hey Remar nurses guess where we are this is the Remar skills Lab look I'm so excited oh girl this is nice this is nice I got nurse Unice coming on to tell us all about how we are going to dominate nursing skills and you guys just don't know the blessing it is to be a nursing student or a nurse or International Nurse in the United States and being able to come to a place and not just any place a safe place where you can practice your hands on skills and a place where the instructor is Remar approved meaning that she is patient and compassionate and has a Ministry and so I'm so excited to be here I'm so excited to be here at Florida a medical training academy and listen to me listen to me this is this is the location for the skills lab people are asking me where you at where you at it's in Jacksonville which let me tell you I actually love the vibe here in Jacksonville I came up from from Orlando yesterday Drive easy Hotel I stayed in beautiful and and so I I'm getting the full Remar nurse skills lab experience and I'm giving it a A++ okay so we're going to talk more about skills Labs the importance of Hands-On training and when you come to the skills lab you actually have the ability to get something special which is the V2 so when nurse Unice comes in she actually has the six Monon program for v2 which let me tell you nobody in the US has the six-month program our International Partners in Africa have it yeah but we don't even sell the six-month V2 program so she has the six-month V2 program plus the skills lab addon so talk about blessings on top of blessings that's today so get ready for it we're also going over our subject today p c o p d so let's get into all of the good stuff that we have going on I'm telling you when Remar nurse Community started to expand I never thought we would have all these great things but skills lab COPD speaking of the V2 for those of you who are interested in getting it for one month or three months 50% off sale right now today is the last day so mosy on on to remarnurse.com to get into that program also we're going to be talking about today again the skills lab training it's a two-day course that we are going to dive into for those of you who are going to be coming here yes Remar is expanding Remar is expanding um and then we're going to do a tour of the skills lab too so it's not just one room there are multiple multiple stations that you will be um attending to okay also one more thing is if you are interested in the jobs you know on Wednesdays we do two sessions we do job um travel nurse jobs at 7 pm and then I have my winning win set at 900 PM so that's just a reminder of all the things this week that we are working towards Wednesday's a busy day for us as well if you are signing up for one of the travel nurse jobs and you don't have the way to email or anything like that it's always quicker to text so go ahead and text j o BS jobs to 855 696 01 3 2 I'm going to leave that up for a second so you can screenshot it this is how you find out the jobs that we currently have in your state or in your location okay good stuff on Mondays good stuff on Mondays we're getting into COPD are you guys ready are you ready ready ready put I'm ready in the comments and also let me know where you're from I know I have nurses in Kenya shout out to nurse wlef I did not forget about his amazing testimony who remembers nurse wff's testimony from last week wasn't it so good wasn't it so good about how he passed inlex he's still in Kenya right now but uh USR in in Kenya isn't that amazing yes okay so COPD let's get into it well let me ask you this first let's set the groundwork for COPD who has it in quickx let's get out our material today boom COPD is COPD reversible or irreversible because that's that's the thing we need to focus on is COPD reversible or irreversible what do you say she said I'm danda says I'm ready I'm in Cincinnati Ohio I'm sick with the flu but I'm still trying to focus and study girl that's why I got out of Ohio I had to get out of Ohio the flu was going around I had caught it twice and you know I was only there for like two days okay COPD what page irreversible absolutely COPD is irreversible and we know that patients who get COPD these patients are typically having what type of habit what type of habit is going to be the most common cause of a person getting COPD which is a compilation of asthma bronchitis osma right patients who there you go boom patients who are smoking patients very rarely will people develop COPD from something else right I mean there are other risk factors but that's smoking for a long period of Time how many people know somebody who has COPD my grandmother had it and she had been smoking since she was like nine years old because you know back in the day but that's a different story but what I'm trying to say is this is on the inlex because it is a very common condition because people still smoke in the United States at a very high rate at a very high rate okay so we know that all right quicka have actually on page 25 in my book this is actually a full page of information about COPD that's why that's why um we need to review it because it is a big part of the actual um test plan for Respiratory conditions but here we go chronic obstructive pulmonary disease COPD this is a condition of limitations and so what we see from a pathophysiology ology standpoint is that a patient's airf flow is going to be restricted and it it becomes progressively progressively limited down to the alvioli okay so it's not just like a lung condition in general is literally the AL alvioli um and so there's two well there's two types of main causes it's going to be either a bronchitis um how can I say this either it's going to be a bronchitis issue or enyma issue in terms of which one is the prevailing uh disease process now can patients have both yes absolutely can patients have a little touch of asthma yes absolutely but this is where nursing students get confused as when what are the clinical symptoms of a bronchitis based COPD and an Osa based COPD so we're going to talk about that today I want you to understand it clearly before we leave now COPD can be a critical care issue because of what because the oxygenation of your patient is going to be in a state that is less thanin so yes they're going to have chronic hypoxia they're going to be chronically low in their oxygen they're going to have severe disia to the point where it's not just with activity but also patients with COPD can have dnia on rest and that's dangerous um in exacerbations we also see changes in the mental status of the patient worsening of that hypoxemia uh respiratory acidosis and other hemodynamic instability uh symptoms how do we treat it the management of COPD is going to be either nonpharmacological or we're going to be using medications I want to take a step back because I want to actually go back to the different causes all right so I want to go back to the different causes where it says bronchitis or osma so bronchitis or empyema just really quickly this is in school where we had the characteristics called pink puffers or blue bloaters do you remember that right and it it's it's really confusing in nursing school when we learn about blue bloaters and we learn about pink puffers because actually the COPD when it is diagnosed clinically sometimes the patients don't present like a pink puffer or a blue bloater okay at all and so if it confused me because I was like man am I looking for what am I looking for in this way but um when you learn it in nursing school the blue bloater is going to be for uh bronchitis the bronchitis COPD and these patients are typically even when they're drawn they're typically patients who are obese patients who have that um that productive cough right patients who are essentially full of mucus and why are they full of mucus what is causing the mucus in the blue bloater anybody know I know come on in I'm in the skills lab I'm I'm so excited about it and we're gonna talk all about it how do you sign up for it how do you register for it all the good stuff trust me okay but we we got to know this we got to know this so the bronchitis the blue bloater this patient has a lot of mucus production because of the bronchitis okay because they have an infl infation of the bronchial and so what's happening is mucus is getting to mucus is getting to that area and the patient coughing it up yeah and the secretions they can't really move so this patient is the one that's obese they they are um they have dmia at rest they need oxygen therapy the patients with osma the danger of osma is that it is like a um it's like a a a it what it does is it's going to trap air so that it can't get out so these patients are typically very thin and their shortness of breath is so Progressive that they can't even eat so patients with COPD that is the enyma origin they have issues with severe COPD retention and that hypoxia because with osma the air can go in but it can't get out all right so these are the pink puffers these patients have um a profusion that they have a normal skin color but actually they're really oxygen deprived really oxygen deprived they may or may not have that cough yeah all right so that is the scenario that's the situation when you take care of these patients they're acutely ill these patients are um you know their quality of life is severely severely decreased when they get the COPD diagnosis all right um so we talked about uh the characteristics of it uh let's talk about the non phological management of it so pulmonary rehab as much as you can do Inus perometry you know you're going to do the pur lip breathing just really helping the ventilation to be at a m maximum capacity nutritional counseling malnutrition is big for our patients with inisa okay patients with um COPD that's bronchitis they're typically eating uh but still you want to make sure they're eating the right things nutrition and not just empty calories smoking sensation of course this will only make the condition worse and as we know that COPD patients do require oxygen therapy and so you should not smoke when you are on oxygen at home or when oxygen is in the home and so that's something that you will do a lot of education on because some patients will continue to smoke even with oxygen I know we know patients like that so it's very important that they understand the importance of quitting smoking we're going to be using Bronco dilators we're going to be using cortical steroids and the indications for those are in front of you so we should know that as nurses a little bit deeper into the respiratory medications um theophine theophine is a medication that you should be familiar with almost inside and out before you take incx examination understand what it does so it's going to decrease the dnia and it's going to improve gas exchange but you have to watch out for theophine because it can become toxic in the system so you need to know that therapeutic range and it um need to know the therapeutic range because it'll damage the liver the Ailene doeses interact with a lot of medications so you have to be careful of that antibiotics if we are talking about a bronchitis from a bacterial infection then antibiotic Supply but only if there is a bacterial infection present we never give antibiotics for viruses for some of you I have not added any knowledge by just saying that but for other people sometimes they forget and the mutic Agents of course would be to help that mucus move out of the patient so that's good yep filene 10 to 20 one of the easier ones to remember oxygen oxygen therapy this is a huge point for the exam we know COPD patients can have oxygen but not too much oxygen okay they can have oxygen but not too much oxygen so we expect the oxygenation to be lower than normal in patients with COPD and for them that's fine they can manage with more carbon dioxide in their body than others but we will put oxygen on them if their oxygen saturation is less than 88% they should have an oxygen um a little bit higher than that um also if there's a low pa2 or if their hematocrite is great greater than 55% let's stop right here when you see this hematocrit greater than 55% what is the issue that will happen if a patient has a high hematocrite what's the issue that um patients with COPD have and think about it you know normally hematocrit is uh what 35 to 45 in women 40 to 50 in men those numbers might be a little bit off but when you start having herat Crites that are high and this is related to the blood when you start having hematocrits that are high what does that put the patient at risk for okay this is why you come to class today so I can press you so I can press you good job good job not bleeding because remember hematocrit is the amount of what that you have it's the amount that you have of red blood cell production it's good it's good to have herat crit that's normal it's good it's good to have red blood cells but you don't want to have too many blood red blood cells because yes a hematocrit greater than 55 wow your patient is at risk for blood clots and so the reason why this is happening in COPD why is the hematocrit raising up in COPD what's the connection okay and this is how you pass inlex by knowing about content you see we're not in a question bank at all we're not in a question bank at all right now but we're talking about some very highlevel things that you have to make the connection from laboratory results to respiratory issues and the what I'm seeing in the comments lets me know that that's not being done right now so I'm going drag you through it okay if a patient's hematocrit level is high that puts them at risk for blood clots why we care about this in COPD is because the hematic crit being high is a compensatory mechanism because the body is not getting enough the body is not getting enough oxygen so the bone marrow is trying to produce more red blood cells to get the oxygen flowing but that's not the problem so now you just have more red blood cells being look how look how amazing the body is the body is like hey I got to produce more red blood cells to get this oxygen flowing and is that really helping no that's not helping at all right because the problem is the oxygen is trapped in the lungs in the alvioli can't get out so now your patient has blood clots and they still are not getting the oxygen they need so what we need to do is we need to increase the oxygen okay we need to increase the oxygen and that will bring that will bring the hematocrit down all right so but this we have to be very careful because can't give a COPD patient too much oxygen no more than 2 liters so if we do that if we give them too much then that you know that carbon dioxide induced respirations they will decrease all right so thinking about that right now let's talk about the surgical therapy for COPD of course there are some things that we can do uh you can do a a lung reection a lung reduction where we are removing tissue from the lungs that is not healthy and is and we do that we improve the mechanical function of the lungs because we're getting rid of bad tissue um you can do a bomy where we are also just removing parts of the lung that have inasa and that's going to help de decrease the dmia improve the overall lung function or you could go and do a lung transplantation and just put a new lung in there and all of those things are great but they are going to require the nurse to have what skills because we know that if a patient has has a lung procedure what are they going to get afterwards what are they probably going to get afterwards to monitor to facilitate drainage and this is why you need to come to the skills lab because no matter what unit you're on I'mma bring it in what is this gay ass all right what is this all right for my International Nurses that are coming here to the US if you don't get skills training before if you don't get Hands-On skills training in your country all right then you need to make your way here because understanding how to manage a chest tube system is something that everybody needs to be prepared for and this is an example of one that we have in the skills lab all of these things okay all chest tube systems will have the three chambers y'all know them from the V2 and that's why you need to have the V2 first before you come here because you know the three chambers you know you got your collection chamber your water seal chamber and your suction control chamber yep you got to know it Kristen says that's on my Med sege certification exam oh definitely for Med surge so that's what I'm saying um it's bigger it's it's so much bigger I know we focus on inlex a lot but after inlex you still have a work to do to be a competent nurse and knowing how to navigate this is one of them yep yep yep yep yep yep all right so now let us let us Mosey on along okay Mosey on along and this is the beauty of today V2 plus Hands-On clinical skills yes and like I said if you don't have the V2 system um you can get it right here nurse Unice will have it for the six-month program plus Plus+ plus the Hands-On clinical skills you cannot beat that let's go into our inlex questions I need comments on the screen remember you pay for this class by comments that's the tuition of today's class so comments on the screen like and share this video too here's our first question it is this question number one the nurse examines a client presenting with shortness of breath COPD is suspected because the client is Barrel chested upon further assessment the nurse should also expect to find is it number one blood tin sputa two lymphadenopathy three decrease resting respirations for flattening of the diaphragm what are we expecting to happen have I see some ones I see some threes ones or threes correct answer I ain't even gonna hold y'all is number four flattening of the diaphragm is the correct answer a barrel chest on a patient is a result of air trapped in the avioli and so what happens is that hyperinflation flattens out the diaphragm of the patient yes I'm doing I'm moving on question number two we got to go a nurse is caring for a patient with a history of COPD that's today's topic the patient has increased shortness of breath a productive cough green sputum and a fever the nurse suspects an exacerbation of COPD which test is the priority is it number one a pulmonary function test two chest x-ray three arterial blood gas analysis or four a sputum sample for viral infection what's your priority today Remar nurses tap tap tap in over 700 are studying right now on a Monday amazing amazing amazing okay I see some fours I see some threes oh this one is good this is a great priority question the correct answer you got it if you pick number three blood gas analysis come on we talking about COPD we talking about a patient that is having an exacerbation if the fever distracted you no don't do that because respirations respiratory exams are going to be higher than viral infections all right so I put in a good distractor there with the fever and I got some of y'all all right all right I'm g go to the next question though let's recover because on inlex you know what if you get a question wrong you just got to forget about that and keep it pushing here's the next question a client with COPD is admitted for rout evaluation the nurse notes a hematocrit level of 56% and an oxygen saturation of 86% on room air the client reports occasional dizziness and headaches what's the nurse's priority action number one increase the oxygen flow rate to maintain an spo2 above 95% to increase IV fluids to reduce blood viscosity three notify the healthare provider four administer a lowd do aspirin to reduce the risk of clot formation what you g to do nurses what are you going to do if you're put in this situation I'm so excited I'm so excited somebody is testing this week and you've been studying for a long time and your day is coming you should be getting these questions right you should be feeling comfortable I get excited when I study for inlex with y'all correct answer is number we're going for safety here number three call the doctor you got no business doing anything else until you have called that doctor why because you got it irregular laboratory value your patients's oxygenation is 86% on room air the doctor needs to send through some orders to help stabilize this patient you can't do anything about it did you get that one right did you get that one right you feeling good about it got it all right okay here we go next question I think I got one more ah here we go a client with COPD reports worsening shortness of breath and confusion the nurse notes a respirations of 30 okay the oxygenation is 89% on 2 L nasal canula the arterial blood gas is this pH 7.32 p258 and the bicarb is 29 what is the priority medication what's the priority medication this is different number one is it an anti-coagulant number two IV fluids number three oxygen number four Bronco diil what do we need to do and you have the ability to give them all you have orders for everything but inlex is seeing whether you can make the connection to the condition to the medication this is the importance of showing up for class and studying every week correct answer absolutely number four absolutely number four all right everyone that wraps up the question portion of the Remar study session Bronco dilators the most important because the patient's having obstruction and the Bronco dilator is going to open that up and now I want to get into the skills lab training so I'm going to invite nurse Unice in if you're ready for the skills lab say skills in the comment come on in okay and we are ready they're saying skills in the in the comments so everybody this is your skills lab instructor extraordinaire um my my you know just inspiration honestly like a nurse Unice welcome the Remar nurses say hello hi everybody I am Unice matis I've been a nurse now for 26 years I'm the owner of Florida training academy and my why is you my why is safe nurses safe patients and so I am proud to be a partner with Remar nurse and so thank you Regina for coming all the way to Jacksonville Florida and if you know about Jacksonville we say doall okay oh no I'm learning I'm learning about this area so tell me um why did you start why did you start Florida Training Academy why did you start it actually a CNA that I work with and we still work together to this day she came up to me and she said Unice um students are felling their CNA exams and we need to do something about it and I was like we do we speak French right and so um we actually started in our house and our first set of Transporters in the hospital passed their CNA test and this was 16 years years ago and from then we knew we had a business but now those CNAs many of which are now nurses yeah and so we supplement the education for CNAs for nurses Nurse entrepreneurs and so also working in a college environment and being that clinical lab instructor so I'm the one who makes the mannequins cry and the blood pressures crash I'm your girl love me um you've done it a thousand times in Sim but now you get to do it again right here in our skills Lab at Florida train Academy powered by Remar so um so my why is just making sure that people have a safe place to learn and if you don't know something it's okay it's a judgment free zone we're going to hit the books we're going to hit the video and then we marry all that with Hands-On skills so what can the Remar nurses expect let me know like so if you are interested in coming to review the skills now wait wait wait because I'm going to tell you all about it I know people are saying um what is it like how much does it cost how do we sign up all those things are coming but let's talk about it um you know is the skills lab like a couple of hours like what when they come what do they what are they going to experience all right so it's segmented we're going to start off with the basics and the reason why the basics are important is because it teaches you your communication we're doing bedside report it is so much that we need to cover again because if you don't use it you lose it and so now in this rapid fast-paced environment you don't have those nurse Educators out in the hospitals like you used to or in the nursing homes so we're starting off with just the basics let's do communication then after that it sounds stupid but I need to do it vital signs because if you can't take a pulse if you can't do a manual blood pressure and your CNA doesn't tell you that they can't do it either we need to be safe caregivers and we can't always depend on these electronic devices so from there we're flowing so Vital Signs safe medication administration we're just not talking about IV pushes we're actually talking about you priming tubing you hanging your backs you knowing how to um connect the emergency drugs the atropine the epinephrine and push it um because if there's an emergency we are depending on you to know what to do for that patient right about that that's right and so we're also practicing our IV skills our photomy skills our ostomy skills our tracheostomy skills our assessment skills so our mannequins are um for a fancy term mid Fidelity but kind of like what you had in your skills lab so we can um you're going to hear your organ sound so you can do an assessment again and don't forget about NG Tu um NG tube placement and I need for you to be able to run a code so guess what yes a quick ACLS review but we are going to run through our code spric cardia Tac cardia Cardiac Arrest because if you can prevent it if you can recognize it before your patients you know become postless that is the job of a good nurse and that is what we're going to do together we're going to partner so um to answer Regina's question Professor Regina it's about two hours per topic but you get to work as a team and that's what's important so that way no one feels left out and if you don't understand something if you can't start that IV fast enough you can switch out and knock someone else to start the IV and that's good and Mark was doing a little walkthrough of just some of the um just some of the areas that the nurses will be practicing so you did a good review of day one this is actually a a two-year experience and what I when I walked in I said and I don't know if you know this person but I said nurse harrietta is that you I said is that you Henrietta um just so y'all know we're not talking about you just coming in and watching a PowerPoint slide or you just you know listening to someone talk about how they used to do nursing no the idea is that you actually are able to get your hands in there and be an independent practitioner like you said in a safe environment and that's done through our skills lab that's so amazing um so that's just day one it's actually it's actually a two- day it's a two day experience yes so you know we we're gonna pretty much break it up and probably on day two is when we run our codes at the end you should feel more comfortable um entering into a patient care environment whether it's Home Care nursing home or a hospital and being part of a team you know we've both been there we've been the new nurses the novice nurs and what separates it is our preceptor and so yes we know a lot because we've gone to school but if you don't have a good preceptor or if you're nervous or we just have self-doubt a term that I want you all to look up is called impostor syndrome and so whenever you're starting something new um even though you may be competent because people around you seem to be more competent you may start doubting yourself and so we want to make sure that you can perform skills safely but also improve your clinical competence and that's what we're here to do and one thing that um you know that we've decided to do is we've decided to keep the skills grouping small yes and I mean like really small because the goal is not for us to just have this you know this huge con like cohort of people it's really so at the end of it the students feel valued so how many people are we taking only 10 per session that's it that's it yeah that's it so if you're interested in it I'm going to show you how to get um just get on the list for the skills lab but we are just doing 10 per month right initially 10 per month and then if we see that there's enough need maybe we can do it twice per month but definitely 10 per session and so and we're always looking for I wish you were here in Jacksonville I know you know what I'm I'm trying you know I was so I was so excited to come here because actually people don't know this but you and I start started talking in 2022 y yeah two years in three years now yeah 2022 so you know glass timing is always perfect so this was the time you were the student who needed to see this and so um the opportunity is here so um if you are interested in the tway skills training course and we're we have a class next week but we're not opening up for that class right now so we're going to start in March go to Remar nurse.com skills and you can U you can give them a day now I do want to talk about the cost though because the cost is something students asked about and I looked at skills lab training yes I looked at the cost for skills lab training in in on the west coast in New York in Ohio even where I am first of all you can't get in number one you can't they won't accept you if you're a nursing student or if you are not taking classes with a local College that's number one if you can even get in the second is if you do get in it's like $900 yes $950 yes and so the reason why we're starting off so inexpensively is because I want to make sure that it's affordable look I know right now the economy is just tough for everybody Y and my focus is to get more knowledgeable nurses out there working and so right now it's only $300 for the two days and we're using supplies we're using IVs we're using umy equipment I you know honestly you you were actually like she said the $300 that and this is for two days for what 10 hours or how 16 hours total 16 hours with with nurses with nurses that's that's 18 that's $20 an hour right $18 an hour for you to be able to get your own equipment to be able to leave with photomy like some places will will let you do skills but you're not doing photomy like that's not included yes and so the reason why photomy is important to me is because even after completing a baloria program in nursing um one of my first assignments when I was doing travel nursing they said that the nurses had to draw blood and I wasn't going to go home so I said yes I know how to draw blood but I lied you know I got it right but why risk patient safety to keep an assignment that's true so I think that it's really important for us you know yes they'll teach you IV Therapy but it's rather they teach you Flo because they're always going to say we have lab staff what happens if we don't have lab staff we need our nurses to know how to not just start IVs but how to draw blood also and know the order of draw so it's a lot to learn but we can do it and and this is the thing people are people are I think people are really confused like are you saying it's only $300 for on like online no you're coming in person that's what listen hands on you're turning to mannequin you're working with a team you are going to be starting your IVs you're going to run your code it's I mean I'm telling you like it is and look um we showing you like uh Markus showing you some of the equipment now this is literally a real skills lab like you you will have access to everything you those vows us who working as nurses know look the doc the you might not have fot me you have to get a blue tube a purple tube a red tube and they're looking at the nurse to do that now I'm asking is this RN is this for LPN so it's actually for both because I don't know what environment you're going to work at and thankfully when I was trained as a new nurse with a bachelor degree they partnered me with an LPN and so even though I had the higher degree I absolutely loved her and she trained me and so now fast forward post um pandemic LPN are returned to the hospitals and so I don't know where you're going to be working at whether you're LPN or RN I just want to make sure if your patient needs safe care if you can't do it you know how it should be done so that the next person doesn't make a mistake and this is something that we're opening up to nursing students who have V2 because typically in order to come to this skills lab you need to already have been a nurse right and you're you're refreshing your skills but if you have the V2 if you have the V2 you can take advantage of the skills lab now nurse Unice also has her own V2 location yes so she actually has like I said before she actually has six months get my camera right six months she actually has six months in the V2 and it's not $300 it's 169 for six months which is better pricing than I even have and then you can add on the skills and then you can add on the skills lab so when I say I'm bringing the resource to you guys here she is yes and so I see a few questions International Nurses you are welcome we can't bring all the skills and the equipment to California so you got to bring California to us book that flight we have students who do it all the time and our test takers allowed absolutely because if you can put hands if you can add the hands on part to what you've already learned in school and also with the V2 I know that it's going to make it easier for you to answer those questions about delegation to answer those prioriti prioritization questions and um also know the appropriate interventions what about this one what if I forgot how to do the stuff like photomy we're here for you that's what we're here for and it's a safe place so it's not like you're going back to your nursing classmates your cohort and saying oh my God I forgot this you all most of the people who attend our photomy courses are nurses nurses who have already um passed their examination it's not safe for them to tell their hospital um administrator their do that hey um I cannot draw blood so they're going to come to us they're going to come to Florida Training Academy it's a safe Ling Learning Place and they're going to relearn those skills here so it is okay that you forgotten but it's not okay to just be stick in a patient and you don't know what you're doing that's not okay and some of us have to do that like you said when I graduated from college and I got my first job I had never done IV I had never done IV skills at all in my clinicals yes and I went to a three-year program and I did not have that practice so it was impostor syndrome CU I'm like I we made it though we survived but we want to make sure that you are just not surving that's the point that's the point can you do it and get away with it yes but who why have that type of anxiety yes when you can feel confident to come into a place and say I never done this before and then let's talk about the differences in the hospital environment from 26 years ago um those nurses were a little more patient back then um now you have younger nurses training younger nurses and it's not that it's a bad thing it's just that um you know we are missing some of that clinical experience so we want to make sure that if you need something that we have it here for you so how to register um right now go to remarnurse.com skillsskills let me put it up so that you can say hey I'm interested to come in the one two two day skills review class and we are taking our um our students for March March What 20th March 20th and 21st and so we love to have you here that we're we're doing 10 okay so it'll be the first 10 that sign up first 10 that pay and you secure your seat to the skills lab um like I said it is a amazing opportunity look at Mark it's an amazing opportunity Mark's trying to get in there go Mark go marking Mark should be a nurse all right we gotta check on that patient when Mark get done um but no it is it is a great opportunity for you to practice your skills lives and like I said um for Remar to be able to do do a in school we have in school prep now we have inlex prep and then you know jobs but now we have like before the jobs yes we have a transition um into it Jacksonville Florida come on down the weather is beautiful um this time of year it's fun it's a nice trip easy flight you know even for me from Ohio just a two-hour flight Southwest Spirit however you want to do it um just get here and make sure that you have this experience because if will definitely improve your confidence and just talk a little bit about other um other certifications that they can get while they're here because we can do the skills but what else could they do um so with proper planning if you are interested in starting a business we do the American Heart Association just not the certification courses on the provider or student level but we're also an American Heart Association training facility so we teach the CPR BLS ACLS and Pal's instructor courses so if you're like okay what's all those fancy terms just look them up but we would have to with proper planning maybe you won't have a two-day stay maybe you will have a four or five day stay so you can email us to let us know what additional courses you need um we do have the IV Therapy the 30 hour certification course which is a hybrid you complete 24 hours online and then six hours on site so when you leave us you won't have like a certificate of you won't you won't be leaving with a license you're leaving with a certificate of completion saying that you've done these skills is going to have our names on them we'll have the checklist but in some states like for Florida as you mentioned before um you don't get IV training in school so once you leave school Florida requires you to take an additional course so our 30h hour IV Therapy course um is Florida Board of Nursing approved but of course you're not going to be here for 30 hours if you don't pre-schedule all this got it sometimes experience is just as nice as certification so you have your RN degree your LPN certification that's really important and now we're adding on to that so um CNA we do CNA exam prep because in the State of Florida you don't have to go to Traditional School to be a nursing assistant if you know your skills you can pass your test you can become a CNA in the State of Florida so we are here from you know someone's like I heard you train doctors I train anyone with a pulse amazing amazing amazing okay let me grab some of these questions people are asking is it an ongoing program so after March are we doing it again in April yes April May June July it's already pre- scheduled out okay so we have ongoing so I'm saying get in where you fit in if you know June is gonna be your month if you taking that summer trip if you're in school whatever get let's get it scheduled um how many hours per day this is a good one so eight and a half hours um but far as your certificate is going to say 16 hours because you have to eat at some point so there we go there we go all right um do you receive a certificate of completion once completed yes you do okay say this is awesome program yes IV Therapy can't wait to take that trip what else we got going on so um again if you are interested please go to remarnurse.com skills it's right under there all right um what about mechanical ventilation so Maria that is a ICU skill and so I don't have a mechanical vent here but and then in Most states even though a nurse should know how to intubate nurses don't intubate and nurses you know we we have to understand the the um the reading that's not a skill though yeah we have to understand the readings on a ventilator but that is a more advanced skill and so once you get through Med Surge and you apply for a ICU position your hospital is going to teach you about mechanical ventilation good question though good question so again the skills that we have um right here that we'll be going over and these are the ones that will help you be comfortable in most clinical environments like your med surge Progressive Care these are the ones I wish I would have had um for day one and then here is day two yes yes yes yes yes yes uh for day two uh and then Audrey your answer is absolutely yes it's okay for a new new nurse who just passed inlex a week ago you are the perfect candidate come on down all right um so what okay so with this cert with this certificate can you work in a hospital setting so what we're saying is that you are on your way to being a licensed nurse whether you're a registered nurse or a practical nurse you need to know these skills so what we're trying to do is make it comfortable for you to go from student to practitioner in the hospital environment okay um do you have to pay when you schedule yes absolutely yep yep you do have to pay that's what's going to secure your seat okay because like I said it's just 10 so we're not going to have people holding when there's people that actually want to pick looks like eka says what about ECG and so during the ACLS portion of of course we're not going to go through like a full you know learning every different block but you're going to have to in order to you're going to have to know about cardiac Rhythm analysis and so we keep it really simple if it's fast slow it down if it's slow speed it up regardless of the Rhythm on that screen check a pulse Y and so because but you will learn about six rhythms and then in in the hospital I I know it seems like we know a whole bunch what we know is if it's abnormal we are calling the doctor so I need for you to know what is abnormal and when you call the doctor what are you reporting up there's the abnormal Rhythm no the doctor's going to want to know the vital signs how is the patient presenting and so that's part of the basics with you understanding how to actually give a report not just to your nurses but to be comfortable talking to those doctors too yeah and so also I'm getting I see comments about International Nurses if you're International nurse here in the United States can they come yes yeah yes yeah yeah like this is for the Remar nurses if you're in especially if you're in V2 I want you to do V2 before you come here because there is a very necessary need to understand chest tubes before you try to practice skills on chest tubes I want you to have that knowledge first and then do the hands on skills okay way I like to think of it is you'll have a higher level of question when you're here we need to be skill focused all those things that you didn't get enough time to practice all those skills now I want you practicing skills so your ticket to enter is V2 so I don't want you even trying to register for the skills lab if you haven't completed V2 there you go and we're going to be checking too we're gonna be checking so that's another thing um accommodations yes I stayed in the actually I stayed in the the Sheron okay and it wasn't bad I actually I I I enjoyed it I enjoyed the food I enjoyed the service so um we can definitely discuss more about that maybe we can put together a package for those who be flying in um but yeah you can get the six-month training as well as the skills add-on right here from Florida Training Academy um for nurses outside of the US well in order for you to do the skills lab you got to be able to come here to do the skills lab I know we're trying to set up one um in in our um in our Nairobi location we'll probably do the same thing there so I might be remember I told you I might be bringing you yes yes yes I'm coming I'm coming so we can get our International Nurses set up too that's um that's something that I'm so excited about yes but um yeah for right now our location is Jacksonville Florida the Sunshine State so um thank you so much nurse un yes we are associated Remar and thank you so much so it's been two years in the making um we love you all we appreciate you all and um Amilia says how can I get Miss Eunice's V2 and so um it is at I love that it is at fling.com and you're going to see a tab in the drop down menu that says inle prep there you go get you go training.com we'll also put it on the screen and um I don't know I just I just want to thank you for your dedication to nursing students because what we talked about is oh people say that there is a shortage of nurses but actually there's a shortage of nurse Educators abolutely right so depending on you all so I train you you have to be a great preceptor and train the future nurses um so it you what we were taught it was um see one do one teach one yeah there you go yeah and what I remember is don't leave without replacing yourself that's right so that's what we're doing we have 600 700 nurses who will be replacing us oh man and we're be in great hands and so are our patients all right everyone so thank Youk thank you thank you Nurse unit look look look at the skills lab oh gosh for exitting they are they are they are um so people are really excited about it and so am I so am I it's such a beautiful Ministry to be in with nursing but you need a lot of support yes you need a lot of support so we're going to make sure that you feel supported along the journey all right guys we are getting back into it we got Monday motivation this is perfect it is stop waiting start doing oh okay all right I okay listen Monday motivation will be brought by nurse Unice today look this will happen when you stay when you stay so the Monday motivation is stop waiting start doing and it's this this is the idea for this week there is one thing there's one thing let me take this off that you can't teach for inlex you cannot teach this and I'm sure it's the same with the skills lab yes what is it effort I love that can't teach it can't teach it and so what I like to tell students is to show up for yourself the way you show up for everybody else and you know if it was your kid your husband your co-workers your mother you put an effort put that same effort into yourself um and so I know you're going to pass in klex I know you're going to do it and I hope to see you here in the skills lab but if the word of the day motivational money is effort the same effort that you're giving out to others keep some of that for yourself okay please because what happens is this well this is what the Bible says a slugger's appetite is never filled but the desires of the diligent are fully satisfied the diligence so the takeaway was just having the dream alone isn't enough whatever that dream is if it's the past inlex just to think about it that's not enough in the dream is free but the hustle has to be paid every day um strong desires lead to strong results and this week put in an effort that is equal to the success that you want to achieve and anybody that's here obviously is serious about passing inlex yes and when we come on here we pray and praying I love praying praying helps you get through but when it comes to the inlex you can't just pray about it you also have to be prepared yes so you pray and you prepare and so this week I really want us to be intentional about the things that we say we want because this is what I learned everybody has the life that they actually want to have if they put in the effort yep and if you don't have the life that you want to have what do you need to do to change about it because if you don't change anything about it then that's actually the life that you want yes and so write it down so motivational Monday if don't already have your Journal out um write down your plan for the week which includes um how much of your V2 lesson because you have the entire agenda they have a study plan and then you know so just start writing some things out and I see people who are asking for packages well in order for you to get that package we don't know where you're coming from so I need for you to go to Remar nurse.com skills and putting your interest so we can help you with that package so we can help you get here to Jacksonville Florida right so every there is something that everybody needs to accomplish today and like nurse Unice said make sure that you are giving yourself the same amount of energy and time that you give everybody else so I know that I need to sign my kids up for summer camp right and so I'm signing my kids up for summer camp and y'all probably signing your' kids up for summer camp too but sign yourself up for that ATT and sign yourself up for v2 and sign yourself up for your inlex test date because when you do stuff like this happens you congratulations did all right so I showed up for myself finally and passed my inlex on 2525 thanks Remar I am now a Remar nurse yay that's what I'm talking about do it for yourself do it for the plot twist okay just do it because something different might happen for you which is the adventure that's the adventure and um you know I man and listen to me if something if you have an opport this is motivational Monday cuz we just back and forth we just like riffing um if you have an opportunity before you it's because you're ready for it that's right don't doubt yourself if there is an opportunity that is before you it's because you're ready for it so take it I am now a Remar nurse I took my inlex lab Wednesday and find out I passed on Saturday look she look at the challenge look at the challenge who's next tap tap in look here this is her look solo is next she says thank you Professor Regina I tested and passed my inlex RN in Kenya on the 10th of February 2025 I was able to order the quicka for my personal Library thank you for the YouTube videos that is so phenomenal congratulations in Kenya a usrn yes that is big and then dorcus I passed my inlex exam on the 29th of January thanks Remar and your team but listen to me listen and the beautiful thing is that you are all still here even though you pass because you want to spread that motivation to the community and oh man look at this I got my RN license thanks to Remar I wish to do skills lab long time okay I will check my schedule and continue following this the price is amazing too I want to make it affordable for you all thank you Remar yeah I mean 300 for a two-day skills lab you just you're just not going to find that like that's crystal said I'm next and Jacqueline says I'm next and looks like Ivy says I just picked my date today amazing you all yep it it's it's coming for you but this week our motivation is that you have to be diligent you have to be diligent look at florena says hello nurse Unice nice to see you on here nurse Unice also has her own you listen she also has her own YouTube channel tell them the YouTube channel so it is Florida training so YouTube .f florat trining and yes we have ACLS we have CNA we have CPR so um again we train anyone with a pulse and so but I'm happy to be a part of the Remar team a Remar nurse and so yeah we are a good team God put us together and we're going to keep blessing others around the world amazing yep so if you see the comment you can follow nurse Unice and get to know her before you come down so when you come down you you'll be more than familiar with her voice and then when you're doing your skills you'll hear her voice in your head you'll hear you'll hear her voice uh so uh let me let me know so we got we got March 30th coming up what are the dates in April um so April would be April 24th and 25th June is June 22nd and 23rd I bet you that's going to be the most popular one yeah give them a few more weeks to they get everything scheduled out um and so in the future hopefully we will have a larger skills lab and we can have another nurse to assist us so right now we're just starting off with 10 but I I think that's a very good start until we can grow and and get another nurse educator in here no you know what and I'm going tell you right now you got the Hands-On skills because it's not me it's not me so I want you guys to really take advantage of nurse because literally she does so much and so for her to take her time out to do two full days with the Remar nurses on skills skills we got this we're about to rock and she's like also like she said she's training entrepreneurs she's training licensed nurses so um we are we are blessed to have her to do our skills so I just want to thank you so much um for coming on today for this is a great listen you never know what's gonna happen with Remar y'all have to stay tuned y have to stay tuned because we are finding gems all over this planet oh my goodness so so Katrina says hi professor Remar I took the in collect on the 29th from Navi nambia I mispronounce that and guess what I am now a REM martiners thank you so much and God bless you and the team we're so proud of you oh my goodness so very proud of you and welcome to the welcome to the the nurse family now you're on the other side I have to give credit to glennice glennice says her vibe rocks too high five no that's you yeah yep no it is it's amazing and that's one of the reasons why um she's the number one skills instructor I love it on the planet love it I love Planet I love training you all in these skills yes yes yes see see and that's the thing that's the thing you know she she literally says I love training you I love training you man come on it's fun and when the light bulb finally goes off it's like yeah right so we're GNA help turn those light bulbs on help you to become competent nurses so you're gonna pass your inlex yay and then after you pass your inlex you finish your V2 let's put some hands to all of that didactic that lecture classroom let's put hands on I remember being in the lab once and um it was during the um catheter insertion check off and I asked the student to empty the catheter drainage bag and she said my short they did not teach us that so all that teaching in silos your your patient is not a silo holistic head to toe let's figure some things out so and you know unfortunately we just don't have the Educators like we used to have and so we want to fill in that Gap that's true and there is a gap and let's address it and also put in the effort to make sure that you don't have a weakness in an area that you can be strengthened in beforehand okay so going into your first nursing job you are going to be more than prepared you're GNA be more prepared because you're a Remar nurse that's right and and Remar nurse is like to travel and when you travel sure listen we do like to listen if I'm the leader of the Remar nurses we travel that's one thing about it we will get on the flight and we will go and so one thing that's unique about those traveling nurses whether you're LPN or RN is that you're sometimes going to receive the most challenging patience yeah and we need you to be prepared for that assignment and so we have four patients here everybody has their own issue or concern I need you to take very good care of our four patients so we will see you guys um in the skills lab here right here in Jacksonville Florida nurse units will be there waiting for you but go over to uh remarnurse.com skills so we know who you are we know and it's okay if you say you're a nursing student if you haven't passed inlex you my dear are a nursing student yes you are and that's okay that's okay um so we're going to go there put in your information so if we need to email you if we need to call you whatever have you we'll make sure that you get connected to the class that you want to have all right yes yes perfect it was nice meeting you all hey new family hey cousins bye all right and for the rest of you guys now that Monday motivation is over get back in the V2 get back in there and studying all right um and remember as always you got to say it with me yes you can you can you will you will you must you must pass inlex pass the inlex see you later guys bye everybody