ST. MARY S HOSPITAL & MEDICAL CENTER GRAND JUNCTION, CO 81501

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1 MANUAL: Patient Care ST. MARY S HOSPITAL & MEDICAL CENTER GRAND JUNCTION, CO Standards Title: Student Nurse Experience Guidelines Standards #: B.2.4 Department or Group Initiating: Nursing Practice Effective Date: 8/20/1980 Supersedes: Student Nurse Experience Revised: 4/2000, 11/2002, 9/2005 Reviewed: Committee/Team Approval: Risk Management, Nursing Practice Date: 11/2005 Approved by/title/dept.: Signature on File Date: 11/2005 Jerry Spicer RN, MPA, CNAA,BC, VP of Patient Services Review Frequency: Every 3 Years Page 1 of 5 STANDARD: As a Regional Medical Center, and in line with our Mission, Vision and Values, St. Mary s Hospital & Medical Center provides clinical experience for students who request clinical experiences within Patient Services from educational institutions with a hospital affiliation agreement. SCOPE: Patient Services, Educational Institutions including instructors and students 1. GUIDELINES: A. A Student Affiliation Agreement with the academic institution MUST be on file before any clinical experience can begin. The list of current academic institutions and programs having a signed agreement is kept on file in the Administration Office. (Reference: Administrative L-13 Student Affiliations Agreements) B. Nursing care units are available for student clinical experiences twenty four hours a day, seven days a week. C. LPN must follow their scope of practice 2. PRE-REQUSITE REQUIREMENTS: A. Requests for student placement are to be submitted at least 2 months prior to rotation start date to assist in student placement. B. At least 4 weeks prior to initial entry into the facility, both instructors and students must submit: 1. A Background Check Authorization Form. Entry will not be approved without the hospitals completion of a background check. 2. A Pre-Requisite for Student Affiliation form. This form must be completed annually by students and faculty/instructors. C. A schedule of the student rotations with names will be made available to the Nursing Support CRS no later than one week prior to the beginning of the clinical experience ( earlier if possible) D. A list of student names and telephone numbers is to be made available to the Nursing Support CRS through the faculty liaison at least one week prior to the beginning of the clinical experience. 1. Students requesting senior experience or Capstone program, will have phone numbers available to Nursing Support CRS at least one month before clinical days with the preceptor.

2 MANUAL: Patient Care Page 2 of 5 E. An orientation to the facility will be provided for instructors and students entering the hospital for the first time prior to clinical experience. The orientation will include Hospital Mission, Vision and Values, cultural consideration, HR information, infection control, safety and other components to meet regulatory agency requirements. 1. Each instructor is responsible for coordinating with the Nursing Support CRS an orientation for students to the unit and to relevant hospital standards. 3. CHANGES TO STANDARDS/POLICIES A. Changes in policy and procedure initiated by the school pertaining to the clinical rotations that occur during the year must to be brought to the attention of the Nursing Support CRS. B. The Nursing Support CRS will communicate changes as appropriate in organization or department standards initiated by the hospital to the school through the faculty liaison of the school. 4. STUDENT PREPARATION AND SUPERVISION A. Instructor wears a lab coat over either scrubs or street clothes as appropriate for the unit to readily identify him/her as an instructor. B. It is recommended that a maximum of one to ten instructor to student ratio be maintained during the clinical experience. C. Instructor availability for direct observation and supervision of clinical procedures is dependent on the goals and objectives of the clinical experience and the experience and competence of the student. D. Students are expected to be prepared to perform the basic skills for the level of patient care/involvement required by the students assignment. E. The instructor supervises students until they are competent to provide the necessary care. F. Nursing staff may assist with supervision: 1. If the student is repeating a procedure already taught and evaluated by the instructor AND 2. If the instructor and SMH staff member agree to the specific expectations of each student PRIOR to the scheduled experience. G. Whenever possible, student assignments are to be made the evening before the clinical experience in consultation with the nursing unit leadership. 1. Nursing unit leadership will have the final authority for the assignment of patients to students. 5. DOCUMENTATION A. The instructor cosigns for medication administration until the student has been deemed competent, after that, the student may administer and document medications independently. B. Narrative documentation in the patient record by students will be signed by the instructor until the student has been deemed competent. The narrative will always be signed by the instructor for courses where the instructor is present.

3 MANUAL: Patient Care Page 3 of 5 C. Narrative documentation by advanced level students when the instructor is not present and documentation of procedures performed by any level of student under the supervision of a staff RN, will be cosigned by the precepting St. Mary s staff member. 6. PROBLEM RESOLUTION: Nursing unit leadership and the instructor will work together to resolve problems that arise between staff and students as quickly as possible. If unable to be resolved, Nursing Support CRS will be notified and as necessary the Nursing Director and/or Vice President of Patient Services. 7. RESPONSIBILITIES A. Responsibilities of Nursing Support CRS for all student rotations: 1. Works with instructor to find appropriate clinical assignments to meet clinical objectives of students within the limitations of the institution. 2. Facilitates the orientation of students and instructors to the facility. 3. Works collaboratively with instructors, staff, students and nursing management to resolve issues and ensure a positive clinical rotation occurs. 4. Coordinates end of year instructor/nursing leadership meetings for problem resolution and future planning. B. Responsibilities of affiliating instructors: 1. Coordinates through the Nursing Support CRS an orientation for the students to the organization/units. 2. Reviews overall supervision of student experience as appropriate for level of education and goals/objectives of the students. 3. Communicates with Nursing Support CRS the goals/objectives and learning needs of the students and their ongoing progress and evaluations. 4. Serves as a resource to the students, nursing leadership, SMH staff and Nursing Support CRS C. St. Mary s Staff: 1. Willingly works with students to achieve the outlined objectives in a positive and constructive manner. 2. Maintains accountability for all assigned patients while the student is participating in the care. 3. Maintains ongoing dialogue with student and instructor relative to the care provided to the patient, outcomes and plan for care. 4. Provides continuous constructive feedback to student/instructor relative to student performance utilizing nursing unit leadership when appropriate. 5. Provides technical expertise in the areas of nursing skills, such as administration of medications and treatments. D. Responsibility of all students 1. Selects patient assignment based upon: a) Obtain patient permission when possible. b) Goals/objectives (learning needs). c) Consultation with nursing unit leadership. 2. Is prepared at the beginning of the shift for assigned clinical experience. 3. Actively seeks assistance from instructor when seeking/acting on new clinical experiences.

4 MANUAL: Patient Care Page 4 of 5 4. Assumes responsibility for patient care based upon level of achieved clinical competence i.e. ADL, documentation, meds, therapies, etc. and provides ongoing communication with SMH staff and instructor regarding the status of the patient s care. 5. Recognizes that the SMH staff member assigned to the patient maintains accountability for continuous safe patient continuum of care. a) During a Cor Zero, the student may observe but may not take part in the resuscitation unless directed by RN preceptor. b) IV push medications may be given only at the discretion of the precepting RN. c) May participate in administering blood components when the RN instructor checks the blood component with a St. Mary s RN. d) May not delegate to unlicensed assistive personnel independently e) May not take verbal or phone orders E. Additional responsibilities of Senior or Capstone Student Experience: 1. The student is a senior, or in their last semester, seeking a clinical experience with a preceptor frequently in an area chosen by the student to work following graduation, or an area in which they wish to receive additional education prior to graduating. 2. Responsibilities a) Collaborates with the preceptor to determine work schedule. b) Student is to plan scheduled work days that do not conflict with other students assigned to the unit. c) Presents goals and objectives to preceptor prior to the clinical experience. d) Actively seeks assistance from preceptor when seeking/acting on new clinical experiences. F. Characteristics of Preceptor for the Senior or Capstone student 1. The preceptor is an experienced RN, employed by the hospital, who assumes joint teaching responsibility with an instructor when a clinical instructor is not present in the setting. 2. Is a practicing expert RN who demonstrates an advanced level of expertise in a defined area of care. 3. Works with nursing students in clinical and leadership areas and acts as a role model, teacher, and evaluator for the student. G. Responsibilities of Preceptor to Senior or Capstone Student Experience. 1. Collaborates with the course instructor and student to plan for clinical learning activities to meet learning objectives. 2. Provides direct oversight of all clinical learning experiences for the student at SMH. 3. Provides a consistent one on one relationship for effective learning. 4. Allows and encourages the student to build on acquired knowledge/skill base to integrate this into safe, competent nursing practice. 5. Demonstrates knowledge and uses appropriate resources to incorporate principles and concepts relevant to nursing process. 6. Maintains responsibility for the care of assigned patients while allowing the student to assume as much responsibility in the care of the patient as appropriate.

5 MANUAL: Patient Care Page 5 of 5 7. Provides objective, timely information to the course instructor regarding progress of student s ability to meet course objectives. H. Instructor responsibilities with the precepted student. 1. Meets with the student and preceptor on an on-going basis to evaluate the learning objectives of the course. 2. Provides clinical evaluation of students in order to assure comprehensive formative and summative evaluation processes.