Course Title:

Vocational Nursing – CLINICAL I

Course Prefix & Number:

VNSG 1360

Section Number:

100

Semester/Year:

17 1S

Semester Credit Hours:

4

Lecture Hours:

Clinical Hours:

240

Course Description (NCTC Catalog):

This course provides clinical experience in fundamental nursing skills. The nursing process is applied to provide individualized care designed to meet a patient’s particular needs. This is a health-related, work-based learning experience that enables the student to apply specialized occupational theory, skills and concepts. Clinical experiences include care of the adult patient with focus on cultural nursing aspects, therapeutic communication, nutrition, geriatrics, diabetes, mental health and illness, and muscular-skeletal pathophysiologies.

The clinical setting may include acute care facilities, clinics, long-term care facilities, and any other institutions that gainfully employ licensed nurses and/or physicians. The clinical experience will also include patient scenario simulations in the nursing lab, in order to strengthen the student’s clinical skills and provide exposure to patient care situations that may not be readily available to the student. Supervision and evaluation of the student’s performance is provided by a licensed clinical professional in all clinical and nursing lab settings.  

Course Prerequisite(s): successful skills checkoffs

Required or Recommended Course Materials:

Ladwig, GB. and Ackley, BJ. Guide to Nursing Diagnosis 4th ed. (2014) St.Louis: Mosby.ISBN # 978-0-323-08920-3

Linton, A.D. Introduction to Medical Surgical Nursing. 6^th ed. (2015) St Louis, Elsevier ISBN# 978-1-4557-7641-2

Vocational Nursing Student Handbook of North Central Texas College, revised January 2017

SimChart by Elsevier/Evolve access

*Nettina, S. Lippincott Manual of Nursing Practice 10^th ed. (2013) Philadelphia: LWW. ISBN # 13: 978-1-4511-7354-3

Skidmore. Linda-Roth. Mosby’s 2017 Nursing Drug Reference 30^th ed.(2016) St Louis; Elsevier. ISBN# 978-0-3234-4826-0

*Venes, Donald.  Taber’s Cyclopedic Medical Dictionary 22nd ed. (2013), Philadelphia, F.A. Davis

ISBN # 13: 978-0-8036-2977-6

* optional

Name of Instructor:

Ashley Hunsucker, R.N.

Campus/Office Location:

Gainesville, 2411-I

Telephone Number:

940 668-7731 ext. 4237

E-mail Address:

ahunsucker@nctc.edu

Monday

Tuesday

Wednesday

Thursday

Friday

class

Clinical

Clinical

8 am – 5:00 pm

8: 00 am - 12:00

At the successful completion of this course the student will be able to:

the student will be able to perform the following duties.

I.                    Member of the Profession:   (DEC 1-4) (SCANS 1-7) (QSEN 2,3,4) (Cognitive (C), Affective (A), Psychomotor (P) Skills/Behaviors)

A.       Function within the nurse’s legal scope of practice and in accordance with the policies and procedures of the employing health care institution or practice setting. (C, A, P)

B.       Assume responsibility and accountability for the quality of nursing care provided to patients and their families. (C, A)

C.       Contribute to activities that promote the development and practice of vocational nursing. (C, A, P)

D.       Demonstrate responsibility for continued competence in nursing practice, and develop insight through reflection, self-analysis, self-care, and lifelong learning. (C, A, P)

II.                 Provider of Patient-Centered Care: (DEC 5-12) (SCANS 1-7) (QSEN 1, 2, 3, 4, 5) (Cognitive (C), Affective (A), Psychomotor (P) Skills/Behaviors)

A.      Use clinical reasoning and established evidence-based policies as the basis for decision making in nursing practice. (C, A)

B.      Assist in determining the physical and mental health status and health needs and preferences of culturally, ethnically, and socially diverse patients and their families based on interpretation of health-related data. (C, A)

C.      Report data to assist in the identification of problems and formulation of goals/ outcomes and patient-centered plans of care in collaboration with patients, their families, and the interdisciplinary health care team. (C)

D.      Provide safe, compassionate, basic nursing care to assigned patients with predictable health care needs through a supervised directed scope of practice. (C, A, P)

E.       Implement aspects of the plan of care within legal, ethical and regulatory parameters and in consideration of patient factors. (C, A, P)

F.       Identify and report alterations in patient responses to therapeutic interventions in comparison to expected outcomes. (C)

G.      Implement teaching plans for patients and their families with common health problems and well-defined health learning needs. (C, A)

H.      Assist in the coordination of human and materiel resources for the provision of care for assigned patients and their families. (C, A)

III.                Patient Safety Advocate: (DEC 13-18) (SCANS 1-7) (QSEN 3,4,5) (Cognitive (C), Affective (A), Psychomotor (P) Skills/Behaviors)

A.    Demonstrate knowledge of the Texas Nursing Practice Act and Texas Board of Nursing rules that emphasize safety as well as all federal, state, and local government and accreditation organization safety requirements and standards. (C)

B.    Implement measures to promote quality and a safe environment for patients and others. (C, P)

C.    Assist in the formulation of goals and outcomes to reduce patient risk. (C, A)

D.    Obtain instruction, supervision, or training as needed when implementing nursing procedures or practices. (C, A)

E.    Comply with mandatory reporting requirements of the Texas Nursing Practice Act. (C, A)

F.    Accept and make assignments that take into consideration patient safety and organizational policy.

(C, A)

IV.               Member of the Health Care Team: (DEC 19-25) (SCANS 1-7) (QSEN 2,3,4,5,6) (Cognitive (C), Affective (A), Psychomotor (P) Skills/Behaviors)

A.    Communicate and collaborate with patients, their families, and the interdisciplinary health care team to assist in the planning, delivery, and coordination of patient-centered care to assigned patients. (C, A)

B.    Participate as an advocate in activities that focus on improving the health care of patients and their families. (C, A, P)

C.    Participate in the identification of patient needs for referral to resources that facilitate continuity of care and ensure confidentiality. (C)

D.    Communicate and collaborate in a timely manner with members of the interdisciplinary health care team to promote and maintain optimal health status of patients and their families. (C, A)

E.    Communicate patient data using technology to support decision making to improve patient care.  

(C, A, P)

F.    Assign nursing care to LVNs or unlicensed personnel based upon an analysis of patient or unit need. (C, A)

G.    Supervise nursing care provided by others for whom the nurse is responsible. (C, A)

Graded Course Elements

Student evaluations of clinical competency will be based on meeting the clinical outcomes derived from the Differentiated Essential Competencies (DEC), the Secretary’s Commission on Achieving Necessary Skills (SCANS), and the Quality and Safety Education for Nurses (QSEN) matrices as stated in the course syllabus, and the Vocational Nursing Student Handbook, and shall include all actual, as well as laboratory simulated, patient care situations. Grades will be determined by utilizing the Clinical I point sheet and the following grading criteria:

90-100                           A         Students begin the semester with 100 points. Points may be deducted daily

80-89                               B          according to unacceptable behaviors described in the VN Student Handbook,

77-79                   C          and as listed on the grade point sheet. Student must maintain a minimum            

Below 77         F          score of 77 to continue in the Vocational Nursing Program and                     proceed to the next semester.

Documentation of student clinical performance will follow the guidelines outlined in the Vocational Nursing Student Handbook, and may include: Counseling Statements, Clinical Warnings, and/or Clinical Contracts.  NOTE:  Clinical Warnings are cumulative throughout the program.  If a student receives two Clinical Warnings, a clinical failure will be given, resulting in dismissal from the program and a grade of “F” will be recorded.

All rules and regulations will be upheld as stated in your Vocational Nursing Student Handbook, including but not limited to academic honesty, online testing policies, make-up exams, grade rounding, and late work policies. Please refer to you student handbook for these outlines.

1. Assist in determining the health status and health needs of patients based on interpretation of health-related data and preventive health practices, in collaboration with patients, their families, and other members of the immediate health care team.

1.        Take patient history using structured assessment tool.

2.        Perform basic assessment to assist identifying health status. Monitor for changes in health status.

3.        Report and document assessment data. Utilizes correct grammar, spelling, and penmanship.

4.        Identify common actual and potential health care needs of the patient.

5.        Make observations that assist the RN in formulating nursing diagnoses.

2. Assist in the formulation of goals and/or outcomes and a plan of care in collaboration with the patient, their families, and interdisciplinary health care team members.

1.        Identify short-term goals/outcomes, select basic interventions.

2.        Contribute to the development of nursing plan of care. Utilizes correct NANDA nomenclature.

3.        Recognize cost of care for nursing interventions.

3. Implement plan of care within legal and ethical parameters, including scope of education, in collaboration with the health care team to assist patient in meeting health care needs.

1.        Assist in promoting a safe, effective care environment conducive to the optimal health and dignity of the patient.

2.        Implement plan of care to assist patient to meet basic physiologic needs including: circulation, nutrition, oxygenation, activity, elimination, comfort, pain management, rest, & sleep.

3.        Implement nursing interventions to promote rehabilitation.

4.        Initiate basic interventions in emergency situations.

5.        Initiate basic nursing interventions to foster patient’s psychosocial well-being.

6.        Foster patient coping mechanisms during alterations in health status.

7.        Administer medications and treatments and perform procedures safely. Follow RIGHTS of medication administration.   Have knowledge of action, usual dose, desired effect, side effect, dosage calculation, reconstitution, injection site selection, documentation, and reassessment.

8.        Monitor, document, and report responses to medications, treatments, and procedures and communicate same to other health care professionals clearly and accurately.

9.        Assist interdisciplinary health care team members with examinations and routinely performed procedures.

10.     Observe and communicate Patient’s Bill of Rights to patients.

11.     Recognize and communicate ethical and legal concerns through established channels of communication.

12.     Utilize basic therapeutic communication skills when interacting with patients.

13.     Report unsafe practices.

14.     Use current technology to enhance direct patient care.

15.     Maintain patient confidentiality.

4. Implement teaching plan for patient with common health problems and well-defined learning needs.

1.        Identify basic health-related learning needs of patients.

2.        Contribute to the development of a teaching plan.

3.        Implement aspects of an established teaching plan.

4.        Assist in evaluation of learning outcomes using structured evaluation.

5. Assist in the evaluation of the patient’s responses and outcomes to therapeutic interventions.

1.        Using standard references, compare expected and achieved outcomes of nursing care.

2.        Report and document patient’s responses to nursing interventions.

6. Provide direct basic care to assigned patients in structured settings.

1.     Identify priorities concerning basic needs of multiple patients in order to                   organize care.

2.     Implement plans of basic care for multiple patients, including charting.

7. Use the problem-solving approach as the basis for decision making in practice.

1.        Organize care based upon problem solving and identified priorities. Complete care on 1-2patients, including acutely ill.

2.        Identify and communicate patient care problems encountered in practice.

1. Assist in the coordination of human and material resources for the provision of care for assigned individual patients.

1.     Participate in discussion relating to the evaluation of patient care with members of interdisciplinary health care team.

2.       Identify providers and others who can assist in patient care.

2. Collaborate with patients and the interdisciplinary health care team to provide direct care to assigned individual patients.

1.        Work with interdisciplinary health care team members to provide patient care across the life span.

3. Participate in the identification of indivindividual patient needs for referral to resources that facilitate continuity of care.

1.        Identify support systems of the patient.

2.        Communicate patient needs to family or significant others and appropriate members of the health care team.

4. Participate in activities which support the organizational framework of structured health care settings.

1.        Report unsafe patient care environment and equipment.

2.     Implement established cost containment measures in direct patient care.

1. Demonstrate accountability for own nursing practice.

1.        Provide nursing care within limits of vocational nursing knowledge, education, experience and ethical/legal standards of care. Adhere to all policies stated in the Vocational Nursing Student Handbook.

2.        Provide nursing care in a caring, nonjudgmental, nondiscriminatory manner.

3.        Use self-evaluation process to improve own nursing practice.

4.        Assume accountability for own nursing practice. Ask questions for clarity, as needed, pertaining to nursing practice.

5.        Follow established policies and procedures. Revise techniques and skills according to instructor suggestions.

6.     Maintain professional boundaries in the nurse-patient relationship.

2.   Participate as an advocate in activities that focus on improving the health care of patients.

1.        Respect the privacy and dignity of the patient.

2.        Act as an advocate for patient’s basic needs.

3. Demonstrate behaviors that promote the development and practice of vocational nursing.

1.        Demonstrate behaviors which promote a positive image of vocational nursing, as in accountability, dress, attitude, honesty, punctuality, attendance, and accepting constructive criticism of skills and performance of care procedures.

2.        Practice within the LVN role and Scope of Education.

3.        Serve as a positive role model for students and peers.

1. Demonstrate knowledge of the Texas Nursing Practice Act and Texas Board of Nursing rules that emphasize safety as well as all federal, state, and local government and accreditation, organizational safety requirements and standards.

1.     Adhere to safety requirements; follow policies & procedures to ensure

       safety.

2.        Seek assistance if practice requires behaviors or judgments outside of

individual knowledge and expertise.

3.        Use accepted standards to provide & evaluate patient care.

4.        Recognize & report unsafe practices & contribute to quality improvement.

2. Implement measures to promote quality and a safe environment for patients, self, and others. Comply with mandatory reporting requirements of the Texas Nursing Practice Act, and assist in care that reduces risks of injury and/or illness.

1.     Utilize principles of patient safety including safe patient handling.   Follow Standard Precautions and Transmission Based Precautions for infection control.

2.     Promote a safe environment using current standards & guidelines. Include measures to prevent risk of harm resulting from errors & preventable occurrences.

3.     Promote culture of safety including safe disposal of medications and wastes.

4.     Accurately identify patients.

5.     Provide safe patient care, safe medication administration, & safe treatments.

6.     Identify inaccurate, non-efficacious, contraindicated, or unsafe environments or interventions, and report such so that harm does not occur.

7.     Document, report reactions, side effects to medications, treatments, procedures, and inform all health care team members.

8.     Educate patients & encourage participation in their care to ensure accuracy     in individual care plans and interventions.

3. Obtain instruction, supervision, and/or training as required when implementing nursing procedures or practices, including utilization of new equipment & technology.

1.     Basic understanding of disaster plans and disease prevention.

2.     Evaluate individual scope of practice & competency related to assigned tasks.

3.     Report safety concerns, incidents & issues immediately to faculty, preceptors, and facility personnel. Follow protocol for incident reporting.

Name of Chair/Coordinator:

Theressa Borden

Office Location:

Gainesville – 2411-B

Telephone Number:

940-668-4291, ext.4330

E-mail Address:

tjborden@nctc.edu

Name of Instructional Dean:

Dr. Jane Leach

Office Location:

Gainesville-

Telephone Number:

(940) 668-7731, ext. 4374

E-mail Address:

jleach@nctc.edu