Collaborative Bachelor of Science in Nursing Program

(University of Windsor, LambtonCollege, St. Clair College)

Introduction to Nursing III

Clinical Nursing Experience

63-372

(10 hours/weekly)

Course site - Faculty of Nursing, University of Windsor

Fall 2007

Lead teacher: Prof. Patricia McKay

University of Windsor

Room 313

253-3000 ext 2287

E-mail:

Office Hours

1:00 – 2:30 pm Monday

or

By Appointment

© faculty of nursing: COLLABORATIVE NURSING PROGRAM 2005

ALL RIGHTS RESERVED

63-372 Clinical Nursing Experience

(10 clinical hours/week for 13 weeks)

I. Course Description

This course is the seventh course in a sequence of 12 clinical practice courses. Emphasis is on the practice of professional and technical skills in the care of teens, and young adults experiencing complex or multi system health disruption within the context of family and community (Prerequisites: 63-278). (Corequisites: Registration in all year 3 fall semester courses.) (Offered on a Pass/Non Pass basis.)

II. Course Intent

This seventh nursing clinical course is intended to introduce the 3rd year nursing student to the significance of complex health problems on family. Assessment skills will be further developed and enhanced, crisis theory, and counselling skills will be used. Evidenced based interventions will be practiced

III.Program Competency Outcomes

By the completion of the program, graduating students will be able to:

1.Implement behaviours to promote personal and professional self-development.

2.Integrate the ethical, legal, professional and regulatory parameters into nursing practice.

3.Formulate clinical judgements that are based on critical inquiry and analytical reasoning.

4.Integrate nursing and multidisciplinary knowledge into nursing practice.

5.Integrate research findings into clinical practice, education and management.

6.Implement the nursing process to promote, maintain, and restore the health of individuals, families, groups and communities.

7.Use of teaching/learning process to promote health of individuals, families, groups and communities.

8.Collaborate with clients, their families, communities, and members of the health team and other organizations for the promotion, achievement and restoration of optimal health.

9.Integrate leadership and management roles into the delivery of health care.

10.Engage in activities to promote the development of the profession of nursing.

IV. Course Competency Outcomes 63-372

By the end of this course the student will be able to:

1. Build positive personal, interpersonal, group, community and professional relationships to foster the health of families experiencing crisis due to complex health problems and common mental health issues.

CRITICAL ELEMENTS

  • Use a reflective journal to analyze how one’s own values and beliefs influence professional practice when working with families in crises.
  • Integrate feedback from faculty/other health professionals and the client /family to set goals to improve own practice.
  • Analyze own learning needs & develop a personal learning plan to reflect the current clinical area.
  • Identify & discuss leadership styles and group processes in the clinical area.
  • Use negotiation to motivate, and promote learning, and health outcomes for self and others.
  • Relate group processes and “self” through reflective activities and communication skills labs.
  • Successfully completes complex skills labs.

2. Maintain standards of professional practice as they apply to the care of families in crisis.

CRITICAL ELEMENTS

  • Provides care to individuals or families in crisis, or with complex needs within the role of student nurse consistent with the College of Nurses of Ontario standards of practice
  • Adhere to the policies of the Collaborative Nursing program and participating agencies, when caring for families in crises
  • Advocates for the rights of clients or families through application of CNO consent to treatment in the provision of care to families in crises, or with complex needs.
  • Analyze with assistance ethical dilemmas encountered in the care of clients or families
  • Document nursing care accurately.

3. Formulate clinical judgments based on the health needs of families in crises and in the care of adults and families living with complex life-long challenges, crises, and disabilities.

CRITICAL ELEMENTS

  • Assess and adequately diagnose the needs of clients or families using health histories, physical assessment & diagnostic reasoning.
  • Assess stress, fear and anxiety behaviours in clients or families experiencing loss/crisis or grieving.
  • Assess occupational health risks for adults in Southwestern Ontario.
  • Prioritize the needs of clients or family members in crisis, or with complex health problems using critical analysis skills.
  • In collaboration with clients or families experiencing crises or with complex health problems, generate strategies to promote family-centered health.
  • Verify evidence-based clinical judgments with faculty or other healthcare professionals..
  • Identify gaps in adult Mental Health Services in Southwestern Ontario.
  • Analyze own nursing actions with clients or families experiencing crises, or with complex needs.

4. Integrate selected theoretical frameworks to promote health in families experiencing complex health problems

CRITICAL ELEMENTS

  • Using Bevis, identify the relationship between an individual and/or family’s health, maturation and adaptation,, when experiencing high-level stress.
  • Use multi-disciplinary theories including change,crisis, systems, and family theory to promote the health of clients or families in crisis, or with complex needs.
  • Provide theoretical rationale for all actions taken to promote client or family’s health during crises or with complex needs.

5. Apply the concepts of evidenced-based nursing and research strategies to promote the optimal well being of families in crises and for children and families with common complex problems.

CRITICAL ELEMENTS

  • Demonstrate evidenced-based practice in health promotion with clients orfamilies in crises or with complex health problems.
  • Provide rationale for the use of research & evidence-based practice in health promotion with clients or families in crisis or with complex health problems.
  • Identify & summarize a research study applicable to the current clinical area.
  • Formulate researchable questions to promote the health of clients or families experiencing complex health problems

6. Apply the nursing process to promote health and well-being and prevent illness/injury within families with complex health concerns/crises.

CRITICAL ELEMENTS

  • Generate diagnoses that logically follow from data collected.
  • Collaborate with clients & families to formulate outcome criteria
  • Integrate selected Evidence-Based Practice Guidelines related to clients or families in crisis or with complex health problems.
  • Foster holistic selfcare abilities & sustainability in clients/families and care givers
  • Apply selected criteria/formats to develop comprehensive care plans for individuals, families/groups.
  • Evaluate client or family outcomes when in crisis or with complex care needs by comparing actual to anticipated outcomes and modify the plan of care as required.
  • Compare and contrast client or family decision-making strategies related to their care.
  • Articulate theoretical rationale behind planned interventions.

7. Implement teaching/learning plans to assist families in crises in promotion of health and illness/injury prevention.

CRITICAL ELEMENTS

  • Collaborate with a client or family in crisis or with a complex care need to determine learning needs.
  • Mutually develops outcome criteria with client or family
  • Implement effective learning plans to promote client orfamily centered health.
  • Evaluate effectiveness of teaching strategies with clients or families by comparing actual to anticipated outcomes.
  • Modify teaching/learning plan as required for clients or families.

8. Collaborate with families experiencing complex health problems, and the health care team, in developing empowerment strategies to achieve optimal health.

CRITICAL ELEMENTS

  • Empower clients, families or groups to build on the assets they possess.
  • Develop strategies to promote self –care in clients or families.
  • Use therapeutic and professional counselling and communication techniques with clients or families in crisis or with complex care needs.
  • Advocate for a client or family’s plan of care.
  • Collaborate with members of the health team and related agencies to promote family health with clients or families experiencing crisis or with complex needs.

9. Analyse student nurses’ leadership roles concerning policy development, resource management, and advocacy related to the complexity of health care for adults living with complexity, change and marginalization.

CRITICAL ELEMENTS

  • Develop leadership strategies that optimize client health.
  • Demonstrate awareness of mission, intent, and functions of programmes & resources in clinical area.
  • Develop client or family/group partnerships that support health care networks and coalitions.
  • Demonstrate time and resource management in the care of clients or families in crises or with complex care needs.
  • Lead discussions on a health care issue relevant to a client or family in crisis.

10. Influence Nursing’s role in the promotion of health for families in crisis

CRITICAL ELEMENTS

  • Critique how and to whom nurses communicate their findings, concerns and ideas (plans) associated with the client or family in crisis or with complex care needs.
  • Demonstrate professionalism and competent care in complex situations using the CNO standards “Therapeutic nurse client relationship”
  • Contribute to clinical group conferences on health promotion for clients or families in crisis or with complex care needs.
  • Participate in nursing and other professional conferences on family health promotion and illness/injury prevention during crises.
  • Identify factors which influence the role of nursing in client or family-centered care.
  • Discuss nurses’ influence in relation to social action, social justice and political action!

Course Competencies:

Application of the Lenburg COPA model with its 10 Core Practice Competencies and Universals will be applied to selected human health care needs. Nursing interventions and application of critical thinking to the Nursing Process will be performed for simulated, virtual (computerized) and real individuals in the “client” role.

A Universal Competency (UC) is an outcome that nurses must continue to demonstrate in any nursing activity or action. Critical elements are defined as single, discrete, observable behaviours that are mandatory for designated target elements. As such, all critical elements must be demonstrated safely, professionally and knowledgeably for the designation of practice “competence”. All course competencies must be demonstrated in this course for a “pass” indicating the first/beginning/novice practitioner level of achievement in this course.

Technical elements/skills are psychomotor activities that integrate universal competencies into care/interventions. 63-372 Course Competency Outcomes are derived from the program competency outcomes. Critical Elements are developed to guide experiences and learning activities throughout the semester to provide learning opportunities as students strive to master Universal Competencies and CPEs, and to apply knowledge through CPE activities.

Students must integrate theoretical components and rationale, safety, critical thinking, and current CNO Standards and therapeutic interactions as well as the level of expectation of 10 core competencies by the end of the first semester.

V. Course Requirements, Evaluation Methods, Grading System

63-372 will be offered on a Pass/Non Pass basis

All critical elements must be met. All universal competencies must be consistently demonstrated.

“At midterm the student will receive a formative evaluation. If there is no opportunity to assess a specific competency, it is to be left blank at midterm. Plans should be made by the student to meet unmet competencies by the end of the experience. All competencies must be evaluated on the final evaluation”.

Clinical Assignments:

1.Learning Plan – due first week of clinical experience.

2.One “mini” client assessment (using the Clinical worksheet) and a care plan (see sample care plan framework) on one identified nursing diagnosis. Due week 4 of clinical.

3.Client health assessment (see sample Health Assessment framework) and a care plan on two nursing diagnoses. Due week 8 of clinical.

4.Reflective journals to be completed weekly. The purpose of the journal is to provide documentation of progress towards completing course competencies. Journals should also include thoughts and feelings related to the clinical experience. The LEARN framework is recommended to be used as a framework.

5.Critique of research article – see outline – due week 9 of clinical.

* Due dates may change somewhat with individual clinical instructors.

Critique of Research Article 63-372

Select a research article related to some aspect of your clinical experience. You CANNOT use an article in the 63-373 course package.

Identify:

  1. Title of the article
  1. Author(s)
  1. Purpose of the research
  1. Research design (qualitative, quantitative)
  1. Sample: (Describe the subjects studied. What were the criteria for inclusion and exclusion in the research? Were the subjects similar to the clients you are seeing in clinical practice this semester?)
  1. Was the research approved by an ethics board or other review board?
  1. Findings: (State the major findings from the research. Which of the findings, if any, were statistically significant.)
  1. Clinical relevance (State how the research does or does not guide your thinking. State why you can or cannot use the findings in clinical practice).
  1. Derive a researchable question or hypothesis (relevant to the promotion of health of clients and/or families) that the authors could address in their next study.

VI Faculty of Nursing Policies

No supplemental examinations or assignments will be offered in this course.

(Policies adopted by Steering Committee April 5, 2001, Revised December 2002)

Clinical

Students must attend all clinical nursing experiences and laboratories unless they have permission from the professor and/or a medical certificate to account for their absence.

There will be both Communication skills & Complex health care labs.

Student nurses in the clinical setting are to be punctual (if going to be late notify agency/

instructor).

1. Prior to administering medications, a student must achieve 100% on their medication / calculation quiz. If a student has achieved 100% in the 378 calculation quiz, that will be sufficient to allow them to administer meds in 63-372. Students will have a maximum of 3 opportunities to pass the test. Use of calculators will not be permitted. Students must show their calculations on the test sheet. Students are not permitted to administer meds until 100% has been achieved. Students who do not achieve 100% by the third test will be deemed to have not met the Universal Competency of patient safety & will be deemed unsuccessful in the clinical course.

1. In the event of absence, students must notify the clinical setting prior to the scheduled start time. It is assumed that students will return for the next day of experience unless the instructor/agency has been otherwise notified. A medical certificate or other documentation is required to explain absence.

2. In the case of prolonged absence due to illness, students may be required to provide medical clearance before returning to the clinical setting. This clearance should be obtained from your own physician or nurse practitioner or through the University of Windsor, St. Clair College or Lambton College Health Centre.

3. Students with casts or wounds are not permitted on some hospital units. Check agency policies for each setting.

Professional Conduct and Appearance

Nursing students are offered experiences in a variety of settings. As members of the nursing profession, conduct and personal appearance should be congruent with professional expectations of the College of Nurses of Ontario.

Conduct

Nursing students are required to demonstrate behaviours consistent with the following College of Nurses of Ontario documents:

  • Professional Standards for Registered Nurses and Registered Practical Nurses
  • The Standard for the Therapeutic Nurse - Client Relationship
  • The Ethical Framework for Nurses in Ontario and Explanation of Professional Misconduct

The failure of any nursing student to conform to these documents and the policies of the Faculty of Nursing, University of Windsor, may result in dismissal from the nursing programme.

Dress Code Policy

A dress code policy is necessary for the purpose of infection control and the conveyance of a professional, well-groomed appearance.

Hair must be neat, clean and worn above the collar; moustache and beards must be neatly groomed.

Hands: Nails must be short, clean and well manicured. Clear or pastel polish may be worn but must not be chipped.

Make-up may be used conservatively, but must be scent-free. Proper hygienic practices are expected.

Jewellery is restricted to a plain wedding band, watch and only a small earring worn in one or both ears. Tattoos must be concealed wherever possible.

Equipment: Students must follow medical asepsis practices to care for their equipment; i.e., bandage scissors and stethoscope.

Uniforms

  1. Students provide their own uniform, white lab coat, white duty shoes, white stockings or socks, watch with a second hand, bandage scissors, penlight, stethescope and photo-identification name tag.
  2. Uniforms are to be clean and sized appropriately. They may be either white or a solid colour. Students must follow the uniform policies for specialty areas Renal Dialysis, Psychiatry and the Operating Room). Students’ nametags should be clearly visible.
  3. Solid white, closed, athletic shoes are acceptable in lieu of duty shoes. “Crocs” or similar shoes are not allowed.
  4. Students are to be dressed in casual-business attire (no jeans) when uniforms are not required, i.e. Orientation days, Psychiatry, community agencies, seminars or field trips. Refer to agency’s policy and professional guidelines.
  5. Lockers are generally not available. Areas for coats and back packs will be identified. Keep valuables on your person or in designated areas. Uniforms should be worn only while on duty. Changing after duty, though recommended, may not be feasible; therefore, cover your uniform when it is necessary to wear it home to maintain infection control. Do not wear the same uniform from one institution to another without washing it first.
  6. When doing clinical research, students must wear appropriate professional attire, for example, a lab coat over street clothes and photo-identification badge.
  7. No gum chewing. This has been specifically requested at all sites

VII Complex Health Care Laboratory Experience/ Expectations

Students are expected to do readings and previewing of video or DVD content as outlined prior to labs.

Students are expected to be familiar with all relevant materials listed and covered in labs as these materials will form the basis for testing, and students are expected to practice in lab in addition to attending scheduled lab times.