NURS 192 Nursing Care of the Adult II Lab/Practicum Renton Technical College
Syllabus LPN Program Winter 2010
WHERE:H Building: Nursing Lab H-101/ Assigned Clinical Location
WHEN:LAB: See: Tentative schedule for dates and times
CLINICAL: As assigned:
Orientation: As assigned ~ see individual clinical schedules
INSTRUCTORS:LEAD INSTRUCTOR: Nancy Cusick RN, MSN-ED, CCRN
Phone: 425-235-2352 ext. 7910
Email:
Office: H-211
Office hours: By appointment
CO-INSTRUCTOR:Neil Foltz, LPN, RN, BSN, MN
Mary Kangas, RN, BSN
Michael McEwen RN, MSN
CLINICAL LOCATIONS: As assigned:
COURSE DESCRIPTION
Students build on skills learned from long-term care facilities and acute care clinical. The focus is building on skills learned from Adult I and building new skills learned in the lab, reinforcement of assessment skills and communication skills. Emphasis is placed on skills including assessing client physical and psychosocial needs, setting goals, providing appropriate care interventions, and evaluating client’s response to care and treatment as a Licensed Practical Nursing student. Students demonstrate how to accurately and safely prepare and administer medications. Students care for one or two clients with chronic, acute, and medium acuity problems in long-term care and in acute care. Using the nursing process, LPN students begin write care plans that focus on problems identified in selected clients which would be developed with the RN in the clinical setting. This is achieved through the use of Orem’s Self Care Model and is supported by Roy’s Adaption Model. The basis of the theory/practice is provided by the lecture portion of the Adult Health 1.
The instructor will provide a QUIA PAGE with the handouts, outlines, and any learning activities for you to access and print out. The student will watch videotapes and take the quizzes that are with them on the Delmar computer based learning tool prior to the scheduled lab and print out the results of said quizzes (must be 80% or above) to be turned in at the start of each lab class. The Students are highly encouraged to reference the RTC learning resource library.
COURSE OBJECTIVES:
Upon successful completion of this course, the student will be able to:
- Apply principles and concepts of the nursing process in delivering care to patients and clients in a variety of clinical settings
- Work collaboratively as an effective member of the healthcare delivery team
- Demonstrate effective verbal and written communication skills
- Demonstrate proficiency in performing complex procedures
- Use equipment and supplies safely and effectively
- Demonstrate responsible work habits
- Learn to develop time management and critical thinking skills to improve efficiency in practice.
CLINICAL and LAB COMPETENCIES
By the end of the course the student will demonstrate the following skills in the lab and clinical setting with competency and safety as the opportunity is provided:
- head to toe physical assessment
- medication administration techniques
- oxygen therapy
- Ostomy care
- Nasogastric and tube feedings
- Sterile wound care/dressing/techniques
- Wound specimen collection
- Wound specimen collection
- Tracheotomy care
REQUIRED TEXT
Linton. (2007). Introduction to Medical-Surgical Nursing - Text and Study Guide Package, 4th Edition Elsevier-978-1-437-70030-5
Taylor,Lillis, and LeMone.(2005). Fundamentals of Nursing, The Art and Science of Nursing Care, 6thEdition, Lipponcott, Williams & Wilkins, Philadelphia. With associated skills book
Deglin, J.H., and Vallerand, A.H. (2005). Davis’s Drug Guide for Nurses, 9th Edition. F.A. Davis Company, Philadelphia; (or comparable text).
RECOMMENDED REFERENCE
Miller, J. (2003). Delmar’s NCLRX-PN Review. Delmar Learning, a division of Thompson Learning, Inc.
Venes, D. & Thomas C.L. (2001). Taber’s Cyclopedic Medical Dictionary. F.D. Davis, Philadelphia.
ATTENDANCE
Attendance is mandatory for both lab and clinical rotations. If a student must be absent due to illness he/she must notify the instructor and the clinical unit at least 1 hour prior to start of shift. There will be no tolerance for tardiness or leaving early in the lab/clinical sites unless approved in advance with the clinical instructor. Three late arrivals to clinical will count as an unexcused absence. If there is an emergency. the instructor must be notifiedimmediately if such incident occurs. If a student is absent without an excuse, this may result in failure of clinical and the course. Excused absences are reviewed carefully by the instructor and LPN coordinator. Students must meet with clinical faculty and coordinator following an excused absence to schedule makes up assignments. Excused absence approval is at the discretion of the instructor. Calling in does not mean your absence will be excused. Absences excused by the instructor or doctor will not count against your grade, however, it does affect your attendance.
CLINICAL ASSIGNMENTS
Patient Care Assignments shall be made at the discretion of the instructor with input from staff at each clinical facility. This will include case study, demonstration of skills and procedures in providing safe patient care and pre/post conference.
Students will be expected to write: one care plan with 3 problems due at midterm, reviewed by instructor-if not acceptable, student MUST choose another patient & start over (write a new care plan).
This is in addition to the creation/ use of a Daily clinical sheet and medication sheet which will be explained to you at clinical.
Students are expected to write a creative journal entry to be e-mailed/handed in by following Monday or first class day after clinical. Creative reflective inquiry in clinical practice is important thinking in nursing education. It allows students to analyze and make sense of events and situations in their clinical experience to enhance future practice.Students will be writing in order to process and reflect upon experiences and then evaluating them to improve care. Journals are to be typed with correct grammar, spelling and punctuation. All three components must be included during this clinical experience to pass clinical. The clinical instructor will direct students as to when and where journals need to be submitted.
DRESS CODE
Students will wear the RentonTechnicalCollege uniform unless otherwise required by the clinical facility. Students must wear name badges at all times in the clinical area. Students who do not have their name badges or in full uniform will be sent home and will not receive credit for the clinical experience for the day.
REQUIRED MATERIALS AND EQUIPMENT
While in clinical or in lab come prepared or you will not participate and be marked absent. Name tags, uniform (polo shirts, white pants, white shoes), stethoscope, wrist watch with second hand, scissors, pen light, black or blue pen and measuring tape and blood pressure cuff are required. If the student is not in uniform the student will not be allowed to participate in lab or clinical and will count as an unexcused absence. You will need a 3 ring binder to file handouts, care plans, and lecture notes.
Suggestion: purchase a fanny pack to hold equipment.
ELECTRONIC DEVICES SUCH AS CELLULAR PHONES AND PAGERS
Due to the distraction caused by such items in the classroom, students will be required to turn these devices off during class time. If electronic devises interrupt class time, the instructor reserves the right to take this item until the end of the class day. An option is to use voicemail message system and get your messages while on break.
Cellular Phones in clinical sites: leave the cell phone in the car or at home. Cell phones are not to be used in medical facilities. If the instructor finds the student with a cellular phone, the instructor has the right to take the phone for the day and return it at the end of the clinical day.
GRADING AND EVALUATION PROCEDURES
Grading will be a satisfactory/unsatisfactory as follows:
Satisfactory: completed skill sets competently, with the ability to care for 1-2 patients in a clinical setting.
Unsatisfactory: does not meet the requirements of lab and clinical.
Feedback will be given as an on-going basis. A clinical evaluation tool is used to help determine student grades.
Testing of practical skills: Each student will be tested on skills that have been practice during the labs. A student will have 20 minutes to demonstrate the skill with only 2 prompts from the instructor. A student can correct themselves and not have it count against them. If a student fails to demonstrate the skill then the student will have the chance to retest at the end of the day. If the student is unable to demonstrate the skill without being prompted more than 2 times the student will get the opportunity to set up a time to practice and retest. The student must not make any mistakes during the retest. The student only has one such opportunity to remediate during the quarter.
Instructors may spot test a student at any time during lab. This includes any CNA skills, CPR airway clearance, skills learned in precious LPN labs and skills learned during the current lab curriculum.
ADDITIONAL ASSISTANCE
Renton Technical College is very interested in helping you succeed. If you are a student that has a mental or physical disability that substantially limits your ability to learn, you are encouraged to contact the Special Populations Counselor in Student Services, Bldg. I Room 225. All information acquired during a visit with the Special Populations Counselor is confidential and is used to help you succeed in your program. In addition, any student who is having difficulty studying is encouraged to contact your assigned LPN Advisor for assistance.
Student Contract for Clinical Renton Technical College
Nursing Clinical Expectations LPN-RN Program
To ensure safe nursing practice and accountability for professionalism in the clinical setting, students will meet the guidelines in this contract. Failure to do so will adversely affect the student’s clinical grade and may result in disciplinary action.
Documentation
Students will document a handwritten progress note on his or her patient(s) using the SOAP format each clinical day and will submit it to the instructor for approval time to be announced. Upon instructor approval, the student will enter the note onto the electronic medical record (EMR) time to be announced. The instructor will then electronically sign the note. When the instructor indicates the student is documenting well, the student may enter the documentation onto the EMR directly time to be announced informing the instructor that it is ready for signature thus not needing to document a handwritten note for prior approval.
Daily Care Sheets / Medication sheets
Students will submit a nursing daily care sheet(s) / medication sheet(s) on his or her patient(s) utilizing NANDA criteria and consisting of at least 2 actual problems. The care sheet(s) / medication sheet(s) are to be completed and are due at the beginning of post conference each Friday
Care Plans
Students will submit a nursing care plan on one of his or her patients utilizing NANDA criteria and consisting of at a set criterion defined in the course syllabi. Please review individual course syllabi for directions.
Critical Reflective Journal
Students will follow guidelines in the critical reflective journaling handout and complete a journal for each week of clinical. The journal for a week of clinical is due the following Tuesday morning at 0700 (a separate entire for each day). E-mail the faculty no later than Tuesday 0700 of following week of clinical i.e. week 1 due Tuesday week 2. When you seed attachment it should be saved as your name, clinical site, journal # (i.e. Neil Foltz VA SICU ms II Journal # 1, 2).
Creative reflective inquiry in clinical practice is important thinking in nursing education. It allows students to analyze and make sense of events and situations in their clinical experience to enhance future practice.
Students will be writing in order to process and reflect upon experiences and then evaluating them to improve care.
Journals are to be typed with correct grammar, spelling and punctuation. All three components must be included during this clinical experience to pass clinical. The clinical instructor will direct students as to when and where journals need to be submitted.
Each journal entry must address the following three (3) components.
- DESCRIPTIVE PHASE – objective and detailed summary of one clinical situation.
- Clinical experience – date and description of event or situation. Include who was involved, their roles in the situation and circumstances under which things happened. Include any verbal and non-verbal communications that occurred to add clarity to the event.
- Reaction – Describe your emotional responses, your thinking or processing of the event/incident.
- REFLECTIVE PHASE – interpretation and analysis of this event.
- Evaluation of your performance – describe your strengths and weaknesses asyou participated in the event (even if you only observed).
- CRITICAL PHASE – focus on what you learned for the future. Identify new
learning, new perspectives, new insights, or new solutions to enhance your clinical practice.
Preparation for Clinical
The instructor will give various assignments including research on a patient diagnosis, preparation of a presentation for post conference, writing up medications, and completing daily clinical sheets. Such preparation for clinical is the student’s “ticket” into clinical for the day. Lack of preparation may result in dismissal from the unit and will result in a zero and an unexcused absence for the clinical day.
Punctuality
Punctuality is expected in the clinical setting and demonstrates professional behavior.
Students are expected to be on time and prepared to take report by to be announced.
Traffic in the Puget Sound area is among the worst in the nation. Anticipating the worst, students must leave plenty of time to get to clinical to avoid being late. Students who are more than 5 minutes late and/or miss report on their patient(s) may be sent home and will receive a zero score for that clinical day.
Identification
Students and faculty must wear proper identification at all times while in the facility. This is a security issue. When the nation is on alert, ID is checked at the door. Students should place RTC identification behind their VA identification. Students who choose to store their computer user names and passwords with their ID badge must not have it visible on either side of the ID.
Appearance
Students must wear the approved RTC uniform, hair must be tied back, and students must be neat and clean. Refer to the Allied Health handbook for other information regarding appearance. Students are representing the RTC name and must arrive at the clinical site appearing professional.
Vital Signs
The use of electronic equipment to check BP and P is strongly discouraged.
Students must bring manual BP cuffs(where permitted) and check radial and apical pulses manually. Electronic equipment is poorly calibrated at times, and nursing students need to practice manual skills.
Required Materials and Equipment
Valuables should be on the student’s person rather than left in the break room. Items left in a car should be hidden. Theft happens. Students must bring the following:
- 3 ring binder for organizing assignments, notes, care plans
- Pen
- Identification badge (facility and RTC)
- Uniform (maroon scrub top, all white pants, all white shoes, long hair tied back)
- Stethoscope
- Watch with second hand
- Bandage scissors
- Pen light
- Measuring tape – disposable is recommended
- Blood pressure cuff
- Computer user names and passwords, ID
- Reference books such as a medical dictionary, drug book, care planning book, skills books; students may arrange with each other to each bring certain books so all students do not need to bring all books
Recommended Materials and Equipment
- Fanny pack to hold equipment
- Small skills and assessment book
- PDA or Pocket PC with reference books
I have read and understand these expectations. I also understand that this signed document will be placed in my permanent student file.
______
Student Signature Date
______
Instructor/ TitleSignatureDate
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