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Walla Walla Community CollegeNursing Education

Summer PracticumNURS 113

Summer Transition Practicum: LPN to ADN NURS 114

Summer Quarter, 2010

To request accommodations related to a disability, contact Claudia Angus, Ph.D., Coordinator of Disability Support Services, at 527-4262 or email [email protected] on the Walla Walla Walla

Campus. Clarkston students may contact Carol Bennett, at 758-1718 or email [email protected].

Every effort is made to ensure accuracy in the syllabus at the time of printing. However, the Walla Walla Community College Nursing Education Program reserves the right to change any provision or

requirement, which is necessitated by circumstances arising during the course. All changes shall be provided in writing.

NURS 113-114 Syllabus- FinalSummer, 2010

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Course OutlineNURS 113

Summer Practicum

Credits: 7

Clock Hours per Quarter: 140

Lab Hours: 140

DescriptionAn application of theory from NURS 103. The focus is on providing care for clients in acute care and community based settings. An additional focus is on transition to the role of Practical Nurse. Prerequisites: NURS 102 and 112. Co-requisite: NURS 103.

Intended Learning Outcomes Demonstrate critical thinking in the use of the nursing process. Demonstrate use of management/leadership principles in the delivery of client/patient care. Perform interventions in a safe and effective manner. Use therapeutic communication. Demonstrate professional behaviors.

Course Topics Interdisciplinary Communication Management Concepts Review of Course Topics from NURS 110, 111, 112

Evaluation Devices: Client Data Sheets Nursing Care Plans Clinical Evaluation Tool Dosage Calculation/Medication Administration Tests

Teaching Format: Clinical Practicum

Locations: Walla Walla Campus – Acute care facilities and community based agenciesClarkston Campus – Acute care facilities and community based agencies


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Course OutlineNURS 114

Summer Transition Practicum: LPN to ADN

Credits: 7

Clock Hours per Quarter: 140

Lab Hours: 140

DescriptionFocuses on enhancing skills for LPNs entering the second year of the nursing program. Care is provided in acute care facilities and community based settings. Prerequisite: Admission to second year of the Nursing program. Co-requisite: NURS 104.

Intended Learning Outcomes Demonstrate critical thinking in the use of the nursing process. Demonstrate use of management/leadership principles in the delivery of client/patient care. Perform interventions in a safe and effective manner. Use therapeutic communication. Demonstrate professional behaviors.

Course Topics Interdisciplinary Communication Management Concepts Review of Course Topics from NURS 110, 111, 112

Evaluation Devices: Client Data Sheets Nursing Care Plans Clinical Evaluation Tool Dosage Calculation/Medication Administration Tests

Teaching Format: Clinical Practicum

Locations: Walla Walla Campus – Acute care facilities and community based agenciesClarkston Campus – Acute care facilities and community based agencies


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FACULTY CONTACT LIST

NOTE: Students are encouraged to contact the faculty member responsible for the content area or clinical experience about which they have a question. Contact your faculty advisor for academic concerns and advising.

Faculty hours are posted on the Level I bulletin board.

Walla Walla Campus: Nursing Office: 509-527-4240Clarkston Campus: Nursing Office: 509-758-1702

Director of Nursing Education: Marilyn D. Galusha, RN, MSN

Walla Walla-based Instructors Office Number

Email addresses

Kathy Adamski, RN, M.N.(Summer Lead Instructor)

527-4244 [email protected]: 509-200-0904

Rob Becker, R.N., M.N. 527-4334 [email protected]: 509-301-9500

Brenda Anderson, R.N., M.S.N 527-4327 [email protected]: 509-240-4084

Patti Becker, R.N., M.N. 527-4242 [email protected]: 509-301-9680

Lana Toelke, R.N., B.S.N 527-4240 [email protected]

Clarkston-based Instructors

Sue Rammelsberg, R.N., M.S.N.(Clarkston Lead Instructor)

758-1705 [email protected]: 509-595-5731

Stephanie Carpenter, R.N., B.S.N. 758-1722 [email protected]

Debra Scheib, R.N., M.S.N. 758-1707 [email protected]


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COURSE EXPECTATIONS

ATTENDANCE:

1. Attend all scheduled learning activities (attendance is taken). Absences and tardiness will be tracked. Three episodes of tardiness, in any combination of NURS 113/114 activities, equal one absence. Three absences, in any combination of NURS 113/114 activities, equal a letter grade drop from total points earned. Four absences constitute a clinical failure.

2. Attendance at Pre-Clinical Conference and Hospital Orientations are mandatory. Absence may affect a student’s ability to start a clinical rotation on time.

3. If unable to attend practicum or arrive on time, the student must notify the WWCC Nursing Department and the assigned practicum unit prior to the beginning of the assigned practicum shift. Failure to notify the practicum agency and the WWCC Nursing Department of an absence or tardy (no call/no show) prior to the start of the assigned shift will result in a “contract” or a “special concern.”

4. Note: There is no provision for make-up of missed practicum hours.

ASSIGNMENTS:

1. Students are responsible for all content missed due to absence or tardiness.2. All assignments must be accounted for in order to complete course work.3. Required written assignments are to be considered professional documents. Students must use proper,

professional terminology, spelling, grammar, punctuation, and sentence structure. Slang is not permitted. Grade reductions should be expected if these instructions are not followed.

4. Late papers will receive a one-point deduction per school day as described in the Nursing Student Handbook. A school day is defined as any day the school is officially open.

5. Academic integrity will be strictly enforced. Duplicate answers presented on separate papers will result in a score of zero for the paper(s). Papers (e.g., competencies, care plans, patient data packets, etc.) with plagiarized answers will also receive a score of zero. Any issues of suspected plagiarism or cheating will be referred to the Level I faculty for consideration of disciplinary action including but not limited to Special Concern with course grade drop.

6. No student shall copy any documents from a client's chart unless otherwise instructed by clinical faculty. Confidentiality rules will be strictly enforced.

PROCEDURES/ SKILLS:

1. Students must maintain competency for all learned skills. This includes previously learned skills.2. All procedures/skills (medication administration, dressing change, foley catheter placement, injection, etc.)

may only be performed under the direct supervision of the clinical instructor or a licensed nurse.

CLINICAL PERFORMANCE:

1. Grades are earned by students, not given by instructor.2. Grading Scale: See Nursing Student Handbook.3. Contracts/Special Concerns: Students not performing at expected performance/critical-thinking levels

will be placed on a practicum contract or receive notice of special concern. More than one special concern may be earned. A grade reduction should be expected for each "special concern." The amount of grade reduction will be determined on an individual basis by the level faculty.


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CRITICAL ELEMENTS

1. Follow all policies as outlined in Nursing Student Handbook.2. Maintain confidentiality for clients and agency personnel at all times. 3. Consistently follow the 6 rights of medication administration.4. Consistently ask for guidance and assistance when unsure or in doubt regarding any issues of care

delivery.5. Communicate in a timely manner with staff and/or instructor regarding abnormal/unexpected client

assessment data.6. Consistently follow Clinical Expectations provided by clinical instructor.7. Show readiness to perform procedures.8. Consistently perform all procedures according to agency/college policies.9. Consistently demonstrate timeliness in meeting professional/course expectations.


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POINT DISTRIBUTIONNURS 113/114

Name ________________________

Points Earned: ________ Percentage: ________ Clinical Grade: ____________

Assignments Points Available Points EarnedMedication Competency Test - Must have 80% to pass (one retake only)

Pass/Fail

Competency Performance Evaluation

Instructor observation of clinical performance

Student Written Competencies

25

30Comprehensive Nursing Plan Of Care (aka “Major Data Packet”

26

Journal Entries (five entries @ 6 points each) 30

Attendance 16

Late Point Deductions

FINAL TOTAL 127

Practicum attendance (3 points per clinical week; 1 point per day for a 3-day, 8-hour per day clinical week or 1.5 points per day for a 2-day, 12 hour per day clinical week)

____ ____ (____) / ____ ____ ( ____) / ____ ____ ( ____) / ____ ____ (____) /____ ____( ____)Week 1 Week 2 Week 3 Week 4 Week 5

Pediatric Workshop :_______

GRADING CRITERIA:

1. Medication Competency Test: If less than 80% is achieved, the student will be allowed to take one remedial exam covering similar content. If 80% is not achieved on the remedial exam, the student will receive a “C-” grade in NURS 113/114 and will not be allowed to progress.

2. Competency Performance Evaluation: A student is evaluated on how well he/she is able to meet the five core competencies in NURS 113/114. Components of this evaluation include instructor observation of clinical performance (which may include evaluative feedback from others) and written examples of competency performance provided by the student.


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Name ________________________

Instructor Observation of Clinical Performance of Competencies:

Competency Points Available

Points Earned (instructor’s initials)

Total(average score)

1. Demonstrate critical thinking in the use of the nursing process

5

2. Demonstrate use of management/leadership principles in the delivery of client/patient care

5

3. Perform interventions in a safe and effective manner

5

4. Use therapeutic communication 5

5. Demonstrate professional behaviors 5

Total 25

5 = Independent (100%) Excellent, without direction, safe and accurate, proficient, coordinated, confident, expedient use of time

4.5 = Supervised (90%) Above average, with occasional physical or verbal direction, safe and accurate, efficient, coordinated,

confident, expedient use of time4 = Assisted (80%)

Average, frequent verbal and/or physical direction, mostly safe and accurate, partial demonstration of skills, inefficient or uncoordinated, delayed time expenditure

3.5 = Marginal (70%) Below average, continuous verbal and/or physical direction, questionable safe and questionable accurate,

unskilled and inefficient, considerable and prolonged time expenditure3 = Dependent (60%)

Does not meet competency, continuous verbal and/or physical direction, unsafe, inaccurate, unable to demonstrate procedures, lacks confidence, coordination and efficiency

Students will rotate through various clinical sites during PN Summer quarter. Each clinical instructor will have the opportunity to provide a rating of the student’s mastery of each of the five competencies based on their observations of the student and on preceptor feedback. The instructor will write their initials at the top of the column for their rating. If a specific competency cannot be evaluated during a specific rotation, the instructor will write “N/A” (not applicable). An average of the scores for each of the competencies will be calculated and the average total score will be applied towards the student’s NURS 113/114 grade.


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Student Written Examples of Competency Performance

Written clinical competencies are one way that your instructor validates your critical thinking and time management skills. All competencies must demonstrate reflective thinking and must be actual examples of your clinical experience. There are five core competencies that have a maximum of 31 elements/criteria that should be addressed thoroughly to receive full credit.

Competencies should be addressed on a daily basis following clinical. Turn in your competency write up with your clinical notebook each week. Competencies met during a specific rotation my only be evaluated (checked off) by that specific rotation instructor. The last opportunity to turn in competencies for grading is on the last due date for the clinical notebook.

Elements/Criteria addressed (39 possible)

Approximate Percentage Earned

Points Allocated Student’s Points Earned

30-31 94-100% 3029 90-93% 2528 87-89% 2027 84-86% 15

25-26 81-83% 1024 75-80% 523 Less than 75% 0


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Individual Conference Session SummaryNURS 113/114

Student Name:__________________________________

Student Self Evaluation: (strengths and plans for growth) complete prior to ICS

Final Instructor Evaluation:

Instructor Date Student Date


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_____________________ _______ _____________________ _______


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Instructor Concerns/Repeated Reminders(performance issues/timeliness/attendance)

Student Name: ______________________________________________

Any entry on any topic will constitute a concern that could be evaluated by Level I faculty for additional action. The action could include issuance of a Clinical Contract or Special Concern.

Date Concern Incident

Clinical Contract or Special Concern:Your clinical grade or progression in the program may be affected by serious problems or repeated incidences related to unsafe and unethical practice. Each concern will be documented and discussed. Documented instances will be handled through appropriate channels and may lower the clinical grade.


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Weekly Instructor Feedback

Student Name: _______________________________________


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CRITICAL THINKING

Course Competency 1: Demonstrate critical thinking in the use of the nursing process

Element Criteria and Graded Assignments WrittenCompetencies

1A. Use the nursing process to meet the physiologic, psychosocial, and developmental needs of all age groups experiencing normal life processes or common/chronic illnesses

1. Gather and identify data (nursing assessment, labs, diagnostic tests, medical history, etc.) about the patient’s condition (Assessment)

2. Analyze data, determine pertinence to patient condition, and prioritize two (2) nursing diagnoses (analysis)

3. Identify a realistic, measureable, expected outcome related to each nursing diagnosis

4. Identify implemented nursing interventions (3) appropriate to the

expected outcome (only one may be r/t assessment/monitoring); provide evidence-based rationales for the interventions with guidance

5. Evaluate patient response to care related to achievement of the expected outcome; recommend revisions to the POC (evaluation)

Instructor Validation of Data Packets

1B. Demonstrate critical thinking in the provision of nursing care

1. For the patient’s primary medical problem, integrate knowledge of physiology and pathophysiology with pertinent patient history, nursing assessment data, medications and diagnostic testing with guidance.

2. For one medication that a patient is taking, evaluate whether the medication has been effective in achieving its intended therapeutic effect specific to this patient’s condition. Give specific assessment data that your patient exhibited that support your evaluation.

3. For one medication that a patient is taking, explain why a specific lab test is pertinent for this medication and explain the significance of the actual lab value observed in your patient.

4. Explain the significance of serial lab values related to the patient’s diagnosis or medical condition (Serial labs are 2 or more values of the same lab test taken at different times; in your explanation include the reason for the change in the serial values and the significance of the changes for your patient)

5. Explain the rationale for a therapeutic diet as it relates to the patient’s medical condition (Give specific information about the diet criteria and how it affects the patient’s condition; NPO is not a diet)

Instructor Validation of Data Packets

1 examples: _________

1 examples: _________

2 examples: __________________

1 example:________


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1C. Apply teaching-learning principles in addressing patient learning needs

1. For two (2) selected patients, conduct teaching/learning projects with instructor guidance

Identify a learning need with rationale (Assess/Analysis) Identify an expected learning outcome (Plan) Prepare and implement a teaching plan (Implement) Evaluate the effectiveness of teaching/learning in relationship to

achievement of expected outcome (Evaluation)(Teaching/learning plan must be approved by instructor or licensed nurse; all bullets must be addressed for credit)

2 examples:________________

1D. Complete documentation that demonstrates organization and application of the nursing process in addressing specifics of patient situation

1. Develop documentation using PIE format, with instructor guidance that:

Problem: Identifies pertinent assessment data Identifies appropriate nursing diagnosis, if applicable

Intervention: Identifies interventions related to problem

Evaluation: Evaluates patient response to interventions

2. Documentation should be clear, complete, concise, and correct; according to agency policy, and using professional/medical terminology

3. Document patient education

Instructor Validation of Data Packets and actual patient charting

Instructor Validation


CRITICAL THINKING

Course Competency 2: Demonstrate use of management/leadership principles in the delivery of client care


2A. Manage care for medical-surgical patients

1. Report changes in patient condition to nurse and/or instructor in a timely manner and identify appropriate action with guidance

2. Plan and prioritize nursing care based on the needs of one or two patients Begin to implement revisions to the above

3. Demonstrate organization and time management in the care of 1-2 patients

4. Present organized hand-off report with direct guidance of a licensed professional

5. Recognize the role of communication and mutual support in the function of the nursing team

2 examples:________________

Journal


1 example:________

Journal

2B. Participate in providing care with an

1. Communicate with interdisciplinary team members to facilitate patient care with guidance



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interdisciplinary team2. Speak to the patient’s physician or health care provider regarding the

patient’s condition (describe content of conversation)

3. Assist a physician or other health care provider

4. Identify the need for referral to another discipline based on assessment of patient needs, including rationale

5. Delegate appropriately to unlicensed assistive personnel

1 example: ________

1 example: ________

1 example: ________

1 example: ________

2C. Access resources appropriately and manage them effectively

1. Identify ways to minimize costs while maintaining quality of care

2. Assure appropriate charges are applied

1 example:_________

1 example:_________

CARING

Course Competency 3: Perform interventions in a safe and effective manner


3A. Administers medications safely evaluating the need for and the response to prescribed medications, with guidance

1. Identify the patient condition and focused assessment data for which the medication is given

2. Identify the drug classification, desired therapeutic effect, and potential side effects of medication therapy specific to the patient

3. Begin to integrate medication information with patient’s diagnosis, history, pathophysiology and laboratory values

4. Identify pertinent nursing implications related to administration of IV fluids and IVPB medications, including medication/fluid compatibilities (Give a specific example of an actual patient order and the nursing implications of the IV fluid or IVPB medication for your patient)

5. Under the guidance of a licensed professional, verify the safety, effectiveness, and appropriateness of medication orders specific to the patient, including, but not limited to: Dose within recommended rage, considering implications r/t age

and body size Known allergies/sensitivities and/or adverse reactions Look-alike, sound-alike medications

Instructor Validation and Data Packets

Data Packets

Instructor Validation andData Packets

1 example:_________



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6. For the following routes of administration, consistently administer medications safely and appropriately following the six (6) rights Gastric tube IVPB Oral/Sublingual Intramuscular Subcutaneous Intradermal Topical (skin, ear, eye) Rectal

7. Evaluate and document behavioral and physiologic response to medications with supervision of a licensed professional


Instructor Validation and Data Packets

3B. Performs technical procedures safely and effectively

1. Communicate expected outcome of and correct protocol for procedures prior to implementation with instructor guidance

2. Perform previously learned and current quarter skills with supervision and, as indicated, direct guidance of licensed professional in the clinical setting

3. Monitor patient for response to and potential complications of procedures and intervene as indicated with guidance of a licensed professional (Give specific response or complication that you monitored and the assessment information observed)

4. Demonstrate accountability for technical competence of previously learned and current quarter skills by practicing in the Skills Practice Lab

1 example:_________


1 example:_________

As available PN Summer quarter

CARINGCourse Competency 4: Uses therapeutic communication


4A. Use therapeutic communication skills to meet patient needs

1. Identify the subjective and/or objective data observed in a patient (or support person) relating to an emotional state (Assessment)

2. Identify and emotional state of the patient (or support person) derived from the data noted above (Analysis)

3. Develop an expected outcome for the patient (or support person) experiencing the identified emotional state (Plan)

4. Document three or more verbal exchanges in a therapeutic interaction with the patient (or support person) identifies above (Intervention) Label each exchange as either therapeutic or non-therapeutic and

identify the communication technique used

5. Evaluate the effectiveness of the interaction in achieving the expected outcome Suggest changes to improve the interaction

(Criteria 1-5 must be addressed on the therapeutic interaction)

2 examples:__________________

4B. Identify coping 1. Identify coping mechanisms used by the patient and/or significant 1 example:


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mechanisms used by the patient and/or significant others related to illness and stressful life events with guidance

others related to illness and stressful life events with guidance

Resources for coping mechanisms include:Potter & Perry, 7th ed., p. 488Silvestri, 4th ed., Box 62-2 “Types of Defense Mechanisms”, p. 916 http://changingminds.org/explanations/behaviors/coping/coping.htm

_________

PROFESSIONAL BEHAVIORS

Course Competency 5: Demonstrate professional behaviors


5A. Demonstrate sensitivity and attentiveness to the patient, family, and others including their life experience and cultural, spiritual, social background

1. Recognize patient needs and respond appropriately in a timely manner.

2. Describe potential modifications to nursing care based on cultural, spiritual, social and/or developmental factors

3. Discuss plan of care with patient (give specific information about the plan you discussed and the patient’s response)


1 example: _________

1 example: ________

5B. Demonstrate accountability and responsibility

1. Take responsibility for own learning experience

2. Identify own strengths and areas/plan for improvement

3. Appropriately seek guidance from others when patient needs exceed the student’s abilities/experience

4. Utilize feedback to improve performance

5. Demonstrate punctuality and meet course/program obligations in a timely manner

6. Attend all clinical/lab experiences (workshops, clinical conference, etc.) and participate appropriately

7. Incorporate evidence based findings into nursing practice (Give specific information about evidence based research findings and how your own nursing practice will change because of this new information)

8. Begin to demonstrate initiative and accountability for own learning by seeking out non-mandated learning experiences


Journal and ICS Self Eval

1 example: ________




1 example: ________

1 example: ________


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http://changingminds.org/explanations/behaviors/coping/coping.htm


5C. Practice within ethical, legal, and regulatory guidelines

1. Follow agency/school policies and procedures, referring to agency Policy and Procedure manuals as needed with guidance

2. Maintain confidentiality of information

3. Function within legal scope of practice

4. Provide safe and effective care in accordance with established standards of care

5. Describe ethical principle(s) involved in issues encountered in the clinical setting (Give an example of a patient/family situation that you encountered where a specific ethical principle was an issue)

6. Describe legal principle(s) involved in issues encountered in the clinical setting (Give an example of a patient/family situation that you encountered where a specific legal principle was an issue)

Resources for ethical and legal principles include: Silvestri, 4th ed., Ch. 7 “Ethical and Legal Issues”





1 example: ______

1 example: ______

5D. Demonstrate professional behaviors

1. Present and conduct oneself in a professional manner as evidenced by conveying respect and courtesy for others, and diplomacy in interpersonal relationships

2. Demonstrate self-awareness of behaviors with feedback

3. Demonstrate intellectual humility in professional relationships


1 example: ______

1 example: ______

5E. Participate in the processes that affect healthcare practice

1. Engage in activities to promote the profession of nursing

2. Participate in the provision of non-practicum health-care related activities

Not applicable for PN Summer quarter


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Practicum Grading Criteria and Instructions

Maintain clinical notebook according to Pre-Clinical Conference directions. All clinical paperwork to be reviewed/graded by your instructor should be placed in the left side pocket of your

clinical tool notebook Be sure to label notebook in the upper right hand corner with your name, your instructor’s name, & your box

number. Additional clinical forms are available on the WWCC Nursing Program Resource webpage:

http://www.wwcc.edu/CMS/index.php?id=1464&deptcode=NURS Points will be deducted from professionalism for each week that clinical papers are received outside the notebook

or for notebooks turned in without appropriate paperwork filed. One (1) point will be deducted from the total points earned for each working day a notebook or Prenatal paper is

late. Students are responsible for the completeness of their notebook Completed notebooks must be turned in prior to final ICS with student Self-Evaluation completed. Points will

be deducted from professionalism if the self-evaluation is not completed and turned in with the final week’s notebook.

Clinical Preparation: The patient data sheet (including priority nursing assessment, nursing diagnosis, expected outcome, and

interventions), pathophysiology, and medication sheets (scheduled and PRN) are the minimum preparation required for all clients that you will care for. This will be submitted to your instructor prior to the beginning of clinical as assigned by your clinical instructor.

Comprehensive Nursing Plan of Care (26 points possible) – One Comprehensive Nursing Plan of Care (aka “Major Client Data Packet”) must be submitted from your acute care (medical-surgical) experience

Client Data Sheet/Projected Plan of Care (1 point) Pathophysiology (1 point) Medication Sheets (2 points)

o List all medications you will give during clinical and any PRN medication given in the past 24 hours. You must be prepared to answer questions on any of the medications you will give.

Lab/Diagnostic Sheet (1 point) Physical Assessment (1 point) Gordon’s Functional Health Patterns (1 point) Documentation Sheet (1 point) Nursing Care Plan (9 points each – total 18 points) – You must identify which nursing diagnosis is priority #1

and priority #2.

OB Clinical Data Packet (3 points possible) – An OB Client Data Sheet (1 point) and a Newborn Assessment Sheet (2 points) must be completed and turned in with the clinical notebook when the student is assigned to OB. This assignment takes the place of the journal page for that clinical day.


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http://www.wwcc.edu/CMS/index.php?id=1464&deptcode=NURS


JOURNAL TO DESCRIBE CLINICAL EXPERIENCE

Purpose: To assist the learner in reflective thinking regarding the learning opportunities and clinical experiences that occurred during the clinical week

Method: Each student is expected to complete a weekly journal which reflects his/her clinical experience that week. Students assigned to OB will complete an OB Data Packet consisting of an OB Client Data Sheet and a Newborn Assessment Sheet. This packet replaces one day of the weekly journal and is worth 3 points.

Inadequate analysis will result in a reduction of points. No points will be given for areas that are not addressed.

Format: Journal entries should be word processed using 12 pt. font, single-spaced, and no longer than one page in length.

Time Management: (1 point for a two-day clinical week; 0.5 points for a one-day clinical week)

Describe your anticipated plan to efficiently complete required care for your client.

What part of your anticipated plan went well and/or not so well in terms of time management? What changes did you make to your anticipated plan on the second day or could you make in the

future to improve time management?

Prioritization: (1 point for a two-day clinical week; 0.5 points for a one-day clinical week)

Describe an example of how you had to prioritize your care based on Maslow’s Hierarchy of Needs during your clinical shift. (This is based on your decision between 2 or more activities/skills or based on 2 patients regarding who should be cared for first.

Identify why your choice of priority was highest in regard to your patient’s needs anddisease process.

• Identify your desired outcome. Identify how you met your desired outcome. (How did your decision work out?)

Personal Analysis: (4 points for a two-day clinical week; 2 points for a one-day clinical week)

Analyze your feelings about the practicum experience for the weekDescribe your personal accomplishments (may include technical skills accomplished)Describe what made you most comfortable/uncomfortable?Describe your plan for continued growth (What will you do differently? What do you need to focus on?)

3 points will be deducted from total points achieved for each clinical absence in a week.


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SAMPLE JOURNAL FORMAT

Name:__________________________________ Date(s): ________________ Points __________

TIME MANAGEMENT:

PRIORITIZATION:

PERSONAL ANALYSIS:


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SPECIALTY UNIT REACTION PAPER(Emergency Department, Minor Care, and other units designated by instructor)

Purpose: To assist the learner in reflective thinking regarding the learning opportunities and clinical experiences that occurred in the specialty unit. Replaces one journal page worth 3 points.

Method: Each student is expected to complete a journal which reflects his or her experience in the specialty unit.

Inadequate analysis will result in a reduction of points. No points will be given for areas that are not addressed.

Format: Journal entries should be word processed using 12 pt. font, single-spaced, and no longer than one page in length.

Time Management: (0.5 point)

Describe the nurse’s time management in the specialty unit. How did the nurse manage his/her time? Was there a routine that he/she developed

to ensure timely care of patients? Describe how the team manages patient flow? What was the nurse doing during “down-time”?

Prioritization: (0.5 point)

Describe the triage system in the specialty unit in applicable.

Describe an example of how the nurse(s) prioritized his/her or their care of a patient based on Maslow’s Hierarchy of Needs. This example should be based on a specific patient.

• Identify the desired outcome. Identify why the choice of priority was highest in regard to the patient’s needs and

disease process. Identify how the desired outcome was met. (How did your decision work out?)

Personal Analysis: (2 points)

Analyze your feelings about the practicum experience for the weekDescribe your personal accomplishments (may include technical skills accomplished)Describe what made you most comfortable/uncomfortable?Describe your plan for continued growth (What will you do differently? What do you need to focus on?)

Total Points (3) :______________


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OBSTETRICS (OB) EXPERIENCE

*Not all students will have this experience; those who do will submit an OB Client Data Sheet (1 point) and a Newborn Assessment Sheet (2 points) in place of one day’s journal

OB CLIENT DATA SHEET

Student Name:

Week of Care:

History of Pregnancy & Labor (include information on length of labor )Date of Admission:

Reason for Cesarean Section (if applicable)

Client Needs Assessment

Ht Wt

Allergies

Activity Level

Diet

I & O

IV (solution) Flow RateSite:

PCA

Tubes: (Foley Catheter, NG tube, surgical drains

Other:

Vital signs:

Breasts:

Fundus:

Flow:

Episiotomy:

Lower Extremities:


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Laboratory/Diagnostic tests

Date Lab or Diagnostic Test

Test ResultClient Result (Normal Result)

Client specific reason for abnormality

Expected effects Based on test result

Other:

Postpartum only (info from prenatal record)Blood Type/Rh:

Rubella Titer:

Other abnormal data:

Source & page number ______________________


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Newborn (NB) Physical AssessmentNURS 113-114

Describe your assessment data using correct terminology. Highlight abnormal data.

General Appearance:

Vital Signs: Time _____ Temp _____ Pulse _____ Resp _____ BP _____ (if applicable)

Neuro/SensoryFontanels:

Eyes:Ears:

Hand Grasps:

Movement:Upper Extremities:Lower Extremities:

Reflexes:MoroRooting

IntegumentaryMouth:

Skin:

Breasts:Umbilical cord:

Circulatory

Apical Pulse rate: ____________ Rhythm ____________ Femoral Pulses ____________

Acrocyanosis:Edema:

Respiratory

Breath Sounds: Anterior Posterior

GI/GUBowel Sounds:

Stools:Voiding:

Circumcision:

Psuedomenstruation:


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JOURNAL TO DESCRIBE COMMUNITY/ SKILLED NURSING FACILITY PRACTICUM EXPERIENCES

Purpose: To assist the learner in reflecting on the learning opportunities and practicum experience in the community/skilled nursing facility

Method: In Community and Skilled Nursing Facility Practicum, the student will: Write 2 specific, measurable learning objectives (prior to first Community/Skilled Nursing

Facility clinical day) related to expectations for assigned clinical experience. Complete a journal entry for each community or skilled nursing facility practicum week.

Journal is to be written in narrative format and contain the three parts specified below.

Format: Journal entries should be word processed using 12 pt. font, single-spaced, and nolonger than one page in length.

Journal:

1. Describe what you did: Describe your personal accomplishments (may include technical skills accomplished) Describe what you did when plans were changed by circumstances out of your control Describe the types of patients seen and common problems encountered

2. Describe how you did or did not meet your objectives: What changes did you make to meet your objectives after the first day?

3. Analyze and Describe your feelings about the experience Describe what you learned about the role of the nurse in the setting Describe what made you most comfortable/uncomfortable about the experience

Evaluation: Your instructor will review objectives prior to your first day of community or skilled nursing facility

clinical. No points will be given for late objectives At the completion of your community experience you must turn in original objectives along with your

journal on the date specified by your clinical instructor. You must also turn in a medication sheet(s) with a list of the 3 most frequently medications given in your

community or skilled nursing facility setting. Any medications you gave from this list should be highlighted. Note: medications can include immunizations.

Grading Criteria Possible Achieved

Objectives (2 minimum completed- prior to clinical) 1Medication sheet of common meds (3 meds minimum) (Highlight all meds actually given) 1

Journal entries 4

Total 6


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