Facilitating A Learning Environment

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Gavin Atkins
8 years ago
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1 Facilitating A Learning Environment Expectations of Students, Faculty, and Staff Nurses In Acute and Residential settings In order to promote a supportive, effective learning environment, we have developed some guidelines and suggestions to clarify communication, physical environment and continuity of care issues in acute and residential care settings. Patient is used to refer to both patients and residents. Communication - Oral Before or immediately following shift report, introduce yourself to the nurse in charge of your patients. In many cases, you will need to report on to a RN or RPN and a LPN depending on the assignment. Tell the nurse(s) what you will be doing for your patients and what procedures you are not trained to do or will not be doing that shift. At this time, you may need to clarify what you need from the RN/RPN/LPN in terms of supervision, etc. Keep in regular contact with the RN/RPN/LPNs to let them know of abnormal vital signs and changes in patients condition. If you are unable to complete the nursing care for patients as planned, you must let the RN/RPN/LPN know (including carrying out procedures, giving medications, administering tube feeds, doing frequent patient checks, completing OR checklists, etc). You must at least let us know one hour before the end of your shift. In most cases, the sooner the better. Report off to the RN/RPN/LPN before you leave the unit for breaks, conferences, etc. Tell the nurse(s) what care you have given or gave during the shift and report any changes in the patients condition. If you have problems or concerns with a nurse you work with, feel free to discuss them with that nurse. If you feel uncomfortable doing this, talk to your Faculty. Wear your school nametag as well as VCH ID prominently so you are easily recognized as a student. Regional Clinical Education 1

Patient is used to refer to both patients and residents. Communication - Oral Before or immediately following shift report, introduce yourself to the nurse in charge of your patients.

2 At the beginning of the rotation, provide some direction to nursing staff on how much supervision and consultation they might need to do with the students. Let the charge nurse and the nurse(s) involved know if there are changes in student assignments. You may need to informally let the RN/RPN/LPNs know when the students can assume more clinical skills or when there is a change in student expectations. If you and/or the students have any concerns about any of the nurses please approach them directly. For unresolved issues talk to the educator or manager of the unit. Introduce yourself to the student group. Wear your nametag prominently for ease of recognition. When reading off the Kardex during report ensure that students can hear and can participate in discussion prn. Be available and receptive when you receive report from the students at the beginning, throughout, and the end of the shift. Provide the student with appropriate positive reinforcement. Discuss issues/concerns directly with the student. Take unresolved issues to the faculty. Discuss issues/concerns common to the student group with the faculty. Discuss issues/concerns about the faculty directly with the faculty. If you feel uncomfortable doing this, approach the educator or manager of the unit. Regional Clinical Education 2

You may need to informally let the RN/RPN/LPNs know when the students can assume more clinical skills or when there is a change in student expectations.

3 Communication - Written When removing a chart from the chart rack please follow the procedure on the unit for letting others know you have the chart out. Find out where and when the unit staff record intake and output totals and vital signs other than the clinical record i.e. Clipboards or worksheets at bedside or the nursing station. First thing in the morning, the night shift nurses are completing their charting. Be cognizant of this when you are reviewing your patient(s) chart - be prepared to return the chart promptly to the RN/RPN/LPN at his/her request. If appropriate for your rotation, record a brief patient status summary on the Kardex at the end of your shift. Check charts regularly throughout the shift for new doctors orders. Provide a list of skills that students will or will not be doing with their patients and post it with the student assignment sheet. Update the student assignment list daily as patients are discharged, students become ill, etc. Find out where memos to the staff can be posted. Forward a list of the students names and phone numbers to the unit for staff reference. Check the student assignment list daily - which students are assigned to which patients and what skills they will or will not be doing. Find out where the best place is to leave notes or messages for the faculty. When possible, keep charting up to date so the student is informed and so nurses notes are recorded chronologically. Regional Clinical Education 3

First thing in the morning, the night shift nurses are completing their charting.

4 Physical Environment Because physical space is often at a premium, it is helpful to have some guidelines so that all everyone has their own space to do their work and have breaks. During report, make sure you sit or stand where you can hear the nurse reading off the Kardex. Find out where the staff on the unit prefer you to do your charting. Find out if there is a multipurpose room on the unit that may be used for student/faculty discussions. Ask about using the staff lounge on the unit. Sometimes they may be designated as quiet areas for staff. It is recommended that most breaks be taken in the Cafeteria. Several nurses may share one medication cart or medication preparation area. Find out from your faculty where the right place for you to prepare medications is. During orientation review physical environment issues with the educator or manager of the unit. Find out where student/faculty can store valuables such as purses on the unit. Also, find out where other belongings should be stored i.e. In student designated lockers in the facility or the staff lounges. Make sure that students and faculty have a place during report to hear the nurse who is reading and to see the Kardex (if possible). Be flexible in accommodating the needs of students. Regional Clinical Education 4

Find out if there is a multipurpose room on the unit that may be used for student/faculty discussions. Ask about using the staff lounge on the unit.

5 Continuity Of Care As much as possible, follow unit routines in terms of times for morning care, vital signs, and ambulation. Consult with the RN/RPN/LPN or your faculty if you are having difficulties maintaining the routine. Please offer analgesics on a regular basis. Feel free to ask your nurse or faculty about the pain management techniques used here. At mealtime, check to make sure that your patient(s) received the correct diet. Be aware of break times. For example, try to keep consultations with the nurse(s) in charge of your patient to work time. Obtain a listing the RN/RPN/LPN routines for day and night shift from the educator or manager. Be aware that students need supervision for many skills. Therefore, following the unit routines may not always be possible. Regional Clinical Education 5

Feel free to ask your nurse or faculty about the pain management techniques used here. At mealtime, check to make sure that your patient(s) received the correct diet. Be aware of break times.

6 Miscellaneous Fill laundry bags 1/2 to 2/3 full only. Full bags are too heavy to lift and can cause back injuries. Change linen only if soiled. It is costly to change linens daily. The Kardex is a valuable commodity early in the am and is required by many disciplines. The Kardexes should not be sought out immediately after shift report. If you have completed your patient care, please do not stand around the nursing station talking. There is limited room around the station. If you have completed care for your patient, and there is a call bell ringing but no nurses are available to answer it, as a courtesy to the staff and patient, please answer the light. If what is required is outside your scope, pass it on to the appropriate nurse and let the patient know you are doing so. Please make sure that you are here before the start of the shift so that you are available as a resource if the students have any questions. At the end of your shift, please do not leave the unit until all of the students have left the unit. Thank you to all for your cooperation! We know that students, faculty, and staff nurses all benefit from the learning experiences. Regional Clinical Education 6

If you have completed your patient care, please do not stand around the nursing station talking. There is limited room around the station.

WEEK BY WEEK GUIDE TO CLINICAL PROGRESS IN PRECEPTORSHIP 1. Clinical Experience

WEEK BY WEEK GUIDE TO CLINICAL PROGRESS IN PRECEPTORSHIP 1 During your first discussion with your preceptor, the following topics may be useful: Decide on the starting date and shift for your first clinical