of those letters LVN and keep those letters always at the forefront of your day.  Remember it’s a journey and every journey begins with one step forward.