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CLARK COLLEGE DEPARTMENT OF NURSING
PROFESSIONAL LEADERSHIP IN PRACTICE
NURSING 231
COURSE OVERVIEW
Fall 2009
Copyright © 2009 All rights reserved.
Materials in these modules have been prepared for use by Clark College nursing students in the
program of study. No portion of this material may be reproduced in any manner whatsoever
without the written permission of the Department of Nursing.
Printed in the United States of America
For information contact
The Department of Nursing Clark College
1933 Fort Vancouver Way
Vancouver, WA 98663
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CLARK COLLEGE DEPARTMENT OF NURSING
PROFESSIONAL LEADERSHIP
NURSING 231
COURSE OVERVIEW
HOURS OF CREDIT:
Eight quarter hours
TIME ALLOTMENT:
160 clinical hours over a 10 week period
PLACEMENT:
Third quarter of second year
PREREQUISITES:
A grade of “C” or above in Nursing 220 and Nursing 222, a “satisfactory”
grade in Nursing 221 and Nursing 223, level C CPR card, current TB test,
Hepatitis B vaccination or waiver. Health insurance may be required.
CONCURRENT ENROLLMENT REQUIRED: N 230 and N 232.
PROFESSOR INFORMATION:
Becky Ellis MN, RN
Office:
Phone:
E-mail:
Office Hours:
Urgent Messages:
CCW 225G
360-992-6090
bellis@clark.edu
Tuesdays 9am-12pm and Wednesdays 2pm-4pm
360-992-6078 Toni Fulkerson, Secretary
COURSE DESCRIPTION:
Nursing 231 is a clinical course which students are paired with RN clinical preceptors in various
local and regional health care agencies. The students have been placed in areas of interest to
them after graduation. The 6th quarter student is ready to expand their role as a professional
nurse and is expected to function as a team member on their assigned unit. A major goal for
the student is to become clinically proficient on that unit and to assimilate into the role of the
professional nurse. Instructional methods include: clinical practice, group discussion, clinical
seminar and reflective journaling.
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COURSE POLICIES: CLINICAL AND LAB
1.
2.

All clinical labs are required. Arrangements for make-up work for missed labs are the
responsibility of the student in conjunction with faculty and the clinical facility.
It is unethical, unprofessional and cheating to:
 Fail to make-up missed days
 Fail to inform instructor of absences
 Skip a clinical day without permission from the instructor
 Telling preceptor permission was granted by instructor when in fact it was
not.
Any such behavior is unethical and unprofessional and will be grounds for immediate
disciplinary action
3.
In Nursing 231, students will continue to use the ID badge issued for senior students.
4.
Students will be provided with feedback either verbally or in writing from the clinical
preceptor and faculty. In the event the student's performance falls below acceptable, the
student will be notified.
5.
Unless a student's clinical practice is declared unsafe, the student will have until the end
of the scheduled clinical to resolve identified deficiencies. Repetition of previously
documented unsatisfactory behaviors will be viewed as failing clinical behaviors in N 231.
A student not meeting the standard for passing clinical will receive a clinical grade of “U”
and receive a D for N 230 regardless of the earned theory grade. Please see policy on
unsafe clinical practice located in the student nurse handbook.
6.
Assignment of the clinical grade will include input from the preceptor and the student.
7.
Students are expected to use the practice lab as appropriate during the quarter to refresh
prior skills and for IV start practice. Students are expected to take advantage of any skills
available in the clinical setting.
8.
Students are expected to follow the dress code as stated in the Student Handbook and
that of the facility where the clinical occurs. Sixth quarter students may wear scrubs of
their choice in the clinical setting and a white lab coat with the school patch sewn on the
sleeve will be worn over the scrubs.
9.
Students are expected to model professional behavior and a positive attitude in the
classroom and in clinical settings.
Student Responsibilities and Medication Guidelines in the Clinical Setting
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Please note that these are the goals that must all be satisfactory in order to pass this quarter.
Students are expected to establish goals for the day and discuss them with their preceptor
and instructor weekly.
 Adhere to client confidentiality and practice professional boundaries.
 Evaluate the legal responsibilities of the healthcare team.
 Adhere to the clinical facility, nursing department and college policies.
 Apply theoretical concepts in the clinical settings.
 Utilize appropriate channels of communication for personal and professional
problem solving.
 Show respect for others in all settings
 Safely manage a group of clients as a direct caregiver with minimum RN supervision.
 Request assistance for new or skills not yet mastered.
 Demonstrate increasingly independent practice
 Demonstrate good critical thinking and problem solving.
 Model positive attitude toward the profession of nursing.
 Accept responsibility for own learning and behavior.
 Attends all clinical days arrives on time and stays the entire clinical time. Notifies
instructor and preceptor is they are not going to be at clinicals.
 Students will be well groomed and appropriately attired in the clinical setting.
 FOLLOWS THROUGH WITH SUGGESTIONS FOR IMPROVEMENT GIVEN BY FACULTY,
AND. /OR PRIMARY PRECEPTOR.
LEGAL CONCERNS
 Verbal and telephone orders may be taken ONLY WITH YOUR PRECEPTOR ON THE
EXTENSION WITH YOU> Preceptors must co-sign any telephone or verbal orders.
 Students may not administer any chemotherapeutic agents or experimental drugs.
In some setting students are not allowed to give IV Dilantin or Valium know your
own policy.
 You may change IV bags with common additives (potassium, vitamins) without
supervision when cleared by your preceptor. IV bags must be compared against the
physician’s orders in the chart. All IV push medications must be directly observed
by a RN.
 All insulin’s and anti-coagulants must be checked by an RN.
CLINICAL HOURS
Total Hours required = 160 hours
Break down of Hours
Clinical Hours with preceptor
Hospice
Weekly Clinical Seminar
=
Total Hours
= 134 hours
= 16 hours
10 hours
= 160 hours
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LEARNING ACTIVITIES:
The student will:
Write Weekly Goals
 Construct three goals each clinical week.
 New goals must be written as others are met.
 Goals must be correctly written (i.e. Who, What, When).
 Goals must reflect course, clinical, or personal goals.
 Goals are to be evaluated in the journal every day.
 Share goals wit preceptor and instructor.
 Utilize the Daily Learning Goals record for this activity.
Reflect Upon the Clinical day utilizing a journal. The journal will:
 Assist the student to remain focused on meeting course, clinical and
personal learning goals.
 Be a private and confidential communication between student and
faculty.
 Analyze and document activities of how goals were met (clinical,
personal, unit).
 Analyze and document problems, situations, issues, and conflicts etc.
encountered in the clinical setting.
 Address daily goals. Were your goals met? If not, why?
Attend and participate in weekly clinical seminars which are held every Wednesday after
our theory class from 11am-12pm.
COLLEGE WIDE ABILITIES:
Clark College has identified six campus-wide abilities that form the foundation of our
educational emphasis: 1) critical thinking/problem solving; 2) information technology; 3)
communication; 4) life-long learning; 5) effective citizenship; and 6) global/multicultural
awareness. All of these abilities are addressed as some point in the nursing program.
The primary emphasis for student assessment for N231 is:
 Communication Ability– The ability to understand and deliver written, spoken
and visual communication clearly and accurately.
 Critical Thinking/Problem Solving Ability– The ability to formulate evaluate and
synthesize facts, data, ideas, assumptions, values and points of view.
COLLEGE-WIDE STUDENT LEARNING OUTCOMES:
Clark College has nine student learning outcomes: 1) communication; 2) Health & Physical
Education; 3) Human Relations; 4) Humanities; 5) Information; 6) Quantitative; 7) Science;
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8) Social Sciences; 9) Technology. All student learning outcomes are taught or used
throughout the nursing program. The primary ones used and assessed for N231 are:
 Communication – Present information effectively through written and/or oral
communication; Demonstrate effective oral and/or written communication
appropriate to the discipline and /or occupation.
 Human Relations – Demonstrate effective interpersonal/human relations skills
appropriate to the discipline and/or the occupations.
N231 STUDENT LEARNING OUTCOMES:
o Behaviors that are essential to the safe and competent practice of nursing are
identified in bold print. At the completion of this course the student will:
Function in the role of the entry-level professional nurse (College Outcomes – CO)
Demonstrate effective interpersonal/human relations skills appropriate to the occupation.
(College Abilities –CA) Life-long Learning, critical thinking, and communication
I. Assimilates into the role of the professional nurse
A. Maintains professional boundaries, does not share
confidential information.
B. Acts in a professional and ethical manner at all times
C. Identifies ethical issues and discusses the situation
D. Evaluates professional conduct of heath care providers in a
variety of clinical settings
E. Is dependable, punctual, reliable and accountable
F. Acts responsibly for own practice
G. Models positive professional behavior even when others are
not
H. Questions and addresses the legal concerns of the health care
team
I. Adheres to policy and practices as outlined in Nursing
Program Student Handbook, the clinical
J. facility policy and procedures, and the N231 syllabus
K. Is well groomed and appropriately attired in the clinical
setting
L. Attends and /or makes up ALL clinical days. Arrives on time
and stays the entire clinical time. Conforms to the procedure
for reporting absence or tardiness to facility
M. Maintains professional demeanor in the clinical setting
N. Accepts responsibility for own practice
II. Integrate the Nursing Process into Practice
A. Accurately assesses patient’s health status and functional
ability in a timely manner
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B. Evaluates the effectiveness of client care and nursing
therapies based on client’s response to interventions and
progress toward meeting desired outcomes
C. Consistently applies the nursing process to the care and
management of patient care
D. Initiate clinical care plan, care maps, or clinical pathways
according to facility protocol
E. Modify the care plans, care maps, or clinical pathways
according to facility protocol
F. Evaluate the effectiveness of nursing therapies based on
client’s response to interventions and progress towards
meeting desired outcomes
G. Apply theoretical concepts in the clinical setting
H. Integrate all previous leaning and new learning into the
management of the client and/or family
I. Assimilate cultural and spiritual beliefs and practices into the
management of the client and/or family
J. Model medical and surgical asepsis in all settings
III. Practice Effective Communication
A. Shares written daily goals with preceptor
B. Practices good listening skills
C. All written work is clear, concise and articulate
D. Effectively and accurately communicates pertinent
observations or changes in patient health care status and
needs to appropriate personnel in a timely manner.
E. Provides appropriate and accurate teaching to patients,
families, staff and peers.
F. Uses appropriate channels of communication for personal
and professional problem solving
G. Clearly verbalizes concepts, thoughts and observations.
H. Participates appropriately within the group
I. Collaborates with multi-disciplinary and inter-disciplinary
health care teams.
IV. Integrate Holistic nursing concepts when providing care to the patient, family,
and
community
A. Communicates caring compassion, warmth, respect and
genuine interest using verbal and non verbal skills.
B. Takes breaks as appropriate. Responds to patient requests in
a prioritized manner.
C. Establishes rapport with staff/clients/peers.
D. Demonstrates respect for everyone.
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E. Demonstrates an accepting attitude of others regardless of
their diversity
F. Appropriately demonstrates empathy
G. Is an active advocate for patients, families and co-workers
H. Utilizes therapeutic communication skills effetely
V. Function as an Entry Level Nurse
A. Organizes work so that care and charting are completed on
time.
B. Consistently provides safe care
C. Consistently corrects or modifies practice to ensure safe
care.
D. Safely manages a group of clients as a direct caregiver, team
leader, or charge nurse as appropriate to the clinical setting.
E. Alters care based upon assessments.
F. Organizes care according to high priorities
G. Uses time efficiently
H. Requests appropriate assistance for new and/or skills not yet
mastered.
I. Recognizes personal limitations
J. Accepts and adjusts to change.
K. Consistently demonstrates development of increasingly
independent practice.
L. Requires minimal supervision
M. Demonstrates good critical thinking and problem solving
N. Demonstrates good judgment
O. Correctly delegates to qualified staff appropriate to the clinical
setting and according to the Nurse Practice Act
P. Supervises the care of others.
Q. Provides positive feedback and constructive suggestions as
appropriate to the clinical setting.
R. Makes assignments based on client need and qualifications of
available staff
S. Follows through with suggestions for improvement given by
faculty, primary care nurse and/or preceptor.
T. Comes to clinical experience with appropriate resources for
the expected learning experiences
U. Continually seeks self-improvement and new experiences
V. Reflective Journal is thorough, descriptive of how goals and/or
outcomes were met, includes appropriate reflection and
analysis of clinical learning as indicated in log guidelines.
W. Uses appropriate resources to prepare for clinical experience
X. Completes the portfolio according to established guidelines.
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CRITERIA FOR EVALUATING CLINICAL PRACTICE
Bolded behaviors are “critical” behaviors. An unsatisfactory grade of "U" will be given when a
student does not meet a single bolded item. An unsatisfactory grade will also be given for a
pattern of behavior involving three or more items listed, persistent problems in any area of
practice or a single serious incident. The following list is not all-inclusive.
I. Assimilate professional conduct and ethical behavior.
SATISFACTORY BEHAVIORS
USATISFACTORY BEHAVIORS
In order to successfully pass in clinical practice, the
student:
Does not meet requirements, the student:
A. Maintain Professional Boundaries and does not share
confidential information
A. Does not maintain Professional Boundaries
B. Acts in a professional and ethical manner at all times.
B1. Identifies self to the appropriate facility personnel
when entering the clinical area
B. Acts in an unprofessional and/or unethical manner.
B1.Fails to identify self.
B2.Cheats and/or facilitates cheating by others.
B3.Fails to notify professor and/or preceptor of
absences.
B4.Skipping a clinical without permission and/or
informing preceptor permission was granted to
skip a day without making it up.
B5.Plagiarism.
C. Identifies ethical issues and discusses the situation.
C. Does not recognize ethical issues or behavior is unethical
D. Evaluates the professional conduct of health care providers
in a variety of clinical settings
D. Unable to identify poor conduct in the health care setting
E. Is dependable, punctual, reliable and accountable.
E. Is not dependable. Is frequently late. Lacks flexibility.
Projects own problems onto others.
E 1. Conforms to the procedure for reporting absence
or tardiness
E1. Fails to follow procedure for reporting absences or
tardiness. Has a pattern of being absent or tardy.
F. Accepts responsibility for own practice
F. Does not accept responsibility for own practice
G. Models positive professional behavior even when others
are not
G. Is negative and/or unprofessional towards client/resident,
preceptor, peers, and/or faculty. Resists modifying
identified inappropriate behaviors
H. Questions and addresses the legal concerns of the
healthcare team
H. Lacks knowledge of scope of practice of healthcare team
members
I. Adheres to policies and practices as outlined in Policies and
Practices for Nursing Students, clinical facility policy
books, and in N231 syllabus overview
I. Fails to follow policies and practices as outlined in the
student handbook. Does not know and/or adhere to
policies and procedures within the clinical facility
K. Is well groomed and appropriately attired in the clinical
setting
L. Attends and/or makes up ALL clinical days. Arrives on time
K. Is negligent in personal hygiene or is inappropriately attired
L. Skips clinical days and does not arrange appropriate make-
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and stays the entire clinical time. Conforms to the
procedure for reporting absence or tardiness to facility
up days. Arrives late or leaves early. Fails to follow
procedure for notifying facility for absence or tardiness. If
frequently absent or tardy
II. Integrate nursing process into practice
A. Accurately assesses patient’s health status and functional
ability in a timely manner
B. Evaluates the effectiveness of client care and nursing
therapies based on client’s response to interventions and
progress towards meeting desired outcomes
C. Consistently applies the nursing process to the care and
management of patients
D. Initiate care plans, care maps, or clinical pathway according
to facility protocol
E. Modify the care plan, care map, or clinical pathway
A. Assessments are omitted, inaccurate, inappropriate, or
insufficiently focused for client heath status. Fails to note
changes in health status or condition.
B. Continues to provide care or completes interventions that
are ineffective or inappropriate. Fails to evaluate patient
response to nursing or medical interventions and
progress toward meeting desired outcomes
C. Level of performance is inconsistent in quality and quantity
D. Does not initiate a plan of care within the facility’s required
timeframe
E. Does not modify the plan of care as it changes
F. Does not evaluates the effectiveness of therapies
F. Evaluates the effectiveness of nursing therapies based on
client’s response to interventions and progress towards
meeting desired outcomes
G. Applies theoretical concepts in the clinical setting
H. Integrate all previous learning and new learning into the
management of the client and/or family
I. Assimilates the cultural and spiritual beliefs and practices into
the management of the client and/or family
J. Model medical and surgical asepsis in all settings
lll. Practice Effective Communication
G. Does not base their nursing care on a theoretical concept
or model
H. Fails to apply previously learned task and procedures
I. Fails to acknowledge the diversity of the patient and fails to
incorporate their cultural beliefs and practices into their
care plan
J. Fails to maintain medical and surgical asepsis
A. Shares written daily goals with preceptor
A. Does not have goals written out and/or has not shared them
with the preceptor
B. Practices good listening skills
B. Does not pay attention to others, interrupts, or draws
conclusions before the other person is finished
C. All written work is clear, concise, and articulate
C. Written work is not complete, vague, or uses inappropriate
terminology. Unable to organize thoughts.
Documentation is incomplete, inaccurate or illegible
D. Effectively and accurately communicates pertinent
observations or changes in patient heath care status
and needs to appropriate personnel in a timely manner
D. Fails to accurately communicate pertinent changes in
patient health care status to appropriate personnel in a
timely manner. Communication is inaccurate,
incomplete, or not according to facility procedure
E. Provides appropriate and accurate teaching to patients,
families, staff, and peers
E. Fails to assess, plan or implement patient teaching according
to the learning needs of the patient
F. Utilizes appropriate channels of communication for
personal and professional problem solving
F. Uses inappropriate methods and/or channels of
communication
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G. Clearly verbalizes concepts, thoughts and observations
H. Participates appropriately within the group
I. Collaborates with multi-disciplinary health care teams
G. Unable to communicate clearly. Reacts rather than
thinking through a response. Is disrespectful towards
clients, residents, peers, faculty and/or other members
of the healthcare team or circumvents the appropriate
channels of communication or provides inadequate
and/or inaccurate information
H. Does not participate or participates inappropriately within
the group
I. Is uncooperative, does not work well with others or fails to
use available resources in managing patients.
IV. Integrate Holistic nursing concepts when
providing care to the patient, family, and
community
A. Communicates caring, compassion, warmth, respect and
genuine interest using verbal and non-verbal skills
B. Takes breaks as appropriate. Responds to patient requests
in a prioritized manner
C. Establishes rapport with staff, clients and peers
D. Demonstrates respect for everyone
E. Demonstrate an accepting attitude of others regardless of
their diversity
F. Appropriately demonstrates empathy
G. Advocate for clients and families in a variety of health care
settings
H. Utilizes therapeutic communication skills effectively
V. Functions as an entry level nurse
A. Organizes work so that care and charting are completed on
time
B. Consistently provides safe care
C. Consistently corrects or modifies practice to ensure safe
care
D. Safely manages a group of clients as a direct caregiver, team
leader, or charge nurse as appropriate to the clinical
setting
E. Alters care based upon assessments
F. Organizes care according to high priorities
G. Uses time efficiently
H. Requests appropriate assistance for new and/or skills not
yet mastered
I. Recognizes personal limitations
J. Accepts and adjusts to change
K. Consistently demonstrates development of increasingly
A. Lacks compassion. Is rough with clients/residents and makes
disparaging remarks
B. Does not take breaks or takes too long or frequent breaks.
Does not prioritize patient requests
C. Avoids clients or staff. Implements care without respect for
patient or peer feelings or suggestions
D. Is disrespectful
E. Rejects others beliefs, judgmental toward others
F. Sympathizes instead of showing empathy. Becomes over
involved.
G. Notes problems, but does not intervene as an advocate
H. Gives advice, does not listen, jumps to conclusions,
interrupts
A. Is disorganized and unable to complete work assignment
on time
B. Care is unsafe. Fails to correct previous unsatisfactory or
unsafe behavior or lacks consistency.
C. Fails to correct previous unsatisfactory or unsafe
behaviors
D. Unable to manage groups of clients greater than four in
number. Does not determine priorities. Is unorganized.
Inconsistent in requesting assistance when needed.
Implements actions without full under-standing, acts
without thinking
E. Implements interventions that do not reflect patient
assessments or are inappropriate to the patient
condition.
F. Does not address high priority issues, while doing lesser
priority work
G. Wastes time
H. Practices without appropriate supervision. Does not
recognize own limitations. Overconfident with
skill/knowledge level that results in failing to obtain
necessary supervision
I. Practices outside of scope of practice
J. Does not accept or adjust to change
K. Requires significantly more faculty and/or preceptor
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independent practice
L. Requires minimal supervision
M. Demonstrates good critical thinking and problem solving
N. Demonstrates good judgment
O. Correctly delegates to qualified staff appropriate to the
clinical setting according the Nurse Practice Act
P. Supervise the care of others
Q. Provides positive feedback and constructive suggestions as
appropriate to the clinical setting
R. Makes assignments based on client need and qualifications
of available staff when available
S. follows through with suggestions for improvement given by
faculty, primary care nurse and/or preceptor
T. Comes to clinical experience with appropriate resources for
the expected learning experiences
U. Continually seeks self-improvement and new experiences
V. Reflective Journal is thorough, descriptive of how goals
and/or outcomes were met, includes appropriate
reflection and analysis of clinical learning as indicated in
log guidelines
W. Uses appropriate resources to prepare for clinical
experience
X. Completes the portfolio according to established
guidelines
supervision than is usual for the level of student
L. Requires more supervision than is acceptable for routine
client/resident or team management
M. Fails to apply knowledge to solving problems. Makes
decisions with inadequate or inaccurate data. Lacks
good judgment. Thinking is scattered. Unable to identify
the problem or take appropriate steps to correct the
problem
N. Lacks good judgment
O. Fails to delegate or inappropriately delegates’ activities
P. Does not supervise care provided by others
Q. Does not provide positive feedback or criticism is not
supportive. Avoids providing feedback or is not
constructive in such situations
R. Fails to base the assignments on patient needs and/or staff
qualifications
S. Fails to act on or is inconsistent in following suggestions
given
T. Comes to the clinical experience without the appropriate
resources
U. Does not follow through with suggestions for self
improvement and does not seek new learning
experiences
V. Log is incomplete and is a poor reflection of learning and
analysis
W. Comes to clinical unprepared
X. Portfolio is unorganized and not complete
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Non-Discrimination Notice:
Clark College does not discriminate on the basis of race, color, national origin, sex, disability, age,
religion, sexual orientation, gender identity, gender expression, creed, disabled veteran status,
marital status or Vietnam-era veteran status in its programs and activities.
ADA Accommodations:
If you have emergency medical information that should be shared, or if you require assistance in
case the building should be evacuated, please make an appointment to see me as soon as
possible during the office hours indicated in this syllabus.
Any student with a disability who may require some consideration or assistance in order to fully
participate in this class should contact the Disability Support Services Office at 992-2314 or 9922835 (TTY).
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CLARK COLLEGE
DEPARTMENT OF NURSING
Emergency Plan
In emergencies, students should do the following:
Inclement weather or emergency information:
1. Go to www.clark.edu or call 360-992-2000 as your first means of getting information. The
College does send notices regularly to radio and television stations, the College’s web site and
switchboard are the official platforms for the most accurate information. Clark College Nursing
Program at WSU
Campus will follow WSU campus information which has a link from the Clark College web site.
Immediate emergency communication alert:
2. To receive immediate notice on emergencies, you can register your cell phone number to
receive text pages and your email address to receive email messages. To do this, go to
www.flashalert.net, select “subscribe” on the left, and follow the instructions. Mass
communication will also be sent to all college employee phones and computers.
Fire Alarm:
3. Evacuate the building through closest exit; evacuation maps are located in the hallways. Take
personal belongings only if it is safe to do so. Remain at least 50 feet from the building. Notify
others of evacuation. Do not re-enter the building until instructed to do so.
Parking Lot Identifiers:
4. New parking lot identifiers using colors and numbers have been assigned to all Clark parking
lots. To help emergency or security personnel locate you, please refer to these identifying
features.
5. Clark College Nursing must follow WSU parking regulations.
Security Escort:
6. Security Officers are available for escorts please call 360-992-2133 WSU 360-546-9001 select #0