1 1 CENTRAL OREGON COMMUNITY COLLEGE Nursing Program Edited by: Michele Decker RN, MSN, MEd Rebekah Cook, JD Nursing Program Progression Policies
2 2 Nursing Program Progression Policies Table of Contents Page Number Policies Related to Student Progression in the Nursing Program Progression in the Nursing Program Review of Student Progression Nursing Program-Level Critical Elements Standards and Indicators of Safe and Unsafe Practice Student Progression Records
3 3 Policies for Progression in the Nursing Program TITLE: Progression in the Nursing Program POLICY: The Nursing Program reserves the right to refuse or discontinue enrollment at any time, of any student if the student violates the Nurse Practice Act of the State of Oregon, or in the judgment of the Nursing Faculty, the student does not meet the outcomes, technical standards, policies and/or safety standards of the Program or College. RATIONALE: Nursing Faculty of the College have a legal and professional responsibility to assure for the public, other students, the College, and the Nursing profession that students can practice safely and professionally in their various learning clinical practice settings. This policy embodies that accountability by defining technical standards, unsafe practice, unprofessional practice and behaviors, and deficient practice; by establishing guidelines for Faculty to make judgment of technical standards, unsafe practice, unprofessional practice, and deficient practice; and by providing procedures to be followed when a judgment of failure to meet technical standards, unsafe, unprofessional, or deficient clinical practice is made. It is expected that all students will practice safely at all times during their practicum experiences, which includes clinical and Learning Resource Center labs. Safe practice in the performance of Nursing care requires the application of scientific knowledge, and technical and cognitive skills to provide for the welfare and to protect the well-being of patients and clients. Safe practice demands that practitioners be aware of personal and professional limitations that could affect the safety of their performance. Decisions and actions that threaten or disrupt the biological, psychological, sociocultural, physical, or physiological integrity of patients or clients constitute unsafe practice. A Nursing student who demonstrates behaviors that call into question the student s ability to meet technical standards; who engages in unsafe, unprofessional, or deficient behavior or practice in the academic setting (on-campus) give the Nursing Program Faculty reason to suspect that the same behaviors or practices would continue in the patient care setting. Therefore, progression policies apply to the classroom, lab, and campus, as well as clinical settings.
4 4 PROCESS: The Nursing Faculty are committed to promoting student success. To this end, Nursing Faculty assess student progress toward meeting course (classroom, LRC, clinical) outcomes and Nursing Program Critical Elements throughout the term and advise students accordingly. If problems are detected that may affect student success in a Nursing course, Faculty will inform the student and develop with the student a progression plan for improved performance. Students are responsible for implementing the plan, including following up on referrals for assistance and maintaining frequent communication with the Nursing Faculty on the student s progress. In making decisions about the retention and progression of students, the Nursing Faculty reserve the right to dismiss students who do not adhere to the guidelines for personal and professional conduct as addressed in the questions asked of applicants for certificate by the Oregon State Board of Nursing (OSBN). Furthermore, if a student holds a certificate issued by the OSBN and engages in behavior defined as Conduct Derogatory to the Standards of Nursing (see OSBN Administrative Rules ), even though she/he does so as a student, the situation will need to be reported to the OSBN. This also applies to students holding licenses from other State Boards of Nursing. As registered nurses, the Nursing Faculty, Nursing Program Director and Department Chair are responsible for the mandatory reporting requirements in OSBN regulation It is the COCC student s responsibility to know and abide by the College Wide policies including Student Rights and Responsibilities which can be found on the COCC Website under the Student Life heading.
5 5 TITLE: Review of Student Progression POLICY: When a Nursing Faculty judges that a student has performed, practiced or behaved unsafely, unprofessionally, or deficiently; or performance or behavior indicates failure to meet the technical standards of the program, the student s progression in the Nursing Program will be reviewed with the appropriate Nursing Team, and when indicated the Nursing Program Director, Department Chair, Director of Student Life, Instructional Dean, Vice President for Instruction and/or other appropriate College Representatives. Faculty will notify the student in writing of behaviors or actions that demonstrated unsafe, unprofessional or deficient performance or behavior as a part of the progression record. PROCEDURE: At the time of notification the student will be provided with a written description of: Specific actions necessary to demonstrate satisfactory performance. Timelines for corrective action to be achieved. Any modifications in the clinical practicum experience pending completion of specific corrective actions necessary to demonstrate safe practice and/or behaviors. For example: restriction in care activities and responsibilities, direct supervision of Nursing care, or removal from clinical setting. Any modifications in the on-campus experience pending completion of specific corrective actions necessary to demonstrate appropriate behaviors. The action to be taken if the student fails to achieve the corrective actions prescribed in the progression plan. For example: higher level of progression or failure of the course. The action to be taken if the student achieves the corrective actions. For example: Pass the course, or pass the course but continue improvement activities into the next term(s). At the time of notification the student will conference with the Nursing Faculty. This conference may also include the Team Coordinator and/or the Nursing Program Director, Department Chair or other appropriate College representatives. During the conference the student will be expected to: Actively listen to the Nursing Faculty s concerns.
6 6 Be receptive to feedback on performance and/or behaviors. Demonstrate accountability for own actions and performance level. Provide personal perspective regarding the problem situation and generate problem-solving ideas. Participate in planning for remediation, including a student generated written plan for improvement identifying strategies and resources to achieve the corrective actions. (The date for submission of this plan will be determined during the conference.) Sign the record. If the student does not sign the record, this does not indicate that the record was not reviewed with the student. DEFINITIONS UNSAFE PRACTICE UNPROFESSIONAL PRACTICE OR BEHAVIORS Behavior in providing care to patients/clients in the LRC or clinical setting that fails to achieve the standard of care, violates the Nursing Practice Act, violates the ANA Standards of Practice, or calls into question the professional accountability or behaviors of the student. A single event of unsafe practice will result in the evaluation of a student for progression in the Program and will result in level one or two remediation, or dismissal from the program. The level of progression is dependent upon the degree of actual or potential harm a patient/client did/may suffer with gross negligence resulting in immediate dismissal. A student judged by the faculty to require continuous direct supervision beyond a shift of assessment in the clinical site will be immediately dismissed from the program. Behavior in providing care to clients that violates the ANA Code for Nurses, the ANA Code of Ethics, the Oregon Nurse Practice Act, or the policies of the Nursing Program and/or College. Behavior in the classroom, LRC, or clinical setting that violates the policies of the Nursing Program, and/or College. A student who falsifies patient records or engages in other dishonesty in patient care give the Oregon State Board of Nursing reason to suspect that he or she will continue the same dishonest acts after licensure. The board expects to be made aware of acts committed as a student and an investigation will be conducted once the student makes application for licensure. DEFICIENT PRACTICE Behavior in providing care to patients/clients that fails to achieve previous and/or current course outcomes; and that fails to achieve the standard of care.
7 7 ACADEMIC DISHONESTY From COCC Student Rights and Responsibilities Offenses against academic honesty are any acts which would have the effect of unfairly promoting or enhancing one's academic standing. Academic dishonesty also includes knowingly permitting or assisting any person in the commission of an offense against academic honesty. All academic work (e.g. homework, assignments, written and oral reports, creative projects, performances, in-class and take-home exams, extra-credit projects, research, etc.) are subject to the following standards of academic integrity: Cheating: Intentionally using or attempting to use unauthorized materials, information, or study aids in any academic exercise. Students must adhere to the guidelines provided by their instructor for completing coursework and may not present the same (or substantially the same) work for more than one course without obtaining approval from the instructor of each course. Fabrication: Intentional and unauthorized falsification or invention of any information or citation in an academic exercise. Plagiarism: Representing the words or ideas of another as one s own. All ideas, arguments and phrases submitted without attribution to other sources, must be the creative product of the student. Plagiarism includes copying portions of the writing of others with only minor changes in wording, with inadequate footnotes, quotes, or other reference forms of citation or only a list of references. Paraphrasing without appropriate citation is also plagiarism. Collusion: Intentionally or knowingly helping or attempting to help another to violate the academic honesty policy. Students may only collaborate within the limits prescribed by their instructors. For full discussion of COCC policies see: /default.aspx COCC NURSING PROGRAM POLICY Students may discuss course assignments with other students. Answers to all assignments must represent individual student work. Your answers cannot be duplicated, copied, or plagiarized from another student s work. TITLE: Nursing Program-Level Critical Elements POLICY: Critical Elements must be met throughout the Nursing course(s) at the satisfactory level. Failure to meet any one of the critical elements will result in the evaluation of the student for progression in the Nursing course. DEFINITION: Nursing Course Critical Elements describe essential skills, values, behaviors, and
8 8 beliefs of the profession of Nursing. Faculty believe that these Critical Elements flow through every level and every learning center in the Nursing Courses and Program. To violate any of these Critical Elements is to put the patient, families, staff, faculty, other students, our colleagues in healthcare and/or the integrity of the profession of Nursing in jeopardy. All students are expected to demonstrate safety, integrity, and accountability at all times. CRITICAL ELEMENTS Safety (actual and potential) The student will act in a safe manner with all patients/clients, families, staff, faculty, other students, and healthcare facility staff. Actual injury need not be established. (OSBN Division 45) See Minimum Safe Nursing Standards See Indicators of Unsafe Clinical Behaviors The student will refrain from committing offenses against persons including abuse of self or others, assault and/or battery, defamation or threats, extortion, harassment, hazing, non-consensual sexual act, and stalking. These actions will not be tolerated and will result in the evaluation of the student for progression in the Nursing course/program. See Offenses Against Persons under Student Rights and Responsibilities in the College Catalog, or College website. Integrity The student will display behaviors of integrity and honesty throughout the program including the admission process. The student will adhere to the American Nurses Association Code of Ethics. The student is expected to communicate (verbally and nonverbally) with the College, Nursing Program Faculty and staff, patients/clients/families, healthcare facility personnel, and other students in a mature and professional manner. This includes oral communication in person or on the telephone, and written communication via , and through the US Postal Service. Accountability The student will demonstrate accountability by accepting responsibility for individual actions, behaviors, and level of performance. The student will maintain knowledge and clinical competency appropriate to the
9 9 level of the Nursing course. The student will follow all College, Nursing Program, Nursing course, and healthcare facility policies, procedures, and requirements. The student will meet all expected deadlines for submission of student work and meeting scheduled examination times. Late work does not have to be accepted by the Nursing Faculty. The COCC student will act according to the Rights and Responsibilities outlined in the Central Oregon Community College Catalog and according to the policies outlined in the Student Code of Rights and Responsibilities found on COCC s website: TITLE: Standards and Indicators of Safe and Unsafe Practice POLICY: Students are expected to practice safely, ethically, and legally in the delivery of Nursing care to clients in all areas including both the lab and clinical practicum settings. Students are expected to demonstrate integrity and accountability in the academic and clinical settings. Failure to meet any one of the standards or indicators will result in the evaluation of the student for progression in the Nursing program and will require a written progression record. STANDARDS FOR SAFE NURSING CARE Safe Nursing care is demonstrated when the student: Assists in the application of the Nursing process in the performance of patient care. Demonstrates respect for and maintenance of the Nursing lines of communication. Maintains confidentiality with regard to information received about patients during the clinical practicum. Makes decisions about Nursing care when failure to make a decision would endanger the patient. Maintains communication that promotes the continuity of care. Ensures that correct performance of skills is validated by the Nursing Faculty according to the Guidelines for Calling the Clinical Instructor. Recognizes own limitations. Recognizes that previously learned knowledge and skills are required to properly implement Nursing care in the clinical setting.
10 10 Demonstrates professional behaviors and attitudes in demeanor, dress and language. INDICATORS OF UNSAFE CLINICAL BEHAVIORS OR PERFORMANCE Unsafe clinical behavior is demonstrated when the student: Violates or threatens the physical safety of self, patient, significant others, staff, Faculty, or others. Violates or threatens the physiological safety of the patient. Violates or threatens the psychological safety of the patient or significant others. Violates or threatens the microbiological safety of the patient. Violates or threatens the chemical safety of the patient. Violates or threatens the thermal safety of the patient. Inadequately or inaccurately utilizes the Nursing process. Violates previously learned principles/outcomes in carrying out nursing care. Demonstrates inappropriate dependence/independence in carrying out nursing care. Attempts nursing care without adequate orientation, theoretical preparation, skills preparation, or supervision. Commits acts of omission or commission likely to cause harm to patients including but not limited to: physical abuse; placing in hazardous positions, conditions or circumstances; and treatment errors, or near-miss treatment errors (errors that were prevented from occurring by the Nursing Faculty). Violates confidentiality, privacy, or security standards as discussed in the Health Insurance Portability and Accountability Act (HIPAA). Violates healthcare facility policies and/or procedures. INDICATORS OF LACK OF INTEGRITY OR ACCOUNTABILITY Lack of integrity or accountability is demonstrated when the student: Commits academic dishonesty including but not limited to: a) cheating, b) fabrication, c) plagiarism, and d) collusion. See Academic Honesty under Student Rights and Responsibilities in the College Catalog, or College website. Knowingly producing false evidence or false statements, making charges in bad faith against another person, or making false statements about one s own behavior related to education and professional matters. Violates the ANA Code of Ethics for Nurses. Fails to provide accurate, inclusive, written and verbal communication or falsely documenting in a patient record, or course written assignment. Engages in behavior that is disrespectful of a person s social or economic status, personal attributes, or health problems.
11 11 Exhibits behavior disruptive to the learning process, or to the academic/practicum environment. See Disruption under Student Rights and Responsibilities in the College Catalog, or College website. Fails to communicate and/or interact in a professional manner with students, Faculty, staff and/or healthcare team members. PROCESS AND CONSEQUENCES In the event that a student is showing potential for not meeting the course requirements, or violating Nursing Program or College policies, a Nursing Student Progression Record will be initiated by Nursing Faculty following consultation with the appropriate Nursing Program Team members and possibly the Nursing Program Director, Department Chair, Director of Student Life, Instructional Dean, Vice President for Instruction or other appropriate College representatives. Process Steps: 1. The Nursing Program Student Progression Record will be reviewed with the student. 2. The student will be informed that he/she has a right to appeal to the Dean of Students within five business days from the date of the student conference. See Formal Hearings under Student Rights and Responsibilities in the College Catalog, or College website. INELIGIBILITY FOR READMISSION: A student will be considered ineligible for readmission or advanced placement into the Nursing Program if: The student has been immediately dismissed from the Nursing Program for documented acts of dishonesty or unethical behavior and has not been conditionally approved for readmission by the Nursing Faculty. The student has been immediately dismissed from the clinical practicum for safety reasons and there is no evidence of engaging in and completing a remediation plan. The student has been dismissed from the Nursing Program for drug/alcohol offenses (See OSBN s Conduct Derogatory to the Standards of Nursing Defined, OAR ) and there is no evidence of engaging in and completing an appropriate rehabilitation program. The student has failed or been immediately dismissed from the Nursing Program due to not meeting the Nursing Course and Program level Critical Elements, polices and/or procedures, and there is no evidence of engaging in and completing a remediation plan. The student has failed to satisfactorily complete a given Nursing course after re-
12 12 enrolling in that course once (1 time). The student has two chances to pass a Nursing course. TITLE: Student Progression Records POLICY: Whether problems in student behavior or performance result in level one or two remediation, or dismissal from the Program is a Nursing Faculty decision made at the Team level, with input from the Nursing Program Director, Department Chair, Director of Student Life, Instructional Dean or Vice President for Instruction, or other appropriate College representatives as needed. In making decisions related to student progression, Nursing Faculty consider the implications of student behavior or performance for patient safety, professional and personal integrity, and student success. While Nursing Faculty make every effort to alert students as early as possible to problem situations, there is no implied process that requires that a Level One progression record must precede a Level Two progression record, or that either of these must precede immediate dismissal from the Nursing Program. Level One Remediation Plan: Communication Record The intended purpose of student progression is to call attention to the student, as early as possible, to a situation that, if uncorrected, could lead to academic failure. In the event that a student is showing potential for not meeting the course requirements, a progression Communication Record will be initiated by Nursing Faculty following consultation with the appropriate Nursing Program Faculty Team members and possibly the Nursing Program Director and Department Chair. Subsequent occurrences of problem behavior/performance will result in further progression by the Nursing Faculty Team, and may include the Nursing Program Director, Department Chair and other appropriate College representatives. Students may continue on Level One remediation, be progressed to Level Two, or be immediately dismissed from the Program as determined by the seriousness of the student s issues. Academic: Classroom-related performance or behaviors that indicate a need for problem-solving and the creation of a level one progression record. Examples of such issues include: a theory exam score below 76.55%, late submission of written work, repeatedly missing or arriving late at exams, or failure to meet responsibilities of students as outlined in the College Catalog.
13 13 Practicum: Clinical and/or Learning Resource Center performance that indicate a need for problemsolving and the creation of a level one progression record. Examples of such issues include skills check-off failures, lack of progress towards meeting clinical outcomes, missed clinical time, inadequate preparation for patient care, unsafe practice, lack of professional conduct, failure to notify Nursing Faculty for skills supervision, failure to keep Nursing Faculty and nurses apprised of patient progress, and failure to follow established policies of the Nursing Program, College, and/or healthcare facility. Satisfaction of the progression Communication Record Plan: At the end of the term the student s progress towards achieving the plan will be evaluated and reported to the appropriate Nursing Program Team. The team will review the terms of the plan and present a recommendation to the Faculty. The student will be notified of the Faculty s decision regarding progression in the Nursing Program. If the student successfully completes the plan, a note will be placed on the plan in the student s record indicating such and that no further action is required. A consequence of failing to demonstrate adequate progression toward achieving the plan will be failure of the course. Level Two Remediation Plan: Probation This record is notice to a student that immediate changes in behavior or performance are needed to prevent either failure or dismissal from the Nursing Program. Students may be advanced directly to probation as determined by the seriousness of the student s behavior or performance issue. Subsequent occurrences of problem behavior/performance will result in disciplinary action, which will include continuation on probation or immediate dismissal from the program, and possible ineligibility for readmission. The Nursing Faculty identifying the problem behavior/performance informs the student and schedules a multi-person conference among the student, the instructor(s), the Nursing Program Director, Department Chair, and other appropriate College representatives. Students may invite a support person (Note: this person cannot be currently enrolled in the Nursing Program) to appear with them at this meeting. The support person is at this meeting as an observer only, and is not invited to participate in the dialogue between the student and the Nursing Program/College representatives. Students will receive a copy of the probationary record. Students are referred to the College Catalog for the Judicial System and Procedural Rights.
14 14 Academic Honesty: Students who fail to practice academic honesty will be immediately placed on probation. Grievous violations will result in immediate dismissal from the program. Satisfaction of the Academic Honesty Probationary plan: Students placed on probation for academic dishonesty will remain on probation for the remainder of their enrollment in the Nursing Program (or upon admission and throughout enrollment in the Nursing Program if the episode of academic dishonesty occurs during the Nursing Assistant course). A second occurrence of academic dishonesty will result in immediate dismissal from the Program. Dismissed students seeking to re-enter the Nursing Program are subject to the guidelines for readmission. Practicum: Students who continue to demonstrate a trend of unsafe practicum behavior or performance will be placed on probation. Grievous safety, integrity, or accountability violations will result in progression by the Nursing Faculty Team, Nursing Program Director, Department Chair, and appropriate college representatives for possible immediate dismissal from the program. Satisfaction of the Practicum Probationary Plan: Students who continue to demonstrate unsafe practicum behaviors or performance while on probation will be barred from the clinical practicum, in which case their clinical grade will be no pass. If a serious unsafe behavior is demonstrated at any time during a Nursing course, the student will remain on probation throughout subsequent Nursing courses. Once a student has met all the conditions of the probationary plan and can consistently demonstrate a trend of satisfactory performance in the clinical setting the plan may be resolved. Any further occurrence of unsafe care will result in the reactivation of the probationary plan or immediate dismissal of the student. Level Three: Immediate Dismissal Dismissal of a student reflects an academic and instructional judgment of the Nursing Faculty. Immediate dismissal will be employed in the following circumstances: The student s performance, behavior, abilities, or legal status prevents the student from
15 15 appropriately participating in the Nursing Program. (See Technical Standards; Conditions that May Affect Entrance, Clinical Placement, and/or Continuation in the Nursing Program) The student s performance, behavior, abilities, or legal status clearly indicates that she/he lacks the knowledge, skills, judgment or abilities to safely provide Nursing care, thereby placing patients at risk of injury or death. (See Indicators of Unsafe Clinical Behaviors or Performance) Examples of circumstances that could lead to immediate dismissal include: 1) Gross negligence and/or major safety violation. 2) Conviction of a crime, while a student, under circumstances bearing on the suitability of a student to practice a health related profession. 3) Use of any controlled substance or intoxicating substance to an extent that is dangerous or injurious to the student or others and such use impairs the ability to safely conduct Nursing practice or participate in academic activities. 4) Conduct derogatory to the standards of Nursing (See Oregon Administrative Rules, Board of Nursing Chapter 851, Division 45, ). 5) A condition or life situation that causes the student to be unable to meet the Technical Standards of the Nursing Program. 6) Coercive language or behaviors that put patients, clients, families, healthcare facility personnel, other students, or Nursing Program faculty and staff at risk for psychological harm, physical injury, or death.
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