Medical Training

Well, the Summer break is officially over at Gurnick Academy of Medical Arts, and it’s time to roll up those sleeves again and get back to work. For some of our LVN students it’s time to continue their studies, get back to those thick textbooks and get ready to take more lecture notes. They feel like the seniors of Gurnick Academy. LVN classrooms come back to life after a two-week break, and like a busy bee-hive, our LVN college is buzzing again with students hurrying to their classes, instructors walking down the hallways, locomotion in the corridors, moving desks, equipment, projectors… lights… camera… action!

And yet, though some of our nursing students are soon to graduate, others are only beginning their journey. We are talking about the LVN students who are just starting their LVN program now. This will be their first module, and they are about to take their first LVN course, the Fundamentals of Nursing. Our newcomers are about to experience their first contact with this profession, with the world of nursing, as they attend the Clinical Skills Lab course. And even though they have a long way to go to their graduation day and they may feel a little nervous right now, they are excited, because they know that they are on their way to something wonderful, stimulating, and very rewarding. Welcome back to school, Gurnick!

Our Groups 11 and 12 have just begun Module 4.  We’ve advised them even though they see the light at the end of the tunnel, they should hope it’s not a train! (LOL)  Their coursework in becoming an LVN is now covering the specialties of obstetric nursing, pediatric nursing and psychiatric nursing.  They have finished with 24 weeks (that was intense) of Medical Surgical Nursing parts 1 and 2, and Pharmacology, parts 1 and 2.  They will take their 2nd HESI exam next week, this one on Medical Surgical Nursing.

They will go on various field trips this module to Sonoma Developmental Center, John Muir Medical Center, Telecare Gladman, a psyche facility in Oakland, and California Medical Facility, the men’s prison in Vacaville which houses inmates with medical problems—they even have a hospice.  Various LVN schools in California may also have these types of clinical rotations.  Module 4 clinical will also include a day-long OB mock-up using our exciting new patient simulation lab.

They will also earn pediatric clinical hours required for becoming an LVN at Lynn Center in Pittsburg, a school for special needs children from 18 months to 5 years.  They will visit Martin Luther King, Jr. Preschool, where they observe normal growth and development as well as abnormal growth and development. They will also visit with children at the Concord HeadStart site where they will interact with children from infancy through pre-Kindergarten.  They will also spend clinical time at the Juvenile Justice Center Medical Unit in San Leandro for a combination Pediatric and Psych rotation.

Did you see the fireworks this year? Amazing! Well, they are amazing every year, actually. This year, however, for Gurnick Academy, the fireworks seem especially bright to our LVN students, who have worked so hard during this past module! Now that the Final Exams are behind, it is time to enjoy the summer break.

Yes, yes, we know, it is never long enough, and the nursing students are craving a bit longer vacation, but in this accelerated program, two weeks is all you get, if you want to finish your VN nursing degree in just one year. This is why these students come to our LVN program: fast-paced, efficient, effective, packed with information, knowledge to gain, and skills to learn in a fairly short period of time. Besides, Gurnick is the LVN school who cares about our LVN students, helping each and every one of them to succeed and make it to that ever-so-anticipated graduation day.

In just another week, it will be time to again roll up our sleeves and get back to work, but for now, it is time for romantic getaways, hanging with family, Fourth of July fireworks, barbeque, and nice weather. There is time for work, and there is time for play. You deserve a good time, Gurnick!

If you have ever been a patient in a hospital, you might have asked where are the male nurses?  You also may be surprised to know that the career for paid nurses started not with female, but with male nurses, and the first nursing school, which opened in India during 250 BC, only accepted male nursing students.  During the era of Hippocrates (460-370 BC), who was the father medicine, nursing care was delivered by men.  In the December 2009 article 10 Most Famous Male Nurses in History posted on Nursetini, Walt Whitman (1819-1892) is listed as one of the 10 most famous male nurses.  Whitman is famous for being a writer and poet, but it turns out that after his brother was wounded in the American Civil War, Whitman devoted both time as a volunteer nurse and writings about the need for nursing care for the soldiers.

According to the Winter 2009 AHNA Beginnings article, “Why Aren’t There More Men in Nursing?” editor Lynne Nemeth states that the Reformation era (1550-1850), which was referred to by some as the dark ages of nursing, more women were becoming hospital nurses and medical care deteriorated allowing prisoners work as nurses “…in lieu of prison terms.”  With the Industrial Revolution, which took place in mid 17th and 18th centuries, men took advantage of higher paid jobs, which excluded low-paid nursing positions.  Nemeth refers to how “Ironically it is Florence Nightingale, considered to be the founder of modern nursing, who is credited with the demise of men in nursing.”

In 1867 Nightingale wrote about how she wanted the female head nurse to have the power over nursing and not the male nurse. Despite all the positive contributions to nursing, it wasn’t until 1955 when Edward L.T. Lyon became the first male nurse in the military. According to a 2005 Men in Nursing Study by Bernard Hodes Group, men only make up between 5-6 percent of registered nurses.  Fortunately there are both men and women working together to support and educate men into the career of nursing.  If you are presently in a LVN or LPN program and want to join a nursing organization that supports male nurses, the American Holistic Nurses Association (AHNA) has a history of supporting and honoring both male and female nurses.  In 2008, the AHNA named Richard Cowling, III, RN, PHD, APRN-BC, AHN-BC the Holistic Nurse of the Year. Unlike the AHNA, the American Nurses Association (ANA) did not allow men to become members until 1940.

Whether you are thinking about becoming a male LVN, LPN, or registered nurse, read about the many resources such as the free online Male Nurse Magazine at www.malenursemagazine.com. Today there are several LVN & LPN schools, such as Gurnick Academy of Medical Arts that encourage the presence of men in nursing, and have male faculty role models.

In June 2010 the American Holistic Nurses Association was blessed with having Jean Watson, PhD, RN, AHN-BC, FAAN as keynote speaker.  Mrs. Watson’s extensive biography includes her published theory of nursing “The philosophy and science of caring.”  Nursing theories are important for the student LVN or LPN to guide the way in development as a licensed nurse.  In the Spring 2010 AHNA Beginnings publication, Watson lists examples of how to implement the Caring Theory in her article Caring Science and the Next Decade of Holistic Healing: Transforming Self and System from the inside Out.  She states, “When systems begin to authentically embrace Caring Theory and its role in healing, and thus creating biogenic practices, the foundation for professional nursing shifts.

Within this article, she acknowledges the participants of International Caritas Consortium (ICC, www.cartiasconstortiu.org) for their efforts toward this nursing shift.  One of the simple examples that can be practiced not only by the ICC participants, but also in LPN schools and hospitals is hand washing.  Hand washing is not just used for cleaning our hands, but according to Watson this ritual can somehow “…energetically cleanse oneself…” which allows for “…pausing to set intention before entering a patient’s room.”

Another one of Watson’s simple, yet profound suggestions is to have magnets with positive affirmations and messages on patients’ doors.  This affirmative idea can be easily initiated by student nurses in any nursing program, including the LVN or LPN program.  One of the most intimate of Watson’s practices is to be “seeking” as we nurses look and connect to the “spirit-filled” person that might be hiding behind their diagnosis.   For more information about Jean Watson caring philosophy visit www.watsoncaringscience.org

Even though students are on vacation, we are preparing for Module 4 that begins on July 6, 2010, and the admissions manager is continuing to enroll new students for the July 6th prerequisites class for VN and PT students.  Our new Radiologic Technology students continue with their ongoing program and new applicants continue to come and in and take the entrance exam and speak to our new financial manager, Camilia.  Our new Manager of Student Services, Gena, is awesome, catching on very quickly as to student life here at Gurnick Academy of Medical Arts.  She is always approachable and seems to be very happy to help anybody in any way.

Our new patient care simulators have arrived (METIman, the adult simulator; Noelle, an expectant mother; Hal, the infant she delivers, and 5 year old Hal, the pediatric simulator.)  All will be set up in the lab this week, with their computers.  The clinical coordinator is scheduling field trips and assigning students to satellite clinics such as Juvenile Justice Center in San Leandro.

We are setting up the HESI exams for the month for July for fundamentals (for Module 2 students) and medical surgical evaluation (for module 4 students.)  These exams do not count towards student grading, but enable the students to familiarize themselves with the HESI testing process.

We anticipate an exciting move to a new campus, larger and more suitable to our growing needs.  The LVN program director is continuing to work on our VN-RN bridge program.  We are also continuing the ongoing acquisition of new clinical sites to offer our students the most interesting clinical experiences in the area.

There is excitement in the air because Gurnick’s LVN students in Group 11 and 12 have their last clinical day tomorrow, Friday, June 18, 2010.  The Gurnick LVN students have been working for LVN certification and studying hard the last couple of months and they await a well needed break. The students will enjoy two weeks off before their last module starts. Many Gurnick students have discussed that even though they will not be going to class, they will start to look into the availability of LVN jobs in California.  The students are realizing that with only one more module to complete before graduation, their career in nursing is becoming a reality.

As a clinical instructor, I have seen the students grow and develop their nursing skills, critical thinking and self confidence. They are well on their way to becoming wonderful nurses. This last module they have focused on bedside care, vital signs, documentation, administrating medication, wound dressing changes and insertion of Foley catheters. Many of the students had the opportunity to remove stables and apply steri-strips to an incisions site.

For their last module, the Gurnick students in Groups 11 and 12 will be able to focus on OB/GYN, Pediatrics and Psychology.

As we head into the last weeks of the current module, our students are looking forward to a well-earned 2-week summer break.  Students in groups 11 and 12, who are currently in Module 3, have been studying Medical Surgical Nursing and Pharmacology for 22 weeks straight (as there is no break between Module 2 and Module 3), and they are feeling it.  They are also feeling more accomplished and comfortable in their student-nurse role, and all that it entails.  Students in Groups 13 and 14 are finishing up Module 1, and looking forward to beginning the clinical internships at various skilled nursing centers in the Concord area.  They have also made strides in becoming capable student nurses as they continue their education and training at Gurnick Academy.

We are looking forward to our new batch of LVN and PT students scheduled to begin their prerequisite class on July 6th.  The VN/PT prerequisite class, Essential Medical Bioscience, includes an introduction to anatomy and physiology, as well as introductory study of medical terminology and drug calculations.  For those that haven’t practiced math since high school, manipulating fractions, decimals and metric conversions can be challenging.  But through steady practice, most all students are successful in mastering the drug calculation skills necessary for becoming an LVN.

Our students come from a variety of backgrounds when they enter the LVN program.  Some are Certified Nursing Assistants furthering their career in health care.  For these students the practice of patient transfer and general approach to patient care is familiar.  For these students, however, the training and education to become an LVN usually involves “unlearning” their role as a CNA.  The approach to the patient or client as an LVN requires a deeper level of critical thinking and analysis of client data.  Beginning with obtaining vital signs, the CNA turned LVN student recognizes not just abnormalities, but takes the VN student into the realm of, “why is this happening?”  More education in anatomy, physiology and critical thinking enables the CNA turned LVN student to begin to think like a nurse.

The rights I am referring to are not professional rights, and not even the “five rights” of medication administration.  Instead a new set of rights are emerging, called the “Five Rights of Humor Administration.”  After reading an article in CE Express by Western Schools 2010 “Infusing Humor Into Healthcare” by Enid A. Schwartz, RN, MS, MC, I suspect students will read about these “rights” in future LVN school textbooks.  Schwartz states that the “rights” of using humor…[include:] the right patient, the right type of humor, the right time, the right amount of humor, and the right route or form of humor.” When checking the “right patient” the author emphasizes the importance of being sensitive and “for some patients, humor is inappropriate or unhelpful.

As a nurse I can not imagine telling a “knock-knock” joke to someone who is just coming out of anesthesia.  Not only would that be the “wrong patient” but also not the “right type” nor “right time” for humor.  The “right amount” of humor might not be as obvious to know.  I guess if you start to sound like a stand-up comic spouting off one-liners you have gone too far.  Then there is the “right route or form;” I recall a pediatric nurse, who instead of telling jokes, was great at imitating voices.  He could give instructions and reassurance as John Wayne or Mickey Mouse and have his patients laughing during what could have been a challenging procedure.  One of the reasons I enjoy being a part of the Gurnick Academy of Medical Arts – LVN program is how we value humor and without knowing it are already utilizing these “five rights.”

F. Gardiner’s Article “Why We Must Change: The Research Evidence” raises a number of very important questions concerning modern college education system.As an LVN program, we provide education to adults with at least high school level of knowledge, and therefore, the level equivalent to college level. In fact, being a degree-granting LVN program, we consider our LVN school as college-level institution. And teaching at this level, we must bring up the appropriate questions about reaching out and getting through to our Nursing students. Do they learn what we teach them?
Apparently, based on the most recent research completed at multiple universities and colleges  on teaching techniques, methods of information delivery, and students’ retention of information, how we teach is not necessarily is how the students learn.

In particular, many teachers employ the method of delivery that requires mere memorization and regurgitation of information. The larger the class size, the less thinking is expected and required of the students, and the more simple recall of information taught. The studies show that students in classes of medium size (20-45 students) are more oriented toward comprehension of the material, and in the small classes (15 students or fewer) the students were able to analyze and integrate the information taught.

Moreover, a very small percent of undergraduate students (only 14%) were ever taught how to study. And when later surveyed on course material retention, in the best cases it was only up to 50%, and in most cases it was as low at 20% of the material taught. So, only one fifth of what we teach, spend so much time and effort on, is retained by our students. Clearly, something needs to change in our education system.If the students retain only one fifth of the lecture, what happens to the rest of the information given to them over the time frame of a course? And why are the retention rates so low?

The answer is simple: the students are not thinking during lecture. What are they doing during lecture, if not thinking? Only about fifty percent of the lecture they are asking or answering questions, or taking notes, the rest of the time, their attention drifts. In fact, science shows that if the student does not stay involved, actively participating in the process of learning, their attention wanders off the subject within 10-15 minutes of the beginning of the lecture, and up to 15 % of the lecture time is spent in day-dreaming!

So, how do we improve the education system for our LVN students? to improve LVN certification. Do we need to change the course curricula or change methods of presentation? Maybe so. However, it is absolutely vital to the process to do everything to retain the attention of the students by keeping them involved in the learning process. Learning is effective only when it is active. The information will be retained, only when thoroughly understood, and it will be understood only if the students come to discover that information on their own.