VOCATIONAL NURSE PROGRAM EXPECTED CLINICAL ROTATION PERFORMANCE GUIDELINES

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Revised 11/28/2011 VN: Objective 01

VOCATIONAL NURSE PROGRAM

EXPECTED CLINICAL ROTATION PERFORMANCE GUIDELINES

• Clinical rotation expected performances are reflected in the clinical objectives. Clinical objectives are posted by instructor at each clinical facility. Student is responsible for knowing objectives. • Clinical days are 8 hours. If the student arrives more then 15 minutes late they will be sent home

and marked absent. In addition, if the student misses more then 15 minutes of the clinical day (i.e. leaves early) they will also be marked absent. All missed time must be made up.

• If the student is going to be absent, the instructor must be notified at least 30 minutes prior to the scheduled class time. If the instructor is not notified it will be considered a “no call/no show”. If the student is unable to contact the instructor, they must notify the DON or Clinical Coordinator. Telling a classmate is unacceptable.

• Within one week of being absent, arrangements for make-up time must be made. Skills lab hours must be made up before attending clinicals at the assigned facilities. In addition, all (theory and clinical) make-up time must be completed by the end of each term to continue to the next term. • Contact Clinical Coordinator to make arrangements for makeup time. Make-up assignments may

include traveling to other campuses or clinical facilities greater then 35 miles of distance.

• Pre conference will provide the student/instructor time to review assignment. Post conference will reflect what has occurred during the day. The instructor may also add other items to review or test on during post conference.

• All students must complete head to toe assessments on each patient that is being cared for. Documentation on clinical assignment forms is mandatory. Documentation at each facility will vary. Instructions will be given at each facility orientation.

• Students are responsible for knowing all medications that their patients are receiving even if they are not administering them. A medication card will be due on every medication, vitamin and supplement unless indicated by instructor.

• The patient research form, clinical assignment packet, medication card, and medical diagnosis cards are due weekly on day two of clinical. If student is absent on day two, assignment must be submitted to DON/Clinical Coordinator no later then Friday of that same week.

• Grooming and uniform guidelines must be followed at all times, refer to nursing handbook for details. Appearance will be evaluated daily. Students may be sent home for inappropriate grooming and/or for not wearing student badge.

• Students are expected to arrive at clinical prepared and may be sent home if unprepared.

• Clinical evaluations will be completed by the instructor and reviewed with the student every four weeks. The evaluation will then be reviewed by the Clinical Coordinator/Director of Nursing and a copy of the evaluation will be available for the student.

Student Name: ______________________________________ Student Signature: ___________________________________ Date: ______________________________________________

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Revised 6/18/10

VN: Objectives 2

VOCATIONAL NURSE PROGRAM CLINICAL OBJECTIVES

Skilled Nursing Facility Term 1, 2 and 4

The level of expertise expected for these clinical objectives is that of a Level one student. The student must present a professional attitude and appearance at all times. All patient care must be performed observing the standards of infection control, patient safety and comfort, and observance of proper body mechanics. These standards must be met at all times. The student must also consistently demonstrate a respect for the patient, staff, other students, and faculty as shown by the ability to communicate effectively and by observed behaviors.

In order to successfully complete this level the student must be able to:

1. Give a complete bed bath, perineal care, oral hygiene, a partial bed bath or a shower to at least 10 patients 2. Utilize theoretical knowledge by adapting nursing care according to the condition of the patient

3. Demonstrate knowledge of medical and surgical asepsis by observing principles of sterile technique and utilization of standard precautions at all times

4. Perform and document a head to toe assessment on all assigned patients

5. Report and document any signs or symptoms that may indicate a change in the status of a patient 6. Indicate knowledge of medical terminology by charting accurately

7. Perform procedures according to the hospital’s policy manual

8. Adapt the principles of positioning, moving, lifting, and transporting according to the condition of the patient 9. Collect and organize data to present in post-conference as related to specific patients

10. Provide for patient comfort, utilizing appropriate pain relief methods 11. Make an occupied, unoccupied and other specialty beds as needed

12. Properly position patients and perform range of motion both passive and active

13. Utilize safe and effective methods to transfer patients from bed to chair, wheelchair, gurney, and back 14. Take and record vital signs on all assigned patients

15. Provide care for a patient with a G-Tube and/or a NG tube including insertion, checking for placement, irrigation and feeding

16. Utilizing policies and procedures discussed in class perform dressing changes, urinary catheterizations, (both male and female) and ostomy care

17. Begin to develop nursing care plans for all assigned patients

18. Explain the classification, normal dosage, side effects and purpose of all medications each assigned patient is receiving. Calculate medication dosages as assigned by the instructor

19. Demonstrate the ability to perform all procedures covered in level one lab 20. Demonstrate the ability to perform oropharyngeal or nasopharyngeal suctioning 21. Insert a catheter, obtain a sterile urine specimen and provide catheter care 22. Perform a finger stick and test blood for glucose

23. Perform tracheotomy care, utilizing principles covered in skills lab

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Revised 6/18/10

25. Provide for patient comfort, utilizing appropriate pain relief methods 26. Administer treatments (i.e., wound care) to assigned patients

Term 2:

In addition to the above the student will:

1. Under supervision, administer medications accurately and safely to patients 2. Administer medications utilizing the rights discussed in class

3. Administer treatments (i.e., respiratory) to assigned patients

Term 4:

The student will also:

1. Demonstrate the ability to assign actual nursing care tasks to students.

2. Describe elements that need to be focused on when receiving and giving change of shift report, including: a) Patient’s name, room number, physician

b) New problems/concerns

c) Contact with physician and new orders d) Progress of current, established problems e) PRN medications given – drug, time, reason

f) Patient’s behavior during shift, including changes in physical and mental status g) Patient’s voiding pattern- BM’s, continent vs. incontinent

3) List elements that need to be avoided when receiving and giving report, including: a) Meaningless chatter not related to patient care

b) Routine care unless there is a change in patient response or nursing care plan c) Personal opinions about the patient’s condition

d) Value judgments about the patient’s life styles, behaviors or families 4) Evaluate the condition of patient’s assigned in a safe and timely manner 5) Review charts for new orders

6) Demonstrate knowledge of patient’s condition at all times

7) Validate that nursing care is being provided according to physician’s orders and established standards of care 8) Demonstrate efficiency of work loads, including neatness and orderliness

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Revised 6/18/10

VN: Objectives 03

Medical/Surgical Unit Term 2

The level of expertise expected for these clinical objectives is that of a term two student. The student must present a professional attitude and appearance at all times. All patient care must be performed observing the standards of infection control, patient safety and comfort, and observance of proper body mechanics. These standards must be met at all times. The student must also consistently demonstrate a respect for the patient, staff, other students, and faculty as shown by the ability to communicate effectively and by observed behaviors.

In order to successfully complete this term the student must be able to:

1. Demonstrate basic nursing skills in providing complete nursing care of selected patients

2. Utilize theoretical knowledge by adapting nursing care according to the condition of the patient

4. Perform and document a basic assessment of patients with diseases/disorders discussed in class

5. Report and document any signs or symptoms that may indicate a change in the status of the patient

6. Indicate knowledge of medical terminology by charting accurately

8. Adapt the principles of positioning, moving, lifting, and transporting according to the condition of the patient

9. Collect and organize data to present in post-conference as related to specific patients

10. Provide for patient comfort, utilizing appropriate pain relief methods

11. Under supervision, administer medications accurately and safely to patients

12. Demonstrate the ability to perform oropharyngeal or nasopharyngeal suctioning

13. Perform tracheotomy care, utilizing principles covered in skills lab

14. Demonstrate how to regulate oxygen flow and how to provide care to a patient with a nasal cannula, nasal prongs or oxygen mask

15. Insert a catheter, obtain a sterile urine specimen and provide catheter care

16. Administer treatments to assigned patients

17. Perform a finger stick and test blood for glucose

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Revised 6/18/10

VN: Objectives 04

Medical/Surgical Unit Term 3 and 4

The level of expertise expected for these clinical objectives is that of a term three and term 4 student. The student must present a professional attitude and appearance at all times. All patient care must be

performed observing the standards of infection control, patient safety and comfort, and observance of proper body mechanics. These standards must be met at all times. The student must also consistently demonstrate a respect for the patient, staff, other students, and faculty as shown by the ability to communicate effectively and by observed behaviors.

18. Demonstrate basic nursing skills in providing complete nursing care of selected patients

21. Perform and document a basic assessment of patients with diseases/disorders discussed in class

22. Report and document any signs or symptoms that may indicate a change in the status of the patient

23. Indicate knowledge of medical terminology by charting accurately

25. Adapt the principles of positioning, moving, lifting, and transporting according to the condition of the patient

27. Provide for patient comfort, utilizing appropriate pain relief methods

28. Under supervision, administer medications accurately and safely to patients

29. Prepare an outline and teach a diabetic patient and/or the family about diet, medications and foot care

30. Provide care to a patient who has had surgery related to an endocrine and/or reproductive disorder

31. Prepare a patient for diagnostic tests related to the patients in objective 4

32. Under supervision administer various types of insulin, monitor blood glucose, including administering sliding scale coverage as ordered

33. Discuss the care of dialysis patients

34. Contrast/compare the signs and symptoms of hypo and hyperglycemia

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Revised 6/18/10

VN: Objectives 05

Day Surgical Unit Term 3

The level of expertise expected for the performance of these clinical objectives is that of a third term student. The student must present a professional attitude and appearance at all times. All patient care must be performed observing the standards of infection control, patient safety, patient comfort, and good body mechanics. These standards must be met at all times. The student must also consistently demonstrate respect for the patient, staff, other students, visitors, and faculty as shown by the ability to communicate effectively and by observed behaviors.

1. Observe the functions of the members of the Day Surgery staff

2. Assist the staff nurse with patient care including (if available) vital signs and procedures, admission and discharge

3. Observe the type of documentation used in the unit and submit a sample to the instructor 4. Assist with post-operative recovery of a patient

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Revised 6/18/10

VN: Objectives 06

GI Lab Term 2 and Term 3

The level of expertise expected for the performance of these clinical objectives is that of a second or third term student. The student must present a professional attitude and appearance at all times. All patient care must be performed observing the standards of infection control, patient safety, patient comfort, and good body mechanics. These standards must be met at all times. The student must also consistently demonstrate respect for the patient, staff, other students, visitors, and faculty as shown by the ability to communicate effectively and by observed behaviors.

6. Observe the functions of the members of the GI Lab staff

7. Assist the staff nurse with patient care including (if available) vital signs and procedures

8. Observe the type of documentation used in the unit and submit a sample to the instructor 9. Document experiences by keeping a written diary of experiences of this observation 10. Discuss in post-conference patient care and any special procedures observed

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Revised 6/18/10

VN: Objectives 07

Intensive Care Unit Term 3 and 4

During this rotation the student will be perform as a term three or term four student. They will

demonstrate at all time respect for patients, staff, faculty and other staff members. They will provide care to assigned patients observing the principles of infection control, body mechanics and safe nursing care.

11. Observe the functions of the members of the Intensive Care Unit staff

12. Assist the staff nurse with patient care including (if available) vital signs and procedures 13. Observe the type of documentation used in the unit and submit a sample to the instructor 14. Place/replace EKG leads on a patient

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Revised 6/18/10 VN: Objectives 08 VOCATIONAL NURSE CLINICAL OBJECTIVES Emergency Department Term 3 and 4

During this rotation the student will demonstrate at all time respect for patients, staff, faculty and other staff members. They will provide care to assigned patients observing the principles of infection control, body mechanics and safe nursing care.

1. Observe the functioning of the Emergency Department and its staff.

2. Assist the staff where possible with vital signs and admission of a patient to the Emergency Room 3. Assist with procedures under the supervision of the Emergency Room staff and/or the instructor 4. Discuss in post-conference the types of patients and their care as provided in the Emergency

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Revised 6/18/10

VN: Objectives 09

VOCATIONAL NURSING PROGRAM CLINICAL OBJECTIVES

Team Leading Term 4

During this rotation the student will perform as a term four student. They will demonstrate at all times respect for patients, staff, faculty and other staff members. They will provide care to assigned patients observing the principles of infection control, body mechanics and safe nursing care.

3. Demonstrate the ability to assign actual nursing care tasks to students

4. Describe elements that need to be focused on when receiving and giving change of shift report, including:

a) Patient’s name, room number, physician b) New problems/concerns

c) Contact with physician and new orders d) Progress of current, established problems e) PRN medications given – drug, time, reason

f) Patient’s behavior during shift, including changes in physical and mental status g) Patient’s voiding pattern- BM’s, continent vs. incontinent

10) List elements that need to be avoided when receiving and giving report, including: a) Meaningless chatter not related to patient care

b) Routine care unless there is a change in patient response or nursing care plan c) Personal opinions about the patient’s condition

d) Value judgments about the patient’s life styles, behaviors or families 11) Evaluate the condition of patient’s assigned in a safe and timely manner 12) Review charts for new orders

13) Demonstrate knowledge of patient’s condition at all times

14) Validate that nursing care is being provided according to physician’s orders and established standards of care

15) Demonstrate efficiency of work loads, including neatness and orderliness

16) Maintain a safe and hazard free environment, ensure patients right to privacy and respect the dignity of patients

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Revised 6/18/10

VN: Objectives 10

VOCATIONAL NURSE PROGRAM CLINCAL OBJECTIVES

Medical/Surgical Unit Term 4

The level of expertise expected for the performance of these clinical objectives is that of a fourth term (senior) student. The student must present a professional attitude and appearance at all times. All patient care must be performed observing the standards of infection control, patient safety, patient comfort, and good body mechanics. These standards must be met at all times. The student must also consistently demonstrate respect for the patient, staff, other students, visitors, and faculty as shown by the ability to communicate effectively and by observed behaviors.

1. Demonstrate basic nursing skills in providing nursing care for selected patients

3. Indicate knowledge of medical terminology by using appropriate medical terminology, correct grammar and spelling in all documentation

4. Organize assignments around scheduled break and lunch periods, and complete assignments on time

5. Perform accurate patient assessments and document appropriate interventions in a timely manner, utilizing the nursing process

6. Write nursing care plans that are specific to meet the needs of assigned patients

7. Record treatments and medications promptly, accurately, and concisely, including the patient and family members in the management of care

8. Under supervision of the instructor, administer medications accurately and safely to assigned patients

9. Describe and demonstrate knowledge of the legal principles concerning the vocational nurse and patient care

11. Utilize the nursing process to complete assessments, identify patient needs, formulate problem statements, and plan nursing actions in the care of patients with disease/disorders as discussed in class

12. Provide/explain care for a patient with a neurological disorder, or spinal cord injury, or neurological surgery

13. Observe/describe seizure precautions and document seizure activity

14. Provide nursing care to a blind patient, and one with a hearing loss

15. Act as team leader (i.e. receive patient report, make rounds, make assignments, check/pickup orders, answer phone, give report, supervise nursing care given by team members)

16. Assist the charge nurse giving report to the oncoming shift either in the clinical arena or in post-conference.

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Revised 6/18/10

18. Provide for patient comfort, utilizing appropriate pain relief measures

19. Confer with the instructor to evaluate and determine actions in difficult/delicate situations

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Revised 6/18/10

VN: Objectives 11

Obstetrics Term 4

The level of expertise expected for the performance of these clinical objectives is that of a fourth term (senior) student. The student must present a professional attitude and appearance at all times. All patient care must be performed observing the standards of infection control, patient safety, patient comfort, and good body mechanics. These standards must be met at all times. The student must also consistently demonstrate respect for the patient, staff, other students, visitors, and faculty as shown by the ability to communicate effectively and by observed behaviors. These objectives will be met in the clinical setting or in a simulated skills lab.

The student will:

1. Observe the functions of the members of the Labor & Delivery, Post-partum, Newborn Nursery staff and Neonatal Intensive Care

2. Assist the staff nurse with patient care including (if available) vital signs, perineal care and other necessary procedures

3. Observe the type of documentation used in the unit and submit a sample to the instructor

4. Observe a delivery (vaginal and cesarean)

5. Observe and assist with the care of a newborn admitted to the nursery

6. Discuss medication used in the labor and delivery rooms, and those used for the newborn

7. Administer/explain medications given to the post-partum patient

8. Discuss in post-conference patient care and any special procedures observed

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Revised 6/18/10

VN: Objectives 12

Mental Health Term 4

During this rotation the student will be perform as a term four student. They will demonstrate at all time respect for patients, staff, faculty and other staff members. They will be assigned patients and note the influence mental adaptation can have on the physiological functions of the body.

1. Observe the functions of the members of the patient care team

2. Interview a patient in order to gain information to be used in the nursing care plan 3. Observe the type of documentation used in the unit and submit a sample to the instructor 4. Attend group session or other therapy sessions as available

5. Write a nursing care plan for assigned patients

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Revised 6/18/10

VN: Objectives 13

Pediatrics Term 4

The level of expertise expected for the performance of these clinical objectives is that of a fourth term (senior) student. The student must present a professional attitude and appearance at all times. All patient care must be performed observing the standards of infection control, patient safety, patient comfort, and good body mechanics. These standards must be met at all times. The student must also consistently demonstrate respect for the patient, staff, other students, visitors, and faculty as shown by the ability to communicate effectively and by observed behaviors. These objectives will be met in a clinical setting or in a simulated skills lab.

In order to successfully complete this rotation the student will:

1. Demonstrate/perform a physical assessment of a child

2. Assist the staff nurse with patient care including (if available) vital signs and procedures

4. Assess the growth and development of the child; physical development, behavior, and play

5. Discuss how to assess parental concerns

6. Write a nursing care plan for an assigned child

7. Administer/discuss medications given to a pediatric patient

8. Discuss in post-conference patient care and any special procedures observed

9. Demonstrate the ability to calculate pediatric dosage using the kilogram of body weight method

10. Compare and contrast the physical and emotional development of the normal well preschool and school age child

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Revised 6/18/10

VN: Objective 14

Ambulatory/Clinic

Term 2, 3, and 4

The student must present a professional attitude and appearance at all times. All patient care must be performed observing the standards of infection control, patient safety, patient comfort, and good body mechanics. These standards must be met at all times. The student must also consistently demonstrate respect for the patient, staff, other students, visitors, and faculty as shown by the ability to communicate effectively and by observed behaviors.

Upon successful completion of this rotation the student will be able to:

1. Provide/assist with provision of care to a patient in the clinic setting

2. Demonstrate/discuss the role of the LVN in the clinic/outpatient setting

3. Confer with the instructor to evaluate and determine action in difficult/delicate situations

4. Assist with taking vital signs and preparing the examining room for the patient

5. Assist the physician as requested (within scope of practice as defined by the instructor and head nurse)

6. Determine how patient’s visits are scheduled and be prepared to discuss with instructor

8. Document experiences by keeping a written diary throughout the day/rotation

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Revised 6/18/10

VN: Objectives 15

Ambulatory/Clinic Breast Center Term 2, 3 and 4

2. Demonstrate/discuss the role of the LVN in the clinic/outpatient center setting

3. Confer with the instructor or charge nurse to evaluate and determine action in difficult/delicate situations

4. Assist with taking vital signs and preparing the patient for required procedure/exam

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Revised 6/18/10

VN: Objectives 16

Ambulatory/Clinic Infusion Center Term 2, 3, and 4

2. Demonstrate/discuss the role of the LVN in the clinic/outpatient/infusion center setting

3. Confer with the instructor or charge nurse to evaluate and determine action in difficult/delicate situations

4. Assist with taking vital signs and preparing the patient for required infusions

5. Assist with monitoring patient throughout infusion and post infusion

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VN: Objectives 17

Radiology Unit Term 2, 3, and 4

1. Observe and describe the clinical functions of each Radiology Unit team member

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VN: Objectives 18

Transplant/Surgical Unit Term 2, 3 and 4

1. Identify Federal Regulations regarding transplant guidelines.

2. Identify pre/post-operative risks for transplant surgery.

3. Observe the functions of the members of the Transplant/Surgical staff.

4. Assist the staff nurse with patient care including (if available) vital signs, procedures, admission and discharge

5. Observe the type of documentation used in the unit and submit a sample to the instructor.

6. Assist with post-operative recovery of a patient.

7. Document experiences by keeping a written diary throughout the day/rotation.

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VN: Objectives 19

Special Procedures Unit Term 3

1. Observe the functions of the members of the Special Procedures Unit.

3. Observe the type of documentation used in the unit and submit a sample to the instructor. 4. Discuss in post-conference patient care and any special procedures observed.

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VN: Objectives 20

Post Anesthesia Recovery Unit Term 3

1. Observe the functions of the members of the PACU.

3. Observe the type of documentation used in the unit and submit a sample to the instructor.

4. Assist with post-operative recovery of a patient.

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Revised 6/18/10

VN: Objectives 21

Surgical Unit Term 3

1. Observe the functions of the members of the Operating Room staff

4. Assist with pre-operative and post-operative recovery of a patient