BSN Student Guide, Policies & Scope of Practice

Bachelor of Science in Nursing (BSN) Program Years 1 & 2 BSN Student Guide, Policies & Scope of Practice 2013 2014 Okanagan College Science, Technology, Health & Social Development Portfolio Adapted with permission from the University of British Columbia Okanagan School of Nursing; Revised Sept 2011; July 2012; Aug 2013 This document is on the home page for the BSN program and in the College Online Calendar. The on line version will be updated as needed and will be considered the most current.

Table of Contents Curriculum Overview... 1 BSN Student Guidelines & General Information... 2 1. Professional Conduct in the Nursing Program... 2 Nursing Standards... 4 Standard 1: Responsibility and Accountability... 4 Standard 2: Knowledge based Practice... 5 Standard 3: Client focused Provision of Service... 6 Standard 4: Ethical Practice... 7 2.Nursing Practice Experiences... 8 3.Evaluation of Nursing Practice... 11 4.Guidelines for Use of Health Lab (C206/210)... 14 Okanagan College & BSN Program Policies... 16 A. Professional Appearance... 16 B. Basic Life Support (CPR Level C) Certification and Recertification... 18 C. Gift Giving and Receiving... 18 D. Length of Time for Degree Completion... 19 E. Laboratory Time & Missed Practice & Skills Testing... 19 F. Nursing Practice... 20 G. Nursing Practice Grading... 21 H. Plagiarism... 22 I. Grading Assignment/Posting Grades... 23 J. Preparation for Nursing Practice Assignments... 23 K. Professional Conduct... 23 L. Progression and Advancement... 24 M. Dropping Courses/Withdrawing... 25 N. Student Injury during Practice Experience... 26 O. Student Records and Portfolios... 26 P. Submission of Student Assignments... 27 2

Q. Unsatisfactory Practice... 27 R. Use of Student Work for Teaching/Learning Purposes... 29 S. Freedom of Information & Protection of Privacy... 30 T. Use of Electronic Communication Devices in the Classroom, Lab & Practice Experiences... 30 U. Out Of Region Student Practice Placement Guidelines:... 31 V. Exam/Quiz Writing & Review... 31 W. Medication Dosage Calculation Assessment (MCDA)... 32 X. Conflict of interest... 33 Student Resources... 34 The College of Registered Nurses of British Columbia (CRNBC) Student Representatives Program at Okanagan College... 34 Scope of Practice: Psychomotor Skills for BSN Students 36 3

Okanagan College BSN Program Years 1 & 2 Curriculum Overview Semester One Semester Two Consolidated Practice Experience NSGU 111 Health and Healing I: Living Health (3) NSGU 112 Professional Practice I: Introduction to the Profession of Nursing (3) NSGU 113 Relational Practice I: Self and Others (3) NSGU 114 Nursing Practice I: Introduction to Nursing Practice (3) BIOL 131 Anatomy & Physiology (3) English (3) NSGU 121 Health and Healing II: Health Indicators (3) NSGU 122 Professional Practice II: Introduction to the Discipline of Nursing (3) NSGU 124 Nursing Practice II: Coming to Know the Client (6) BIOL 133 Anatomy & Physiology (3) Elective credit (3) NSGU 130 Consolidated Practice Experience I (2) (60 hours) Total credits 18 Total credits 18 Total credits 2 Semester Three Semester Four Consolidated Practice Experience NSGU 211 Health & Healing III: Health Challenges/Healing Initiatives (3) NSGU 213 Relational Practice II: Creating Health promoting Relationships (3) NSGU 214 Nursing Practice III: Promoting Health and Healing (6) BIOL 231 Health Sciences I: Pathophysiology (3) NSGU 221 Health & Healing IV: Health Challenges/Healing Initiatives (3) NSGU 224 Nursing Practice IV: Promoting Health and Healing (6) BIOL 235 Health Sciences II: Pathophysiology (3) NSGU 230 Consolidated Practice Experience II (4) (180 hours) Total credits 15 Total credits 12 Total credits 4

BSN Student Guidelines & General Information Guidelines and general information are designed to assist you to move into the role of a nursing student. Nursing is a professional practice and college professors will guide you in the development of professionalism as you progress in the BSN program at Okanagan College and UBC Okanagan. 1. Professional Conduct in the Nursing Program The BSN Program at Okanagan College values a collaborative learning environment that supports diversity, empowerment and creativity. Emphasis is placed on the quality of relationships experienced in our education program. The learning environment is fostered by people working together in cooperative, caring ways. Refer to the Professional Conduct Policy in this guide. As professional nurses and nursing students, our ways of being are guided by the Professional Standards for RNs and Nurse Practitioners (CRNBC, 2012). The guidelines for professionalism in the nursing program are based on the College of Registered Nurses of BC (CRNBC) Standards and are intended to clarify the parameters of professional relationships in all learning environments wherever the student is present as a nursing student. These expectations of student conduct are in addition to the Professional Conduct Policy identified in the Okanagan College BSN Student Guide & Policies. Each student is expected to recognize his or her own limitations, act responsibly at all times, and take responsibility for ensuring continued competency and learning. A student may be required to withdraw from a practice placement if the above expectations are not met, or when medical and/or other problems interfere with satisfactory performance. Students will be denied their experience if the preparatory work is deemed unsatisfactory or if the Dean of Science, Technology & Health Portfolio determines that their participation in practice puts the receiving agency or its clients at unreasonable risk. Communicating professionally: Communication between students, professors/professors and others on campus and away from campus is expected to be respectful and professional. Students will use their myokanagan email address for all email communication. Voice mail is less reliable than e mail. Students are asked send email messages from your myokanagan email account to the email address of the professor/professor rather than leaving messages on the telephone. Professors/professors are not expected to respond on evenings, weekends, or during statutory holidays and vacation.

Students are reminded of the expectation that e mails sent to professors and other professional contacts be composed in a manner that is respectful in tone and content. A professional email address (myokanagan) must be used at all times. Students are required to ensure that e mail messages do not reflect the following: Over familiarity Use of first name without permission Abuse of e mail etiquette It is the student s responsibility to check e mails to your myokanagan account on a regular basis (at least daily) or more often according to the norms set out in each course. Students will receive BSN program messages to your myokanagan account. Communicating professionally includes knowing who to talk with when you have a concern, issue or problem. Communication must always be respectful. The following guides student nursing communication: First, talk with the person or person(s) involved to find resolution Second, talk with your college professor Third, talk with the BSN Chair Fourth, talk with the Associate Dean STH Communicating professionally is the responsibility of all nurses and nursing students. Process to be followed when unprofessional conduct is observed: First occurrence: the unprofessional conduct will be explored with the student with the aim of promoting quality relationships. The student will be informed if this incident or a repetition of any unprofessional conduct results in documentation to the student file. In the BSN program, a Student Progress Note (SPN) and/or a learning contract are examples of documentation. Subsequent occurrence(s): the unprofessional conduct will be addressed by further discussion with the student and the occurrence will be documented in the student file with a copy provided to the student and BSN Program Chair. Repeated occurrence: the BSN Program Chair will review the student s file, and in consultation with the Associate Dean, Science, Technology, Health & Social Development Portfolio, will determine the need to intervene further. The expectations outlined in this policy about the professional conduct expected of the nursing student and of the Registered Nurse is a topic of discussion in all nursing courses. Professional Practice I (NSGU 112) and Professional Practice II (NSGU 122) will provide nursing students with an opportunity to explore the concept of professional conduct in depth. 3

Clarification of unprofessional conduct: Conduct that impedes professional relationships may include, but is not limited to: In the learning environment: Behaviours that are demeaning toward others Disrespectful behaviour Defence arousing behaviour Attention seeking behaviour Lack of attention when others are speaking Gossip/repetition of rumours Breach of confidentiality Lack of regard for the start, break, and closure times of classes Attire that draws undue attention or is provocative to others Failure to honour diversity Failure to take ownership of the responsibility to meet professional and educational expectations Dishonesty In oral and written communication: Over familiarity Use of first name without permission Not following e mail or social media etiquette Messages that lack respectful tone and content Nursing Standards Nursing standards are set by the College of Registered Nurses of BC (CRNBC) and they assist nurses to provide competent and ethical care by setting the requirements of practice (CRNBC, 2012). You will have many opportunities to learn more about nursing standards and their application to your nursing practice during the BSN program. Standard 1: Responsibility and Accountability Maintains standards of nursing practice and professional conduct determined by CRNBC. 1. Is accountable and takes responsibility for own nursing actions and professional conduct. 2. Functions within own level of competence, within the legally recognized scope of practice and within all relevant legislation (2). 3. Assesses own practice and undertakes activities to improve practice and meet identified learning goals on an ongoing basis (3,4). 4

4. Takes action (5) to promote the provision of safe, appropriate and ethical care to clients. 5. Advocates for and/or helps to develop policies and practices consistent with the standards of the profession. 6. Maintains own physical, psychological and emotional fitness to practice. 7. Maintains current registration. 8. Understands the role of the regulatory body and the relationship of the regulatory body to one s own practice. The Nursing Student: Is accountable and takes responsibility for own learning and professional conduct. Is accountable and takes responsibility for own projects and written work. Is accountable and takes responsibility for working within the scope of practice for nursing students in each year of the BSN program. Works collaboratively and cooperatively in groups. Is accountable and takes responsibility for own share of group work. Comes prepared for class, lab and clinical practice. Actively participates in a manner that is supportive of own learning needs and group learning needs. Engages constructively in the learning process. Maintains own physical, psychological and emotional fitness to practice Takes action to promote the provision of safe, appropriate and ethical care to clients. Standard 2: Knowledge based Practice Consistently applies knowledge, skills and judgement in nursing practice. 1. Bases practice on current evidence from nursing science and other sciences and humanities. 2. Knows how and where to access information to support the provision of safe, competent and ethical client care. 3. Uses critical thinking when collecting and interpreting data, planning, implementing and evaluating nursing care. 4. Collects information on client status from a variety of sources (6) using assessment skills, including observation, communication, physical assessment and a review of pertinent clinical data. 5. Identifies, analyzes and uses relevant and valid information when making decisions about client status. 6. Communicates client status, using verifiable information, in terminology used in the practice setting. 5

7. Develops and communicates plans of care that include assessment data, decisions about client status, planned interventions and measurement of client outcomes. 8. Sets client centred priorities when planning and providing care. 9. Uses decision support tools appropriately to assess and make decisions about client status and plan care. 10. Implements the plan of care, evaluates client s response and revises the plan as necessary. 11. Documents timely (7) and appropriate reports of assessments, decisions about client status, plans, interventions and client outcomes. 12. Shares nursing knowledge with clients, colleagues, students and others. 13. Communicates appropriately in interactions with clients, colleagues, students and others. The Nursing Student: Applies knowledge of professional values, ethics and ways of being to all learning experiences. Demonstrates objectivity, critical thinking, and respect for diversity of values, beliefs, and opinions of others in the learning community. Uses a problem solving approach to clarify and resolve issues or concerns that may arise in their learning experiences. Is encouraged to seek the professor s guidance when clarifying issues or concerns. Engages in self evaluation and takes action to develop competence. Welcomes critique and feedback from peers, nursing faculty, and other members of the health care team to promote student learning. Critically analyses and uses feedback to develop competence. Recognizes and respects the unique, ongoing nature of learning for all participants in professional practice. Endeavours to make the most of learning opportunities in the nursing program. Standard 3: Client focused Provision of Service Provides nursing services and works with others to provide health care services in the best interest of clients. 1. Communicates, collaborates and consults with clients and other members of the health care team (10) about the client s care. 2. Coordinates client care in a way that facilitates continuity for the client. 3. Assigns (11) clients and client care activities to other members of the health care team to meet client care needs. 6

4. Delegates appropriately to other members of the health care team. 5. Provides appropriate regulatory supervision of student activities. 6. Instructs and guides other members of the health care team to meet client care needs. 7. Participates in changes that improve client care and nursing practice. 8. Reports incompetent or impaired practice or unethical conduct to appropriate person or body. 9. Understands and communicates the role of nursing in the health of clients. 10. Assists clients to learn about the health care system and accessing appropriate health care services. The Nursing Student: Demonstrates ambassadorship for the profession and the BSN Program when interacting with members of the public and the health care community. Initiates, maintains, and terminates professional relationships with colleagues, professors and clients in a respectful and professional manner. Is considerate of the needs and perspectives of those who are providing learning experiences for the nursing student. Communicates, collaborates and consults with nursing faculty and nursing students to improve learning experiences and professional relationships. Respects the lines of communication within the BSN program and other agencies. Reports unsafe practice or unprofessional conduct of peers or others to appropriate nursing professor. Standard 4: Ethical Practice Understands, upholds and promotes the ethical standards of the nursing profession (13). 1. Makes the client the primary concern in providing nursing care. 2. Provides care in a manner that preserves and protects client dignity. 3. Demonstrates honesty and integrity. 4. Clearly and accurately represents self with respect to name, title and role. 5. Protects client privacy and confidentiality. 6. Recognizes, respects and promotes the client s right to be informed and make informed choices. 7. Promotes and maintains respectful communication in all professional interactions (14). 8. Treats colleagues, students and other health care workers in a respectful manner. 9. Recognizes and respects the contribution of others on the health care team. 10. Makes equitable decisions about the allocation of resources (15) under one s control based on the needs of clients. 11. Identifies the effect of own values, beliefs and experiences in carrying out clinical activities; recognizes potential conflicts and takes action to prevent or resolve. 7

12. Identifies ethical issues; consults with the appropriate person or body; takes action to resolve and evaluates the effectiveness of actions. 13. Initiates, maintains and terminates nurse client relationships in an appropriate manner. The Nursing Student: Gives to, and receives feedback from, peers, professors, and guests in ways that demonstrate respect, honesty, and sensitivity. Is respectful, civil and courteous to peers, professors, classroom guests, and the health care team. Maintains a professional approach in oral and written communications. Promotes integrity of self and others when engaging in professional relationships. Supports group members in establishing a respectful learning environment. Applies the principles of confidentiality in dealing with information about clients and peers. Maintains professional standards at all times. 2. Nursing Practice Experiences Location Nursing practice (clinical) experiences are an integral part of the nursing program. They occur across sites (hospitals, community agencies and organizations) and with a variety of populations. Locations for nursing practice occur within and outside of the Okanagan Valley. Student Preferences While an effort will be made to accommodate students' preferences for types and locations of clinical experiences, Okanagan College BSN program reserves the right to determine the appropriateness of any nursing practice placement. All agencies and institutions serving as nursing practice sites must be approved by Okanagan College BSN program. Okanagan College reserves the right to change a student's nursing practice placement. The student has the right to be informed, in writing, of the reasons for the change. Arrangement of Nursing Practice Placements Nursing practice placements are arranged by the BSN Program Chair in consultation with the nursing faculty, students, UBCO and Interior Health. Student Travel and Expenses Related to Nursing Practice Travel is a necessary component of the nursing program. Students must arrange for their own transportation to and from nursing practice sites. Travel, communication and other expenses 8

(eg. regular contact with instructor, submission of assignments) are the student's responsibility. Each student must take individual responsibility for decisions regarding his/her safety when required to travel in inclement weather. Safety to Practice All nursing students are advised that it is their ethical and legal responsibility to obtain supervision from the clinical professor or designate when carrying out any nursing intervention for which they have not been previously supervised or in which they are not safe or confident to perform independently. Principles in Determining Nursing Practice Experiences The following guiding principles will be used to determine appropriate nursing practice experiences for students in years one and two of the BSN program. Principle 1: Nursing practice placements will be determined by the program with input from the student. Placements for all practice experiences will be arranged by the BSN Program Chair. Principle 2: Nursing practice experiences should help the student to formulate the Registered Nurse role. Principle 3: The expected outcome of all Consolidated Practice Experiences (CPE) is the extension of and/or consolidation of nursing knowledge and skills. Students may have additional practice hours in some settings. Principle 4: All Consolidated Practice Experiences for nursing students must be with, or overseen by, a Registered Nurse or a Registered Psychiatric Nurse. Principle 5: Year 1: each student must have 1 semester nursing practice and 1 CPE practice in extended/intermediate/rehab care. Year 2: each student must have 1 semester nursing practice in acute care medical, 1 semester nursing practice in acute care surgical, and 1 CPE practice in acute care medical or surgical. Principle 6: Students requesting Out of Region placement (NSGU 230) will need to meet the requirements of the Out of Region Policy guideline. Practice Placement Requirements Due to the need for nursing practice in a variety of settings and to limited placement sites, it is necessary for students to travel to placement sites in Vernon, Penticton, Summerland and Kelowna. 9

Year 1: NSGU 124 Students to submit proof of current CPR prior to entering practice areas. This course will emphasize health assessment and coming to know how clients understand and promote their health, and the nurse s role in partnering with clients in this process. The BSN Program Chair, in consultation with the teaching team and UBCO, will select the teaching sites to be used. Lists of tentative practice groups will be distributed to the teaching team for final approval. All students are responsible for transportation to practice sites. Year 1: NSGU 130 Consolidated Practice Experience (CPE) Students to submit proof of current CPR prior to entering practice areas. This course provides two weeks of clinical practice to assist students as they continue to move forward from a health focus toward a health challenge focus. Students will develop an understanding of nurses responsibilities in health and health promotion. It is recommended (not always possible) that NSGU130 students remain in their NSGU124 practice area. Students are expected to work days, evenings, or a combination of both, Monday through Friday, for the duration of this practice experience. Out of Region and international placements are not available for NSGU130. Year 2: NSGU 214 & NSGU 224 Students to submit proof of CPR prior to entering practice areas. These courses will provide students with the opportunity to develop caring relationships with people experiencing episodic health challenges in a variety of acute care settings and in the transitions from hospital to home. The BSN Program Chair, in consultation with the teaching team and UBCO, will select the teaching sites to be used. Lists of tentative practice groups will be distributed to the teaching team for final approval. All students are responsible for transportation to practice sites. 10

Year 2: NSGU 230 Consolidated Practice Experience (CPE) Students to submit proof of current CPR prior to entering practice areas. This practice experience is the consolidation of skills used in acute care medical and surgical units. This practicum is 180 hours and is preceptored by an RN on a medical or surgical unit. The student is expected to work the same shifts the RN is working for the duration of the practice experience. The continuity of the shifts is crucial in the consolidation of the skills and knowledge. It usually takes approximately 4 6 weeks to complete. This practice experience may begin at any time, based on the availability of preceptors, from the end of the winter exam period to mid July. The BSN program Chair, in consultation with UBCO, will develop the process for selecting preceptorship sites. The teaching team will inform students of their practicum site based on a review of their practice, identified learning needs and preceptor availability. NSGU 230 students may be able to apply for an out of region placement experience (outside of the Okanagan area) see Out of Region policy. International placement is not available for NSGU 230. 3. Evaluation of Nursing Practice Practice Appraisal Forms (PAFs) Student performance in nursing practice courses is assessed and evaluated on a PAF based on domains of practice. Each semester, the quality indicators for each domain reflect the standard of expectations for students in that semester. Each domain is rated satisfactory (S), needs improvement (NI), not experienced (NE) or unsatisfactory (U). Each domain in final evaluations is rated as satisfactory (S) or unsatisfactory (U). Students with an unsatisfactory rating (U) on a final evaluation will not be eligible for an Out of Region Practice Experience (NSGU 230) or an international nursing experience at UBCO. The PAF is completed by the student and clinical professor, is signed by both and a copy is given to the student. The original is placed in the student's academic file. All academic records are shared by the nursing faculty at Okanagan College and UBCO for purposes of academic progression. 11

Student Responsibilities in Nursing Practice Attendance (see BSN Program Policy Missed Practice/ Laboratory Time): Students are expected to attend, and to be on time for all scheduled nursing practices. Students are expected to notify their instructor and the nursing practice site whenever they will be late or absent for any reason. Absence or failure to notify instructors of any absences may result in an unsatisfactory (U) rating in a practice domain. Attendance at nursing practice courses, consolidated practice experiences, and labs is mandatory. Inability to attend any of these courses must be communicated to the clinical professor prior to the experience. Course syllabi will outline attendance requirements. Self Evaluation: Students are expected to complete an appraisal. This completed self appraisal will become part of the student's ongoing nursing practice performance record. The self appraisal must be based on a process of regular documentation by the student about his or her own nursing practice. The written documentation shall be available to the professor on request. Directions for regular documentation and completion of the final self appraisal will be provided by the student's professor. If the above obligations are not met, the student will receive an unsatisfactory (U) rating in a practice domain. Ongoing Feedback: Students have the right to receive on going feedback about their nursing practice performance and also have the responsibility to seek feedback from their professors. Student Responsibility When Experiencing Difficulty in Nursing Practice Courses If a student is experiencing difficulty in a nursing practice course, the student can expect to meet with the supervising professor to discuss specific issues. A Student Progress Note (SPN), Learning Contract (LC) or mid term evaluation may be designed to address the specific issues identified and the activities required by the student to demonstrate satisfactory practice. A time frame for completion of the required activities or performance will be included in the document. If the student wishes to discuss a difficulty in any nursing course, that student should first approach the professor teaching the course. If there is no resolution of the difficulty or if there are other concerns that cannot be resolved by this method, it is appropriate for the student to discuss the difficulty with the Chair of the BSN program, who will take the necessary steps to 12

resolve the issue. The Chair of the BSN program exercises the right to discuss the difficulty with the Associate Dean of the Science, Technology, Health & Social Development Portfolio. It is unprofessional for students to discuss course difficulties with other professors or students. Students are encouraged to resolve difficulties with the professor involved. (Refer to BSN Program Policies Nursing Practice Grading and Unsatisfactory Practice and to Student Guidelines Communicating Professionally in the BSN Program). Nursing Practice Portfolios: The nursing practice portfolio is a record of the student's work in the program that directly impacts or reflects upon the student s developing practice. The responsibility for the portfolio lies with the student. The portfolio must minimally contain the face sheets of all practice appraisal forms maintained in a professional manner. The portfolio may also contain: Examples of semester work presentations, group work Attendance at workshops, conferences Skill list record Reference letters, feedback Journaling on very meaningful learning/practice situations The nursing practice portfolios enhance and support the philosophy of partnership in student practice evaluations. The use of student nursing practice portfolios will foster student/professor relationships and create opportunities for open dialogue between student and professors. The nursing practice portfolios will assist the student in developing a better understanding of his/her individual practice and growth, and of learning experiences. The use of portfolios promotes student ownership of his/her practice appraisals. Portfolios also enhance career management, and are helpful in resume writing and job interviews. The nursing practice portfolios will assist professors to develop an understanding of the practice appraisal process for each student. The portfolio does not replace the student file, but will assist the professor to better understand a student's progress in the program. As part of the evaluation process at the end of practice experiences, the student and professor will develop the face sheet of the practice appraisal together. The student will then be given a copy of the face sheet for his/her portfolio. At the beginning of each semester, the professor will be responsible for reviewing the portfolio with the student and discussing practice goals, learning opportunities and expected achievement. 13

4. Guidelines for Use of Health Lab (C206/210) 1. To protect the respiratory health of all users, the Health Lab will be fragrance free. NO SMOKING is permitted on the premises. 2. The Health Lab is to be used ONLY by Okanagan College Health program students. Absolutely NO CHILDREN and/or SIGNIFICANT OTHERS permitted in the Health Lab. When students require a partner to practice techniques, a classmate must be chosen due to Worker s Compensation Board (WCB) Regulations. 3. Students in the Health Lab will NOT perform any procedures unsupervised if those procedures involve a threat to the safety of themselves or others. This includes, but is not limited to, lifts and transfers and invasive procedures. The presence of a Lab Monitor DOES NOT constitute supervised practice, since the Lab Monitors are there for the protection of material property and assistance in getting out equipment. 4. Use only WCB approved footwear. This means: flat, non skid soles, closed toes, and closed heels (no clogs or sling backs). 5. In the event of an accident/injury, please let your lab professor know immediately. In the event of an accident/injury during lab practice time when the Lab Monitor is present, please have the Lab Monitor contact Security at local 6699. After hours and weekends, call 317 2435. All accidents/injuries must be reported and an Incident report must be completed. 6. Students are reminded that, after a session in the Health Lab, they are to pick up their belongings, straighten bed linen, stack chairs, and attempt to leave the area better than they found it. 7. Schedules of practice times will be posted on bulletin boards outside the Health Lab. Students using the Health Lab during practice time are responsible for signing in and out on the Lab Monitor s clipboard. 8. Be alert and help maintain vigilant surveillance in the Health Lab to safeguard equipment or possessions. Try to keep the doors locked when no one is around. Report suspicious activity to Security at local 6699. 9. Food and beverages may be used ONLY for selected lab practice in assisting patients/clients with eating. Students are responsible for cleaning up tables and garbage before leaving the lab. 10. The Health Lab is here for the student s benefit and use. Any comments and suggestions for improvement are welcome contact the Lab Monitor or the Lab Sim Coordinator. 14

Dress Code for Health Labs The BSN Program relies on the judgment of students to maintain a reasonable standard of dress and appearance. Guidelines for personal care skills in the Lab include: a) Clothes functional, comfortable, and non restrictive; comply with principles of asepsis ie. Forearms exposed; no bare torsos front or back; no torn clothing. Uniforms will be required in Lab classes as directed by professor. b) Shoes comfortable, clean, low heeled shoes with closed toes and heels (note clogs are not acceptable according to WCB regulations). c) Hair clean, neat, and kept off collar and face. d) Jewelry a plain wedding band is suggested; only use small stud earrings (silver, pearl, or gold). e) Fingernails short, clean; no nail polish, false nails, etc. Health Lab Learning Environment & Equipment: Ask your professor for assistance or clarification if in doubt about procedures. Sometimes it is helpful to experiment with your own style of organizing how you want to work through the procedures. Brainstorm with your partner about the pros and cons of your method and adopt an appropriate way of doing each procedure based on sound principles of safety, comfort, and respect. Conserve Linen: o Reuse blankets and bedspreads and do not send them to the laundry unless soiled. o Provide a freshly made bed for the next clinical group when making an occupied bed. o Used linen should be placed in the laundry bags at the end of each day. o Pillowcases can be changed each time. Cleanliness: o If you notice any evidence of poor hygiene in the Health Lab environment such as unclean floors, lack of hand washing supplies, etc., please note the date and problem and contact the Lab Sim Coordinator or the BSN Program Support person. Security: o Many items in the Health Lab are expensive; some are specialty items. Please use with care and make sure all components are replaced correctly. If leaving a lab unattended, ensure the doors are locked. The skeleton and anatomical models need to be handled with gentleness; they are easily damaged and costly to repair and replace. Do not interchange parts of the models. 15

Okanagan College & BSN Program Policies Students are responsible for informing themselves of Okanagan College s procedures, policies and regulations and the specific requirements associated with the degree, diploma or certificate sought. Okanagan College On line Calendar 2013 14 To review college policies, go online at www.okanagan.bc.ca click on Programs, College Calendar, General Academic Regulations & Policies. To review and get updates to the BSN program policies go online www.okanagan.bc.ca click on Programs, College Calendar, Programs, Health & Social Development, Bachelor of Science in Nursing (Years 1 & 2) scroll down to Overview of Program and you will find the link to the BSN Student Guide & Policies 2013 14. This document is in the College Online Calendar. The on line version will be updated as needed and will be considered the most current. A. Professional Appearance Purpose: To present a professional image as a student enrolled in the BSN program at Okanagan College (OC). The following are guidelines for safety, infection control, and professional appearance. Good judgment should be exercised when making decisions as to what is appropriate in a given clinical experience. If an agency has specific or different requirements not covered by these guidelines, students must conform to those requirements. This policy can be adapted on an individual basis to meet specific cultural and/or religious considerations. Inappropriately dressed students will be asked to leave the clinical area. Fragrance efforts should be made to be scent free both in agency placements and on campus. Agencies Where Uniforms are required: Dresses Skirts Pants Tops Over garments: o Clean and in good repair o Fabric that is readily washable o Style Deep pockets, short or three quarter length sleeves; pants must not touch the floor o No attire that draws undue attention or is provocative to others 16

Shoes: o o Style Closed heel and toe Sole Non wooden Identification: o For identification and liability purposes, all OC BSN Nursing students are required to wear OC BSN Photo Identification in all practice settings o To ensure ease of visibility, the identification must be worn on the chest (just below the collarbone) Equipment: o Watch with seconds indicated; pocket note pad; red and black ink pens o Stethoscope Hair o o o Neat and clean. Hair to be secured in a manner that meets infection and control and safety standards. Clean shaven or beards/moustaches must be neatly trimmed. Fingernails: o Short, no false nails, no nail polish. Jewellery: o No visible jewellery except wedding bands (with no stones) and a reasonable amount of small, non dangling jewellery (i.e. 2 pairs of stud earrings and a small facial piercing) Agencies Where Uniforms are NOT required (i.e. community) Clothing: o Neat, clean, appropriate. o No attire that draws undue attention or is provocative to others. o Jeans are not acceptable unless agency approved in agency policy. Identification: o Follow agency policy Shoes: o o Style Closed heel and toe Sole Non wooden 17

Year 2 Code of Conduct/Dress Policy for Clinical Preparation BSN Year 2 students may be required to go to clinical sites on Wednesday afternoons between 1500 and 1800 hours or as directed by your professor to prepare for clinical practice days on Thursdays and Fridays. College professors will complete client assignments for each student and post them on the unit. Students are to prepare as follows: Conduct is to be professional at all times. You are a guest on the unit, a representative of Okanagan College s BSN program. Please keep chatter to a minimum. Wear casual professional clothing (no nursing uniforms; no jeans; no bare backs, breasts, bellies or bottoms; no yoga pants) Must have Okanagan College student ID attached to clothing below left shoulder on chest ID is not to be attached at the hip or waist level Shoes must be clean and cover the foot i.e. running shoes. No sandals, clogs, open healed or toed shoes. Gather information about client(s) assigned by college professor maintaining confidentiality and privacy at all times. Children, family and friends are not permitted on the practice unit. Adhere to policies of clinical agency and unit. Adhere to the most current BSN Student Guide & Policies. B. Basic Life Support (CPR Level C) Certification and Recertification Purpose: To ensure that all nursing students have the ability to administer Basic Life Support, Level C. All students are required to have current certification in Basic Life Support, Level C and to maintain this certification throughout the program. Students will be asked to show their CPR certificate to clinical professors at the start of each practice experience. If your CPR certification is due to expire during a practice experience, it is the student s responsibility to renew certification prior to the start of the practice experience. C. Gift Giving and Receiving Students in the BSN program are discouraged from accepting or giving gifts in the studentprofessor or in student client patient relationships. 18

While recognizing that gifts from students or clients/patients may be of insignificant monetary value, accepting them may violate principles of appropriate professional boundaries and may also represent inappropriate use of power in student professor or student client patient relationships. (Refer to CRNBC Practice Standard Boundaries in the Nurse Client Relationship) D. Length of Time for Degree Completion UBC Okanagan regulations stipulate a maximum amount of time that will be permitted for completion of the various degrees. It is the student's responsibility to be aware of his or her own length of time in the program. Failure to complete all degree requirements in the allotted time will mean that the degree is not awarded. Students in the OC BSN program must meet the degree requirements within seven years of beginning their first nursing course. E. Laboratory Time & Missed Practice & Skills Testing Professional nursing is committed to the provision of safe, competent, ethical care. Educational experiences occur in a variety of practice contexts and are designed to advance nursing competence in a deliberate manner; practice experiences promote nursing competence incrementally on a daily, weekly, and monthly basis. Nursing practice competence involves knowledge, skill, application, and judgment. Attaining competence in practice requires that students actively engage in all planned practice experiences which include lab classes throughout the program. Missed practice time is not simply replaceable. It is not about lost hours it is about lost opportunities to advance individual nursing competence. Students are required to attend all nursing practice and laboratory experiences. Students are accountable for maintenance of their personal health, and for time management that enables them to attend all scheduled practice and laboratory experiences. Time management is a necessary professional skill; punctuality is expected in professional workplaces. Refer to Okanagan College General Academic Regulations & Policies: Attendance In the Event of Practice Absence: Practice Students will follow guidelines given by professors at the start of each semester regarding notification of professors and/or agencies of the expected absence a soon as possible. 19

Laboratory Practice Experience All students are expected to notify the professor by leaving a telephone or email message before or on the day of the scheduled lab. Professors will document the number of days absent on students' final practice evaluation each semester. Prolonged Absence Student absence from practice experience is viewed as a potentially serious disruption of the educational plan for the attainment and maintenance of nursing competence. For any absence, students will: Provide a health certificate or other supporting evidence for the absence if requested by professors. Initiate discussion with professors involved regarding plans to ensure maintenance and advancement of their nursing competence to meet expected outcomes. Absences from practice experiences will be brought to the attention of the BSN Chair for discussion and advisement. Professors will work with the student toward the goal of attaining the expected practice competencies for each course. An unsatisfactory/fail grade will be given when student absence for practice experiences: o prevents adequate assessment of student competencies (knowledge, skill, application, judgment) o results in insufficient progress toward achieving the expected competencies As with all courses, students have the right to appeal a failing grade. Refer to Okanagan College General Academic Regulations & Policies: General Appeals on Academic Standing. Lab Skills Testing Students must achieve a minimum of 80% on each skill tested. Gross breach of technique during skills testing requires an automatic 20% deduction see course syllabi for specific criteria related to skills testing. Students will be permitted to re test a failed skill one time. One skill re test allowed each semester. F. Nursing Practice Nursing practice is defined as that experience in or through acute, extended and community care agencies in which the student is engaged in direct nursing care with individuals or groups or is involved in laboratory learning. 20

The BSN program offers a range of practice experiences. Placements will be organized with a focus on care of the older adult in year one and care of the person with an acute medical and surgical event in year two. The BSN program requires students to gain a range of practice experiences including the some weekends and night shifts. The BSN program expects students to be in full/time engagement in the program and work all shifts arranged. Nursing students may be assessed by a variety of professors. Students are responsible and accountable for finding their own means of transport for practice placements. Many placement start times are as early as 0630 0700hrs and may not be accessible by transit. Students in Year 2 will be N95 Mask Fit tested and expected to provide evidence of fittesting if requested by a clinical agency. The BSN Program Chair and nursing faculty team are responsible and accountable for selecting the best practice placement possible to meet student learning needs. The BSN Program Chair makes the final decision regarding student placements. Practice placements will be assigned in advance of placement start date. If an individual student wishes to request a change in their placement, s/he should speak first with the BSN Chair who, in consultation with the clinical professor, will determine whether rearrangements are possible. Requested placement changes may not be possible. If students have any disability that requires accommodation for nursing practice they must contact Disability Services at Okanagan College. Students are also reminded of their responsibility to be familiar with the CRNBC s Requisite Skills and Abilities document. G. Nursing Practice Grading Professional nursing is committed to the provision of safe, competent, ethical care. Educational experiences occurring in a variety of practice and laboratory contexts are designed to advance nursing competence in a deliberate manner; practice experiences promote nursing competence incrementally on a daily, weekly, and monthly basis. Practice performance will be graded as: Pass or Fail dependent upon the student's ability to competently meet the course outcomes. This policy is applied in all courses with a nursing practice component. Nursing practice competence involves knowledge, skill, attitude, and judgment, and requires that students actively engage in all planned practice experiences throughout the program. Missed practice time is not about lost hours it is about lost opportunities to advance individual nursing competence. 21

Students are required to attend all nursing practice and laboratory experiences. Calculation of nursing practice hours does not include travel time, independent laboratory practice time or required time for preparation related to practice experience. In a course where there is nursing practice, theory and lab components, a passing grade in the nursing practice component of the course is required to pass the course. Should a student receive a failing grade in the nursing practice component, the practice AND the theory (classroom) AND the lab components of the course must be repeated in order to advance in the nursing program. The overall grade for each nursing practice course must be a P (Pass) in order for the student to progress to the next practice course. Each of the domains on the Nursing Practice Appraisal Form (PAF) will be assigned a rating of satisfactory (S), needs improvement (NI), not experienced (NE) or unsatisfactory (U) at the mid point evaluation. A rating of satisfactory (S) or unsatisfactory (U) will be assigned at the final evaluation. In years one and two, an unsatisfactory (U) rating in two or more domains on the final evaluation of the Nursing Practice Appraisal constitutes a failing grade. In semesters 1, 2, & 3, a student may progress to subsequent nursing practice courses with an unsatisfactory (U) rating in one domain only as long as he/she has not previously received an unsatisfactory (U) rating on that same domain. This applies also to students who are readmitted to the program within one year of failure or withdrawal. If, at the completion of NSGU 224, a student has an unsatisfactory (U) rating in any one domain, the student will not progress to NSGU 230. If a student is gravely at risk for receiving a failing grade, the student will be notified in writing. The current professor, the next practice area professor, and the student will meet to discuss the concerns and ways to address issues. Normally a learning contract will be put in place. The BSN Chair is made aware of students placed on learning contracts. The final grade will be determined by the two practice area professors in consultation with the BSN Chair. Students who withdraw while on a learning contract, or from the mid point onward in a nursing practice course, will be assigned either a satisfactory (S) or an unsatisfactory (U) rating for each of the domains in the Nursing Practice Appraisal Form based on their achievement up to that point. If a student withdraws from the course before the Okanagan College withdrawal deadline, a W for the course will normally appear on the student's transcript. The completed and signed PAF will be placed on the student s file. Students will receive a copy of their completed ad signed PAF. H. Plagiarism Students are responsible for knowing about plagiarism and cheating see the Okanagan College Academic Regulations & Policies: Academic Offences. 22

I. Grading Assignment/Posting Grades Refer to Okanagan College s General Academic & Regulations Policies: Grading Practices. Nursing professors will post all grades to Moodle and students are reminded that final grades are tentative only and subject to final approval of the college. J. Preparation for Nursing Practice Assignments Since the safety and well being of health care recipients is of paramount concern, both professors and students are responsible and accountable for ensuring that appropriate professional standards (i.e. CRNBC Professional Standards for Registered Nurses and Nurse Practitioners) are maintained. One important standard is an appropriate knowledge base. Professors will discuss expected professional standards, including what constitutes appropriate preparation for practice assignments, with students at the start of each semester. Unprofessional behaviors such as inappropriate preparation may result in temporary removal of a student from the placement area. The student will be placed on a learning contract and the BSN Chair will be made aware of the situation. Each student is expected to recognize his or her own limitations, act responsibly at all times, and take responsibility for ensuring continued competency and learning. A student may be required to withdraw from a practice placement if the above expectations are not met, or when medical and/or other problems interfere with satisfactory performance. Students will be denied their practice experience if the preparatory work is deemed unsatisfactory, or of the Dean of Science, Technology, Health & Social Development determines that their participation in practice puts the receiving agency or its clients at unreasonable risk. K. Professional Conduct The Okanagan College BSN program and UBC Okanagan School of Nursing faculty are charged with the professional responsibility to ensure that all of its nursing students preparing to graduate have the requisite competencies and can meet the professional practice standards to be eligible for professional licensure as Registered Nurses in the province of British Columbia. Professional nursing behavior is guided and shaped by adherence to the College of Registered Nurses of British Columbia Professional Standards and Practice standards. While at Okanagan College, students who fail to adhere to these guidelines will result in the student being placed on a learning contract and the student will be at risk for failure. The BSN Chair will be notified of the situation. Nursing students and professors alike are expected to behave in a professional manner in all classroom, laboratory and practice learning experiences. 23

Professors are expected to help students interpret specific practice agency guidelines (i.e. dress codes) and apply them in their conduct. Students are expected to demonstrate responsibility and accountability for their actions as members of a professional discipline. Unprofessional conduct (such as disrespect, rudeness, misrepresentation of fact) is unacceptable in both practice and classroom components of the learning experience. Refer to Okanagan College General Academic Regulations & Policies: Student Conduct. Students are expected to be prepared for and attentive to all learning experiences. In the professional context, unexplained absences are inappropriate behavior. If students take issue with the relevance or necessity for any scheduled learning activities, they are invited to express their concerns to the professor of the course who may choose to discuss the issue(s) with the Chair of the BSN program. Practice learning experiences are a critically important component of nursing education, and our practice partners contribute a great deal to students and professors often under difficult circumstances. Students (or professors) whose conduct places the BSN program in jeopardy for losing a practice placement will be immediately removed from that experience. In their capacity as professionals, professors or our practice agency partners have the right to ask a student to leave a practice unit at any time for unprofessional conduct, including violations of dress code or any other behavior that is considered disrespectful, irresponsible or unsafe. The BSN program fully supports our practice partners when they take such difficult decisions in order to meet their primary mandate of safe and effective patient care. Classroom and laboratory learning experiences are also an essential element in education preparatory to professional nursing practice. Students behaving in such a manner as to disrupt educational activities in classroom or laboratory learning contexts will be asked to leave. Refer to Okanagan College General Academic Regulations & Policies: Student Conduct. L. Progression and Advancement The minimum grade for nursing courses for progression within the BSN program is 60%. The minimum cumulative grade average to continue in the program is 65%. Students must receive a passing grade in each nursing course to progress to the next nursing course. Students must satisfy the prerequisites, co requisites and concurrent requirements for each nursing course. Students must maintain a cumulative grade average for all required courses of 65, and may be required to withdraw from the program if their cumulative grade average falls below 65. 24

Assignments and Examinations Supplemental examinations and re writes of assignments are not offered unless indicated in the course outline. The course outline will indicate whether re writes of assignments or midterm examinations are possible, and the specific conditions that pertain will be outlined therein. The course outline will indicate the maximum possible grade and value that can be attained on re write. Final examinations cannot be rewritten. Supplemental examinations are not an option. In order to transfer to UBCO to complete Years 3 and 4 of the BSN program, students must complete required courses in Years 1 and 2 with the following specific requirements: A Pass in each nursing practice course (NSGU 114, 124, 130, 214, 224, 230); A minimum of grade 60 in each other nursing course; A minimum of grade 60 in each non nursing course taken as part of the BSN program; and An overall (cumulative) grade average of 65 or greater. Normally, students are required to complete the entire BSN program within seven years of initial entry. Although satisfactory academic performance is a prerequisite to advancement, it is not the sole criterion in considering the suitability of a student for progression in the BSN program. The BSN program reserves the right to require a student to withdraw from the program if he or she is considered to be unsuited to proceed with the study or practice of nursing. M. Dropping Courses/Withdrawing Students are responsible for checking the Okanagan College on line calendar Important Dates. Readmission Students must apply for readmission. Okanagan College reserves the right to readmit students and to stipulate conditions attached to readmission. Applications for readmission will be reviewed on an individual basis by the BSN program Chair. Applicants seeking readmission need to be aware that there are limited seats available. Re Entry Following Withdrawal A student who withdraws and intends to apply for re entry into Years 1 and 2 of the BSN program must normally return no later than one year after the time of leaving the program, 25

and must apply for re entry. Concurrent registration requirements will determine the courses in which the student must enrol. Re Entry Following Failure A student who fails and intends to apply for re entry into Years 1 and 2 of the BSN program must normally return no later than one year after the time of leaving the program, must apply for re entry and must make arrangements with the BSN Program Chair. Concurrent registration requirements influence the decision about which courses must be repeated upon re entry. A student who re enters following failure in a practice course may be required to repeat and pass a lower level nursing practice course and satisfy concurrent registration requirements for that course. If a student subsequently fails any nursing course, he or she will be required to withdraw from the program for a minimum of two calendar years. If a student returns after the two year waiting period, he or she will be required to enter the first semester of the program and successfully repeat all nursing courses, including courses in which advance standing was previously granted. N. Student Injury during Practice Experience A student who is injured in any way or exposed to a life threatening reportable disease during practice experiences (including needle stick injuries) should immediately inform the professor and follow the facility's notification and treatment procedure. In most cases, the student should be seen as soon as possible by the facility's Employee Health Services for assessment and potential treatment. In the event of injury, an incident report is usually completed. It is important for the student to obtain a copy of the incident report as a personal health record and for follow up care if required. Follow up care may be obtained from the student's own physician. Okanagan College may require the completion of an incident form as well. In all cases, the BSN Program Chair must be notified. O. Student Records and Portfolios As part of their professional role, professors are responsible for recording information which is performance related, accurate, complete, constructive and objective. Students fulfill their responsibility through periodic reviews of their performance record. Access to a student's record is available only to the student, professor, BSN program faculty and designated support staff. Student records will be sent to UBC Okanagan when students transfer to BSN Years 3 & 4. The record may be reviewed by the student in the presence of a professor. The student is responsible for being aware of the contents of the record. 26

All evaluative comments on the cumulative record and formal evaluations are signed by the professor and the student. Students may add comments to their cumulative record or evaluations. Students will receive a copy of completed practice evaluations. It is also expected that students will seek review of their portfolios with their current practice professor and will use constructively the information contained therein. P. Submission of Student Assignments Professors will advise students of any particular format/style requirements (i.e. APA format) in their course syllabi. All assignments must be typed as per the guidelines given by professor. Students are accountable for time management that enables submission of coursework in an appropriate manner. Assignment submissions are expected on the date and at the place determined by the professor. In unforeseen circumstances, a request for an extension may be considered by the professor involved (normally at least 48 hours in advance of the due date). Late papers will be docked 10% of possible grade for the assignment for each day/partial day (weekends are considered to be one day) beyond the due time. Example: If an assignment is worth 40 marks, the student will lose 4 marks for each day it is late. So, if the student would have received a grade of 36/40 and the paper is one day late, the student receives a grade of 36 4 = 32 marks, if 2 days late 36 8 = 28 marks. Students must retain a second copy of all submitted papers. Students submitting electronic versions of assignments may be required to submit a hard copy (as requested by professor). Electronic copies of assignments must be virus free prior to submission (students are responsible for ensuring that their virus protection is effective and current). Papers/assignments/midterm examinations and final exams may NOT be rewritten. Concerns regarding grading are to be discussed with the course professor. Students wishing to appeal an assigned grade may do so upon the completion of the course. (See Okanagan College Academic Regulations & Policies: General Appeals on Academic Standing). Students are reminded that plagiarism constitutes a serious offence. (See Okanagan College Academic Regulations & Policies: Academic Offenses Q. Unsatisfactory Practice The evaluation of nursing practice involves ongoing feedback and documentation of student performance. The nursing practice component of any course is graded as Pass or Fail. Course outcomes and all evaluative methods are clearly identified in each course syllabus and are discussed with students at the beginning of the course. 27

Both the student and professor involved are responsible for early identification of student nursing practice difficulties, which may include input from practice colleagues. Ongoing and timely verbal and written feedback and discussion between professor and student about apparent performance problems is the expected norm. Consultation between professor and student with regard to knowledge application, practice skill development and ongoing learning is both facilitative and evaluative. This consultation involves both written and verbal exchanges over the course of the nursing practice learning experience. When the professor identifies a pattern of behaviour that may be indicative of impending unsatisfactory outcomes early in a nursing practice learning experience, the professor is expected to provide the student with written documentation (which could include secure email communication) to this effect, indicating the particular practice outcome(s) in jeopardy. The student will have an opportunity to discuss the issues raised in the documentation with the professor, who will propose a plan for remedial action. In all such instances, the Chair of the BSN program should be consulted. The BSN Program Chair will refer students onto the Associate Dean of the Science, Technology, Health & Social Development portfolio when necessary. Where there is agreement between the professor and student with regard to a plan of remedial action, the agreement is ideally articulated in the form of a Student Progress Note (SPN) and/or learning contract or both. The SPN and learning contract sets out clear expectations for performance, including the length of the contract, and is signed by both parties and placed in the student s file. The Chair of the BSN program is notified of the SPN and learning contract by the professor. Referral to other support resources (i.e. the Learning Centre and the Health Lab) may be appropriate; referrals and assistance will also be documented in the student's record. Where there is disagreement between the student and the professor with regard to the issues documented or the proposed remedial action, the student will be invited to provide a written response to the documentation, and the response will also be placed on file. All written documentation related to the problem or concern (jeopardized nursing practice outcome; professor & student views; remedial plan; signatures) will be maintained in the student's record. Progress, or its lack, will be clearly indicated and the student's status regarding a potential failing grade will be clearly stated. The student will receive copies of all documentation. The professor will inform the Chair of the BSN program of the student's status on an ongoing basis. Unresolved concerns may be brought to the Associate Dean of the Science, Technology, Health & Social Development portfolio for discussion and advisement. Nursing practice learning inevitably represents a delicate balance between the student s right to learn and the rights of patients or clients to safe and ethical care as well as the rights of practice institutions to ensure such care. Because the nursing practice expectations articulated for each level of the program include explicit requirements with regard to consistent demonstration of such qualities as responsibility, ethical behavior, professional conduct, and safe, effective client care, there are some acts on the part of the student that, even in isolation and not part of an identified pattern, may be of significant concern in the professional judgment of the professor as to justify practice failure and/or immediate withdrawal from the nursing practice learning experience. In all such instances, the professor will obtain consultation from the Chair of the BSN program and Associate Dean of the Science, Technology, Health & Social Development portfolio as soon as possible with regard to the decision. 28

The student must be provided with written documentation of the nature and seriousness of the act and an explanation of the basis for the decision that was reached by the professor. The student will be given an opportunity to respond in writing to the written documentation before it is placed on his/her file and will be informed of the implications of the decision for his/her academic progression. This policy is informed by the College of Registered Nurses of British Columbia (CRNBC) Professional Standards for Registered Nurses and Nurse Practitioners and the Canadian Nurses Association (CNA) Code of Ethics. Student Progress Note (SPN) and Learning Contract: An SPN and learning contract is a written agreement developed collaboratively between a student and professor that specifies learning activities to be undertaken in order to achieve course learning objectives/outcomes and professional practice standards. Learning gaps or deficits related to the course outcomes are identified and specific learning objectives are established. Strategies and resources are identified to assist and support the student in meeting the learning objective(s). The time frame for successfully meeting the objectives/outcomes is also identified. Establishing an SPN and/or learning contract highlights the responsibilities of the parties involved and encourages the student to be a reflective active participant and to take ownership in his/her learning while promoting achievement of competencies. R. Use of Student Work for Teaching/Learning Purposes On occasion, professors may want to use the 'well done' work of individual students (such as a paper/assignment or a learning contract) as a learning example for other students. Exemplary student materials may be placed in the Learning Centre or distributed to a class or to individual students in other ways such as a handout or by email. Permission for the use of such material will be by written consent of the student only. A copy of the consent will be kept on file in the student file, so that it remains accessible for future reference. Please use the following format for the written consent. Student Consent to Use Personal Work as a Learning Resource for Others The undersigned gives permission for the use of (complete details here) as a learning resource for other students. Signature of Student: Name of Student (please print): Signature of Professor: Name of Professor (please print): Date: 29

S. Freedom of Information & Protection of Privacy Refer to Okanagan College Academic Regulations & Policies: Freedom of Information and Protection of Privacy. T. Use of Electronic Communication Devices in the Classroom, Lab & Practice Experiences There is a shared responsibility between students and professors to create a positive learning environment for everyone. Electronic devices include a variety of communication devices such as cell phones, laptops, ipads, etc. To uphold a practical balance between appropriate usage and ensuring that safety standards are met, the following guidelines have been created for Okanagan College BSN student. For professionalism, safety and infection control purposes, these devices are not to be used while delivering patient care. When communication devices are used for clinical purposes (i.e. research medications/diagnoses, calculator), use a professional approach. Be mindful of surroundings, others, be discreet and wash your hands following use. Your professor will outline specific limitations with respect to usage for each course and practice setting. Use of these devices for personal reasons shall be limited to off duty or break times. o Students are not to engage in personal calls, emails, internet surfing, text messaging, or playing games during clinical, classroom or laboratory hours as this activity is disruptive to a positive learning environment and distracting for others. At all times, keep these devices on MUTE or vibrate mode with no audible alerts, to not disturb others. Communication with Professors, Preceptors and Students Text messaging and calling is a common mode of communication. To ensure safe, professional, and clear communication at all times, the following guidelines have been created. Always state who you are at the beginning of each text message. Language must be clear, use full words, no acronyms/short cut words or emotion icons, etc. Be specific to the topic (SBAR communication) when communicating by phone or text message For privacy purposes, confidentiality of subject matter must be followed at all times. Calls must be in a private area, text messages must not uses names of others involved. Use initials only. If your conversation requires more detailed discussion, please request a time to call and discuss the topic. 30

U. Out Of Region Student Practice Placement Guidelines: Out of region student placements provide a unique opportunity for students to practice primary health care in a different context outside of the Okanagan valley and within British Columbia. Guidelines for eligibility are currently in revision and will be available by December 2013. This policy only applies to NSGU 230 Consolidated Practice Experience (CPE). V. Exam/Quiz Writing & Review The following policy applies to the writing and review of exams and quizzes in classroom or lab settings. All exams/quizzes will be printed on one side of the page. This policy reflects the nursing standards of responsibility, accountability and ethical practice. When exams/quizzes are written: All books and bags, including purses, must be placed at the front of the room. All electronic devices turned off, not on vibrate, stored in bags at front of room. Exams are completed in ink, unless otherwise directed by college professor. Students are responsible for having a minimum of 2 ink pens at their desk for the exam/quiz. Students may use a basic calculator (no scientific or programmable calculators) as directed by college professor. Students may not use the calculator function on cell phones or other hand held electronic devices. Students must remain focused on exam or quiz and not appear to be looking around the room or at other students. Students must actively protect their exam from being viewed by other students i.e. arm over exam. Hats and hoods are not permitted in the exam/quiz room. No food, including junk food, is permitted during exams/quizzes. A beverage is permitted. Students are not permitted to leave their seats during the exam/quiz. Should the student have a question about the exam/quiz, the student is to raise their arm and a college professor will come to the student. Please ensure that you have used the washroom prior to the exam/quiz start time. Students are not permitted to have sheets of paper, other than the exam, on the desk during the exam. Students are encouraged to make notes or do calculations on the back side of an exam page. Students are encouraged to review their exams before handing them in to the college professor. An exam may not be retrieved from the college professor once handed in. A student who is late for an exam will be admitted, unless another student has already completed, handed in their exam and left the room. Should this situation arise, the student who is late will receive a mark of 0 on the exam/quiz. No additional time will be given to a student who is late for an exam/quiz. 31

Students are to leave the exam/quiz room as quietly as possible. Please do not discuss the exam in the hall outside of the exam/quiz room. When exams/quizzes are reviewed: College professors reserve the right to review exams/quizzes in class or on an individual basis or not at all. In class reviews will go as follows: o All books and bags, including purses, must be placed at the front of the room. o All electronic devices turned off, not on vibrate, stored in bags at front of room. o No writing devices of any kind will be permitted during exam/quiz reviews. o Students who have concerns about how an exam or quiz was marked are required to make an appointment with their college professor to discuss the marking. In class reviews are intended to benefit all students with learning and class time should not be spent with individual student concerns about marking. Individual reviews will go as follows: o Students are responsible for requesting a meeting with their college professor via email or to meet with their professor during regular office hours. o Electronic devices must be turned off and stored in bag. o No pieces of paper or writing devices will be permitted during the exam/quiz review. W. Medication Dosage Calculation Assessment (MCDA) BSN students will be required to complete a medication dosage calculation assessment (MDCA) in semesters 1, 2, 3 and 4 of the BSN Program Years 1 & 2 at Okanagan College. Students will be required to obtain 95% or higher on the MDCA. Medication dosage calculation proficiency of 95% or greater will be required in each semester before being allowed to administer medications to patients. Medication Dosage Calculation Procedure Nursing students are required to purchase a dosage calculation product (online program or text book) as assigned at the beginning of each year in the nursing program. Students must complete the assigned modules on dosage calculation for administration of medications to prepare for the MDCA. Because there are different calculation methods, we recommend that students choose one method and use that one consistently and systematically in theory, lab, and nursing practice. Students must be able to show their mathematical calculations for each question and may use a calculator to check their work. Only basic calculators are to be used (no personal electronic 32

devices). Sharing of calculators will not be permitted. Students must obtain a score of 95% or greater on every MDCA. In Semester One The student who receives less than 95% accuracy in the MDCA receives one week of remedial practice. After one week to practice, the student writes another MDCA and if the score is less than 95%, the student receives a learning contract for not meeting the competency requirements for medication math. The student may progress to Semester 2 with a learning contract in place and will not be permitted to administer medications. In Semesters Two, Three, and Four The student who receives less than 95% accuracy in the first MDCA receives one week of remedial practice and the student may not be allowed to give medications. After one week to practice, the student writes another MDCA and if the score is less than 95%, the student receives a learning contract for not meeting the competency requirements for medication math. The score will be noted on the learning contract. After 2 more weeks, the student writes another MDCA and if the score is less than 95% accuracy, the student receives a failing grade for the practice course. The student may not be able to progress in the nursing program. The student will be required to meet with the Chair of the BSN program. X. Conflict of interest This policy is under development. 33

Student Resources Accessing Library Resources at Okanagan College You will receive a library orientation during one of your nursing courses. Get to know the library and the many resources available to students. Learning Center at Okanagan College The Learning Center is located in the library. Students are advised to become familiar with the services at the learning center. Student Services Go to college website and enter student services for a complete list of services and contacts available to you. The College of Registered Nurses of British Columbia (CRNBC) Student Representatives Program at Okanagan College The CRNBC Student Representative Program (SRP) is a provincial network of approximately 190 CRNBC student registrants in British Columbia nursing programs who volunteer to represent CRNBC in their nursing program. Student representatives promote good nursing practice by providing information about CRNBC programs and services, and help inform other nursing students about self regulation, professional standards, nursing issues and CRNBC resources. Student representatives are a direct link between CRNBC and other student and practicing colleagues. They provide leadership to help other students express their ideas, concerns, needs and priorities to CRNBC. Their base of operation is the educational institution where they are enrolled and they are supported by the nursing education program administration, faculty and CRNBC Nursing Practice Advisors. The SRP program at OC is currently under review. Role of a Student Representative: Working with the CRNBC Regional Nursing Practice Advisor and the Okanagan College Nursing Faculty Liaison, student activities include: 1. Assisting colleagues to understand and support nursing self regulation. 2. Assisting fellow students to understand and use the CRNBC Standards for Practice. 3. Promoting awareness and use of CRNBC resources to support nursing students in their practice. 4. Providing a communication link between nursing students and CRNBC. 34

Structure: Students represent all years of the BSN program. Year I representatives are selected each fall and usually participate in the SRP program until graduation. Representatives are replaced as needed to ensure representation from all years of the BSN program. A chairperson is chosen from within the group. Benefits: Student representatives develop leadership skills, increase their awareness of nursing practice standards, help to improve their problem solving skills and provide a network for professional practice. Examples of involvement in professional activities at local and provincial levels include participation in: workplace representative sessions district workshops provincial annual meeting CRNBC Board meeting annual CRNBC Student Representative BBQ for all BSN students monthly SRP meetings educational presentations for student nursing body College of Registered Nurses of British Columbia. (2008). Student Representative Program. Retrieved July 17, 2008 from https://www.crnbc.ca/practicesupport/practicesup/srp/pages/srp.aspx 35

Scope of Practice: Psychomotor Skills for BSN Students Standards Limits Conditions Ratified by UBCO School of Nursing April 2013/Revised for OC BSN August 2013

Titles Students enrolled in the BSN program at Okanagan College (OC) should use the following title: BSN student When charting, nursing students should indicate their status by following their signatures or initials with the abbreviation SN (student nurse) followed by their year in the nursing program (1, 2, 3, or 4): e.g. M. Smith, OC BSN SN 2 When signing their names, students should indicate their school, OC to differentiate between students from other schools of nursing: e.g. Date Printed Name Initials Signature Profession dd/mm/yyyy Mary Smith MS Mary Smith OC BSN SN 2 Note: Initials should only be used on flow sheets (not in narrative charting). Scope of Practice for BSN Students Years 1 & 2 This document is modeled after the Scope of Practice for Registered Nurses (CRNBC, 2012c). This scope of practice for OC BSN students provides direction on which skills nursing students may and may not perform, and describes the specific standards, limits, and conditions under which certain skills may be performed. Standards, Limits & Conditions Standards: CRNBC (2012c) defines a standard as a desired and achievable level of performance against which actual performance can be compared. It provides a benchmark below which performance is unacceptable (p.6). There are two levels of standards that BSN students must meet in this nursing program: 1. CRNBC Professional Standards: BSN students are expected to practice according to the CRNBC Professional Standards (2012a). 2. OC BSN Competencies and Quality Indicators: Students in the OC BSN program are expected to meet the competencies and quality indicators described in the domains of the Practice Appraisal Form (PAF) for all nursing practice courses. Limits: Limits describe the activities that BSN students are not permitted to perform. For example, BSN students may not, under any circumstances, take blood for an arterial blood gas analysis. Conditions: Conditions describe the specific circumstances in which BSN students may perform certain activities. For example, BSN students must always be supervised by a Registered Nurse when removing a chest tube. 2

Controls on Nursing Student Practice While CRNBC (2012c) explains that there are four levels of control on registered nurses practice, BSN students have an additional two levels of control: 4. RN Individual Competencies 3. Employer Policies and Procedures 2. CRNBC Standards, Limits, and Conditions 1. Government regulation (i.e. the Health Professions Act) Figure 1: Controls on the practice of a Registered Nurse 6. BSN student individual competencies 5. Standards, limits, and conditions based on student's semester in the BSN program 4. OC School of Nursing policies and guidelines 3. Health authority/agency policies and procedures 2. CRNBC Standards, Limits, and Conditions 1. Government regulation (i.e. the Health Professions Act) Figure 2: Controls on the practice of an OC BSN student 3

Examples of the controls on nursing student practice: Example 1: Example 2: Example 3: Example 4: Example 5: Example 6: A BSN student is caring for a patient who needs a dressing change. The student has been taught how to change this type of dressing, has completed the relevant lab, and has been supervised by the clinical professor and assessed to be competent. Can the student change this patient s dressing? Yes. Changing the patient s dressing is within the scope of practice for this student (Figure 2, Level 6). A BSN student is caring for a patient who needs to be transferred with a ceiling lift system. The student has been trained to use a variety of lifts, but is not familiar with the type of ceiling track system used in this facility. Can the student independently transfer this patient? No. Although this activity is within the scope of an RN s practice, follows employer policies, is within OC BSN program policies, and has been taught in a previous practice course, the student has judged himself/herself as not competent with this particular system. The student must seek out assistance or supervision to perform this activity safely (Figure 2, Level 6). A BSN student is completing a Year 1 practice experience in a Residential Care setting. A Registered Nurse offers to coach the student through the procedure of inserting an intravenous catheter on a patient. May the student perform this skill? No. Although venipuncture is within the scope of practice for a BSN student, it is a complex skill with the potential to cause harm. Therefore, the OC BSN program specifies the condition that this skill is outside of the scope for a BSN Year 1 or 2 student. This skill is learned in BSN Years 3 & 4. (Figure 2, Level 5). A BSN student is spending the day in the operating room as an off unit experience. The anesthesiologist offers to allow the nursing student insert an Endotracheal Tube (ETT) into the patient and states that he will coach the student through the procedure. Can the student perform this activity? No. CRNBC (2012) states that endotracheal intubation is not within the scope of practice of registered nurses. Therefore, a BSN student would never be allowed to perform this skill (Figure 2, Level 2). A BSN student is caring for a patient who is receiving Total Parenteral Nutrition (TPN) through a central line. The TPN bag is empty and needs to be changed. The student has received the appropriate classroom theory on TPN administration, but cannot find the RN or the clinical professor. Can the student independently change the TPN bag to prevent the intravenous bag and tubing from running dry? No. Although changing a TPN bag is within the scope of RN practice, OC BSN program policies specify the condition that students must always be supervised when changing a TPN bag (Figure 2, Level 4). A BSN student is caring for a 2 year old child on the pediatric ward of Kelowna General Hospital who needs an immunization. There is a doctor s order for the immunization, and the RN is willing to supervise the student. Can the student perform this activity? No. Although the OC BSN Scope of Practice: Psychomotor Skills permits a student to administer immunizations with supervision, IHA policy has a limit that does not allow students to immunize children under the age of 5 years. (Figure 2, Levels 3 & 5). 4

Scope of Practice for Registered Nurses The CRNBC (2012c) Scope of Practice for Registered Nurses details the activities that Registered Nurses may perform. These activities are divided into: Activities that are not restricted (e.g. assist a client with activities of daily living) Restricted activities that do not require an order (e.g. make a nursing diagnosis such as a client being at risk for developing skin breakdown and intervene appropriately by placing the patient on a pressure relieving mattress) Restricted activities that require an order (e.g. administer a narcotic medication) Restricted activities for nurses who have completed an approved certification program (e.g. diagnose and treat sexually transmitted diseases) Activities that are delegated by another profession and approved by CRNBC Many of the activities described within the Scope of Practice for Registered Nurses are subject to specific limits and conditions. Refer to the Scope of Practice for Registered Nurses (CRNBC, 2012c) for the full details. Scope of Practice for BSN Students In addition to the CRNBC Scope of Practice for Registered Nurses (CRNBC, 2012c), the OC BSN program Scope of Practice: Psychomotor Skills for BSN Students places additional limits and conditions on the practice of BSN students. BSN students are expected to recognize their own limitations, act responsibly at all times, and take responsibility for ensuring their own continued competency and learning. BSN students must at all times adhere to the Canadian Nurses Association Code of Ethics (2008) and act in conformity with the Standards of Practice (CRNBC, 2012a). Prior to performing a psychomotor skill (a skill that requires both knowledge and manual dexterity), BSN students must first have acquired the necessary knowledge and then they must follow OC BSN program and health authority guidelines as to the appropriate way to gain practical expertise with that skill. This process usually involves: (1) practice in the Health Lab, (2) observation of that skill in clinical practice, (3) performing that skill under the supervision of a qualified RN until deemed competent. Since agencies have the right to designate certain skills as specialized, the following lists are not to be considered all inclusive and must therefore be supplemented by agency policy. BSN students are reminded that it is their responsibility to check the policies, procedures, and clinical practice standards of the agency in which they are practicing, and to abide by these. BLOOD TRANSFUSIONS: The following excerpts are taken from the Interior Health Authority Clinical Transfusion Practices Manual: The TRANSFUSIONIST is the Physician, Registered Nurse, Nurse Practitioner, [or] Registered Midwife who is responsible for the transfusion of blood products at the bedside (Section 2.0, Jan 2011, p. 10). 5

Students can assist in the Transfusionist tasks only if they are supervised directly by the Transfusionist. The Transfusionist is ultimately the responsible provider and must be physically present and must co sign on the patient records. Students cannot be the 2 nd person verifier (Section 3.0, Jan 2011, p. 20). IMMUNIZATIONS: BSN Year 1 & 2 students must follow the policies of the agency or health authority in which they are practicing. For students in practice placements within the Interior Health Authority (IHA): Students are never permitted to immunize children under the age of 5 years. Outside of scope of practice for BSN Years 1 & 2. With a doctor s order (e.g. in an acute care setting), students may administer immunizations to adults, so long as they are supervised by a qualified RN. Without a doctor s order (e.g. in a community setting), students must have completed the BC CDC immunization course AND be supervised by a qualified RN. Students may only provide single dose immunizations to adults (i.e. cannot administer more than one immunization per person). The following excerpt is taken from the IHA Administrative Policy Manual: AU1100 Student Placements (March 2006): 3.10.3 Immunization Administration Students may only provide single dose immunizations to adults and school aged children if the student has been deemed competent either by the learning institution or the clinical practice site. The task must be within the scope of practice of the particular discipline and must adhere to any Professional College limits and conditions. To provide immunization to infants, preschool children and special populations involves complex scenarios that require a more inclusive level of competency. Therefore, because of the time required to demonstrate competency for this immunization practiced, students will not be permitted to immunize infants, preschool children and special populations. (p. 7) Regulatory Supervision of Practice By A Qualified Registered Nurse In the Practice Standard for the Regulatory Supervision of Nursing Student Activities, CRNBC (2012b) specifies that it must be a CRNBC registrant (i.e. Registered Nurse, Nurse Practitioner, or Licensed Graduate Nurse) who is ultimately responsible for supervising all activities of BSN students which may affect clients. This regulatory supervision involves: 1. Knowing the BSN student s competence 2. Authorizing the activity/skill 3. Setting conditions on how/when/where the skill is performed 4. Managing risks to the client 6

This Practice Standard (CRNBC, 2012b) states that the nurse who is responsible for supervising the practice of a BSN student may decide to involve a non CRNBC registrant (e.g. LPN, physiotherapist, social worker) in the regulatory supervision process. In this case, the Registered Nurse must clearly communicate the activities authorized and conditions set to both the non CRNBC registrant and the student. However, the nurse who is primarily responsible for supervising the student (e.g. the clinical professor or preceptor) remains accountable and responsible for the process and for any decisions associated with the process. References CNA (2008). Code of ethics for Registered Nurses. Retrieved from http://www2.cnaaiic.ca/cna/documents/pdf/publications/code_of_ethics_2008_e.pdf CRNBC (2012a). Professional standards for Registered Nurses and Nurse Practitioners: Accountability, knowledge, service, ethics. Retrieved from https://www.crnbc.ca/standards/lists/standardresources/128professionalstandards.pd CRNBC (2012b). Regulatory supervision of nursing student activities. Retrieved from https://www.crnbc.ca/standards/lists/standardresources/695regsupernrsgstudentactivities.pdf CRNBC (2012c). Scope of practice for Registered Nurses: Standards, limits, conditions. Retrieved from https://www.crnbc.ca/standards/lists/standardresources//433scopeforregisterednurses.pdf Interior Health Authority (2006). AU1100 Student Placements. Retrieved from the IHA InsideNet. 7

Limits & Conditions in the BSN Student Scope of Practice (BSN Years 1 & 2) Consult with a BSN program professor re questions related to the scope of practice for BSN Year 1 & 2 students, the standards, limits and conditions placed on their practice, and the requirement for regulatory supervision. Category A: Skills/activities that MAY NOT be performed by BSN Years 1 & 2 students: Accessing, flushing, or administering medications through a central venous access device (CVAD) that is used exclusively for hemodialysis Administer critical care medications (e.g. intravenous amiodarone, intravenous metoprolol) Drawing blood samples from a Central Venous Access Device Venipuncture (peripheral IV infusion initiation) Arterial blood gases Changing/removing a tracheostomy tube Chest tube irrigation Constant care provider: student are not to be designated as a constant care provider (commonly referred to as a 1:1 nurse), including for break relief Defibrillation or cardioversion Endotracheal extubation Hemodialysis Vaginal examination Identification of cardiac dysrhythmias for the purpose of instituting treatment (beyond basic CPR) IHA Nursing Escort: Students are not to be the designated escort for patients requiring supervision during transport. They may however, accompany the designated RN/LPN for observation only Intravenous administration of chemotherapy Immunization of children Management of unstable C spine, e.g. Stabilizing the neck of a patient with skull tongs, with/without a hard collar Measurement of arterial and central venous pressure, or wedge pressure (Swan Ganz catheters) Monitoring oxytocin drip during labour Peritoneal dialysis Removal or adjustment of a TR Band radial compression device Setting up and supervising operation of a mechanical ventilator Triage (in an Emergency Department) Fetal monitoring Neonatal blood glucose monitoring Phlebotomy Vaginal examination Administration of ANY medication, by ANY route to a newborn * Note: The following activities are restricted by BOTH health authority/facility and OC BSN program policy and may not be performed by nursing students: o o o Take a verbal or phone order from a physician Verify a client s signature on a consent form Complete a narcotic count 8

Category B: Skills/activities that MUST ALWAYS BE DIRECTLY SUPERVISED by a Registered Nurse: Chest tube removal and tying of purse string sutures (Note: the student must be supernumerary to the 2 qualified nurses required to remove a chest tube) Immunization and tuberculin testing of adults. Removal of a deflated Laryngeal Mask Airway (LMA mask) Removal of an epidural catheter Transcribing physician orders and completing nightly review of charts and MAR The following skills relating to medication administration must always be supervised: o Intravenous heparin and insulin, including monitoring of intravenous infusions, changing infusion rates, and administration of IV bolus doses o Narcotic/controlled substance administration by any parenteral route including: patient controlled analgesia (PCA) bolus, epidural infusion, subcutaneous infusion device (e.g. Graseby pump), etc. o Verification of the correct patient (using 2 identifiers), medication, name, dose, time/date, route, and reason with the MAR/order: All insulin and heparin doses Any medications that the facility designates as High Alert medications Non parenteral (e.g. oral, sublingual, or rectal) doses of narcotics and controlled substances o Wastage of all narcotics/controlled substances The following skills relating to Central Venous Access Devices (CVADs) must always be supervised: o Accessing an implanted venous access device (i.e. Port a Cath) o Administration of TPN (including changing bags and tubing) o Dressing changes o Flushing and aspirating blood to verify line patency o Administering IV push medications via intermittent access o Removal of a central line Transfusion of blood products Students may only perform tasks that are congruent with the level of theory they have obtained within their education. o Transporter o Assessment checks as assigned by the Transfusionist o General care for the stable patient during transfusion under RN direction o General care for the stable patient for the first 24 hours post transfusion under RN direction Category C: Skills/activities that must be supervised by a qualified Registered Nurse until the BSN student is competent: Most psychomotor skills taught in the OC BSN program fall into this category, in which students must be supervised until they demonstrate competence. Some examples of these skills include: Blood glucose monitoring Midline catheter care and removal Tracheostomy care including suctioning, cleaning, and changing of inner cannula All non high alert medications All assessments, including vital signs 9