Student Handbook for the ASSOCIATE DEGREE PROGRAM IN NURSING Berkshire Community College Pittsfield, Massachusetts January 2015 Table of Contents I. PHILOSOPHY OF THE DEPARTMENT OF ASSOCIATE DEGREE NURSING ..........................................1 PURPOSE OF THE DEPARTMENT OF ASSOCIATE DEGREE NURSING ............................................... 2 STUDENT LEARNING OUTCOMES .............................................................................................................. 2 ADN PROGRAM OUTCOMES ........................................................................................................................ 3 ORGANIZING FRAMEWORK ........................................................................................................................ 4 ANA Code for Nurses* ....................................................................................................................................... 6 NURSING COURSE DESCRIPTIONS/STUDENT LEARNING OUTCOMES ..................................................7 NUR 101 Physical and Mental Health I ............................................................................................................. 7 Expected Student Learning Outcomes ............................................................................................................ 9 NUR 101 Expected Student Learning Outcomes ..................................................................................................10 NUR 102 Physical and Mental Health II .......................................................................................................... 11 Expected Student Learning Outcomes .......................................................................................................... 13 NUR 106 LPN to RN Bridge ............................................................................................................................ 15 NUR 201 Physical and Mental Health III ......................................................................................................... 16 Expected Student Learning Outcomes .......................................................................................................... 17 NUR 202 Physical and Mental Health IV......................................................................................................... 19 Expected Student Learning Outcomes .......................................................................................................... 21 NUR 206 Nursing in Transition ........................................................................................................................ 23 EXL 225 Preceptor Program (Optional) ........................................................................................................... 24 Communication ................................................................................................................................................. 25 Official Bulletin Board ................................................................................................................................. 25 SNO Bulletin Board ...................................................................................................................................... 25 Email/Internet Use ........................................................................................................................................ 25 Learning Management System (LMS).............................................................................................................. 25 CPR Policy ........................................................................................................................................................ 25 Criminal Offender Record Information (CORI) and Sex Offender Registry Information (SORI) Checks ...... 25 Equipment Policy .............................................................................................................................................. 26 Exception/Extension Policy .............................................................................................................................. 26 Mandatory Health Requirements ...................................................................................................................... 27 Picture IDs ........................................................................................................................................................ 27 Student Membership on Curriculum Committee .............................................................................................. 27 IV. ACADEMIC AND CLINICAL POLICIES ........................................................................................... 28 National Student Nurses’ Association, Inc. Code of Academic and Clinical Conduct .................................... 28 Student Behavior/Civility Policy ...................................................................................................................... 29 Attendance Policies ........................................................................................................................................... 29 Class Attendance ........................................................................................................................................... 29 Class Promptness .......................................................................................................................................... 29 Campus Laboratory Attendance ................................................................................................................... 29 Clinical/Data Collection Attendance ............................................................................................................ 30 Return from Absence-Health Clearance ........................................................................................................... 30 V. ACADEMIC INFORMATION/POLICIES ..............................................................................................30 Academic Evaluation ........................................................................................................................................ 30 Examination Policies ........................................................................................................................................ 31 Test Review – Individual and/or Group............................................................................................................ 31 Retake of Exams ............................................................................................................................................... 31 Grade Appeals ................................................................................................................................................... 31 Academic/Clinical Failure ................................................................................................................................ 31 Readmission Following Failure ........................................................................................................................ 32 Clinical Dismissal ............................................................................................................................................. 32 Readmission after Clinical Failure.................................................................................................................... 32 Readmission to Program after Extended Absence ............................................................................................ 32 HESI Exit Exam.............................................................................................................................................. 32 Plagiarism ......................................................................................................................................................... 32 Professional Misconduct ................................................................................................................................... 33 VI. CLINICAL INFORMATION/POLICIES .................................................................................................33 Clinical Absences - Reporting .......................................................................................................................... 33 Clinical Sites ................................................................................................................................................. 33 Community ................................................................................................................................................... 33 Campus Laboratory/Simulation .................................................................................................................... 33 Planning Ahead ................................................................................................................................................. 33 No Call/No Show .............................................................................................................................................. 33 Latex Allergy .................................................................................................................................................... 33 Smoking Policy ................................................................................................................................................. 34 Clinical Site Assignment Information .............................................................................................................. 34 Clinical Placement Form............................................................................................................................... 34 Change in Assignments................................................................................................................................. 34 Dress Codes .................................................................................................................................................. 34 Essential Functions ........................................................................................................................................... 35 Facilities for Storage of Coats/Valuables or Equipment Storage Facilities ...................................................... 35 Leaving the Clinical Site ................................................................................................................................... 35 Mandatory Clinical Agency Requirements ....................................................................................................... 35 Parking .............................................................................................................................................................. 35 Professional Liability Insurance ....................................................................................................................... 35 Substance Abuse/Impaired Student Policy ....................................................................................................... 35 Student Injury/Occupational Exposure Injury .................................................................................................. 35 Occupational Exposure ..................................................................................................................................... 36 Student Medication Administration Policy....................................................................................................... 36 Transportation ................................................................................................................................................... 37 Evaluation of College Laboratory and Clinical Rotation Experiences ............................................................. 37 College Laboratory ....................................................................................................................................... 37 Clinical Conferences ..................................................................................................................................... 37 Clinical Evaluation Conferences................................................................................................................... 37 Expected Student Learning Outcomes .......................................................................................................... 37 Clinical Evaluations in Community Agencies .............................................................................................. 38 VII. NURSING PROGRAM ADMISSIONS/WITHDRAWAL POLICIES AND PROCEDURES ...............38 Admission into the Associate Degree Nursing Program .................................................................................. 38 Maintenance of Acceptance Status ................................................................................................................... 38 Deferred Acceptance ......................................................................................................................................... 39 Withdrawal in Good Standing .......................................................................................................................... 39 Medical Leave of Absence................................................................................................................................ 39 Transfer Students .............................................................................................................................................. 39 Timeline for Meeting Program Requirements .................................................................................................. 39 VIII. LEGAL RESPONSIBILITY RELATED TO NCLEX – RN ....................................................................39 IX. STUDENT RECORDS ..............................................................................................................................40 College Records ................................................................................................................................................ 40 Program Records ............................................................................................................................................... 40 X. GLOSSARY OF TERMS ..........................................................................................................................40 XI. FORMS ......................................................................................................................................................41 Clinical Placement Policy Form ....................................................................................................................... 43 Essential Functions ........................................................................................................................................... 45 Clinical/Field Work Affiliate Random Drug Screening Analysis Notification to Students ..................................47 College Closing Policy ..................................................................................................................................... 49 Student Handbook Statement of Understanding ............................................................................................... 51 I. PHILOSOPHY OF THE DEPARTMENT OF ASSOCIATE DEGREE NURSING The philosophy and purpose of the Berkshire Community College Department of Associate Degree Nursing are derived from those of the College and the nursing profession. They reflect faculty beliefs concerning human adaptation, nursing, the teaching-learning process, the wellness-illness continuum, and the role of the associate degree nurse. The faculty fully subscribes to the college’s mission of academic excellence, student success, and community service. Nursing is a profession whose purpose is to aid those who need assistance in the promotion, maintenance, and restoration of an optimal level of health. It is an interpersonal relationship between the nurse and the client and/or significant other(s) in which there is collaboration in defining health problems and in designing and implementing a therapeutic plan of care to meet human needs. Meeting these needs involves active participation by the client and/or significant other(s) in order to enhance life and health, and to cope with health alterations and end-of-life issues. The practice of nursing requires the acquisition and utilization of knowledge and skills necessary to help an individual satisfy and regulate needs. In order to provide this necessary knowledge and skill, nursing education should occur in an academic setting where humanities, biological, behavioral, physical, and nursing sciences are incorporated into the educational program. The associate degree nurse is accountable for nursing care provided within the accepted scope of practice and for contributing to the overall quality of care that clients receive. The nurse functions according to the ethical and legal standards of the profession, and adheres to the regulations of the Massachusetts Board of Registration in Nursing. The associate degree nurse practices in a variety of settings such as: hospitals, skilled nursing care facilities, home care agencies, clinics, schools, and industry. The primary roles assumed are: provider of care, manager of care, and member within the discipline of nursing. These roles are enhanced through use of the nursing process, an element of critical thinking. Learning is a reorganization of an individual’s perception of the world, which results in the development of new behavior. It is a dynamic process, which constantly expands an understanding of the world and the ability to respond to the present based on anticipation of a climate that is continuously changing. The learner and teacher enter into a relationship, which assists the learner in attaining the goals of the nursing program as well as refining personal values, attitudes and beliefs. The learner brings into the learning situation unique needs and experiences which affect the learning process. The responsibility for learning is a shared process between the educator and the student. The degree of communication, active involvement, and the ability to think critically influences the educational outcome. The teacher promotes learning by designing an appropriate educational environment and by facilitating student access to financial, physical, and support services. The teacher enhances learning by initiating experiences, directing activities and to assessing and evaluating the learner’s performance for the ultimate goal of promoting accountability, independence, individuality, and creativity. To prepare responsible, successful graduates, the curriculum is continuously adapted to the evolving health care system. To strengthen the bond between education and practice, collaborative efforts and open communication are 1 maintained with the alumni and regional healthcare providers. The faculty inspires in students an enthusiasm for life-long learning and personal and professional growth through role-modeling and support for continuing one’s education. The nursing process is central to the practice of the associate degree nurse. Incorporated in this process are the key concepts of human adaptation and a safe and effective care environment, physiological integrity, psychosocial integrity and health promotion and maintenance. The integration and utilization of these concepts provide the foundation of safe nursing practice, based on job analysis study of newly licensed, entry-level registered nurses as defined by the National Council of State Boards of Nursing, Inc. PURPOSE OF THE DEPARTMENT OF ASSOCIATE DEGREE NURSING The purpose of the Berkshire Community College Associate Degree Nursing Program is to prepare graduates as entry-level practitioners who will practice in diverse health care settings. The comprehensive program is designed to be completed in two years and to prepare the graduate for licensure and gainful employment as a registered professional nurse. STUDENT LEARNING OUTCOMES At the completion of the program, the graduate will: 1. Apply acquired critical thinking skills to provide care that emphasizes health promotion, maintenance and wellness for a diverse group of clients across the life span. 2. Communicate effectively by maintaining a therapeutic relationship with the client, family and/or significant other(s) to provide culturally competent care. 3. Practice independently and as a member of the health care team in providing and managing nursing care while incorporating state of the art technologies. 4. Demonstrate proficiency in the performance of entry level psychomotor skills based on best current evidence-based practice and accepted nursing standards. 5. Analyze and apply professional, legal and ethical standards of nursing practice as a safe entry level nurse with a commitment to life-long learning and professional growth. 2 ADN PROGRAM OUTCOMES A. Program Completion Seventy percent of the students entering the first nursing course of the ADN Program will graduate within three years. B. Job Placement* Ninety percent or more of new graduates who seek employment in nursing will be employed as registered nurses within one year of licensure. C. Performance on Licensure Exam The licensure exam pass rate will be at or above the national mean. D. Communication* One hundred percent of graduates communicate effectively and demonstrate caring with clients, families and members of the health care team. E. Service* More than fifty percent of graduates will report a commitment to service in the community. F. Critical Thinking* One hundred percent of graduates apply acquired critical thinking skills in making evidence-based decisions about client care. G. Patient-Centered Care One hundred percent of the graduates prioritize safe patient-centered care to promote optimal wellness for diverse groups of clients in a variety of practice settings. H. Program Satisfaction* Eighty-five percent of the graduates and employers will indicate satisfaction with the Associate Degree in Nursing Program at Berkshire Community College. *Data will be based upon graduates (employers) who respond to the Associate Degree in Nursing Program Alumni Survey and data received during annual Advisory Committee meeting. I. NCLEX Pass Rates DATE 2010 2011 2012 2013 BCC 91.00% 91.30% 91.48% 84.26% STATE 89.17% 89.11% 88.56% 81.16% 3 NATIONAL 86.46% 86.98% 89.32% 81.42% ORGANIZING FRAMEWORK In 2006, the Massachusetts Department of Higher Education and the Massachusetts Organization of Nurse Executives joined forces to develop a framework that would guide nursing education and practice. This framework, the Nurse of the Future (NOF) Nursing Core Competency model, has been selected to guide the curriculum and practice for students at Berkshire Community College. There are ten essential components of the NOF Core Competency Model. They are: patient-centered care, professionalism, leadership, systems-based practice, informatics and technology, communication, teamwork and collaboration, safety, quality improvement and evidence-based practice. All competencies are based on nursing knowledge, which is placed at the core, to represent how “nursing knowledge in its totality” (Nurse of the Future Core Competencies, 2010, p, 4) reflects the art and science of the nursing profession and discipline. There is no hierarchy in the model’s presentation and each competency is of equal importance. A broken line between the competencies reflects that the “competencies overlap and are not mutually exclusive”. (Nurse of the Future Core Competencies, 2010, p, 4-5). Berkshire Community College (BCC) recognizes that “the art of nursing is based on a framework of caring and respect for human dignity”. (Nurse of the Future Core Competencies 2010, p. 7). The NOF Core competencies states that “the art and science of nursing are inextricably linked, as a compassionate approach to patient care carries a mandate to provide that care competently.” (Nurse of the Future Core Competencies, 2010, p. 7). Using the NOF Core Competency model to help students develop the knowledge, attitudes and behaviors, and skills (KAS) to provide care, will facilitate their ability to move more effectively through the nursing program. The NOF Core Competencies also prepares the student to function in a complex work environment and bridge the gap between nursing education and practice. The use of the principles of evidence based practice, safety, patient-centered care, professionalism, leadership, systems-based practice, teamwork and collaboration, communication, quality improvement, informatics and technology ensures that graduates of BCC will be proficient in a core set of competencies and ready to practice in a variety of settings after graduation. This model is reflected in the development of the nursing curriculum. Furthermore the model is combined with the NCLEX test plan to organize content and develop learning objectives for each nursing class in preparation for the post-graduation registered nurse licensure exam. Massachusetts Department of Higher Education. (2010). Creativity and connections: Building the Framework for the Future of Nursing Education and Practice. Massachusetts Department of Higher Education Nursing Initiative: Nurse of the Future Core Competencies. 4 5 ANA Code for Nurses* The BCC faculty subscribe to the ANA Code of Ethics which they believe also provides guidance for nursing students in carrying out nursing responsibilities consistent with the ethical obligations of the profession and with high quality in nursing care. 1. 2. 3. 4. 5. 6. 7. 8. 9. The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems. The nurse’s primary commitment is to the client, whether an individual, family, group, or community. The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the client. The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum client care. The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth. The nurse participates in establishing, maintaining, and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individuals and collective action. The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development. The nurse collaborates with other health professionals and the public in promoting community, national and international efforts to meet health needs. The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy. * www.ana.org or www.nursingworld.com 6 NURSING COURSE DESCRIPTIONS/STUDENT LEARNING OUTCOMES NUR 101 Physical and Mental Health I A. Course Description Introduction to nursing theory, process, and practice Nursing theory includes an introduction to the individual as a consumer of health care, and the nurse as a healthcare professional, focusing on health promotion and wellness. The normal variations of the culturally diverse individual throughout the developmental phases, and the physiological, safety, and interactional needs in relationship to human adaptation and maintaining homeostasis are studied. Nursing practice includes the application of scientific principles and the performance of basic psychomotor skills utilized in meeting client needs in varied health care settings. The role of the nurse as provider of care, manager of care, and member within the discipline of nursing is introduced. Beginning assessment skills in the collection and analysis of simple types of data are emphasized. The elements of critical thinking are introduced through a variety of learning activities including journaling, case studies, and internet activities. Service learning is introduced in this course and focuses on health promotion and application of newly acquired skills in a supervised setting. Prerequisite: Co-requisite: Admission to Nursing Program BIO 201, ENG 101 or 103, and PSY 107 B. Course Student Learning Outcomes 1. 2. 3. 4. 5 Describe normal variations of human needs and adaptation across the life span with emphasis on nursing process, evidence-based practice, health promotion, wellness and maintenance. Describe the principles of communication related to the development of a therapeutic relationship with the client, family and/or significant other(s) to provide culturally-sensitive care. Describe the role of the nurse as provider of care, manager of care, and member of the health care team. Demonstrate the ability to perform basic psychomotor skills. Identify the legal, ethical, and professional standards that govern safe nursing practice. 7 . 8 Berkshire Community College Pittsfield, Massachusetts Student Rotation Dates NUR 101 Expected Student Learning Outcomes I. NURSING PROCESS A. Assessing: 1) Collects simple subjective and objective data B. Analyzing 1) Clusters simple data 2) Uses established guidelines to identify accepted nursing diagnoses from simple types of collected data C. Planning 1) Uses established resources to identify expected client outcomes 2) Discusses with client, significant others, health team members and instructor a basic plan of care 3) Selects evidence-based nursing interventions from standard resources 4) D. Identifies normal developmental needs based upon the client's age Implementing 1) Initiates in a safe manner prescribed basic nursing interventions 2) Performs basic psychomotor skills with appropriate supervision 3) Reports and records observations accurately E. II. Evaluating 1) Compares client responses to expected outcomes Client - Nurse Relationship A. Explains the principles related to the development of a therapeutic relationship with clients and/or significant other(s) to provide culturally sensitive care. B. Maintains the client's right to privacy C. Conducts oneself in accordance with accepted legal, ethical and professional standards III. Clinical Portfolio 9 Did Not Meet Expected Learning Outcomes Final Evaluation ____________________________________________ Met Expected Learning Outcomes Mid-Semester Evaluation ___________________________________ NUR 101 Expected Student Learning Outcomes Attendance _________________________________ Overall Clinical Evaluation: Punctuality _________________________________ _____ Met Expected Learning Outcomes Assignments Instructors Comments: _____ Did Not Meet Expected Learning Outcomes Student Comments: My signature indicates that I have read this evaluation Instructor: Student: Date: Date: Reviewed 5/14 10 NUR 102 Physical and Mental Health II A. Course Description Development of nursing theory, process, and practice Nursing theory includes the utilization of the principles of therapeutic communication with individuals as consumers of health care; the collaborative role of the nurse as an active member of the health team; the complex physiological principles from homeostasis through resolution in relation to human needs and adaptation, developmental phases, and the client/nurse relationship; and the interrelationship among physical, safety, and interactional needs. Nursing practice includes the performance with dexterity of basic psychomotor skills and health promotion and maintenance as components of therapeutic nursing care in a variety of settings. Nursing process includes the collection of a broader scope of data and the analysis of multiple types of data for the purpose of arriving at a nursing diagnosis in order to plan, implement, and evaluate nursing care. The elements of critical thinking and the role of the nurse as provider of care, manager of care, and member within the discipline of nursing are developed and reinforced. Prerequisite: Co-requisite: NUR 101, ENG 101, or ENG 103, BIO 201, PSY 107 BIO 202, PSY 204 B. Course Student Learning Outcomes 1. Identify human adaptation theory and ability to use nursing process to plan, implement and evaluate nursing care with a focus on family-centered needs. 2. Demonstrate the development of a therapeutic relationship with the client, family, and/or significant other(s) through the application of principles of communication to provide culturally-sensitive care. 3. Implement the role of the nurse as a member of the health care team and as provider of care. 4. Demonstrate increasing dexterity in the performance of basic psychomotor skills. 5. Explain and apply the legal, ethical and professional standards that govern safe nursing practice. 11 12 Berkshire Community College Student Pittsfield, Massachusetts Rotation Dates NUR 102 Agency I. NURSING PROCESS A. Assessing: 1) Collects subjective and objective data from multiple resources B. C. Analyzing 1) Uses established guidelines to identify accepted nursing diagnoses from collected data Planning 1) Uses critical thinking to identify expected client outcomes 2) Selects evidence-based nursing interventions that are individualized for the client from standard resources 3) D. Implementing 1) Initiates in a safe manner prescribed nursing interventions 2) Performs with dexterity psychomotor skills in various healthcare settings 3) E. II. Identifies normal variations of developmental needs across the life span Reports and records observations accurately Evaluating 1) Compares client responses to expected outcomes 2) Modifies plan of care based upon client response CLIENT – NURSE RELATIONSHIP A. Demonstrates the development of a therapeutic relationship with client and/or significant other(s) to provide culturally sensitive care. B. Maintains the client's right to privacy C. Conducts oneself in accordance with accepted legal, ethical and professional standards III. CLINICAL PORTFOLIO 13 Did Not Meet Expected Learning Outcomes Expected Student Learning Outcomes Met Expected Learning Outcomes Evaluation ___________________________________________ NUR 102 Expected Student Learning Outcomes Attendance Overall Clinical Evaluation: Punctuality _____ Met Expected Learning Outcomes Assignments _____ Did Not Meet Expected Learning Outcomes Instructors Comments: Student Comments: My signature indicates that I have read this evaluation Instructor: Student: Date: Date: Reviewed 5/14 14 NUR 106 LPN to RN Bridge A. Course Description An introduction to the organizing framework of the ADN Program for the LPNs The principles of the nursing process and the elements of critical thinking will be refined. The role of the associate degree nurse as provider of care, manager of care, and member within the discipline of nursing will be defined. The role transition from LPN to ADN Nursing will be discussed. Prerequisites: PSY 107, PSY 204, BIO 201, BIO 202, ENG 101, current LPN licensure and admission into the nursing program B. Course Student Learning Outcomes At the completion of the course, the student will: 1. Demonstrate use of the nursing process with emphasis on the ability to complete assessment data guide, identify priority nursing diagnoses, and complete a nursing care plan. 2. Compose a clinical journal entry that reflects principles of critical thinking. 3. Demonstrate ability to utilize the Learning Management System (LMS). 4. Identify role transitions experienced by practical nursing students bridging into the RN program. 5. Demonstrate competency in selected psychomotor skills. 6. Demonstrate competency on clinical calculations. 15 NUR 201 Physical and Mental Health III A. Course Description Refinement of nursing theory, practice and process. Nursing theory includes the interrelationships among human adaptation, human needs, developmental phases, and clients/nurse relationship. Complete psychological and physiological principles are emphasized from homeostasis through resolution. Nursing practice includes the performance with efficiency of basic psychomotor skills as a component of therapeutic nursing care in a variety of settings. Additionally, it includes the knowledge of scientific principles and their application in performing advanced psychomotor skills necessary to meet human needs. Nursing process includes the collection and interpretation of complex data for the purpose of arriving at a nursing diagnosis in order to plan, implement, and evaluate nursing care. The elements of critical thinking and the role of the nurse as provider of care, manager of care, and member within the discipline of nursing are refined. Prerequisites: Co-requisites: NUR 102, PSY 204, BIO 202, NUR 106 for LPN Mobility Students COM 104, 105, 106 or 107, SOC 105, and BIO 207 B. Course Student Learning Outcomes 1. Implement a prioritized plan of care that demonstrates critical thinking skills with an emphasis on health promotion, maintenance and wellness across the life span. 2. Communicate effectively by initiating and maintaining a therapeutic relationship with the client and/or significant other(s) to provide culturally competent care. 3. Implement the role of the nurse as member of the health care team in providing and managing care for a small group of clients. 4. Demonstrate competency in the performance of basic and advanced psychomotor skills. 5. Integrate the legal, ethical, and professional standards that govern safe nursing practice. 16 Berkshire Community College Pittsfield, Massachusetts Student Rotation Dates NUR 201 Expected Student Learning Outcomes I. NURSING PROCESS A. Assessing: 1) collects multiple, complex types of data B. Analyzing: 1) utilizes critical thinking to interpret multiple, complex types of data 2) derives nursing diagnoses/collaborative problems based on analysis of collected data C. Planning: 1) collaborates with the client and/or significant other(s) and health team members in developing a prioritized plan of care 2) selects evidence-based nursing interventions that meet the complex health promotion, maintenance and restoration needs of the client 3) selects nursing interventions in accordance with the client’s developmental needs D. Implementing: 1) demonstrates efficiency in the provision, delegation, and management of therapeutic nursing interventions 2) reports and records aspects of care accurately and completely 3) demonstrates efficiency in the performance of basic psychomotor skills 4) demonstrates efficiency in the performance of advanced psychomotor skills 5) maintains a safe care environment E. Evaluating: determines the extent to which the expected client outcomes have been achieved; revises plan of care as indicated II. CLIENT-NURSE RELATIONSHIP A. initiates and maintains a professional therapeutic relationship with the client, family, and/or significant others utilizing the principles of communication to provide culturally competent care B. maintains the client’s right to privacy C. conducts oneself in accordance with accepted legal, ethical and professional standards III. CLINICAL ASSIGNMENTS A. comprehensive care plan and Service Learning Older Adult assignments submitted on time. 17 Met Expected Learning Outcomes Clinical Site Did Not Meet Expected Learning Outcomes Clinical Focus NUR 201 – Expected Student Learning Outcomes – Page 2 Overall Clinical Evaluation: Attendance _____ Met Expected Learning Outcomes Punctuality _____ Did Not Meet Expected Learning Outcomes Assignments Student Comments: Instructors Comments: My signature indicates that I have read this evaluation Instructor: Student: Date: Date: Reviewed 5/14 18 NUR 202 Physical and Mental Health IV A. Course Description Completion of nursing theory, practice, and process Nursing theory includes the more complex interrelationship and alterations among human adaptation, developmental phases, and the client/nurse relationship. Integration of psychological and physiological principles are emphasized from homeostasis through resolution. Nursing practice includes the performance with proficiency of therapeutic nursing interventions in a variety of settings. The components of the nursing process are integrated with proficiency to achieve holistic nursing practice. The elements of critical thinking and the role of the nurse as provider of care, manager of care, and member within the discipline of nursing are integrated and focused on professional and entry-level practice issues. Prerequisites: Co-requisites: NUR 201, COM 104, 105, 106 or 107 NUR 206, an elective in History or Humanities and Fine Arts, ENG 102 or ENG 104 B. Course Student Learning Outcomes 1. Apply acquired critical thinking skills to provide care that emphasizes health promotion, maintenance and wellness for a diverse group of clients across the life span. 2. Communicate effectively by maintaining a therapeutic relationship with the client, family and/or significant other(s) to provide culturally competent care. 3. Practice independently and as a member of the health care team in providing and managing nursing care while incorporating state of the art technologies. 4. Demonstrate proficiency in the performance of entry level psychomotor skills based on best current evidence-based practice and accepted nursing standards. 5. Analyze and apply professional, legal and ethical standards of nursing practice as a safe entry level nurse with a commitment to life-long learning and professional growth. 19 20 Berkshire Community College Pittsfield, Massachusetts NUR 202 Student Rotation Dates Expected Student Learning Outcomes I. NURSING PROCESS A. Assessing: 1) collects multiple, increasingly complex types of data B. Analyzing: 1) utilizes critical thinking to interpret multiple, increasingly complex types of data 2) derives nursing diagnoses/collaborative problems based on analysis and discrimination of collected data C. Planning: 1) collaborates with the client and/or significant other(s) and health team members in developing a holistic plan of care 2) selects evidence-based therapeutic nursing interventions that meet the total health promotion, maintenance and restoration needs of the client 3) selects and adapts nursing interventions in accordance with the client’s developmental needs D. Implementing: 1) demonstrates proficiency in the provision, delegation, and management of therapeutic nursing interventions for a group of clients 2) reports and records aspects of care accurately and completely 3) demonstrates proficiency in the performance of basic psychomotor skills 4) demonstrates proficiency in the performance of advanced psychomotor skills 5) maintains a safe care environment E. Evaluating: determines the extent to which the expected client outcomes have been achieved; revises plan of care as indicated II. CLIENT-NURSE RELATIONSHIP A. independently maintains a professional therapeutic relationship with the client, family, and/or significant others utilizing the principles of communication to provide culturally competent care B. maintains the client’s right to privacy C. conducts oneself in accordance with accepted legal, ethical and professional standards III. CLINICAL ASSIGNMENTS A. comprehensive care plan and Service Learning Older Adult assignments submitted on time. 21 Did Not Meet Expected Learning Outcomes Clinical Site Met Expected Learning Outcomes Clinical Focus NUR 202 – Expected Student Learning Outcomes – Page 2 Overall Clinical Evaluation: Attendance _____ Met Expected Learning Outcomes Punctuality _____ Did Not Meet Expected Learning Outcomes Assignments Instructors Comments: Student Comments: My signature indicates that I have read this evaluation Instructor: Student: Date: Date: Reviewed 5/14 22 NUR 206 Nursing in Transition A. Course Description Application of nursing concepts related to the nurse as a member of the health care profession and individual as a consumer of health care. The role of the nurse is emphasized in relation to the historical development of the profession, legal, and ethical issues faced by nurses today, various educational employment, and community service options in nursing, and leadership roles and responsibilities. Prerequisite: NUR 201 Co-requisite: NUR 202 Spring Semester B. Course Student Learning Outcomes 1. Discuss the health care system, proposed reforms, current trends, and informatics. Focus on how these complex factors affect the health care consumer and the healthcare provider. 2. Identify factors related to the historical development of nursing which have had the greatest influence on present day nursing. 3. Describe current strategies of the professional organization in advancing the nursing profession, improving the quality of healthcare delivery, and political influence. 4. Discuss credentialing activities related to licensure and continuing education. 5. Describe a variety of educational, employment, and community service options available to the associate degree graduate nurse. 6. Apply legal and ethical principles to current dilemmas encountered in nursing practice. 7. Discuss the professional nurse’s role with regards to leadership and the delegation of nursing activities. 8. Identify the quality improvement projects in the health care setting. 23 EXL 225 Preceptor Program (Optional) A. Course Description Intensive clinical practicum designed to reinforce competency in nursing theory, practice, and nursing process abilities acquired during the first two introductory nursing courses. Synthesis of nursing theory with practice is planned under the direct supervision of an experienced staff nurse. Prerequisite: NUR 102 Summer and Intersession B. Course Student Learning Outcomes 1. Apply the nursing process to a small group of clients for an average of 24 hours a week for four/six weeks (64/128 hours). 2. Reinforce competency in clinical nursing knowledge, skills, and abilities acquired during the first two nursing courses. 3. Synthesize nursing theory with nursing practice in clinical areas compatible with the foci of the first two nursing courses. 4. Develop critical thinking and decision-making skills in the clinical area. 5. Participate in job related responsibilities of a registered nurse under the direct supervision of a clinical preceptor. 6. Develop priority and time management skills. 7. Implement legal, ethical, and professional rules that govern safe nursing practice. Course student learning outcomes will be defined by each student on an individual basis in conjunction with his or her clinical nursing faculty member. The objectives will then be discussed with the nursing faculty member teaching the course and adjusted as necessary within the parameters of the course. Finally, the course student learning outcomes will be mutually agreed upon by the student and the assigned preceptor. 24 III. GENERAL INFORMATION/ASSOCIATE DEGREE PROGRAM SUPPLEMENTAL POLICIES* *Please note the following policies are specific to the Associate Degree in Nursing Program. Students must comply with college policies located in the college course catalog and student policy guide. Communication Official Bulletin Board The official bulletin board is located next to Melville 239 (M239). Changes in school policy are posted on this bulletin board. Students may post communications on the student section of the bulletin board across from M239/M240. Information of interest to all nursing students is also posted on this board. SNO Bulletin Board Student Nurse Organization information is posted on the SNO Bulletin Board next to Melville 204 (M204). A list of meeting dates for the semester will be available on this bulletin board. Email/Internet Use All students are mandated to have a BCC e-mail account independent of the LMS. All students are provided with a BCC student e-mail account. Students must activate and utilize this account during their attendance at Berkshire Community College. Faculty communicate essential program information with students via this system. Students may opt to have their personal e-mail as a default to the BCC student email. Directions on how to accomplish this may be found on the BCC Homepage under student e-mail. Students are expected to follow the Internet acceptable use policy outlined in the BCC Student Policy Guide. Learning Management System (LMS) Students will be provided access information for the current Learning Management System (LMS). All clinical journals must be submitted via the LMS. CPR Policy Students must submit proof of current certification in cardiopulmonary resuscitation (CPR) prior to entry into any clinical area. Students are responsible for ensuring that their CPR certification is current throughout the program. The following CPR courses are acceptable for meeting this requirement: American Heart Association: Basic Life Support (BLS) for Healthcare Providers (2 year certification) American Red Cross: CPR/AED for Professional Rescuers and Healthcare Providers (2 year certification.) Criminal Offender Record Information (CORI) and Sex Offender Registry Information (SORI) Checks Each student accepted into the nursing program will be required to undergo CORI/SORI checks at the beginning of the fall semester for NUR 101/201, or at the point of transfer into the nursing program. 25 The Executive Office of Health/Human Services (EOHHS) requires a Criminal Offender Record Information (CORI) check on all persons hired or volunteering to provider services at all state hospitals and mental health facilities (M.G.L. Chapter 6, Section 167-178B). A student who refuses the CORI check or who is denied clearance will be removed from the nursing program. Alternative clinical experiences on or off campus is not an option. Sex Offender Registry Information (SORI) checks will be conducted for those programs where a CORI check is currently required. Eligibility guidelines follow the same procedure as with CORI. In a SORI report, please not that juvenile arrest and conviction information is reported. CORI and SORI checks are done by BCC employees certified by the state to receive and process confidential information. For questions, please contact Mary Martin, Student Affairs at 236-1602. A CORI check cannot be processed without written permission by the individual involved and documentation of a valid, government approved, photo ID (Driver’s License, Passport, etc.). A student who refuses to allow required record checks or other testing will be removed from the nursing program. Equipment Policy The nursing laboratory has equipment available for the student to use for community service projects and home practice. A student who wishes to borrow any equipment from the nursing laboratory should contact the lab coordinator and submit a written request. A student who neglects to return equipment will receive an incomplete grade for the semester. Exception/Extension Policy Following policies and procedures and meeting deadlines on time are professional responsibilities that faculty expect to see in nursing students. However, situations arise where individuals have unusual circumstances that warrant an exception to a policy, procedure, or an extension of a deadline. The Exception/Extension Policy provides an avenue for individual circumstances to be considered in relation to the policies of the college and the nursing program. The exception/extension policy does not apply to readmission requests. Academic standing may be considered in the decision to grant an exception/extension. All exception/extension forms should be submitted to the Director of Nursing for consideration. Guidelines for requesting exceptions include: Speaking to the person in charge as soon as possible. Meeting with faculty advisor for assistance in completing the exception/extension form. Seeking exceptions and extensions sparingly. A repeated pattern of requests for exception/extension may influence consideration. Requesting the exception/extension before the deadline. Waiting until after the deadline will lessen credibility. Showing the problem solving you have done and the resources considered in trying to meet the policy or deadline. 26 Mandatory Health Requirements Tdap/Td (tetanus, diphtheria, pertussis) – 1 dose of Tdap to replace a Td booster if not done within the last 5 years. MMR –(Measles, mumps, rubella) – 2 doses of MMR > 28 days apart or documented laboratoryconfirmed immunity to measles and mumps and rubella Varicella (chicken pox) – 2 doses of varicella vaccine, or serologic proof or immunity or medical proof of history of varicella disease. Hepatitis B – 3-dose series (#1 initial dose, #2: 1 month later, and #3 is given 5 months after dose #2.) or a laboratory titer proof of immunity. Health and Physical Exam – completed on BCC Health and Physical Exam Form, within six months (February to July) of entry into program TB – negative test or titer (must be kept current throughout the program) or negative chest x-ray within 5 years Please note: An Influenza – 1 dose of TIV IM or LAIV intranasally) every flu season is required by some agencies when the influenza vaccine is available (usually September/October). Proof of immunization or completion of a waiver form/note from a clinical agency or health care provider must be submitted to the BCC Immunization Records Office. Students should be aware that some clinical agencies may have restrictions or protocols with direct patient care for health care providers who are not immunized against influenza. Timeline: Requirements must be submitted to Donna Connors, Immunization Records Office, A100/413236-1614. Consequences of Failure to Comply Students must complete all health requirements in order to participate in clinical experiences. Personal Identification Information Students must provide current name, address, telephone number, and college email address at the beginning of each semester. This information will be provided to faculty for course related communication. Picture IDs Students are required to have a BCC picture ID for use in clinical agencies and for all course examinations. Student Membership on Curriculum Committee Membership will include one first and one second-year student representative. Membership may also include one alternate from each class. Students are asked to volunteer, and election of student representatives is determined by the faculty. Each member has one vote. The functions of the Curriculum Committee shall include, but not be limited to: A. Providing a forum for the review and evaluation of the existing curriculum with input from the student constituencies. B. Recommending new courses and/or changes. C. Developing and evaluating standardized format of nursing course syllabi based on suggested college format. D. Developing and evaluating tools for student and program evaluation. 27 IV. ACADEMIC AND CLINICAL POLICIES National Student Nurses’ Association, Inc. Code of Academic and Clinical Conduct Preamble Students of nursing have a responsibility to society in learning the academic theory and clinical skills needed to provide nursing care. The clinical setting presents unique challenges and responsibilities while caring for human beings in a variety of health care environments. The Code of Academic and Clinical Conduct is based on an understanding that to practice nursing as a student is an agreement to uphold the trust with which society has placed in us. The statements of the code provide guidance to the nursing student in the personal development of an ethical foundation and need not be limited strictly to the academic or clinical environment but can assist in the holistic development of the person. A Code for Students As students are involved in the clinical and academic environments we believe that ethical principles are a necessary guide to professional development. Therefore, within these environments we: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. Advocate for the rights of all clients. Maintain client confidentiality. Take appropriate action to ensure the safety of clients, self, and others. Provide care for the client in a timely, compassionate, and professional manner. Communicate client care in a truthful, timely and accurate manner. Actively promote the highest level of moral and ethical principles and accept responsibility for our actions. Promote excellence in nursing by encouraging lifelong learning and professional development. Treat others with respect and promote an environment that respects human rights, values and choice of cultural and spiritual beliefs. Collaborate in every reasonable manner with the academic faculty and clinical staff to ensure the highest quality of client care. Use every opportunity to improve faculty and clinical staff understanding of the learning needs of nursing students. Encourage faculty, clinical staff and peers to mentor nursing students. Refrain from performing any technique or procedure for which the student has not been adequately trained. Refrain from any deliberate action or omission of care in the academic or clinical setting that creates unnecessary risk of injury to the client, self or others. Assist the staff nurse or preceptor in ensuring that there is full disclosure and that proper authorization is obtained from clients regarding any form of treatment of research. Abstain from the use of alcoholic beverages or any substances in the academic and clinical setting that impair judgment. Strive to achieve and maintain an optimal level of personal health. Support access to treatment and rehabilitation for student who are experiencing impairment related to substance abuse and mental or physical health issues. Uphold school policies and regulations related to academic and clinical performance, reserving the right to challenge and critique rules and regulations as per school grievance policy. Adopted by the NSNA House of Delegates, Nashville, TN, on April 6, 2001 28 Student Behavior/Civility Policy Students are expected to always conduct themselves in a professional manner in the classroom, campus lab, and clinical area. It is the responsibility of each student to behave in a manner which does not interrupt or disrupt the delivery of or receipt of education within the classroom, lab, or any clinical facility. The determination of disruptive behavior will be made by the faculty member as per college policy. Talking with peers during formal presentations is disruptive to the class, and is unacceptable classroom behavior. All communication devices must be turned off or placed on vibrate during class lectures and examinations. If a student is expecting a call and must leave during class, the student should inform the instructor before class starts. Use of cell phones and PDAs in the clinical area must follow agency policies. Students with disruptive behavior will receive documentation of professional misconduct. Please refer to the Student Code of Conduct found in the Student Policy Guide Rights and Responsibilities for more information. Attendance Policies “Theory without practice is empty; and practice without theory is blind” (Immanuel Kant) Students must comply with all attendance policies in the student handbook, college catalog and student policy guide. Absenteeism and tardiness may result in withdrawal from the nursing program. Class Attendance This is an on-campus face-to-face course and class attendance is essential to academic success, safe clinical performance and competency. The faculty expects students to attend and actively participate in all scheduled lectures. A student who misses class is responsible for the content and assignments for the class, regardless of the reason for missing the class. Any student with excessive absenteeism, which is more than the number of hours the class meets per week, may be withdrawn from the course. (Weekly Class Hours are as follows: NUR 101 > 5 hours; NUR 102, NUR 201, NUR 202 > 4 hours). Class Promptness Students are expected to be seated and ready to participate promptly at the start of class. If a student is late and the instructor has started the lecture, the student should enter the classroom in the least disruptive manner and sit in the designated late seats. A late student is expected to complete the late form and submit it to the faculty member at the break. Excessive utilization of late seats may be brought to the course faculty for discussion. Students should make every effort to wait until break to leave class as leaving during class time and re-entering is disruptive to classmates and faculty. Campus Laboratory Attendance College labs are critical to performing optimal client care and practicing skills prior to clinical experiences. Each student is expected to attend campus laboratory on time for the full number of hours designated. Students must be prepared for all college laboratory sessions. A student who is absent from a campus lab or dismissed due to lack of preparation is responsible for making up the content of that lab. Clinical skills lab absences MUST be made up during designated make-up time. It is the responsibility of the student to contact and schedule make-up time with the lab faculty. All skills lab absences MUST be made up within one week of the student will not be allowed to attend clinical. The student may receive a failing grade for not meeting clinical student learning outcomes and may be withdrawn from the course. 29 Clinical/Data Collection Attendance Clinical courses provide experienced-based learning that supports the acquisition of essential clinical skills and knowledge. The credits allotted to each course determine the number of clinical hours required. Each student is expected to attend each clinical day on time for the designated number of hours, and be appropriately prepared to provide safe nursing care. Dismissal from clinical due to illness or for being unprepared for the clinical day constitutes an absence. It is expected that all clinical absences must be made up. Absences of more than 10% may result in a grade of (F) for the course. Excessive absenteeism in a clinical course prohibits faculty from adequately assessing achievement of clinical student learning outcomes and may result in the student being withdrawn from the course. Return from Absence-Health Clearance A health clearance is required before a student can return to clinical after an illness or injury if more than one week of clinical experience was missed (usually two clinical days). Health clearance is also required for conditions including but not limited to pregnancy, fractures, back conditions, surgery, psychiatric conditions, acute or chronic medical conditions requiring hospitalization; or any condition that warrants removal from class and/or clinical by a healthcare provider. A student seeking health clearance must present a written release from the healthcare provider at least one day before the next scheduled clinical experience. Substance Abuse/Impaired Student Policy Students enrolled in the program may be required by a clinical agency to undergo and pass a drug screening analysis in order to participate in a clinical experience at the site. Refer to BCC Student Policy Guide. V. ACADEMIC INFORMATION/POLICIES Academic Evaluation Students are expected to meet course objectives. Examinations for all nursing courses are developed around the major concepts of the organizational framework. A minimum grade of 75% in all nursing courses must be maintained in order to continue in the nursing program. Students must achieve a cumulative average of 75% on all exams (math, modular/unit and final exams). Each course may elect to add additional percentage points for required assignments once 75% has been achieved. During the semester, grades are not rounded. Final grades of 75 or higher will be rounded up or down by the next whole number. Any final grade of 74.9 or lower will be considered a failing grade. A student will receive a numerical grade for the theory and a satisfactory grade for the clinical component. In order to pass the nursing course, a student must achieve both a final grade of 75% or above in theory, and a satisfactory clinical grade. 30 Examination Policies Each student is required to bring a photo identification (BCC picture ID is preferred) for entry into all course examinations. All exams should be completed on the scheduled date. Any student arriving late will be allowed to write the examination providing no other student has finished the examination and has left the room. No extra time will be granted, and the student will be expected to hand in the examination at the termination of the scheduled time. If a test or exam is missed as a result of an emergency or unforeseen circumstance, the student must contact the designated instructor within twenty-four hours of the exam date. Failure to contact the designated instructor within twenty-four hours of the exam date will result in a grade of zero. Documentation of the emergency or unforeseen circumstance may be required. The exam must be made up before the next class or clinical experience. An alternate format of the test may be used. The use of any type of electronic devices during nursing department examinations is prohibited. This includes, but is not limited to, cell phones, PDAs, and graphing calculators. All such devices must be secured in purses or backpacks which must be placed either in front or in the back of the room where the test is being held. Student should not have any personal items or wear hats during exams. Test Review – Individual and/or Group Review of examinations will be held at the discretion of the individual faculty team. There will be one group exam review held. Individual exam reviews will not be conducted by the faculty. Students may not record verbally or in writing any of the actual test questions. All pocketbooks, bags, and electronic devices are to be left in the front/side of the classroom. Retake of Exams There are no retakes of any nursing exam. Grade Appeals A student who alleges an error or an injustice in the grading process may file a grievance under the Student Grievance Procedure. For purposes of a grade appeal, the Vice President of Academic Affairs or said designee shall serve as the Student Grievance Officer throughout the grade appeal process. See Student Policy Guide for further information. Academic/Clinical Failure A student may be readmitted into a failed nursing course only once. For example, a student who fails NUR 101 may repeat NUR 101 one time only. Students with two nursing course failures (elsewhere, at BCC, or in combination) will not be admitted or re-admitted into the program. Clinical failure will result in overall course failure regardless of the course theory grade. A student must have a grade of C (73) or better in all required science and co-requisites for the Associate Degree in Nursing Program: ENG 101, ENG 102, PSY 102, PSY 107, PSY 204, BIO 201, BIO 202, BIO 207, SOC 105, COM, and a general education course. 31 Readmission Following Failure A student who is unsuccessful on either theory or clinical may be required to complete a remediation plan, including validation of clinical skills, math competency and successful demonstration of previously learned content by examination, prior to return. Failure to meet the remediation plan at a satisfactory level may result in removal from the course. Remediation fees are assessed dependent upon the individual student’s remediation needs. Readmission to the nursing program is granted on a space available basis. Refer to Petition for Re-admission to a Health Program available from the Director of Nursing or the Dean of Nursing, Health and Social Sciences. Clinical Dismissal Faculty reserve the right to withdraw a student who engages in activities which place the client in physical or emotional jeopardy or for inappropriate or excessive absenteeism. A student who is dismissed from the nursing program due to unsafe clinical performance or inappropriate behavior which endangers, or has the potential to endanger, the physical or emotional well-being of the client will not be readmitted. This student will receive an “F” for the course, regardless of course theory grade. Faculty will utilize the ANA Code of Nurses and National Student Nurses’ Association Code of Academic and Clinical Conduct as a guideline in making their decision. Readmission after Clinical Failure At the direction of the nursing faculty, a student who demonstrates safe clinical practice, but has not achieved the expected clinical outcomes for a specific nursing course, may be readmitted to that course on a space available basis within two years. Refer to Petition for Re-admission to a Health Program from the Director of Nursing or the Dean of Nursing, Health and Social Sciences. Readmission to Program after Extended Absence Students returning following a one to two years’ absence will be required to demonstrate retention of prior knowledge of successfully completed courses (NUR 101 and/or NUR 102) via secured HESI computerized exam(s) prior to returning to the program. HESI Exit Exam Students are expected to complete designated HESI modular exams during each nursing course. The purpose of these modular exams is to assist the student in identifying areas of weakness and to allow practice taking a computerized exam. Results of these exams are not calculated into the student’s course grade, but they are essential for completion of the course and successful NCLEX preparation. During the final semester of the ADN program, students will be scheduled to complete the mandatory HESI NCLEX exit exam. A student who does not achieve a predetermined score on this exam is required to complete a mandatory remediation program prior to sitting for the final course examination in NUR 202. Failure to take the HESI exam may result in a course incomplete. Plagiarism Plagiarism, the claiming of the “words and ideas of another as their own”, is considered a violation of academic integrity. (APA Ethics Code Standard 8.11, Plagiarism). Students who plagiarize on assigned classroom and clinical assignments may be subject to disciplinary action. Disciplinary action may include failure on the assignment, which could result in course failure. Refer to Student Policy Guide. 32 Professional Misconduct The school defines professional misconduct as behavior that jeopardizes or potentially jeopardizes patients, colleagues, the school or affiliating agencies. It includes, but is not limited to: Violation of confidentiality of information related to patients or affiliating agencies. Behavior that may disrupt the normal activities of the school or affiliating agencies, or violates their established policies and procedures. Physical or verbal abuse. Disciplinary action may include dismissal from the program. Refer to Student Policy Guide. VI. CLINICAL INFORMATION/POLICIES Clinical Absences - Reporting In the event of an absence from the clinical laboratory, the student is asked to take the following actions: Clinical Sites If clients have been assigned in the clinical area, the student will notify the designated clinical area of his/her absence for that particular day. The student should obtain the name of the person to whom the absence is reported. Community Notify the agency first and then notify your clinical instructor according to instructions given at the beginning of the rotation. Campus Laboratory/Simulation Attendance at campus laboratory is mandatory and is considered as a clinical absence when validation of skill is scheduled. Student must notify the instructor if ill or if student anticipates being absent for any reason. Whenever possible, please notify and verbally confirm with the laboratory faculty. In the event of an emergency or inability to reach the faculty member in advance, please call the program secretary at 413-236-4634 first to relay the message. If there is no answer the notify BCC Security directly at 413-236-1010 to give a message to the clinical laboratory faculty through the in-college phone line for M206 (ext. 6313). Planning Ahead If the student knows that he/she will be absent before the actual day on which clinical or data collection is assigned, student should notify the clinical instructor as soon as possible so that assignments are not made unnecessarily. No Call/No Show Failure to notify a faculty member of absence or tardiness according to the clinical call-in procedure demonstrates a lack of personal responsibility and will result in documentation of professional misconduct. Latex Allergy Every effort has been made to make the campus laboratory as latex-free as possible. A student who has a latex allergy must self-identify to the clinical faculty and the campus lab coordinator. Reporting must be made during the first week of school. 33 Smoking Policy A student in the Associate Degree Nursing Program is not allowed to smoke in uniform (or other identification denoting affiliation with BCC such as name badge). Clinical Site Assignment Information Clinical Placement Form Each student is required to read and sign the Clinical Placement form (copy available for reference in the back of the Student Handbook). Change in Assignments The faculty reserve the right to change a student’s clinical assignment and/or facility at any time during the semester. The student will receive notification by the faculty of the change in assignment. Dress Codes The BCC nursing uniform which is purchased from the designated uniform company is required for all experiences taking place in clinical settings. The uniform consists of: standard skirt or slacks and shirt. white stockings or socks (with slacks). clean, white shoes; white sneakers with minimal logos as well as white nursing clogs with backs/straps are acceptable. White lab jackets and sweaters may not be worn while giving direct client care. A white T-shirt or ¾ length sleeve T-shirt may be worn under the required uniform top. Hair must be clean, neat, and off the collar. No fad designs or colors will be accepted. Hair cannot fall in front of the shoulders while providing patient care. Mustaches, beard, and or side burns must be neatly trimmed. No artificial nails, including but not limited to, bonding, acrylics, gels, tips, wraps, tapes or nail jewelry. Nail polish is permitted but must be freshly maintained and free from chips. No chewing gum during clinical time. Perfume, cologne or any other substance that could potentially create an offensive odor for patients or staff should not be used in the clinical site. Acceptable jewelry to be worn with the uniform consists of: name pin – required watch with a sweep second hand – required plain wedding band small, unobtrusive earrings may be worn; no visible body piercing and/or tattoos; no fad devices may be worn Mental Health street clothes of a professional style clothing that is neat, clean, washable, and does not obstruct movement shoes that have a back strap and non-slip soles; open-toed shoes are not acceptable no necktie/scarves, necklaces, chains, or dangling earrings name pin – required 34 Community Each student must follow the dress policy of the specific agency. Dress must be professional; no jeans, non-nursing sneakers, sweatshirts, T-shirts, short tops or low riding slacks exposing skin will be allowed at any time. A BCC name tag must be worn by the student while in the community. Essential Functions Each student is required to read and sign the Essential Functions form. Each student must be able to meet all of the criteria stated on the form located in appendix. Facilities for Storage of Coats/Valuables or Equipment Storage Facilities Lockers or equivalent storage facilities may be provided at all county hospitals. However, the student is encouraged not to bring valuables into the clinical setting. Leaving the Clinical Site Except in an emergency, an ADN student may not leave the clinical area/hospital campus during the assigned work hours including breaks via automobile, public transportation, etc. The student is expected to utilize the designated hospital break area or cafeteria for all breaks. A student must contact clinical faculty in the event of a personal emergency that requires the student to leave the clinical site. Failure to notify the clinical faculty is considered abandonment of patient and will result in documentation of professional misconduct. Mandatory Clinical Agency Requirements Each student must complete mandatory clinical agency requirements prior to the start of the clinical experience. Parking Parking is available at all clinical sites. Each student is expected to adhere to the parking regulations for students at the facility. Professional Liability Insurance Professional liability insurance is required by contract for the protection of the individual student, faculty members, and clinical facilities used by the nursing program. Each nursing student will assume the responsibility for payment of this insurance coverage which is charged by Student Billing to the student’s account prior to the first semester of each year of the program or upon admittance if mid-semester. Substance Abuse/Impaired Student Policy Students enrolled in the program may be required by a clinical agency to undergo and pass a drug screening analysis in order to participate in a clinical experience at the site. Refer to BCC Student Policy Guide. Student Injury/Occupational Exposure Injury A student must immediately report any injury in the clinical area to the assigned clinical instructor. The faculty member and student will then contact the appropriate healthcare provider/or nursing supervisor for that agency. The agency shall provide work-related first-aid treatment to any student needing such care at no cost to the agency. The agency will bill the student’s insurance company; the cost of the deductible is the student’s responsibility. The agency shall not be obligated to furnish any other medical or surgical service. If a student wishes follow-up, the student should make an appointment with his/her own healthcare provider. 35 A student who sustains any type of injury in the evening are required to go to the emergency department for first-aid treatment. The emergency department will bill the student’s insurance company of this visit in compliance with Berkshire Community College’s contracts with local agencies which state that the cost of these visits will occur at no cost to the agency. This means that the cost of the deductible is the student’s responsibility. Occupational Exposure The student is responsible for any cost incurred as a result of any occupational related exposure. This includes the cost of evaluation/testing, treatment, counseling, and follow-up care. In the event of a needle stick or occupational exposure to body fluids in the acute care setting, the student is required to immediately contact the appropriate faculty member and fill out an agency incident report. Testing of the student and the source will be done by Occupational Health/Employee Health Services. After regular business hours of Occupational Health/Employee Health Services, the student will be directed to the emergency department if the source is known HIV/positive. In the event of needle-stick or occupational exposure to body fluids in an assigned community agency, the student is required to immediately contact the appropriate faculty member and follow agency protocol for documentation. Permission for, and testing of the source, will be carried out according to the agency’s policies. The student is responsible for his/her own care via primary care provider for evaluation/testing, treatment, counseling and follow-up. The student’s primary care provider is responsible for contacting the agency regarding confidential results of testing from the source. Student Medication Administration Policy Objective: To clarify the responsibility of faculty and students in the administration of medications. The student must be deemed competent in clinical calculations prior to medication administration. The student may administer oral/topical IM/SC medications upon successful completion of the competencies verified by the faculty member in the laboratory and clinical settings. Verification of competency will be completed in each clinical rotation. A student may independently administer oral, topical, eye, nasal and ear solutions/ointments, subcutaneous and intramuscular medications, based on the faculty’s discretion following verification of competency. The student must have verification (double-check) of administration of all medications with the medication administration record by the faculty or licensed staff member prior to the administration of any medication. The student is directly supervised in all aspects of the administration of IV medications, including tubing and dressing changes by a faculty member/RN. As per agency policy, the student may mix and administer IV meds (by drip), change, and flush IV tubing including PICC, midline, and central catheters; and perform central line IV dressing changes. At the discretion of the faculty, the student may give IV push medications in the final semester of the program. Administration of IV push medications must be directly supervised by the faculty and in adherence to agency policy. Additional Information/Summary: All medications must be checked by the faculty member prior to administration. The degree of supervision by faculty members is dependent upon the level of the student 36 and the completion of various medication competencies. The student may have a licensed nurse on the clinical unit supervise medication administration once the faculty member has given approval. The student shall never administer any IV medication without the direct supervision of the faculty member/RN regardless of the level of the student. The administration of blood products requires that the unit members be check by two licensed nurses. The student may not be one of the persons to check blood numbers. However, the student may perform assessments related to the administration of blood products. Documentation is to be completed on the Medication Administration Record as per institution policy. Signatures for all medications administered must be legible and include full legal name and title (i.e. Jane Jones, BCC SN). Transportation Each student is responsible for transportation to and from clinical agencies. A student may be placed in clinical agencies throughout Berkshire County during the clinical portion of each nursing course. Evaluation of College Laboratory and Clinical Rotation Experiences College Laboratory Psychomotor skills will be evaluated on a satisfactory/unsatisfactory basis according to the criteria developed for each skill. It is the student’s responsibility to prepare for and to schedule evaluation sessions with his/her instructor. College laboratory performance must be satisfactory in order to pass that required nursing course. Clinical Conferences Pre-conference may be held prior to the clinical experience at the discretion of the faculty. The purpose of pre-conference will be to address the assessment and planning phases of the nursing process specifically related to the student’s client care assignment for that clinical day. Post-conference may be held at the end of the clinical experience at the discretion of the faculty. The purpose of the post-conference will be to address the intervention and evaluation phases of the nursing process specifically related to the student’s client care assignment for that clinical day. Each student is expected to actively participate in clinical conference. Clinical Evaluation Conferences A student/instructor evaluation conference will be scheduled at the end of each clinical rotation. Each student is expected to complete a “Student Self-Evaluation” form prior to meeting with clinical instructor for evaluation conference. Faculty will complete an “Expected Student Clinical Outcomes” form for each student in their clinical group. Conferences throughout the semester may be initiated by the student or instructor as the need arises. The instructor will meet with the student during a clinical laboratory rotation in which a problem area has been identified and documented in order to discuss ways in which the student might overcome the problem(s). Expected Student Learning Outcomes The “Expected Student Learning Outcomes” form contains two columns: “Met Expected Student Learning Outcomes” and “Did Not Meet Expected Student Learning Outcomes”. 37 1. 2. 3. “Specific Evaluation Criteria Related to the Clinical Evaluation form” for each course will serve as the standard for determining if the student “Did” or “Did Not” meet expected student outcomes. Faculty will make written comments on the form related to the student’s major area(s) of strength and major area(s) needing improvement. Clinical evaluations for the related nursing course are completed according to the clinical configuration of that particular nursing course. The student will be evaluated as “Satisfactory” or “Unsatisfactory”. The student must be satisfactory at final evaluation to pass the course. Clinical Evaluations in Community Agencies Specific guidelines for the evaluation of students in a community-based setting will be determined by the appropriate faculty team and discussed with both agency personnel and the student in his/her clinical group. In a community-based agency, the agency personnel to whom a student is assigned will complete an evaluation of that student. Unsatisfactory performance in a community agency may result in a clinical failure. 1. At the end of each semester, all the expected student outcomes must be satisfactorily met in order to pass the related clinical experience. 2. Unsafe performance is a major criterion in determining a student’s clinical grade. A student who is determined to be unsafe will be governed by the nursing division policy on Clinical Failure/Dismissal. 3. Each student will not perform nursing activities/skills without supervision of the clinical instructor or designated preceptor unless permission to do so is granted by the BCC faculty member. 4. A student performing in the clinical setting should not engage in any activities that have not been taught by a faculty member from Berkshire Community College in either the classroom or clinical skills laboratory. This policy will also apply to the EXL 225 Preceptor Program. 5. Each student is responsible for notifying faculty of any problems in the clinical area promptly. VII. NURSING PROGRAM ADMISSIONS/WITHDRAWAL POLICIES AND PROCEDURES In addition to the specific nursing program policies and procedures noted below, nursing students are governed by the general college policies and procedures as noted in the BCC Student Handbook. Admission into the Associate Degree Nursing Program Admission into the nursing program is dependent upon completion of the ADN matriculation form which is available in the Admissions Office. A grade of “C” or better is required in all co-requisite classes for graduation from the nursing program. Transfer students accepted with a previous nursing course failure will be dismissed from the program if they have a second failure. Maintenance of Acceptance Status A student accepted into the nursing program must pay the tuition and fees bill in August in order to maintain acceptance status. Failure to comply with this request will lead to removal of the student’s name from the acceptance list. 38 A student must have a grade of C (75) or better in all required science and co-requisites for the Associate Degree in Nursing Program (ENG 101, ENG 102, PSY 107, PSY 204, BIO 201, BIO 207, SOC 105, COM course, and a general education course). Deferred Acceptance A student accepted into the nursing program who did not wish to start nursing classes for the year accepted may defer admission only once. A brief note describing the request for deferral must be given to the Admissions Office prior to the start of fall classes in order to maintain acceptance status. This policy will also apply to a student withdrawing/failing. Withdrawal in Good Standing A student who withdraws from the nursing program in good standing (a passing grade of 75 and satisfactory clinical performance) may apply for readmission. The student should meet with the Director of Nursing for an exit interview and to obtain information regarding the readmission process. A student leaving the program for any reason through the withdrawal period, as stated on the academic calendar, is responsible for the withdrawal procedure. The student should consult the BCC catalog for further information. Medical Leave of Absence A medical leave of absence may be granted for a student in the nursing program who is in good standing in both theory (75% average or above) and clinical. The student should refer to the BCC College Catalog for information on obtaining a medical leave of absence. Transfer Students A student interested in transferring from another degree program must meet all of the admission requirements and complete challenge exams and validation of clinical skills prior to admission. In addition, a student with two nursing course failures (elsewhere, BCC, or in combination) will not be admitted into the program. Timeline for Meeting Program Requirements Each student must meet the program admission and graduation requirements in effect at the time of admission, deferred admission, or readmission into the nursing program. VIII. LEGAL RESPONSIBILITY RELATED TO NCLEX – RN In the event that an applicant has ever been convicted by a court of law, or is convicted during his or her tenure in the nursing program, the student should be aware that he/she may be denied the right by the Massachusetts Board of Registration in Nursing to sit for the National Council Licensing Examination (NCLEX-RN) which leads to RN licensure upon graduation. It is the student’s responsibility to initiate the process. See Licensure Policy 00-01: Determination of Good Moral Character Compliance, www.mass.gov/dph/boards/rn 39 IX. STUDENT RECORDS College Records Any student may withhold public disclosure of any or all items of so-called “Directory Information” by written notification by the Dean of Student Affairs and Enrollment Services within two weeks after publication of this notice in the annual Student Policy Guide. The term “Directory Information” includes a student’s name, confirmation of enrollment, degree earned (if applicable), and major course of study. Program Records All clinical evaluations on file are destroyed two years after a student’s date of graduation. This policy exists for the protection of the graduate as the validity of the evaluation may diminish over time. The composites and evaluation forms of a student who has taken a leave of absence or who has withdrawn from the program will be kept on file for three years. X. GLOSSARY OF TERMS Client/Nurse Relationship The client/nurse relationship is a professional, interpersonal situation that occurs when the client and nurse agree to interact to achieve mutually determined health-oriented goals. The nurse regards the client as a holistic being and an active participant in the process of maintaining or regaining homeostasis. It is the client’s right to receive safe, informed quality care which upholds the client’s Bill of Rights and recognizes available resources. The nurse, through various roles as provider of care, client-teacher, communicator, manager of client care, and member within the profession of nursing, ensures the client’s right to receive such care. In accomplishing their goals, a therapeutic relationship is developed. There are four phases in this therapeutic relationship: preinteraction, introductory, working, and termination. The length of time in each phase can be variable. Graduates of the Berkshire Community College Associate Degree in Nursing Program are able to provide safe and effective care to clients by assuming the following roles in the delivery of individualized nursing care: Provider of Care The graduate is responsible for the delivery of safe, effective, and proficient care to clients. The five-step nursing process is the primary methodology utilized by the nurse in the delivery of care to individuals in diverse health care settings. Manager of Care The graduate is proficient in both locating and organizing services for the client and collaborating with other healthcare providers to coordinate and delegate care in a responsible and appropriate manner. The graduate is able to prioritize needs and provide care for a variety of clients, and to seek assistance in unfamiliar or complicated situations. Member of the Health Care Team The graduate is recognized as a vital and active member of the profession of nursing who provides for clients in a manner consistent with acceptable legal and ethical standards. The graduate recognizes the influence of political, economic and societal forces upon the practice of nursing and advocates for clients rights and the delivery of quality health care. Continuing education through formal programs, on the job experiences, and professional resources are recognized as essential to the continued interest and personal involvement in the 40 discipline of nursing. Nursing actions are performed to help the client to adapt to conditions within self or environment. Critical Thinking A method used to assess a situation holistically, develop assumptions from clustered data, arrive at inferences; and evaluate the outcome. The critical thinker has practical and situational knowledge necessary to be aware of alternate solutions, and is guided as well by written resources and professional experts. Cultural Competence Cultural competence consists of cultural awareness, knowledge, skill, encounters, and desire. Culturally competent nurses understand their personal world values and principles and those of clients in the communities they serve. Their behavior demonstrates attitudes, policies and structures that allow them to adapt to and understand, communicate, and care for various cultures, avoiding stereotyping and misapplication of scientific knowledge. Reassessment of values and adapting to diversity is an integral part of their practice. Evidence-Based Practice The deliberate practice of obtaining the most current, best evidence within nursing and the health disciplines in order to make reasonable judgments and decisions in providing appropriate interventions in the care of clients. Evidence based practice allows for the integration of research data, clinical guidelines and outcome assessments into the clinical setting. The goal of utilizing evidence based practice is to avoid ineffective and potentially risky treatments, instead of employing those with statistically significant effectiveness in improving client outcomes. Health Care Team Care of clients under a multi-disciplinary team comprised of nurses, healthcare providers, social workers, case managers and other healthcare personnel who work in a collaborative manner to contribute to the well-being of the client. Informatics Informatics is the management of computer-based information systems; use of information and technology to communicate, manage knowledge, mitigate error, and support decision making. Service Learning Service learning emphasizes engaged learning with the goals of active citizenship, community involvement, social responsibility, and life-long learning. When service is used as the basis for critical reflection, students better understand their roles and responsibilities as citizens. Therapeutic Nursing Interventions Selected practices and procedures whose focus is a holistic approach to the promotion and maintenance of an optimal level of health. The nursing process is utilized to identify and assist in the management of risk factors and health alterations. XI. FORMS 41 42 BERKSHIRE COMMUNITY COLLEGE Clinical Placement Policy Form I, (student name), a student in the Associate Degree Nursing Program at Berkshire Community College, understand and agree that as a student in the Associate Degree Nursing Program, I can be sent to any clinical site in Berkshire County at the discretion of the Faculty. Clinical placements may include day, evening and weekend clinical rotations throughout the Program. Printed Name: Student Signature Date: 9/14 43 44 Berkshire Community College Associate Degree Nursing Program Essential Functions ****************************************************************************** Berkshire Community College seeks to provide equal access to its programs, services and activities for people with disabilities. Therefore, to the extent practicable, the College will endeavor to make a reasonable academic adjustment for an applicant with a disability who is otherwise qualified. The Essential Functions of a student enrolled in the ADN Program requires that the student, with or without reasonable accommodations, must be able to: 1. Demonstrate the ability to perform essential functions for a maximum of an 8-hour shift. 2. Demonstrate the ability to protect a patient when the patient is standing and ambulating on all surfaces with or without the use of assistive devices, including canes, crutches and walkers. 3. Demonstrate the ability to safely move a patient over 100 pounds from one surface to another using the appropriate level of help. 4. Demonstrate safe body mechanics in the process of all patient treatments, including lifting and carrying small equipment (under 50 pounds) and moving large equipment (over 50 pounds). 5. Demonstrate the ability to manipulate dials on equipment. 6. Demonstrate the ability to coordinate simultaneous motions. 7. Demonstrate the ability to perform occasional overhead extension. 8. Demonstrate the ability to hear blood pressure, heart and lung sounds with or without corrective devices. 9. Demonstrate the ability to palpate soft tissue including pulse, muscle and bones. 10. Demonstrate the ability to perform nursing interventions such as sterile procedures, dressing changes and administer medications (including dosage calculations when necessary) following infection control procedures. 11. Display adaptability to change. 12. Establish effective relationships with others. 13. Communicate effectively, safely and efficiently in English by: Explaining procedures Receiving information from others Receiving information from written documents 45 Exhibiting appropriate interpersonal skill (refer to ANA Code for Nurses) Analyzing and documenting assessment findings and interventions 14. Distinguish color changes. 15. Detect an unsafe environment and carry out appropriate emergency procedures including: a. Detecting subtle environmental changes and odors including but not limited to the smell of burning electrical equipment, smoke and spills. b. Detect high and low frequency sounds, including but not limited to alarms, bells, and emergency signals. These are the Essential Functions of the Associate Degree Nursing Program. If there are any reasons why you may not be able to perform these functions with or without reasonable accommodations, you should notify the Program Director as soon as possible. I have read and am aware of the policy regarding Essential Functions. I understand that if there are any reasons I cannot perform these functions, I must notify the Program Director to arrange reasonable accommodations or innovative assistance. _______________________________ Student Signature _________________________ Date Student Name Reviewed Workshop 5/07 46 Clinical/Field Work Affiliate Random Drug Screening Analysis Notification to Students Please be advised that students enrolled in the following Health and Behavioral Sciences programs may be required by an agency to undergo and pass a drug screening analysis in order to be eligible for placement in a clinical or fieldwork facility. Students who are assigned to clinical or fieldwork experiences at the facilities may be required to undergo and pass random drug screening analysis in order to remain in the facility. Students who either fail to pass, or refuse to submit to, a drug screening analysis will be deemed ineligible for clinical placement which may affect their status in the program. If you have any questions pertaining to this policy, please contact the Office of the Assistant Dean of Academic Affairs, Division of Health and Social Sciences. Programs in which students may be subject to Drug Screening Analysis Criminal Justice Early Childhood Education Human Services Massage Therapy and Bodywork Nursing – Associate Degree Nursing – Practical Nursing Physical Fitness Physical Therapist Assistant Respiratory Care By my signature, I acknowledge that I have been provide with notification that clinical or fieldwork facilities may require me to undergo and pass a drug screening analysis. I am aware if I do not pass, or if I refuse to submit to a drug screening analysis, I will be ineligible to participate in the clinical or fieldwork component of my program. Student Name (Printed) Student Name (Signature) Date 47 48 College Closing Policy BCC Day Classes A decision will generally be made by 6:00 a.m. if the college will be delayed in opening, or if the day classes are cancelled and the college will be closed. If classes are cancelled or the college is closed, only essential employees (as designated in advance) should report to work. For Nursing Students (LPN & ADN): Students and faculty should check with radio, TV, or main operator before leaving their home for a clinical site. (The phone system will most likely have the information before the other media.) If the school is closed, for both day and evening classes, there is no clinical (day or evening). If school is open: For students and faculty traveling a distance during inclement weather, a window of 2 hours (from 6:00 AM) will be allowed for late arrival. If students arrive BEFORE faculty, they should wait in a common area until the faculty member arrives. If the faculty member does not arrive within the 2 hour time period, and notification to students has not been made, students should LEAVE the clinical site. BCC Evening and Saturday Classes A decision will generally be made by 3:00 p.m. if BCC evening classes are cancelled and by 7:30 a.m. on Saturday. Evening Classes Cancellation: Keeping in mind that evening clinicals start at 3:00 PM, faculty and students on their way to clinical sites should be alert to the possibility of school closings and listen to the radio station carrying school closings. (See list below) If Saturday classes are cancelled, clinical is cancelled. Sunday clinical is at the determination of the DON and Dean based on forecasts and experience. If Sunday clinical is cancelled, faculty will be notified and should initiate the phone tree to alert students of the cancellation. For All clinical, practicums, and Experiential Learning Early Childhood Education, Physical Therapist Assistant, Complementary Care (Massage Therapy), Respiratory Care, and Human Service : 49 If Berkshire Community College is closed but the clinical site is open, and has appropriate onsite supervision, students should use reasonable discretion in determining if they can travel safely to the site from their home. If a student determines he/she cannot reach the clinical site, notification should be provided to the site and academic faculty. As long as clinical supervision is provided at the site, students may attend their scheduled clinicals. If their facility is closed and Berkshire Community College is open, the students will follow individual program policy in their Student Handbooks. Early Closing Employees should await notification from the Human Resource Office regarding early release due to inclement weather. Employees who leave before notification must use vacation, personal, or comp-time. Internet Sites, TV, and Radio Stations For cancellations or delay in openings, check the following: BCC: 413-499-4660 www.berkshirecc.edu Station WBEC 1420 AM / Live 95.5 FM WUPE 1110 AM / WUPE 96 FM WBRK 1340 AM / STAR 101.7 FM WSBS 860 AM WNAW 1230 AM WMNB 100.1 FM School Closing Network Capital News 9; The Times Union; WFLY – Fly -92; WGY 810 WGY; WNYT TV; WRGB TV; WRVE-The River; WTEN TV; WYJB-B95.5; WXXA TV WKZE 1020 AM / 98.1 FM WTIC/WRCH/WZMX – CBS RA – Hartford Storm Center WWLP – Channel 22 50 BERKSHIRE COMMUNITY COLLEGE PITTSFIELD, MASSACHUSETTS 01201 ASSOCIATE DEGREE NURSING PROGRAM Student Handbook Statement of Understanding I state that I have received a copy of the Student Handbook for the Associate Degree Program in Nursing. I have read the information within and understand that I am responsible for the policies and procedures and agree to abide by them while enrolled in the Associate Degree Nursing Program. I understand that noncompliance with any of the policies and procedures may be grounds for my withdrawal from the nursing program. Printed Name Signature Date 9/14 51