Victor Valley College
The Journal
The Bi-Monthly Nursing School and Allied Health Newsletter
October 2013 Volume 4 No. 2
Article By:
Maria Altamirano
Photo By:
Kathy Vara
On June 15 2013, Victor
Valley College’s
Nursing Department,
alumni, professors and
students all gathered
together in the SAC
building to honor and
celebrate one of the
school’s most
prestigious instructors,
Professor Diane Cline.
There is no doubt the
nursing department is
losing one exceptional
and important member
of its team. Professor
Diane Cline retired after
working at the college
for over 35 years.
Diane graduated in 1972
with a Bachelors in
Nursing from San Diego
State University. She
then went on to receive
her Masters from Cal
State Los Angeles. With
over 40 amazing years
of nursing experience,
Diane has had a great
influence on the Victor
Nursing & Allied Health
Celebrating a Great Instructor
Valley College Nursing
Program and its
students. She has seen
hundreds of nursing
students graduate,
including Professor Sal-
Diane Cline at her retirement party
Diane Cline with Brandi Scott
ly Thibeault, Professor
Renate Longoria and
clinical instructor Lisa
Crouch.
Diane has held many
positions within the college which including
Dean of Math/ Science,
Health and Physical Education, Director of
Nursing and clinical instructor. Her goal was to
help of graduate the best
qualified nurses in the
High Desert. Her last
position included
Lead Instructor for the
Nursing Process 4
semester, a position she
Nursing Graduate Kathy Vara
with Diane Cline
Victor Valley College 18422 Bear Valley Road, Victorville, CA 92395
ph:
shared with Sally
Thibeault for over 10
years. When asked what
would she miss most
about instructing the
NP4 students, Diane
responded “The every
day contact, watching
them grow up and
[realizing] all of a sudden they get it!”
Her influence on students has been immense. Recent nursing
graduate Kathy Vara
expressed how “Diane
always encouraged me
not to give up and she
would say that becoming an RN would be the
hardest thing I would
ever do. She was right,
but with her help and
the help of the wonderful nursing staff at
VVC, I and many others
have accomplished our
dreams of becoming a
registered nurse and for
that I will always be
grateful.”
The Journal Victor Valley College
Article By:
Maria Altamirano
Photos By:
Jessica Moreno
On Saturday September
7 2013, several of our
ASB and CNSA members along with VVC
Fire, Paramedic Academy and Veterans Club
attended the ceremony
at the college to remember the fallen of 911.
The students worked
hard for three hours to
October 2013 Page 2
Remembering 911
plant over 3,000 flags in
representation of each
fallen victim. However,
this amazing undertak-
ing did not just stop
there. At 7am on the
day of September 11,
2013 the whole Fire
Paramedic Academy, &
several nursing and
ASB students attended
the wreath ceremony
taking place at Victor
Valley College.
It was a heartwarming day and Jessica
Moreno, NP4 student,
expresses how she “felt
very honored to participate in this event.”
Article By:
Maria Altamirano
Wise Words for Fellow Students
Every nursing student
knows what comes over
them once they realize
they have passed yet
another semester. It is
an exhilarating awareness, a sense of accomplishment, and most
definitely a wash of relief.
sure, there are many
frightening moments,
however, this beautiful
journey would not be
complete without the
amazing support one
finds in their peers.
There are those that go
out of their way to help
out fellow students by
either giving advice or
simple encouragement.
We have all been there.
So if you ever see a student in need, share your
wisdom! It could very
well make a world of
difference to them. With
that in mind, here are
some wise words from
our very own students
to those that need it:
Yet, VVC nursing students also know that
those moments do not
come without sacrifice
or even days without
insanity! There are of
course frustrations,
sleepless nights and an
occasional breakdown.
But nursing school is
not impossible. To be
Wade Walker NP1
Clinical tip for 246: “Relax, work
with the team, work with other
students. It can be overwhelming
but at he same time rewarding
because you are getting to do what
you wanted to do all this time.”
Chanlynn Kao NP3
Clinical Tip for Np2: “Practice your
skills during the first two rotations
[Med-Surg/OB] because you don’t
get much practice in Peds.”
Andrew Ostrom NP2 Study
good and long, always ask questions, don't procrastinate (that's
a big one), know your drugs,
and what's helped me keep focused is always make time for
yourself and try to have a little
fun while you're at it!
Samantha Campos NP4 Test
taking strategy: “KNOW YOUR
STUFF! Always know the nursing
interventions and safety, safety,
safety!
Test Your Knowledge
Match the ethical principle with the
correct example.
1.Justice
2.Autonomy
3. Beneficence
4. Nonmaleficence
5. Fidelity
A. A client decides not to have open heart surgery despite significant blockage.
B. A nurse offers pain medication to a client who is postoperative prior to ambulation.
C. A nurse takes a client outdoors in a wheelchair after lunch as promised.
D. All clients waiting for a kidney transplant have to meet the same qualifications.
E. A nurse questions a medication prescription as being too extreme in light of a client’s
advanced age and unstable condition.
Answer and reasoning: see page 6
Nursing & Allied Health
Victor Valley College 18422 Bear Valley Road, Victorville, CA 92395
ph: (760)245-4271 fax:(760) 951-5861
The Journal Victor Valley College
Article By:
Alma Lopez
Photo By:
content.time.com
As a practicing nurse
we will be confronted with
ethical and legal issues related to patient care. As a
nursing student I recently
encountered and witnessed
an emotional ethical dilemma and I decided to share
my experience.
The ethical/ legal dilemma involved an elderly
patient who several years
ago prepared a Living Will,
a Durable Power of Attorney, and had signed a do
not resuscitate (DNR)
form . Unfortunately, the
patient’s wife was not in
agreement with what he had
decided and when the patient became unresponsive
at home, she called 911.
The patient required chest
compressions and was intubated. When the couple’s
adult son arrived to the hospital he presented a Durable
Power of Attorney that appointed him to make health
care decisions on his father’s behalf now that the
patient was unable to make
his own decisions. He also
presented the Advance Directives; Living Will and
DNR forms, which clearly
stated he did not want to be
resuscitated and did not
want to be kept on artificial
mechanical ventilation. A
family meeting was called
where all family members
except his wife agreed for
the patient to be weaned of
the ventilator and understood the probable outcome
was death.
According to Saunder’s
5th Edition, ethics is defined
as; the ideals of right and
wrong. (Pg 48 Saunders
5th Edition; Comprehensive
Review for NCLEX RN
Nursing & Allied Health
October 2013 Page 3
Ethics and withdrawing of Life
Sustaining Treatment
A young Karen Quinlan
Examination) It also states
our nursing actions should
be directed or governed by
the Codes of Ethical Practices which include: Autonomy; respect for an
individual’s right to selfdetermination, Nonmaleficence; the obligation to do or cause no
harm to another, Beneficence; duty to do good to
others and to maintain a
balance between benefits
and harms, Justice; equitable distribution of tasks,
determining the order in
which patients should be
cared for, Veracity; the
obligation to tell the truth
and Fidelity; the duty to
do what one has promised.
I decided to research
how these codes, rules,
and guidelines came about
in respect to dealing with
the patient’s right to die. It
turns out that there was a
case in 1975 that became
the pioneer for these types
of dilemmas. The case
became known as “The
Right- to- Die Case.” The
case involved a young
women by the name of
Karen Ann Quinlan and
her parent’s fight to re-
move mechanical ventilation
after it was determined she
was in a vegatative state. The
Right-to-Die Case became
the first legal case that highlighted the widening rift between medical technology
and what is considered a
"good death." For the first
time, many people found
themselves thinking about
important decisions that need
to be made at the end of life.
The story began in 1975,
when at the age of 21 Karen
Quinlan attended a friend's
birthday party at a local bar
where she reportedly had a
few drinks in addition to Valium. After feeling faint, she
was taken home and put to
bed; and after fifteen minutes
she was found not breathing.
An ambulance was called and
mouth-to-mouth resuscitation
was attempted. In the emergency room, her pupils did
not react, she did not respond
to deep painful stimuli and
was unable to breathe on her
own, all indicators of extreme
hypoxic brain injury. She was
placed on a ventilator. It was
determined after several days
that Karen Ann was in an
irreversible coma, also
known as a persistent vegeta-
Victor Valley College 18422 Bear Valley Road, Victorville, CA 92395
tive state (PSV).
After Karen’s parents
receiving the news that
Karen’s condition was irreversible, and considering all
their options, they decided
that Karen would not want
to be kept alive by machines. They reached the
decision to take Karen off
the ventilator. The hospital
representatives initially
agreed, but then changed
their minds, setting the
stage for a big legal battle.
The legal battle started in a
New Jersey courtroom
where they requested to
remove their daughter from
the ventilator. A courtappointed guardian for Karen argued that the parents
had no right to propose
what appeared to be euthanasia. The Quinlans’ lost
their first round in Court.
They decided to take their
case to the New Jersey Supreme Court, which ruled
in their favor. Karen Ann
was removed from the ventilator, but continued to
receive artificial nutrition
and hydration. She lived
another nine years in a
nursing home until her
death in 1985 from pneumonia. The Quinlan's legal
case established a patient's
right to refuse medical care
and control his or her own
medical treatment. Karen’s
case brought changes in the
way health care decisions
are made, including the
creation of ethics committees in hospitals, nursing
homes, hospice, and the
creation of advance directives.
ph: (760)245-4271 fax:(760) 951-5861
December 2013 Page 4
The Journal Victor Valley College
Article By:
Alma Lopez
Photo By:
Www.vvc.edu/coop
Do you remember your
very first day of clinicals? I
do. I remember wanting to
drive away once I got to my
clinical site because I was
so nervous, scared, overwhelmed, and uncertain of
what was looming around
the corner. Regardless of
which nursing process you
find yourself in right now,
we all still feel a bit hesitant
the first day of clinicals. I
can compare the first day of
NP1 clinicals with the first
day of NP4 clincicals and
there was still apprehension
amongst us as we realized
that with the advancement
into NP4 there was more
expected out of us. Although there was still an
uneasiness walking into my
clinical site this semester, I
can definitely affirm I felt
more confident and comfortable since becoming a
student extern with the CoOperative Program through
Victor Valley College and
Desert Valley Hospital.
With this article I
would like to bring light to
a wonderful program that I
believe is not recognized
for the excellent service it
has provided for our nursing program. The Cooperative Education Program is a work experience
program that sets career
guidance in a real setting
while still in the nursing
program. Each semester
Desert Valley Hospital
hires 10 of our students in
the nursing program, primarily to help with nursing
education while still in
nursing school and later
hiring you as an RN once
Nursing & Allied Health
you have obtained a license. As with anything in
life, you get out what you
put into something. The
students should go into this
program expecting a different role, responsibility, and
experience than with clinicals. As a student extern we
are expected to perform any
duties within our scope as
student nurses. Our capabilities are determined by our
competencies that we have
been signed off for during
each nursing process. Furthermore, the externship
provides more hands on
practice and experience
while still in the nursing
program, but as externs we
are being paid for it. This
program has many positives
and seems ideal, but there
are certain requirements
one must meet to continue
in the program. Each semester you will be required
to meet certain objectives
set by Desert Valley Hospital according to the nursing
process you are in. There
are also homework assignments to be submitted in a
timely manner. I decided to
interview the Co-Op educator Ms. Maggi Dunsmore to
have her answer some of
the most common questions
I have encountered.
1. How long has this program been available? The
nurse extern program began
about 15 years ago. We
have several hospitals participate over the years, but
Desert Valley Hospital is
the only hospital participating at this time. Other hospitals that did participate
include Barstow Hospital,
Victor Valley Hospital, and
St. Mary Medical Center.
These hospitals discontinued the program a few
years ago when the economy changed and their budgets wouldn’t support paying
for nurse externs.
2. How many hours is the
student required to work
to stay in the Co-op program?
Students use their worksite
as their classroom and work
a minimum number of
hours per the units enrolled.
Nursing externs must work
a minimum of 75 hours per
unit (Nurse-138 = 1unit)
each semester.
3. My understanding is
that NP2 is the earliest
one can apply to the program. Is this still the
case? Yes, students who
are in NP2, NP3, & NP4
and have been hired by the
hospital can enroll in Co-op
Education, Nursing 138.
4. Who should a student
contact first about applying to the program?
Should they email Co-op
Education directly or contact the education coordinator at Desert Valley? Students should contact the hospital first
(Education Coordinator or
Director, Med-Surg) to get
hired before contacting the
Cooperative Education Department, which is located
in the Academic Commons
Building. They are welcome to come in to find out
about the class and obtain
information regarding the
program.
5. What is the percentage
rate of extern students
Victor Valley College 18422 Bear Valley Road, Victorville, CA 92395
being hired after completing the program? The
percentage is very, very
high. I would say it’s probably around 95 –
98%. Currently, most are
hired by Desert Valley Hospital, but some have been
hired by other medical facilities/hospitals.
6. How does a student apply for Co-op?
Desert Valley Hospital has
a website where students
should apply for the nurse
extern positions through.
Students should also feel
free to contact the Human
Resources Dept. at Desert
Valley Hospital to inquire
about their online applications if they haven’t heard
anything back within a reasonable amount of time.
Students should not enroll
in the NURS-138 class
(1unit) until the hospital has
clearly hired them. Students may not work as
nurse externs until they
have enrolled in the NURS138 class. Otherwise, they
will be out of compliance
with the Board of Nursing
and could suffer detrimental consequences.
Once hired, the student
must contact the Co-op Education office to find out
how to enroll and to fill out
the necessary class paperwork before the semester
starts.
7. During what dates
should a student attempt
to apply?
Students should contact the
hospital at least 2-3 months
in advance of the semester
they are wanting to enroll
in. It takes time to com-
ph: (760)245-4271 fax:(760) 951-5861
The Journal Victor Valley College
December 2013 Page 5
Article By:
Alma Lopez
Photo By:
Www.vvc.edu/coop
plete the hiring paperwork which may include a
physical, background
check, etc. For the spring
semester, students should
contact the hospital by the
first part of November. For
the fall semester, students
should contact the hospital
by the first part of
June. For the summer semester, students should
contact the hospital by the
first part of March.
8. What do you look for
from the student during
your selection process? I
do not select the students. I
am sure the hospital is
looking for someone with a
certain skill level based on
the NP that they are in or
have just completed. Students must be signed off on
the competencies for each
process and must present
that signed off list to the
hospital before starting
work there. They are also
probably looking for someone who is genuinely caring
and sensitive to the needs
of patients and who has a
passion for nursing. Nurse
externs should also be team
players—willing to get involved and help where
needed or requested. Good
work attendance is also
required, so students should
work at least one shift a
week.
9. What are the class
requirements and how do
students receive a
grade? Students must enroll in the class (NURS-138
for one unit), buy a book at
the bookstore (Cooperative
Education Notebook that
costs approximately $20/
Nursing & Allied Health
one-time cost), fill out all
class paperwork before the
semester begins, attend a
two-hour orientation at the
first part of the semester,
attend a group nurse extern
meeting at the hospital at
the first of the semester
along with their prospective
supervisors at the hospital,
submit one homework assignment towards the end
of the semester, turn in
monthly timesheets documenting their work hours,
meet with the instructor at
the college toward the end
of the semester to grade
themselves on their learning objectives and receive
their graded homework
assignment, and anything
else that is required by the
instructor. Students receive
a grade for the class that is
based on five different
parts: time management/
communication, supervisor’s grade of the student’s
objectives, student’s grade
of their objectives, instructor’s grade, and homework
assignment. Students must
also work a minimum of 60
hours to pass the
course. Students may reenroll in the class each semester as long as the hospital is willing to keep them
on or until the student has
graduated.
10. What would you recommend every student
receives out of the program? I recommend that
student nurse externs learn
as much as they can from
the hospital staff as they
complete their semester (or
semesters) of this class.
Students are required to
complete a minimum of
four new learning objectives each semester. These
learning objectives have
been preset by the hospital
staff and are in alignment
with the competencies that
the student has already been
signed off on in their previous nursing process. As
students graduate, new
nurse externs are brought
in. Students are also allowed to participate in
Skills Day and other hospital activities, they’re considered employees of the
hospital.
With the hope of getting
another student’s view and
experience from Co-op I
interviewed Jesse Contreras
NP4 she enrolled into CoOp her 4th semester of nursing school. Here’s what she
had to say.
1. Has Co-op been what
you expected?
It’s different than what I
expected. I have been in
clinical before, but as an
RN Extern I felt more of
the responsibility. This experience gave a distinctive
view of reality vs. student
nurse.
2. Being that this semester
was your first time working and going to school,
have you felt overwhelmed or felt like it was
too much to handle?
In the beginning it was hectic. The stress came from
adjusting study hours, personal time, and organizing
paperwork for Co-op Ed
and hospital requirements.
Victor Valley College 18422 Bear Valley Road, Victorville, CA 92395
Time management was the
most difficult to adjust, but
in time it became manageable. It is overwhelming but
staying focused and organized helped cut some of
the stress.
3. What words of advice
do you have for anybody
considering enrolling into
the program?
It is a great opportunity to
feel the RN role. It differs
from clinical because there
aren’t any instructors or
peers, and it’s not as structured. You get to think “on
your feet“. It really gives a
sense of reality. I’d advise
to enroll in Co-op Ed but
also think about the commitment to the program and
the worksite. Consider your
schedule, study hours, clinical hours, personal time,
and other demands. It is a
great opportunity to gain
experience and knowledge.
In conclusion, I hope
that this article conveys the
positive influence that this
program may have on your
future as registered nurses.
I would like to thank Jesse
Contreras for her input and
a very special thank you to
Ms. Dunsmore and Chris
Guinotte for all that you do
for us nursing externs.
ph: (760)245-4271 fax:(760) 951-5861
The Journal Victor Valley College
December 2013 Page 7
Peers Empowering & Educating Peers
(PEEPs)
TEST YOUR KNOWLEDGE
The PEEPs program is a volunteer program designed for nursing students enrolled at VVC. The
intention of the program is to provide supplemental support to students that are having difficulty with comprehending the theoretical and
clinical concepts in nursing. For more information visit my PEEPs at
Answer
D. Justice
A. Autonomy
B. Beneficence
E. Non maleficence
C. Fidelity
WWW.VVCPEEPS.PBWORKS.COM
Citation
Or
Contact Kristen Jimenez NP4
ATI Fundamentals of Nursing Edition 7.0
Ethical Responsibilities pg.16
klnemzek@yahoo.com
Don’t forget to order your scrubs and other
nursing supplies at Advance to help nursing
students now and in the future have wonderful
graduations. Use the code provided at the left
and go to
http://www.vvcrams.com/
Buy anything at this site with the use of the
code and support your fellow nurses.
Acknowledgments
Interested in purchasing AD
space to support this
newsletter?
This section is to thank those that worked hard to help create and promote this newsletter.
Director:
Dr. Joseph Morris, CNS, GNP, PhD Special Thanks to:
Supervising Instructor:
Prof. Alice Ramming, RN
Editor:
Alma Lopez
SN NP4
Maria Altamirano SN NP4
Story Writers:
Alma Lopez
SN Np4
Maria Altamirano SN NP4
Photographers:
Kathy Vara
Grad 2013
Jessica Moreno SN NP4 CNSA
Dr. Joseph Morris– For your encouragement and continued involvement.
Please contact the Nursing Department at 760-245-4271 for
more details.
Prof. Alice Ramming– Your calm kindness and assistance
NP4 class of Fall 2013– Thank you for your continued dedication to our
school and perseverance no matter the trials that we may face.
Donna Derryberry– Thank you for always being willing to take the time to
help.
Laura Katnic– Your are always willing to lend a hand whenever asked
and we thank you.
ATI Fundamentals of Nursing 7.0 Edition– Thank you for providing us
with the review NCLEX question
ALUNMI GIVING
Your contributions are welcomed. All
proceeds help support the student
community service projects, pinning
ceremony, and the growth and development of the nursing department.
Please Contact:
The Victor Valley College Foundation
in care of the VVC School of Nursing
at:
www.vvcfoundation.com
Nursing & Allied Health
Victor Valley College 18422 Bear Valley Road, Victorville, CA 92395
ph: (760)245-4271 fax:(760) 951-5861