Introduction to Medical-Surgical Nursing Practicum

West Coast University

Bachelor of Science in Nursing

Clinical Course Additional Guidelines, Forms, and Tools

Dear Instructors and Students,

Below are forms and tools designed to assist you with your clinical instructions and experience.

These include pre-and post-conference guidelines, clinical orientation guidelines in general, orientation scavenger hunt and pharmacology (medication) research items for clinical rotation.

Please feel free to notify me if there are any additional information that we may need to address during your clinical orientation.

Sasha Rarang, MSN, CCM, RN

Pre and Post Conference Guidelines:

During the Pre- and Post-Conference, students are required to actively participate. Your participation is 2 % of your total grades for the course.

Students during Pre- Conference:

1. Students will receive their assigned client from the instructor unless otherwise instructor allows students to pick their assignment at some point.

2. Receive clinical instructions daily objectives from the instructor.

3. Clarify any question from previous meetings prior to clinical instruction if necessary.

4. Students should participate actively in client endorsement or shift change report.

Students during clinical instruction and in post conference:

1. be able to identify client (age, marital status, psychosocial history, medical condition, mental status, and safety issues.

2. State client needs.

3. Describe pertinent observations in a review of system manner, significant events of this hospitalization (admitting diagnosis, surgery, emotional crises, fracture, restraints, swallowing difficulties, presence of tubes, etc.)

4. Report situation and potential or real problem experience of assigned client to instructor or to the staff assigned to client. Always report to your instructor first unless staff involve is with you. Practice SBAR reporting.

5. Discuss nursing approach/solution to perceive client problem to clinical instructor.

6. List the drugs administered, state their actions, doses, side effects, desired effects, untoward effects and method of administration for each (in short a drug study).

7. List treatments, and state the purpose of, and client’s response to each.

8. Labs pertinent to the client.

9. Participate in the teaching of the client concerning their medical/nursing concerns.

For Post-Conference:

1. Discuss about your client’s significant event for this hospitalization.

2. What are your client’s needs today (Describe client situation, your assessment, potential and real problems (Utilize Gordon’s Functional Health Pattern in relation to Nursing Process). Basic needs and needs requiring special attention.

3. What medications were administered, or is your client receiving? Why? What safety measures were used?

4. What treatments were done? Why were these done? What special principles or safety measures were involve?

5. Did You meet your client’s needs? Explain.

6. What could you do to improve your nursing care for your client(s)?

7. What were your feelings about taking care of your client(s)?

8. Presentation of special topics if necessary.

CLINICAL ORIENTATION

Focus: During orientation, students will:

1. Learn the physical layout of the clinical area and client unit.

2. Review and be familiar with the OSHA guidelines, National Patient Safety Goals, Standard Precautions, HIPPA guidelines, abuse reporting, QSEN initiatives as related to the clinical setting, Rapid Response Team; Code Blue, Code Red, and other emergencies, know where to find protective equipment, sharp disposal boxes, and infection control manuals, MSDS book, located on the unit.

3. Discuss the ethical, legal issues involve in the nursing care of clients. Discuss about “Patient Rights.”

4. Identify the chain of command as it relates to the clinical area.

5. Be familiar with usual routines for the unit (a) vital signs, (b) meal time, (c) visiting policies.

6. Be introduced to the charting system for the clinical facility.

7. Be introduced to policies related to IVs and medication administration.

8. Discuss nursing responsibilities related to medication administration.

9. Review course syllabus, school policies as they relate to clinical experience, location and time of pre and post conferences and other scheduled clinical experiences for this course.

10. Be oriented to clinical assignments.

11. Review the clinical evaluation tool and rubrics.

12. Review the clinical assignments and schedule for submission e.g. Nursing care Plan, Nursing care Map.

13. Discuss the role of baccalaureate prepared nurse as provider of care, manager of care, and member of the profession.

14. Discuss the issues of confidentiality related to clinical setting.

15. Review the requirements for documentation and papers related to this course (nursing assessment, Clinical Prep. Guide, 60 Seconds Assessment, Nursing Progress Notes (Checklist), Nursing Care Plan, and Care Map, etc.

16. Review lab, library, and tutoring available to assist student learning.

ORIENTATION SCAVENGER HUNT

Students are required to locate the following in the clinical setting:

Resources:

___ Policy and procedure books

___ OSHA information

___Infection Control Procedures

___Charting Guidelines

___Textbooks and other resources

Medication Room:

___Code

___How and where are narcotics dispensed?

___Where are emergency drugs kept/code cart?

___Where are clients medication kept?

Emergency (Crash Cart) with defibrillator

___Emergency oxygen

___Emergency equipment

___Restraints (when to and when not to)

___Suction equipment

___What equipment do you need to suction?

Patient Medical Records

___ Lab results

___Transcribed orders

___Advanced directives guidelines

___Patient teaching information

___MAR

___History and Physical/Doctor’s Progress notes

Nutrition Room

____Code

____Ice Machine

____Refrigerator for client’s food

____Nourishments

____Tube Feedings

____Supplements

____What equipment do you need to initiate a tube feeding?

Treatment Room

_____Catheterization and irrigation supplies

_____Oxygenation supplies

_____Sterile dressings and supplies

_____Bowel and Urinary supplies

_____Tape

_____Syringes and Needles

_____How are supplies charged to the client?

Equipment (Clean)

_____Wheelchairs

_____Backboards

_____IV poles

_____Accucheck machines and supplies

_____Bedside commodes

_____Cardio-respiratory monitors

_____Oxygen saturation monitors

_____Linens

Locate the following:

_____Fire alarms and exits

_____emergency outlets (red)

_____Client’s census/assignment

_____Human resources

_____Radiology

_____Laboratory

_____Emergency Department (ED)

_____ICU/CCU

_____Pharmacy

_____Cafeteria

_____OR/PACU/ Day –Surgery

_____Chapel/Meditation area

_____Parking lots (for students)

Clean Holding

____Linen Care

____Isolation cart

____bedpan/urinals/bath and emesis basins

Client Unit

____Signage (NPO, Fall Risk, No BP to right or left arm, no blood drawing to which arm.

____Outlets/emergency outlets

____Sharp containers

____client call buttons

____familiarize yourself with bed controls

____lighting & emergency call lights in rooms

Common Medication Required for Clinical to Research

Aspirin

Acyclovir

Colace

Coumadin

Demerol

Digoxin

Dilantin

Heparin

Inderal

Insulin

Isordil

Lasix

Maalox

Penicillin

Prednisolone

AZT

Colchicine

Capoten

Glyburide

Glucotrol

Gentamycin

Guaifenesin

Epogen/Procrit

Levaquin

Librium

Morphine

Nitroglycerin

Reglan

Simvastatin

Synthroid

Tenormin

Vasotec

Vancomycin

Xanax

Zantac

Ancef

Albuterol

Atrovent

Bactrim

Cardizem/Diltiazem

Darvocet

Humulin Insulin – regular, NPH, 70/30

Novolin- regular, NPH

Humalog insulin

Lopressor

Lorcet/Lortab

Lovenox

Neupogen

Norvasc

Percocet

Plavix

Prinivil/Zestril

Rocephin

Ertapenem

Merepinem

Rocephin

Valium

Vicodin

Zocor

Zofran

Tylenol # 3

Tylenol

Tucks

Narcan

Erythromycin ointment

Vitamin K