Guidelines and Tools for the Orientation of
New Clinical Nursing Faculty to Clinical
Facilities/Hospitals Prior to Conducting
Student Rotations
(11/07/2013)
These materials have been compiled by the LANRC Advisory Board to establish
consistent expectations and provide useful guidelines for clinical facilities and
schools in conducting orientation for nursing clincal faculty in the Los Angeles
region. Documents and “example” tools may be copied, adopted, and/or modified
for use as needed to support individual faculty orientation processes.
References:
Adapted from Orange County Long Beach Consortium, Huntington Memorial Hospital, Kaiser
Permanente Southern California Hospitals, & Providence Healthcare Instructor Orientation
Tools.
Date
EXAMPLE
Dear Education Faculty Members,
On behalf of _________ Hospital Medical Center, we would like to Welcome you to our facility
and discuss some important issues related to orientation procedures for clinical faculty, and for
students who will be completing clinical rotations at our facility.
Consistent with current regulatory requirement and ________ (name of Hospital or Corporation),
all clinical faculty must complete the following prior to taking students to the clinical rotation:
1) Contact the facility’s student coordinator at least 2 weeks prior to start of clinical
rotation. Complete Instructor Orientation Requirement Self-Checklist prior to meeting
with the coordinator (Example attachment A)
2) Complete the Student Profile form (Example attachment B)
3) Post clinical objectives and/or course syllabus on the nursing unit(s) no later than the
first day when students will be providing direct patient care.
4) Arrange for and/or complete orientation for faculty to the hospital and/or nursing units
prior to bringing students to the facility (Example attachment C for contact information,
and Example attachment D for Unit Orientation Checklist).
5) Arrange for and/or provide student orientation to the hospital and nursing unit(s) prior to
students providing direct patient care at the facility (if Facility orientation is online –add
link, scheduled if in person or provide Self Study Module).
6) Review patient care standards, policies & procedures specific to the hospital (Facility to
decide how this information is provided).
7) Review clinical documentation requirements (including computer orientation, if
appropriate).
8) Review additional attachments Examples E and for a Preceptorship Communication
Tool and Preceptor Expectations/ Guidelines.
Given the turn-over in clinical faculty, importance of patient safety, and the ongoing need to
meet regulatory requirements of the clinical agencies, all clinical agencies should provide new
and returning clinical faculty with an orientation to the agency and/or nursing units
Including, but not limited to, the following:
1)
A tour of the facility.
2)
Contact information for obtaining room for pre/post-conferences (attachment B).
3)
Copy of the policies & procedures for medication administration.
4)
Copy of the policies & procedures for blood glucose monitoring.
5)
Procedure for obtaining identification (badges etc.)
6)
Information on parking
7)
Copy of the policies & procedures for posting of students; assignments.
8)
Clinical documentation (including computer access & charting, if appropriate).
Students who will provide direct patient care at each clinical agency should receive an
orientation by the clinical faculty or designated other to the agency and/or nursing unit(s)
including, but not limited to, the following:
1)
A tour of the facility.
2)
Copy of the policies & procedures for medication administration.
3)
Copy of the policies & procedures for blood glucose monitoring.
4)
Information related to:
a.
Procedure for obtaining identification (badges etc. when required by the agency).
b.
Information on parking.
c.
Facility mission, vision, philosophy, and/or values.
d.
Patient rights & responsibilities.
e.
Confidentiality
f.
HIPAA
g.
Age-appropriate care.
h.
OSHA bloodborne pathogens and infection control procedures.
i.
Hazardous substances & chemicals
j.
Hospital/electrical safety.
k. Clinical documentation (including computer access & charting).Thank you all in
advance for your compliance with these orientation recommendations for clinical faculty, and
students. By providing adequate faculty and student orientation to the our hospital, it is our hope
to foster better service-academic relationships and provide rich learning experiences for students,
as well as quality care for the patients we serve.
Attachment A (Example)
Instructor Orientation Requirements Self Checklist
 Complete Prior to Clinical Rotation and Preplanning Meeting with the Facility
 Please Check Applicable Response
 I have met with the education coordinator to make arrangements to attend Hospital
Orientation and /or to discuss any updates that may have occurred at the facility since my
last rotation.
 I have received a copy of the following forms and I understand these forms must be
completed and signed by the students and myself prior to the clinical rotation (please use
new forms- old forms will not be accepted)
o Affiliates Vendor Guide (optional)
o The Standards We Live By
o Instructor Verification of Certifications and Licensure Form
o Clinical Roster
o Access & Confidentiality Agreement(attachment at the end of this document)
o Confidentiality, Computer Usage and Accountability Agreement
o Instructor Note- How to Write an Note in EMR System
o Unit Orientation Check-Off List (attachment D)
o TB Questionnaire (Optional )
o Documenting Student eMAR Administrations
o PYXIS/Omnicell –Pharmacy access request form
o Student Daily Communication Tool (attachment E)
o Student Evaluation of Clinical Agency – will be issued at end of rotation (Optional)
o Post-Clinical Rotation Instructor Check-Off List (Optional)
o Parking Request form or arrangements
 I have submitted all the necessary Licenses and Certifications
 I have obtained my instructor’s badge and the badges of all my students
 I understand that I am responsible for providing the students with the necessary computer
training: PCS documentation and e-MAR.(If applicable)
 If I don’t have prior knowledge of the system, I will make the necessary arrangements
with the Education Coordinator to schedule training for myself.
 I understand that I am responsible for reviewing the Annual Update Module/ Information
with my students including National Patient Safety Goals and Regulatory Requirements.
 I need assistance with room scheduling for onsite conference time.
 If not, please indicate where pre/post conference time will be held:
_________________________________________________________
 I have reviewed with the students the policies as noted on the “Access and
Confidentiality Agreement”
I acknowledge understanding that I am responsible & accountable for making certain that the
Education Coordinator has received all the necessary forms signed.
Instructor’s Name:______________________________Course#:_________________________
Name of School:________________________________Date:____________________________
Areas Assigned:________________________Rotation Dates:______________Times: ________
Example
The following section will be completed by affiliate instructors who are also employed by
___________ Hospital
I affirm that when on _________Hospital premises and performing the role as a clinical
instructor- Faculty member for an affiliate school, I will not utilize my employee privileges such
as computer, PYXIS, POCT –glucose testing or parking access nor will I perform any tasks other
than my responsibilities as clinical instructor. I will only use the access issued to me as an
instructor while in the role of instructor.
I will wear my Identification badge issued by the affiliating school as well as the
_________Hospital badge issued to me as an instructor. I will also wear a lab coat or jacket that
identifies me in my role as instructor, and I will notify the staff on the unit the students are
assigned that I am acting in the role of instructor, not Hospital employee.
I also affirm that while I am working in my capacity as an employee of
__________Hospital, I will not perform duties associated with my role as an affiliate Instructor.
This includes, but is not limited to, use of hospital supplies, email, copy/fax services and
phone/voice mail. I understand that failure to comply with this may result in disciplinary action.
Employee Signature: ______________________________________________________
Attachment B Example
Clinical Profile
Instructions for Form Completion
1. Faculty is to contact the Education Coordinator at the assigned clinical agency no later than
two weeks prior to the start of the rotation for pre-planning.
2. Faculty is to complete the information below for each clinical rotation and submit to the
Clinical Coordinator or designee before students arrive in the unit. Please check (√) those
boxes for which the student has met the affiliation standard.
3. Attach a list of the students’ names.
4. All personnel (faculty and students) with patient contact are required to verify health
screening/immunization compliance. Health documents and background check clearance
information may be stored at the academic institution but should be available upon request to
the healthcare agency.
______________________________________________________________________________
Rotation Information
School ________________________________ Instructor’s Work Phone _________________
Instructor E-mail _________________________ Cell Phone ___________________________
Program
NA
VN
ADN
BSN
ELM
Other ____
Clinical Area __________ Sem/Year _______
Clinical Dates: From ___________________ To ___________________________________
Clinical Days ________________________ Time __________________________________
Conference Day and Hours ____________________________ Location _________________
Educational/Clinical Objectives Attached__________________________________
I certify that the students and instructors in this rotation have completed the following
requirements that are checked, and that supporting documentation for verification purposes is
maintained at this academic institution.
Background check clearance
Computer orientation, date ____________
CPR – American Heart Association Healthcare Provider BLS
Ethical conduct
General orientation, date ____________
Faculty licensure current
Health clearance
Hepatitis B vaccine/declination or titer
HIPAA training
Influenza vaccine/declination (Oct. to Mar.)
Injury and illness training
MMR titer
Professional liability insurance
TB screening (annual)
Td/Tdap current
Unit orientation, date ____________
Worker’s compensation/health insurance
Varicella titer
Printed Name and Title _________________________________________________________
Signature of Instructor or Designee _____________________Date _________________
List of Instructors and Students for this current rotation
Please Print or Type Instructor/Student Name below: (or attach list)
Attachment C Example
Contact Info for Nursing Instructors
Room Booking –Name___________ Phone Number ________
Email ___________________
Pyxis/Omnicell/Medication Access - Name___________ Phone Number
________Email ___________________
Accu-check Access – Name___________ Phone Number ________
Email ___________________
For Orientation Packet, Badges & dropping off paperwork or any other questions
for students in the facility – Name___________ Phone Number ________
Email ___________________
Confirm Clinical Placement – Name___________ Phone Number ________Email
___________________
Computer/EMR Orientation- Name___________ Phone Number ________Email
___________________
Unit Educator
Name___________ Phone Number ________Email ___________________
Name___________ Phone Number ________Email ___________________
Name___________ Phone Number ________Email ___________________
For any additional request or information please call
Name___________ Phone Number ________
Email ___________________
Attachment D Example
UNIT SPECIFIC ORIENTATION CHECKLIST
This form is to be completed by the clinical instructor for each area assigned or by student
performing a preceptorship/leadership rotation. The completed form must be submitted to the
Education Department by the first day of the rotation. Instructors will review the following
information with all students prior to working in the assigned area(s).
Student name: ___________________________Instructor name:_______________________
Preceptor name: ______________________________________________________________
School_______________________________________Course #_______________________
List all clinical area(s) assigned:________________________________________________
Rotation Dates: From______________ To_____________Day(s):________Time: _________
The following is a check off list of the items needed to be performed prior to any clinical
rotation.
Please check the box
1. Access for emergency operator (dial #)

2. Location of emergency crash cart

3. Unit specific safety information reviewed and assessed

4. Location of Material Safety Data Sheets

5. Documentation requirements specific to area(s) assigned

6. Clean Utility Room Location and access code

7. Soiled utility room location

8. Staff lounge location

9. Medication administration Pyxis access location

10. Unit specific Biomedical/Equipment location

11. Appropriate computer usage

I have met with the department manager(s) or Preceptor of the above patient care areas to clarify
mutual expectations regarding student clinical experiences. Student objectives, and skill level
have been communicated to department manager and staff member for each unit, and the method
of patient assignment has been reviewed with the Patient Flow Coordinator (PFC).
Instructor or Student signature: ________________________ Date:_______________
Print your name: _______________________________________________________
(student signature only applies to preceptorship rotations)
Manager or Preceptor’s signature:______________________ Date:______________
Print your name:_______________________________________________________
(preceptor’s signature only applies to preceptorship rotations)
Attachment E Example
Nursing Student Daily Communication Tool with Preceptor
Date
Student Name:
School Name:
Instructor Name:
Clinical
Semester#:
Instructor Contact Information:
My Shift Ends at:
1, 2, 3, 4- Preceptorship
I will take lunch break at:
1. ROTATION OBJECTIVES FOR TODAY
2. COMPETENCIES I HAVE ALREADY BEEN SIGNED OFF BY INSTRUCTOR AND
CAN DO WITH NURSE PRECEPTOR:
REQUIRE INSTRUCTOR
PO MEDS
YES
NO
SUPERVISION
ADMINISTER IV
REQUIRE INSTRUCTOR
YES
NO
MEDS
SUPERVISION
OTHERS
3. COMPETENCIES I WANT TO ACCOMPLISH TODAY BASED ON MY CHOSEN
ASSIGNMENT:
(i.e. Dressing changes, Foley insertion, IV Start, PT Teaching, etc)
4. COMPETENCIES THAT NEED INSTRUCTOR VALIDATION AND SUPERVISION:
5. COMPETENCIES I HAVE ACCOMPLISHED TODAY:
Name of RN Preceptor:
Date
RN Student: Please complete items 1 to 4 and give form to your preceptor
Preceptor: Please give form back to student at the end of the shift
Instructor: Please review students remarks and return form to Education Coordinator
Attachment F Example
Preceptorship Expectations/Guidelines
The following guidelines were established to ensure an optimal experience for student nurses
and their preceptors in the clinical setting.
The faculty member responsible for the preceptored student will:

Provide student, preceptor and Student Program Coordinator with a telephone contact
number where he/she can be reached any time the student is at hospital/medical facility for
preceptorship.

Provide Student Program Coordinator and preceptor with a copy of the course description,
learning objectives, date of beginning and ending of the experience and the number of hours
required.

Initiate contact and maintain communication with the preceptor to clarify student, instructor
and agency roles, learning objectives, etc., throughout the semester.

Provide the preceptor with an orientation to the preceptor role and preceptor packet
(handbook or manual) from the school.

Be available for consultation with preceptor, agency, and student.

Visit the clinical site on a periodic basis. First visit to be within the first 3 shifts the
student/preceptor work together. Expectations include a minimum of 3 site visits.
Conduct evaluation conferences with preceptor and/or student at the end of the semester
The hospital/medical facility will select a Registered Nurse with a minimum of 1 year
experience in his/her clinical practice area. This nurse has agreed to:

Serve as clinical expert and professional role model.

Jointly plan and arrange assignments, projects and activities to meet the learning objectives
within designated time frame.

Allow student to provide direct patient care within defined objectives.

Provide feedback to student on an ongoing basis.

Inform the instructor of any problems arising from the student's placement