By Matthew N. Skoufalos
Stefanie LeGrande, MSN, RN is a Clinical Nurse Educator at the Kramer School of Nursing in Oklahoma City, Okla.
For 10 years, LeGrande worked as a veterinary technician. She entered the field with an associate’s degree in applied sciences, and after 10 years of equine surgery had compiled an impressive breadth of experience.
The pace of the clinic was intense: four to seven scheduled surgeries weekdays, plus emergencies. Not only did the environment teach her how to deal with such a workload, it also provided her an education in quick thinking and problem-solving. When something broke in the surgical suite, LeGrande was on the spot to get it working again.
“When you come from the background of being a nursing technician, you don’t have somebody to come on and troubleshoot your problems,” LeGrande says. “There was no one to call. If we were having problems with a pump for fluids, I had to fix it.”
After a number of years, however, LeGrande began to consider a teaching career. She had resolved to return to school for a bachelor’s degree in biology, when she was offered an interesting opportunity. A friend whose father owned an outpatient surgery center suggested that she apply to work at his facility while she was going to school.
“I already knew sterile technique,” LeGrande says. “I already knew my instruments, and they were short a scrub tech one week. As a nurse extern I floated all through the OR and got a lot of great experience in orthopedic surgery.”
Without her veterinary background, LeGrande believes she would not have been prepared to step into such an active nursing role, and that she certainly wouldn’t have been able to take advantage of the hands-on opportunity to train. That realization informed the next stage of her professional development—nursing education—where she works to express to her students the value of seeking a variety of nursing opportunities. Neither is the paradox of getting her students qualified for that exposure lost on her.
“It’s very hard to get slots in the operating room for our students, and often times it’s not easy to enter the operating room without a background,” LeGrande says. “We want you to have experience, but we need OR nurses.”
“The thing that I love about nursing education is bringing a passion for the OR, which often gets overlooked,” she says.
For those students who aren’t fortunate enough to have had a variety of professional medical experiences under their belts, the Kramer School of Nursing recently received grants to purchase a pair of Meti iStan hi-fidelity mannequins. The iStans are able to blink their eyes (which have reactive pupils), perspire, and describe their symptoms to students through embedded voice speakers controlled by the instructors in adjoining rooms. For LeGrande, the robots allow her to simulate various medical conditions for her charges in exacting detail.
“[iStan] gets the students involved,” LeGrande says. “It’s no longer passive learning. The fingers and toes begin to turn blue as the blood pressure drops. You can program crackles and wheezes in the lungs; very amazing stuff.”
The most compelling function of the mannequin, she says, is its ability to open up various avenues of the nursing world to her students.
“I went in and talked about the actual surgical experience the patient would have in the OR,” LeGrande says. “We were able to bring the entire perioperative experience into the classroom.”
LeGrande also believes that a teaching device like iStan is a particularly critical educational component in the nursing field, where she estimates that “probably a good 77 of 80 of our students entering nursing right now are career changes; people with previous degrees,” she says.
“For a lot of people right now, the need for a straight career change is huge right now,” LeGrande says. “Many people enter nursing because they hear it’s a great job and there’s always going to be this demand and need for it. When you begin to open the doors for them and they see the potential, they get excited.”
LeGrande says that the Kramer School in particular is “making a difference in people’s lives and their ability to go to school” because the program can matriculate instantly students with a 3.0 GPA and certain prerequisites. Comparatively, she says, nursing students in a place like California might face a two-year waiting period, or a disproportionately limited number of acceptances from among a large applicant pool.
“This is a very exciting time for nursing right now,” LeGrande says.
Of all the nursing opportunities to which she hopes to expose her students, LeGrande always works to show them the breadth of options available in the OR. From nurse anesthetist to PACU director, “it does give you a lot of career choices,” she says.
“Many patients don’t even understand that there is a [difference among specialists working in the] preoperative, operative and recovery areas,” LeGrande says. “[Explaining this] begins a conversation with students that they could work in any of those areas.”
LeGrande also emphasizes to her students that the variety of their professional experiences yields its own lessons; for example, her background in veterinary medicine informed her work in geriatrics.
“I think the experience I had with non-communicating animals made me more in-tune with my Alzheimer’s patients,” she says. “That just transferred right over; whatever’s happening, you just roll with it very easily.”
LeGrande hasn’t lost her love of animals, either. Together with her children and husband, she breeds and shows champion Bengal cats. She describes the Bengal as “a very fun and active breed” that is “low on the allergen level, looks like a wild animal, but is fully domesticated.” Her success in the cattery comes as no surprise given her ardent dedication to the teaching, nursing and veterinary professions.
“I think that as a nurse in general, bring a passion for whatever you’re going to do,” LeGrande says. “I’ve always had a passion for the OR. Whether it’s horses or people, I have had a passion for making a difference for the person there. It’s a deep responsibility that shouldn’t be taken lightly.”