NURSING PROGRAMS STUDENT HANDBOOK FALL 2014

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1 NURSING PROGRAMS STUDENT HANDBOOK FALL 2014

2 Dear Student: Congratulations on your acceptance to the associate degree or practical nursing program at Craven Community College! You have chosen a challenging, exciting and ever changing career option and with nursing you will find a variety of employment opportunities and a lifetime of learning, as healthcare continues to change. Please use this handbook to guide your educational journey as a nursing student. On behalf of the Administration and Faculty at Craven Community College, we welcome you and wish you good luck in your pursuit of a career in nursing. If you have further questions please do not hesitate to contact me. Sincerely, Carolyn S. Jones, RN, MAEd, MSN Acting Chair of Nursing and Continuing Education Programs - 1 -

3 TABLE OF CONTENTS Introduction by Acting Chair of Nursing and Continuing Education Programs I. Philosophy... 4 A. Associate Degree Nursing B. Practical Nursing..17. C. Program Curriculum and Learning Outcomes Associate Degree Nursing. 5 a. National League of Nursing A.D.N. Competencies b. Institute of Medicine Competencies (IOM) c. Quality and Safety Education for Nurses (QSEN) d. Concept-based Curriculum Exemplars and Concepts Standards 2. Clinical Level Competencies by Program and Course 16 a. Associate Degree Nursing b. Practical Nursing 3. Practical Nursing..17 a. National Association for Practical Nurse Education and Services, Inc. (NAPNES) b. National League of Nursing Practical Nurse Competencies c. Institute of Medicine Competencies (IOM) d. Quality and Safety Education for Nurses (QSEN) II. Faculty- Student Responsibilities A. Faculty B. Student III. Admission Process...23 A. Admission Requirements B. Health Requirements C. Criminal Background Check D. Licensure E. CPR IV. Conduct.. 25 A. School B. Social Media C. Clinical D. Appeal E. HIPPA compliance V. Attendance 28 A. College B. Nursing Department VI. VII. Grading.30 A. Schema of 10 point scale B. Testing Policy and Blueprints C. Written Assignments D. ATI and Computer Assisted Instruction E. Simulation Laboratory F. Strategies for Success Clinical Requirements.31 A. Dress and Grooming B. Malpractice Liability Insurance C. Needlestick, Exposure, or Injury to a Student D. Badges E. Clinical Evaluation F. Skills Performance Limitations 1. Do Not Do List VIII. Progression 34 A. Technical Standards for delivery of safe, effective nursing care a. Standards List - 2 -

4 b. Disability and Accommodation request process B. Requirements C. Readmission D. Transfer Student E. Admission Options IX. Other A. Student Employment a. Accountability b. Suggested Limitations B. Student Transportation a. Student Responsibility b. Impact on Assignments C. Student Clinical Assignments a. Student Learning Outcomes b. Times, Days of week c. Designated clinical sites D. NAI and NAII Requirements X. Pinning Ceremony...38 A. Overview B. Faculty/Chair responsibilities C. Student responsibilities D. Club responsibilities XI. Student Nurse Association 38 XII. Other expenses...39 A. Licensure B. Pinning Ceremony C. NCLEX testing XIII. Signature Sheets and Estimated Costs...40 A. Handbook B. ADN Estimated Cost to Student C. PN Estimated Cost to Student DISCLAIMER: Content subject to change. The most up-to-date information can be found in your course syllabi. Accepted Oct. 1, 1979 Revised 11/06 Reviewed/Revised, 11/86 Revised 5/07 Revised 3/89 Revised 5/08 Revised 7/90 Revised 7/08 Revised 9/91 Revised 7/09 Reviewed 9/95 Revised 8/10 Reviewed 9/96 Revised 1/11 Reviewed 8/97 Reviewed and Revised 8/11 Reviewed 5/98 Reviewed and Revised 4/12 Reviewed 8/99 Reviewed and Revised 4/13 Reviewed 7/00 Reviewed and Revised 7/14 Revised 7/01 Revised 8/02 Revised 5/03 Revised 5/04 Revised 5/05 *Note: For ease in use and consistency, the handbooks for the Associate Degree Nursing Program and the Practical Nursing Program have been consolidated into one handbook entitled Craven Community College Nursing Student Handbook. This handbook was implemented for the Fall 2014 cohorts

5 I. PHILOSOPHY OF THE ASSOCIATE DEGREE NURSING PROGRAM Mission The Associate Degree Nursing program supports the mission of the North Carolina Community College System and the mission of Craven Community College. The faculty is committed to providing accessible high quality nursing education to meet the diverse and changing health-care needs of the service area and to promoting the development of qualified students prepared for the professional role of the registered nurse at the entry level. Graduates of this program meet the education requirements to take the National Council Licensure Examination (NCLEX-RN). The philosophy of the Associate Degree Nursing Program is derived from statements about the health, quality of life, achievement of potential, the individual, environment, health, nursing, practice, and the education of the Associate Degree Nurse. Within this mission, the goal of nursing faculty is to promote the highest quality of nursing care to the individual, families and significant persons, and the community. The aim is to facilitate optimum health, quality of life and achievement of potential for the individual. The Associate Degree Nurse The graduate of the Associate Degree Nursing program at Craven Community College is prepared to meet the educational competencies defined by the National League for Nursing and the Nursing Practice Act of North Carolina. The practice of nursing is directed toward meeting the health care needs of individuals throughout their lifespan. The ADN prepared nurse s role is characterized by evidence-based clinical practice with the provision of care for individuals and families in structured settings. The ADN graduate demonstrates the competencies identified by the National League of Nursing (2000, 2010) and the Institute of Medicine (2004) to provide nursing care. Associate Degree Nursing Education Nursing education at the associate degree level, in the North Carolina Community College System, is a process that facilitates changes in behavior, the acquisition of knowledge, skills, and attitudes necessary to function in the role of the entry-level nurse. The curriculum is conceptually based and founded on principles of adult and collaborative learning. Basic assumptions include self-direction, utilizing adult experience, problem- and activity-centered learning (Rachel 2002). It incorporates evidence-based nursing theory and practice, general education, and the sciences in an environment conducive to learning. The conceptual design defines the essential elements as the environment, quality of life, achievement of potential, and health. The organizing framework contains content related to the individual, the health care system and nursing. The Associate Degree nursing program at Craven Community College provides an education that is flexible, progressive, and sensitive to the changing needs of the individual, significant support person(s), and community. Through these educational experiences, students will have the opportunity to develop critical thinking and problem solving skills. The Associate Degree Nursing Curriculum is based on learning theory rooted in neurobiology. Neuroscientists discovered that the brain develops circuitry and grows as a result of experience and learning. Learning is about making connections. Neurologists and cognitive scientists agree that humans build their minds by constructing mental structures and handson concrete application that connects and organizes information (Barkley, Cross & Major 2005). Learning is a continuous process that results in a change of behavior and occurs when the individual is challenged and motivated to enhance personal knowledge. Teaching and learning is an interactive process between teacher and learner. The responsibility of the faculty of Craven Community College Associate Degree Nursing Program is to facilitate the student s understanding and ability to meet the competencies for nursing practice through the design and evaluation of learning experiences. The nursing student is responsible for actively participating in learning experiences and develops the knowledge, skills, and attitudes necessary to provide quality individual centered nursing care

6 Associates Degree Nursing Program Learning Outcomes Graduates of this program will be able to: Practice professional nursing behavior incorporating personal responsibility and accountability for continued competence. Communicate professionally and effectively with individuals, significant support person(s), and members of the interdisciplinary health care team. Integrate knowledge of the holistic needs of the individual to provide an individualized assessment. Incorporate informatics to mitigate error and formulate evidence-based clinical judgment and management decisions. Implement safe, caring interventions incorporating documented best practices for individuals in diverse settings. Develop a teaching plan for individuals and/or the nursing team, incorporating teaching and learning principles. Collaborate with the interdisciplinary health care team to advocate for positive individualized and organizational outcomes using knowledge, skills and attitudes for continuous improvement and quality. Manage health care for the individual using cost effective nursing strategies, critical thinking skills, nursing and quality improvement processes and current technologies. Take and pass the NCLEX RN exam. The Associate Degree Nursing Conceptual Framework The conceptual model provides a mental scaffold or framework to prepare learners for new instruction and motivates by making a meaningful connection for the learner. The learner must attain mastery of each part of the framework; the individual, the healthcare system and nursing in order to understand the complete curriculum (Knowles 2005). The domains of the individual, the healthcare system, and nursing provide the conceptual framework guiding the associate degree nursing curriculum. Concepts are organized within each these domains and learning occurs from simple to complex

7 Definitions: Individual The faculty of Craven Community College believe that each individual is a complex, multidimensional, unique, and significant being possessing inherent value and worth, and a member of a family, community, and culturally diverse society. All individuals have dynamic bio-physical, psychological, socio-cultural, spiritual, and developmental needs that contribute to health, quality of life, and achievement of potential. Adaptation to the environment requires the individual to change throughout the lifespan. Each individual has a right to healthcare and to information that will assist him or her to participate actively in his or her health care in order to achieve the highest level of wellness possible. All individuals should be cared for, respected, nurtured, understood, and assisted. In order to provide and manage care, nurses must view the individual at the center of any nursing activity. Healthcare System According to von Bertalanaffy (1968) a system consists of the coming together of parts, the power comes from the energy of the interconnection and the way the parts come together. The community healthcare system is a macrosystem and consists of a variety of parts or microsystems. Clinics, hospitals, pharmacies, laboratories, long term care and Internet sites are microsystems that are connected by patients and information to improve health (IOM 2001). Nursing Nursing is a science and the art of integrating and assimilating knowledge and skills derived from biological, sociological, and behavioral sciences and information technology to deliver client-centered, culturally competent, holistic care. Through caring, empathy, ethics, and the development of a therapeutic relationship with the individual and significant support person(s), the nurse integrates the art of nursing with the scientific foundation for nursing practice that utilizes the nursing process. Incorporating documented best practice, the nurse functions autonomously and collaboratively with the interdisciplinary team to assist individuals to reach their maximum health potential through assurance of quality client outcomes, promotion of wellness, prevention of illness, and restoration of health or assistance in achieving a dignified death. According to the North Carolina Nurse Practice Act, the practice of nursing by a registered nurse consists of the following ten components: 1. Assessing the patient s physical and mental health including the patient s reaction to illnesses and treatment regimens. 2. Recording and reporting the results of the nursing assessment. 3. Planning, initiating, delivering and evaluating appropriate nursing acts. 4. Teaching, assigning, delegating to or supervising other personnel in implementing the treatment regimen. 5. Collaborating with other health care providers in determining the appropriate health care for a patient but, subject to the provisions of G.S , not prescribing a medical treatment regimen or making a medical diagnosis, except under the supervision of a licensed physician. 6. Implementing the treatment and pharmaceutical regimen prescribed by any person authorized by State law to prescribe the regimen. 7. Providing teaching and counseling about the patient s health. 8. Reporting and recording the plan for care, nursing care given, and that patient s response to that care. 9. Supervising, teaching and evaluating those who perform or are preparing to perform nursing functions and administering nursing programs and nursing services. 10. Providing for the maintenance of safe and effective nursing care, whether rendered directly or indirectly

8 Environment The individual is in constant interaction with a changing environment that consists of both internal and external forces that varies throughout the lifespan and has the potential to cause stress in the individual. The nurse can assist the individual to alter aspects of the environment and to utilize his/her innate and learned coping mechanisms to adapt to these stressors. Health Health is a dynamic, ever-changing state of mental, physical, and spiritual well-being, which exists on a continuum from optimal wellness to illness and ending in death. The individual s needs for healthcare are determined by his/her position on the continuum. Each individual s health is based on his/her cultural perceptions and beliefs of health and illness and the ability to adapt to internal and external environmental forces. The individual is responsible for and capable of identifying, learning, and practicing health behaviors that can promote wellness, prevent illness, restore or maintain wellness, or achieve a dignified death. Quality of Life Quality of life involves five domains including physical, functional, psychological, social, and spiritual well-being. The individual s perception of and satisfaction with activities of daily living contributes to their worth, meaning, or satisfaction. This empowers the individual to cope successfully with the full range of challenges encountered in the real world (Ignatavicius: Med-Surg Nursing 5th Ed p.5). Achievement of Potential Achievement of potential is the individual s growth toward attaining one s utmost ability and quality of life. It is based on the individual s choices, perceptions, personal goals, life experiences, and holistic health. The following Competencies are integrated throughout the Associate Degree Nursing Curriculum: NLN Core Competencies The eight core competencies outlined by the NLN are; professional behaviors, communication, assessment, clinical decision making, caring interventions, teaching and learning, collaboration, and managing care (NLN 2000). NLN Competencies: Human Flourishing, Nursing Judgment, Professional identity and spirit of inquiry. (NLN 2010) Human Flourishing Advocate for patients and families in ways that promote their self-determination, integrity, and ongoing growth as human beings. Nursing Judgment Make judgments in practice, substantiated with evidence, that integrate nursing science in the provision of safe, quality care and that promote the health of patients within a family and community context. Professional Identity Implement one's role as a nurse in ways that reflect integrity, responsibility, ethical practices, and an evolving identity as a nurse committed to evidence-based practice, caring, advocacy, and safe, quality care for diverse patients within a family and community context. Spirit of Inquiry Examine the evidence that underlies clinical nursing practice to challenge the status quo, question underlying assumptions, and offer new insights to improve the quality of care for patients, families, and communities

9 Institute of Medicine Competencies The five core competencies identified by the IOM for healthcare providers are; patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics (IOM 2005). Provide patient-centered care Identify, respect, and care about patients differences, values, preferences and expressed needs; listen to, clearly inform, communicate with, and educate patients; share decision making and management; and continuously advocate disease prevention, wellness, and promotion of health lifestyles, including a focus on population health. Work in interdisciplinary teams Cooperate, collaborate, and communicate, and integrate care in teams to ensure that care is continuous and reliable. Employ evidence-based practice Integrate best research with clinical expertise and patient values for optimum care, and participate in learning and research activities to the extent feasible. Apply quality improvement Identify errors and hazards in care; understand and implement basic safety design principles, such as standardization and simplification; continually understand and measure quality of care in terms of structure, process, and outcomes in relation to patient and community needs; and design and test interventions to change processes and systems of care, with the objective of improving quality. Utilize informatics Communicate, manage knowledge, mitigate error, and support decision making using information technology. From Health Professions Education: A Bridge to Quality. Institute of Medicine, Quality and Safety Education for Nurses (QSEN) The overall goal of the Quality and Safety Education for Nurses (QSEN) is to meet the challenge of preparing future nurses who will have the knowledge, skills and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work. The competencies for pre-licensure students include patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety and informatics. The full QSEN competencies can be found at with excerpts included in this document. REFERENCES 1 Institute of Medicine. Health professions education: A bridge to quality. Washington DC: National Academies Press; Cronenwett, L., Sherwood, G., Barnsteiner J., Disch, J., Johnson, J., Mitchell, P., Sullivan, D., Warren, J. (2007). Quality and safety education for nurses. Nursing Outlook, 55(3) The Associate Degree Nursing Program, A45110, utilizes the North Carolina A.D.N. Concept Based Curriculum. The concepts and exemplars follow by semester and course

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17 Clinical Competency Level and Expectation for the Associate Degree Nursing Curriculum and the Practical Nursing Curriculum NUR 111 Clinical Competency Level One At this level, in the first semester of the nursing program the students are introduced to nursing concepts and professional behaviors that they are to adhere to and practice under the guidance of experts in the clinical setting. They are expected to carry out the nursing process, perform basic nursing skills, and complete a client s care utilizing a set of rules and provided resources for decision making. NUR 112 and NUR 114 Clinical Competency Level Two At this level students are expected to apply nursing concepts and recognize abnormal physical attributes in clinical settings to an identified patient population, develop the plan of care and make decisions on the basis of general guidelines or principles derived from previous experiences, and use appropriate resources to assist in solving client problems. The student can perform basic skills and applies guidelines that are based on cues from experts. They attempt to correlate theory with practice. NUR 113, NUR 211 and NUR 212 Clinical Competency Level Three At this level students are expected to continue to apply and adapt medical surgical nursing concepts to clients across the life span in a variety of community based health care settings, modify the plan of care and make decisions for clients at a variety of developmental stages on the basis of general guidelines or principles derived from previous experiences, organize and prioritize nursing interventions with supervision, and use appropriate resources to assist in solving client problems. The student can adapt basic skills and develops new skills applying guidelines that are based on cues from experts to different age groups. They attempt to correlate and build on medical surgical theory and practice. NUR 213 Clinical Competency Level Four At this level, which compromises the clinical preceptorship students can demonstrate mastery of the terminal student learning objectives

18 PHILOSOPHY OF THE PRACTICAL NURSING PROGRAM Mission The Practical Nursing program supports the mission of the North Carolina Community College System and the mission of Craven Community College. The faculty is committed to providing accessible high quality nursing education to meet the diverse and changing health-care needs of the service area and to promoting the development of qualified students prepared for the professional role of licensed practical nurse at the entry level. Graduates of this program meet the education requirements to take the National Council Licensure Examination (NCLEX-PN). The philosophy of the Practical Nursing Program is derived from statements about the health, quality of life, achievement of potential, the individual, environment, health, nursing, the practice, and education of the Practical Nurse. Within this mission, the goal of nursing faculty is to promote the highest quality of nursing care to the individual, families and significant persons, and the community. The aim is to facilitate optimum health, quality of life and achievement of potential for the individual. The Nursing Faculty believes that nursing is an ongoing interaction between an individual and his immediate environment. In order to maintain the optimum health of that person, the nurse observes, supports, teaches, communicates with and ministers to the individual. Should this optimum state of health deteriorate, the nurse will assist that individual in fulfilling his/her daily needs; or, when necessary, the nurse will provide support through the rehabilitative and/or dying process. The key to implementation of nursing practice is through the nursing process; an orderly systematic method by which a plan of nursing care is formulated, acted upon, and evaluated for that person by the nurse and patient or his significant other. The Practical Degree Nurse The graduate of the Practical Nursing program at Craven Community College is prepared to meet the educational competencies defined by the National League for Nursing and the Nursing Practice Act of North Carolina. The practice of nursing is directed toward meeting the health care needs of individuals throughout their lifespan. The PN prepared nurse s role is characterized by evidence-based clinical practice with the provision of care for individuals and families in structured settings. The PN graduate demonstrates the competencies identified by the National League of Nursing (2000) and (2010), and the Institute of Medicine (2004) to provide nursing care. Practical Nursing Education Education encompasses the total experiential background of an individual and influences the manner in which that person behaves in order to achieve his/her personal goals. Nursing education provides students with opportunities for the development of intellectual, interpersonal and technical skills necessary for safe, reliable nursing practice. The Nursing Faculty recognizes that students learn by pursuing self-established goals, which they perceive as being a part of their purposes, problems, abilities, desires, interests and needs. Therefore, the nursing faculty create a learning environment in which the student is guided toward assuming increased responsibility for identifying goals and then arriving at an acceptable means to reach these goals. Stressing learning rather than teaching, faculty serve as catalysts, resource persons, role models and general managers of the learning environment. They clarify, emphasize, and interpret data as needed by students to develop their individual mode for thinking, communicating ideas, making relevant judgments, and discriminating among values, all of which enable them to utilize the nursing process effectively. The intellectual, technical, and interpersonal skills required for nursing practice contain varying degrees of difficulty and complexity. Practical Nurses are prepared to assume a variety of roles in order to deliver nursing care. This nursing faculty assists students to prepare themselves for nursing competence as a Practical Nurse. Upon completion of the nursing curriculum, the student is then able to continue his/her education to a higher level of nursing competence, if so desired. We believe graduates from our programs are able to accept responsible positions in healthcare settings to provide efficient, reliable, skilled, and safe nursing care appropriate to their level of nursing preparation

19 Graduates of this program will be able to: PRACTICAL NURSING PROGRAM LEARNING OUTCOMES Practice professional nursing behavior incorporating personal responsibility and accountability for continued competence. Communicate professionally and effectively with individuals, significant support person(s), and members of the interdisciplinary health care team. Participate in the integration of knowledge of the holistic needs of the individual to provide an individualized assessment. Incorporate informatics to mitigate error. Provide safe, caring interventions incorporating documented best practices for individuals. Participate in the development and provision of a teaching plan for individuals and/or the nursing team. Collaborate with the interdisciplinary health care team to advocate for positive individualized and organizational outcomes using knowledge, skills and attitudes for continuous improvement and quality. Participate in implementing the health care plan developed by the Registered Nurse and/or prescribed by any person authorized by North Carolina state law to prescribe such a plan, for the individual using cost effective nursing strategies, critical thinking skills, nursing and quality improvement processes and current technologies. Take and pass the NCLEX PN exam. Course level student learning outcomes are found in each course syllabus. The Practical Nursing Program Curriculum includes: 1. Fundamental Nursing Skills 2. Life Span Care and Needs a. Obstetrics b. Pediatrics c. Adults d. Geriatrics 3. Nutrition 4. Pharmacology 5. Legal/Ethical Issues 6. Communication a. Informatics b. Interpersonal c. Professional 7. Nursing Process a. Assessment Data Collection b. Nursing Diagnosis c. Planning d. Implementation e. Evaluation 8. Stress, Adaptation and Coping 9. Wellness/Illness and health alterations 10. Health maintenance, promotion, prevention and restoration 11. Evidence-Based Practice

20 PRACTICAL NURSING PROGRAM CONCEPTUAL MODEL The conceptual framework for the practical nursing program of Craven Community College has been developed to serve as a guide by which the faculty can provide students with opportunities to develop intellectual, interpersonal and technical skills necessary for safe, reliable nursing practice. The conceptual framework was developed from Chrisman and Fowler's "Systems-In-Change" model, Neuman's "Health Care Systems Model" and the models previously used by the Practical Nurse and Associate Degree Nurse programs at Craven Community College. In our conceptual model, man is represented in a constant state of change as depicted by the ellipses, which represent the three subsystems of man: physical, psychological, and social. These ellipses intersect with each other to show their interaction with each other. The framework also shows the system of man within the boundaries of the environment, showing the interaction of man with his environment. As well as man being in a constant state of change, the environment is in a constant state of change. The environment is symbolized by broken arrows traveling in a circular fashion. From conception to death, man travels on a developmental continuum. This continuum is represented by an arrow above the ellipses representing man. This arrow is enclosed by parallel lines which represent conception and death. The arrow represents man's movement from conception to death. As man moves along the developmental continuum and interacts with his environment, he encounters stressors. Each stressor can be viewed as intra-, inter-, or extra-personal in nature. Man's encounter with stressors is shown by an arrow intersecting with man and producing a reaction. Nursing intervention as a result of the nursing process can occur before a stressor creates reaction or after a reaction has occurred. This is depicted by an arrow traveling from nursing process to nursing intervention and arrow from nursing intervention to man and reaction

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