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.

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.

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.

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.

If you attended this weekend’s graduation ceremony of our VN group 17 and 18, class of 2010, you, probably, would have cried too. Tears of joy of making it to this long-anticipated day, filled with bitter-sweet memories and good-byes, tears of happiness and pride were rolling down the cheeks of our LVN students and faculty. Smiles were on every face, and no heart was left untouched.Following the heartrending Amazing Grace, the speeches of our VN program director and program coordinator, the beloved instructors and counselor, touched the hearts of the graduates and their families, who came to support and celebrate this special day for Gurnick Academy.

When the time came to light those candles and to pronounce the famous Florence Nightingale Pledge, the faces of our graduates lit up. It was not just the glow of the candles, but the deep, sincere belief in every word of the oath they were taking and the pride and devotion in becoming nurses that kindled the radiance on those faces. Oh, how pure that moment was! The distribution of the diplomas and the pinning of each student by their family members: husbands, wives, parents, or children, was simply breathtaking in the sincerity of the moment. Then the speeches by the student body government that brought tears to the eyes of the listeners as well as the speakers themselves were followed by the ever-so-moving slide show, accompanied by song No More You, where pictures of the fun times, working and learning together, growing to be nurses, were shown to the audience.

Our LVN students have finished their studies here at Gurnick, but they will never leave our hearts. And we will always welcome them back with open arms, because no matter where they go, or where their career takes them, they will always have us: their Gurnick family. Congratulations, class of 2010! Farewell and Good Luck!

So you finished going to an LVN school in California and you are wondering, “That was a lot of work, but what can I do with this LVN certification?” Well, first of all, think back to when you made the decision to become a nurse in the first place. Did you want to help people? If so, in what way?  Maybe you took care of a family member who was sick at home and you thought that was something you could do as a career.  Maybe it’s a career change because you wanted to be an advocate for people who are disabled or in capacitated due to illness.  Once you remember the initial reason for your becoming an LVN, you can explore possibilities and options available.  If you like children, look into hospitals, clinics, home health care, pediatric hospice, or maybe school nursing.  You liked the technology and machines, look into the companies who made them and give them a call.  They use nurses to help teach others how to use them and to sell them.  This could be a lot of fun.  If you happen to like the excitement and the adrenaline rush of thinking on your feet and acting quickly and yet not get too emotionally involved with the patient, then maybe emergency room nursing is for you.  It’s a very fast paced area to work.  If you do like working with people, the patients and other health care providers, then bedside nursing is great.  You have 8 or 10 or 12 hour shifts where you will see the patient throughout those hours.  And within that area are several specialties, such as geriatrics, that is working with the elderly.  You could work at skilled nursing facilities, rehabilitation centers, day care facilities, or some retirement homes have need of nurses. Sometimes you have to think outside of the box when considering where to work. Large manufacturing companies often have on-site nurses, sporting facilities where professional athletes play, camp nursing would allow one to be outside and work with either healthy or special populations (asthmatics, cancer patients, etc), and working in the prison system.  Prisoners get sick or already were, so there is another special area of care.

Do you enjoy seeing other parts of the country or even the world?  Travel nursing is an exciting field.  Many nursing magazines have advertisements for travel nurses.  You get to experience living in another part of the country, learning about their culture and beliefs, maybe even a different language.

Registry nursing is a challenging area to be.  Here you would work within a company who would send you out to appropriate places to work.  It could be one-to-one nursing in someone’s home, or possibly working in a hospital, or even giving out flu shots at the local drug store, constantly changing environments with new people.

LVN’s also can become instructors and teach other students to become LVNs.  But, with all these areas of nursing, you have to do research and find out more about it.  Some areas will only accept registered nurses; that is why you have to ask more questions. Sometimes you have to explore further from the cities to find where an LVN can work, but the jobs are out there.