2013
This Bookl et i s to b e read in conjun ction with the following guidelines: -
Supernu merary S tu dents

CUH Group Practice Placement Booklet for BSc. General Nursing Students or

BSc. Childrens and General Integrated Nursing Pathway Students.
Internsh ip year

Information for the Int ernship Year BS c. General Nursi ng
Supernu merary and Ros tered stud en ts

CUH Group BSc. General Nursing Students BSc. Childrens and General Integrated Nursing
Pathway Students P racti ce preparation bookl et
(Y ou can locat e a copy of thes e books i n the BSc. Nursing Student s folder on t he ward)
STUDE NT NAME : -
_________________________
PRE CE PTO R: -
__________________________
ASSOCI ATE PRE CEPT OR: -
_________________
1

WARD AND PAT IE NT RELATE D I NFORMATIO N
WELCO ME NOTE
Welcome to the Step Down Unit Cardiac Renal Centre CUH. We hope you enjoy your allocation with us. This booklet has been complied to assist you during your placement on the Step Down Unit.
This booklet will be reviewed annually to ensure that the information is current and accurate. The information provided in this booklet is not exhaustive. If you have any questions please direct them to the Clinical Nurse Manager, your Preceptor, Nursing Staff or the Clinical Placement Co-ordinator.
The Step Down Unit is an Acute Medical Ward and its specialty is cardiology. The main aim of this clinical placement is to link the theory you learned in the classroom to nursing practice. It is recommended that you observe and participate in the delivery of individualised and holistic patient care with your allocated preceptor. It is suggested that you reflect on practice at the end of each shift to enhance your learning experience.
WARD PHILOSO PHY
We aim to deliver a holistic approach in providing the best possible individualised care for patients with critical cardiac conditions and those undergoing procedures.
Our approach to care delivery is systematic incorporating assessment, planning, implementation and evaluation in liaison with the multidisciplinary team.
We provide nursing care in a safe and friendly environment with patients’ right to dignity and privacy respected.
We value our role as patient advocates and primary carers and involve patients and relatives in all stages of care delivery.
We recognise the role of technology in the clinical setting and acknowledge that its application is reliant on the nurse’s clinical decision-making skills.
We aim to assist our patients to recover and self care, or when this is not possible, to prepare them for a peaceful and dignified death.
We work towards continuously improving the quality of care by ensuring our ongoing personal and professional development.
WARD PROFILE
The Step down Unit is a 19 bedded unit. Patients are admitted to the unit via the Coronary Care Unit
(CCU), emergency department, cath lab or transferred from another ward or hospital with various cardiac, requiring specialist treatment, intervention and care.
The nursing complement comprises of an Assistant Director of Nursing (ADON), Clinical Nurse
Manager (CNM) 2, CNM 1, registered general nurses and nursing students
2

WARD GEO GRAPHY
Unit Location
The Step down Unit is situated on level 3 of the Cardiac Renal Centre.
Access is via the main front door of Cork University Hospital which is located on Level 1. At the main reception desk turn right, go through double doors and take the public lift to level 3. On exiting the lift turn left and proceed straight ahead, the Step down Unit is on the left.
Rooms
There are 19 beds in the Step down Unit. Three 4 bedded rooms, Two 2 bedded rooms and 3 single rooms which have an ensuite.
Staff Base
The staff base is located in the centre of the unit. Located at the staff base is a fire panel and a pneumatic shoot for the transportation of clinical samples directly to the laboratory.
Clean Utility
The clean utility is located directly behind the staff base. It is here that sterile stores are kept using the Kan ban system. Also located in clean utility is the DDA cupboard along with all other medications.
To the right of the staff base on the left side of the corridor is:
Room 6 which is a 4 bedded room with a toilet and a shower room just outside it.
Room 1 which is a 4 bedded room with a toilet and a shower room just outside it.
Procedure room is located at the end of this corridor on the left along with a fire escape with fire extinguishers.
To the right of the staff base on the right hand side of the corridor is:
Room 5 a single room with ensuite
Dirty Utility which contains bedpan washer, macerator and hazardous waste storage cabinet.
Linen Bay
Equipment Sore
Exit for visitors
Pantry with fire blanket
At the end of the corridor to the right of the staff base is entry to CCU.
To the left of the staff base on left side of the corridor is:
Room 11 a single room with ensuite
Fire extinguishers
Room 12 single room with ensuite
CNM office
Medical Staff office
To the left of the staff base on the right side of the corridor is:
Room 9 which is a 2 bedded room with a toilet and a shower room just outside it
Room 10 which is a 2 bedded room with a toilet and a shower room just outside it
Room 14 which is the 4 bedded Observation Room with a toilet and a shower room just outside it
3

At the end of the corridor to the left of the staff base is entry to closed ward and fire exit with fire extinguishers.
Emergency Equipment
Resuscitation Trolley Located on main corridor outside room 6, opposite nurses station
Suction Machine On resuscitation trolley
All bed spaces have access to wall suction
Echo Room & Cardiology Department are located on 3C.
NURSING CARE DELIVERY SYSTEM
The Clinical Nurse Manager (CNM) or Nurse-in-Charge co-ordinates the overall running of the ward. The Registered Nurses in each section accept responsibility for the delivery of direct patient care. Staff and Students are allocated to a 'ward section' on a daily basis to facilitate individualised nursing care. Depending on the workload of the sections and subject to availability a care assistant may also form part of the team.
ETIQUETTE TOWARDS CLIENTS
All patients are to be referred to as Mr./Mrs./Miss unless the patient requests otherwise as per hospital policy.
SAFET Y, HE ALTH AND WEL FARE O N THE WARD
For further inform ati on pl eas e refer to the practi ce pl acement guidelines
MANUAL H ANDLI NG O F PATIE NTS
Aids available on ward include
Hoist (shared with step down unit)
Roller Slide
Located on step down unit in store/ treatment room opposite room
Located in step down unit equipment store room
Maxi Slides Located in step-down equipment store room
It is the responsibility of each Nurse to use the available manual handling and lifting aids available on each ward .
4

FIRE SAFETY
For further information on fire prevention please refer to your practice placement booklet.
Please locate the following on first day of your clinical placement:-
Fire Panel
Fire Blanket
Refuge point and dry riser
Fire Extinguisher
Exit Doors
Fire Plan for Step down unit
At nursing base
In pantry
Located just before entry to CCU opposite ward pantry
Located to the left of staff base through double doors on right
Across from ward pantry (entry to procedure room), on corridor beside rooms 1 & 12
Located just before entry to CCU opposite ward pantry
Located to the left of staff base through double doors on right
Displayed behind nursing base
Fire Assembly Point Car Park 1 at top of steps opposite main CUH entrance
PATIE NT DOCUMENTATI ON
Gen eral Patien t Personal Profile Docu men t
The general patient personal profile document which is to be used for admitting patients to unit who are NOT admitted under a cardiologist i.e. do NOT admitted with a cardiac problem. It contains information regarding the patient and their medical/surgical history, obtained by the nurse on admission. Assessment is based on Roper, Logan and Tierney
’ s Activities of Daily Living (ADL) . It also includes a discharge planning section, multi-disciplinary team involvement, investigations and a signature and initials log.
Cardiac Patien t Personal Profile Docu men t
The cardiac patient personal profile document which is to be used for admitting patients to unit who are admitted under a cardiologist i.e. admitted with a cardiac problem. It contains information regarding the patient and their medical/surgical history, obtained by the nurse on admission.
Assessment is based on Roper, Logan and Tierney
’ s Activities of Daily Living (ADL) . It also includes a discharge planning section, multi-disciplinary team involvement, investigations and a signature and initials log.
N.B.
All Patients on admission to Step Down Unit must have a Waterlow Score, and a Body Mass
Index documented in their Patient Profile Document. Complete the trigger questions in the Personal
Cleansing and Dressing section and the Eating and Drinking section of the patient profile document to ascertain if a Nutritional Assessment and an Oral Hygiene assessment are required. Remember to open core care plans where indicated through your ADL assessment.
It is the responsibility of the nurse admitting the patient that the patient is logged onto the computer, either by the admission office staff, the ward clerk / staff or by the nurse contacting the admission department.
IMPORTANT CONSIDERATIONS WHEN DOCUMENTING PATIENT CARE
5


It is advised that students read the Recording Clinical Practice Guidelines 2002 issued by An
Bord Altranais before clinical placement.

Student Nurses record keeping should be monitored by the preceptor or supervising nurse.
Entries should be co- signed by a registered nurse.

Abbreviations should only be used as per National Hospitals Office Guidelines (2007).

Time of entries should be the 24 hour clock.
An Out Patient Department Cardiology appointment is scheduled by the nurse using the appointment book. A patient identification sticker is placed in the book and the nurse following consultation with the doctor specifies the number of weeks when the patient is to return (i.e. 6 weeks time).
Administration staff in the Cardiology department notifies the patient via postal letter. Generally, private patients arrange their own appointments.
Referral to the Anticoagulant Clinic must be completed by medical staff. The nurse then obtains the appointment details from the warfarin clinic during core hours over the phone. The patient is informed by the doctor.
Patient's menus cards are completed by the health Care Assistant together with the patient under supervision of the registered nurse. Special diet sheets (e.g. low cholesterol/low sodium) are requested each morning. Late ordering - ring ext. 22171. Supplemental drinks are ordered by the dietician and stored in the ward kitchen. Naso-gastric feeds are ordered using the kitchen requisition book.
Log on:
User Name = CUH
The ward practice development computer is located
(Hospital Sterile Store Department) will be managed by Kan ban system.
There will be a top up service once weekly.
The benefits include:

Reduces inventory levels

Collaborate with your supply base to improve on time delivery

Eliminate Stock outs and expediting fees

Trigger Kan ban signals based on actual consumption
Patient discharge is completed as per details in nursing documentation in the Patient Profile
Document. All relevant Multidisciplinary referrals need to be completed by the medical and nursing staff as appropriate. Patients must vacate their bed at 11am on day of discharge once medically discharged. Ambulatory patients may wait in visitors day room/discharge lounge.
6

The patient’s first electrocardiograph (ECG) each day is completed by the ECG technician.
Equipment is stored in equipment room. They must be plugged in when not in use to recharge the battery. Policy for damaged/malfunctioning equipment: refer to bio-medical engineer, ext. 28025 and forward requisition form to this department. Infusion pumps are stored in the medical equipment library (ext 21134) and must be return there when no longer in use by an individual patient.
Bleep 140 - The mortician is informed of the death of a patient in order for facilitation in the mortuary. The doctor informs the mortician when a post mortem is required.
The Assistant Director of Nursing (ADON) is informed of any death in the unit by the registered general nurse. Coroner’s office will be informed by doctor if patient is for a coroners post mortem.
The phlebotomist is available Monday – Friday and attends the unit from 7.30 – 8am. They are also available on Saturday and Sunday mornings. Blood forms must be completed by the doctor. All bloods outside of these times are taken by the medical doctor.
Patients' property and valuables should be taken home on admission. Essentials are kept in the bedside locker. It must be checked by two nurses and appropriate documentation recorded. Correct labeling of property is essential. Valuables are checked by two nurses and sent to Director of
Nursing office to be locked in hospital safe. A record should be kept in patient nursing notes that there is property stored in the hospital safe. On return of the property, the patient and nurses must complete the appropriate documentation.
Porter shared with CCU Bleep: 586. The x-ray porter will transport patients to and from the department if previously booked on line. Urgent transfer to the radiography department is assisted by the ward porter, and the x-ray porter if required.
Cardiac rehabilitation referrals and other Multidisciplinary referrals and their appropriate documentation is completed by the medical doctor and co-ordinated by the staff nurses in the step down unit.
Special stores requisitions are made by Staff Nurses. All generic stores are ordered by the Care
Assistant or registered general nurse on the stock ordering service on the desk top on the PC at the staff base.
The admissions office organises all transfers. For external hospital transfers the nurse must complete a 'Nursing transfer form' which accompanies the doctor's letter and any other documentation as appropriate. If the discharge co-ordinator has been involved in the transfer of the patient a copy of the 'Nursing transfer form' must be given to the co-ordinator involved.
7

In house transfer of patients is co-ordinated by admissions and bed management who inform the relevant CNM or staff in charge. The nurse transferring the patient must ensure all nursing documentation is up to date prior to transfer.
2.30pm – 4.30pm
7.00pm – 8.30pm
Visiting can be restricted on a patient's request or if his/her condition warrants it.
Routine x-rays are performed in the department between 9am and 5pm, emergency films only after 5 pm. Portable x-ray can be requested if the patient is acutely ill \ unable to go to the department. The doctor orders all x-rays. A patient label must be affixed to the request card and these cards are collected by porter and delivered to X-Ray Department.
EDUCATION RESOURCES
SUGGESTED LEARNING OPPORTUNITIES ON THE STEP DOWN UNIT
Admission of a patient including activating appropriate care plans

Assessment of activities of daily living in Patient Profile Document

BMI

Waterlow score

Oral Care Trigger Questions

Nutrition Trigger Questions

Urinalysis (obtaining, performing and interpreting results)
Taking and recording of patients’ vital signs. Reporting abnormalities
The taking and recording of vital signs should be utilised as an opportunity for carrying out a holistic patient assessment where students and staff share responsibilities, skills and knowledge. If assessment of patient was not possible (e.g. patient was at x-ray) the student must inform named nurse and check observations of the patients return

Manual and automated blood pressure

Temperature

Respirations

Manual pulse

Pulse oximetry for Oxygen saturations

Capillary blood glucose monitoring
Fluid balance

Accurately completing and updating Intake -both intravenously and oral fluids

Accurately completing and updating Output - consider catheter drainage, patients’ mobilising out to toilet
 Consider patients’ fasting-nil per mouth
 Consider patients’ on fluid restrictions

Consider wound, naso-gastric drainage and vomitus

Total fluid balance every 12 and 24 hours

Recognise and report abnormalities/changes
8

Medications

Ascertain patient allergies; drug, food, dressings, latex.

Consider the drug, route, purpose, dose, indications, contra-indications and side effects

Be aware of the safe practices in relation to medication administration and the storage of medications, including Schedule 2 medications

Participate in medication rounds under direct supervision of Registered Nurse

Observe and report any abnormalities to intravenous access sites

Observe the checking process for blood/blood products
Personal Cleansing and Dressing
 Assess patients’ level of dependence/independence

Assist patient as necessary
 Promote patients’ independence

Ensure privacy and dignity for the patient

Prepare environment and gather necessary equipment and products
 Assess the patients’ skin integrity

Use this opportunity to talk and develop therapeutic relationship with the patient
Eating and Drinking
 Assess patients’ level of dependence/independence

Assist patient as necessary
 Promote patients’ independence

Complete food chart
 Consider patients’ food preferences and diet restrictions eg. Low salt, diabetic diet

Ensure instructions from Multidisciplinary team, for e.g., Clinical Nutritionalists and
Occupational Therapist are carried out for e.g., weekly weights, high calorie high protein drinks and use of eating aids.
Elimination

Assess patients’ level of dependence/independence

Assist patient as necessary
 Promote patients’ independence

Catheter care, stoma care
 Daily recording of patients’ bowel patterns-reporting abnormalities

Collect samples, performing tests and sending samples to appropriate laboratory
Pre-procedure nursing care

Ensure patients are prepared for their procedures and that the CUH pre-operative checklist is completed if required (patient going to theatre department from 3A).
– ensure patient has had shower/bed bath, gown, TEDS, name band, has been fasting if appropriate,

Establish the patient has made an informed consent

Ensure patients medical notes and x-rays are available to accompany patient

Ensure patient has been given pre & post procedure education and has been given an opportunity to express any worries or anxieties

Prepare the patients bed space to receive patient post procedure – make post operative bed, ensure oxygen and suction are present and functioning, have drip stand and infusion pump beside bed, catheter stand if required.
Post – procedure nursing care
9


If necessary, take the emergency bag containing the necessary equipment with you when collecting patient under supervision of Registered Nurse. It is essential that you are familiar with this equipment

Collect patient from cardiac catheterisation laboratory / x-ray department etc. ensuring that you have obtained the necessary information:
 what procedure was performed and any complications
 what anaesthetic (local, sedation), analgesia or any other medications patient received
 volume and type of intravenous fluids or blood/blood products received
 determine if patients vital signs within normal limits – is patient requiring oxygen and if so what percentage?
 what wound/drains does the patient have – is there any ooze or haemorrhage from the wounds/drains
 are there any specific post procedure instructions

Assist patient into bed using pat slide

Nurse patient in appropriate position taking into account any specific post procedure instructions

Monitor vitals signs, observe wounds/drains

Complete pain assessment and administer analgesia as prescribed under direct supervision of registered nurse and monitor side effects

Administer anti-emetics as prescribed under direct supervision of registered nurse, if patient is experiencing nausea/vomiting

Monitor patients urinary output – provide bedpan/urinal, assist patient to mobilise out to toilet (if appropriate) or measure catheter drainage

Monitor and update fluid balance

Assist patient with oral care needs and oral fluids/diet when patient is able to tolerate same
Discharge Planning

Recognise the importance of discharge planning on and during admission

Liaise with appropriate personnel, for e.g., Discharge Co-ordinator, Public Health Nurse and
General Practitioner

Ensure discharge section of patient profile document is fully completed
Handover Report

Nursing students should document all nursing care given

Students’ must avail of all opportunities to give report on patients’ in their section
Patient Diagnosis / Procedures / Tests

Coronary Artery Disease

Angina & unstable angina

Congested cardiac failure

Atrial fibrillation

Myocardial Infarction

Echo

ECG

Exercise Stress Test

Coronary angiogram / angioplasty / stent insertion
10

Specific Policies

Policy and Procedure on the nursing management of patient undergoing coronary angiogram

Policy and Procedure on management of patient on telemetry

Policy and Procedure on the management of patient on oral anti – coagulant therapy

Policy and Procedure for the assessment, management and treatment of patient with acute MI presenting as St Segment elevation MI
Student must participate in maintaining a safe, clean environment for patients and for colleagues
Students should be able to discuss the rationale for all nursing interventions undertaken
These learning opportunities are not an exhaustive list, and students’ are encouraged to avail of any other opportunities which may arise.
PRE CE PTO R/ ASS OCIATE PRECE PT OR ALLOCATIO N
The Student Nurse is allocated to a Preceptor on commencing placement. If the Preceptor is not on duty or absent then the Clinical Nurse Manager (CNM), Nurse-in-Charge or the Clinical Placement
Co-ordinator (CPC) will allocate the student to an associate preceptor. The student will actively participate in assessing, planning, implementing and evaluating nursing care under the supervision of the preceptor.
N.B.
Students need t o work wi thin t hei r Scop e of Nursing Practice . For exampl e under no circumstances may any pre-registration nursing student be involved in the administration
(i.e. hanging, altering flow rate or disconnection) of intravenous fluids/drugs, additives or ‘flushes’ to I.V infusions.
STUDE NT ASSESSMENT AND CPC ROLE
STUDE NT ASSESSMENT AND IMPO RTANT CRIT ERI A
Students should review their Clinical Learning Outcome (CLO)/Competency books prior to commencing clinical placement. On commencing the placement it is expected that students can identify what they would like to achieve.
The CPC will offer advice on what CLOs/Competencies are achievable in each clinical area.
The C LO/C ompet enc y Bookl et must be availabl e for revi ew ever y da y on placement.
It is the responsibility of the student to arrange suitable interview times with the preceptor.
N.B
. The student must have reflective notes written prior to scheduled interview with their preceptor. Reflective notes form part of the assessment/interview.
The CPC should be contacted as soon as possible if there is a possibility that outcomes may not be achieved.
CPC ROLE

Support and guide the pre-registration nursing students within CUH, CUMH, St.Finbarr’s
Hospital, and External Mental Health sites.

Assist in the creation and maintenance of a quality clinical environment that enhances nursing student’s clinical competence and knowledge.

Provide support, guidance and act as a resource for clinical nursing staff and preceptors.

Actively participate in practice development initiatives in conjunction with Clinical staff.

Facilitate working groups involved in practice development. CPC RECORD OF
STUDENT PLACEMENT
11

The CPC will document the initial and subsequent contact with the BSc Nursing Student for the duration of the practice placement. Significant issues and record of CPC interactions and agreements reached with student will be recorded. The student may ask or be asked to co-sign the record.
2.6 ATTENDANCE AND ABSENTEEISM
Cork University Hospital Group (CUH):
BSc Nursing Programmes: Internship Student
Who to contact prior to and following absence on Clinical Placement
When I realise that I am unfit for duty or before start of shift I make telephone contact to report any absenteeism (including PREP) absenteeism to:
1.
CNM / Nurse in charge
2.
Duty Office / bleep Night Superintendent
Medical Certificates and Fitness to Resume Work Certificates
I forward Medical Certificates and Fitness to Resume Work Certificates to the Duty Office
*When returning from any absenteeism (including PREP absenteeism) I must contact
1. Duty Office or night Superintendent (at least 12 hours prior to commencing duty)
2. CNM / Nurse in Charge
3. ALO
* In the event of I having a day off or annual leave immediately following absenteeism period I must report back to above personnel as appropriate prior to commencing days off or annual leave
Repayment of Clinical Hours:
1. Is not permitted during 36 week Internship
2. Must occur on completion of internship placement
12

CONTACTS
Cork
University
Hospital
CUH
Rose Hayes, Allocations Liaison Officer (ALO), General Nursing
Programme CUH
Bebhinn O’Sullivan, Allocations Liaison Officer (ALO), Integrated
Children’s and General Nursing Programme CUH
CUH Duty Office / Night Sisters Bleep
CUH Clinical Placement Coordinators (CPC’s), Bleep CPC linked to relevant area
Main CPC Office
Telephone
021
– 4922072
021
– 4922060
021
– 4922108
021 – 4922079
021 - 4922059
Bleep
691
702
695/703
13

Absenteeism Algorithm: Supernumerary student
BSc Nursing Programmes, Cork University Hospital Group (CUH)
Who to contact prior to and following absence on Clinical Placement
At start of scheduled shift contact the following personnel in the relevant hospital personnel in must contact:
CUH
1.
Clinical Nurse
Manager (CNM) /
Nurse in charge
2.
Link CPC /
CPC Main Office
Medical Certificates
Submit Medical Certificate and or Fitness to Resume Work Certificate to Allocations Office in UCC.
Make telephone contact with:
Returning from any absenteeism
1.
Clinical Nurse Manager (CNM) / Nurse in charge
2.
CPC
* Please refer to Practice Placement Booklet for further details
Repayment of Clinical Hours
1. Hours may be repaid during placement if cumulative total of all absenteeism is less than 29 hours.
Repayment of clinical hours must be negotiated with the ALO, CPC and CNM.
2. When cumulative hours of all absenteeism during supernumerary placements exceed 29 hours, repayment occurs during the summer and is co-ordinated by the ALO.
Hospital
Cork
University
Hospital (CUH)
CONTACTS
Switch Board
Rose Hayes, Allocations Liaison Officer (ALO), General
Nursing Programme
Bebhinn O’Sullivan, Allocations Liaison Officer (ALO),
Integrated Children’s and General Nursing Pathway
Clinical Placement Co-ordinators
Main CPC Office
Telephone Bleep
021 -
4546400
021 –
4922072
021 –
4922079
021 -
4922059
691
702
695/703
14
SFH
1.
Clinical Nurse Manager
(CNM) / Nurse in charge of the clinical area before start of shift
2.
Link CPC

PUNCTUALITY
The student must report to the Clinical Nurse Manager or nurse in charge on arrival to the area and prior to leaving the area daily. The student is expected to be present in the area at least five minutes prior to commencement of the patient hand-over report
DRESS CODE/UNIFORM
For further information on dress code please refer to practice placement booklet
Regarding:-
Uniforms (please read CUH uniform policy 2011)
Hair
Nails and nail decoration
Jewellery
Footwear
Identification
PRACTICE PLACEMENT BOOKLET
Please refer to your practice placement booklet for information on the following:-

Occupational Health

Safety, Health and Welfare

Student Practice Placement record Sheet

Confidentiality

Smoking, there is a no smoking policy in CUH

Mobile phones

Incidents and Near Misses Involving Nursing Students
15

FOR YEAR 1 THE LEVEL OF ASSESSMENT IS EXPOSURE LEVEL
THE CUES ARE:

THE STUDENT OBSERVES A COMPETENT PRACTITIONER DELIVERING
NURSING CARE

THE STUDENT BECOMES CONSCIOUS/FAMILIAR OF AN EXPERIENCE OR
INTERACTION

THE STUDENT RESPONDS TO AN INVITATION TO PARTICIPATES IN AN
EXPERIENCE

THE STUDENT INTERACTS WITH THE EXPERIENCE AND ANTICIPATES
PARTICIPATION IN IT
FOR YEAR 2 THE LEVEL OF ASSESSMENT IS PARTICIPATION LEVEL
THE CUES ARE:

PHYSICAL & MENTAL INCLUSION/INVOLVEMENT IN AN
EXPERIENCE/LEARNING OPPORTUNITY

AND/OR REPLICATION OF A PREVIOUSLY EXPOSED EXPERIENCE AT ACTIVE

PARTICIPATION LEVEL
FOR YEARS 3, 4 & 5
IDENTIFICATION LEVEL
THE CUES ARE:

ACTIVE PARTICIPATION WITH LESS PROMPTING FROM PRECEPTOR

MORE DEVELOPED COMMUNICATION SKILLS

HUNGER FOR MORE INFORMATION

ANALYSE/BREAKDOWN INFORMATION

INTERPRET/EXPLAIN THE MEANING OF THIS INFORMATION

DEMONSTRATE PROBLEM SOLVING SKILLS
 THE STUDENT’S ABILITY TO REFLECT ON THE EXPERIENCE-EMOTIONAL,
INTELLECTUAL, ORGANISATIONAL, STRUCTURAL & VALUE
INTERNALISATION LEVEL
THE CUES ARE:

SELF-DIRECTED

PROGRESS COMES FROM WIITHIN THE STUDENT

PROBLEM SOLVING BECOMES AN UNCONSCIOUS ABILITY

EXPERIENCE INFLUENCES/IMPACTS UPON THE STUDENTS LEARNING
16

Prior to commencing night duty you should ensure you get plenty of rest/sleep the day that you are due to commence night duty.
 Students must introduce themselves to the nurse in charge on night duty prior to report.
 Student to identify themselves as a student if in contact with any member of the multidisciplinary team
 Student interview times to reflect on clinical learning and achievement of Competencies
/Clinical Learning Outcomes should be arranged by student and preceptor on first night.
 At all times students and qualified staff adhere to the CUH Practice Placement Booklet for B.Sc.
Students.
The canteen is open 12.30 MN – 2AM but it is advisable that you bring food and drinks with you. Full uniform and identification badges as per day shift is required. It is also advisable to bring a warm cardigan (navy).
20.30 – Midnight
 Clarify any uncertainties following report with preceptor / staff nurse.
 Review patient caseload with staff nurse and identify any immediate needs
 When assessing each patient, factors which could impact on patient’s sleeping pattern need to be addressed
 A complete set of vital signs must be done if any abnormality in vital signs is identified and the staff nurse must be informed immediately
 The patient’s physical environment should be organized in a manner that is conducive to sleeping e.g. assist patient with toileting prior to settling, have a drink nearby, put down backrest, give clean sputum carton.
 Vulnerable patients need to be assessed in relation to pain relief, oral hygiene and pressure area management. If problems are identified these must be brought to staff nurses’ attention
 If the patient is fasting from midnight:
 Fasting signs should be put over patient’s bed and an explanation given to the patient to fast from all food types and no drinking permitted (including water).
 Instruct patient on oral hygiene or implement if indicated
 Students may participate in drug rounds, however in some situations at night this may not be practical. The student may take the opportunity to review patient’s drugs with the staff nurse during the night.
 Fluid balance charts should be completed.
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00–04.00 am
 Ensure that lights are dimmed and noise level kept at a minimum
 Walk around every 30 minutes to 1 hour to all areas and check that patients are comfortable
 Continue to assess vital signs of patients who require same throughout the night – ensuring to report abnormalities to preceptor/staff nurse
 Perform oral care and reposition patients who you identified early in night as requiring same
 Assist patient with toileting needs
 Assist in preparing documentation for pre-operative patients or patients who are having investigations done the following day
 Under supervision of staff nurse check emergency trolley, suction machine, glucometer, MDA drugs as is practiced in the area.
 Ensure that all updates on patients are given to nurse writing report.
 Utilise educational resources in clinical area.
05.00 - 08.00AM
 Ensure fluid balances are totaled correctly, that the fluid balance chart for the next day is prepared if appropriate
 Ensure under supervision of preceptor / staff nurse that patients first on list for theatre / procedure are ready.
 Hand-over of a patient with preceptors supervision is encouraged
Please note that suggestions given here are not exhaustive and are given only as guidelines
– care of your patient’s will be determined by the patient’s condition
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IMPORTANT NUMBERS
Emergency
Cardiac
Fire
Security
Nursing Personnel
Director of Nursing
Number
22555
22222
Bleep 137
Ms. Mary Mills
Assistant Director of Nursing
Clinical Nurse Manager 2(CNM 2)
Ms. Betty Hickey
Ms. Mary Crowley
Clinical Nurse Manager 1(CNM 1) Fiona Giles-Kingston
Clinical Placement Co-ordinator (CPC) Kathy Healy
Bleep 695 or 703
Ext. (021) 4922079
CARDIAC REHABILITATION PERSONNEL
Cardiac Rehabilitation Co-ordinator Valerie O’ Sullivan
Cardiac Rehabilitation Co-ordinator Valarie Collender
Chest Pain & Heart Failure CNS Catriona Kenneally
Cardiology ANP
Health Promotion Officer
Gerry Allen
Patricia Good
Cardiology Co-ordinator
Clinical Facilitator - Critical Care Course
Clinical Nutritionist
Catriona O’ Donovan
Breda Doyle
DISCHARGE CO-ORDINATORS
Jane Kelly & Pauline O Keefe (Over 65’s) Bleep 569
Regina McCarthy (under 65’s) Bleep 855
USEFUL TELEPHONE NUMBERS
Name / Location
Hospital Number
Step down unit
CCU
Main Reception
Switchboard
Salaries
Security
Duty Office
Porter
Night Porter
Phone Number
021 4546400
34050
34040/34041
22100
9
20966
22680/22108
Bleep 381
Bleep 384
Ext 20864
VPN 62478
Ext. 22286
086 6871340
Bleep 684
Bleep 411 Ext. 20840
Bleep Number
Bleep 137
Bleep 586
Bleep 587
MEDICAL PERSONNEL
Consultant
Dr. Peter Kearney
Dr. .Eugene McFadden
Dr. Ronan Curtain
Prof. Noel Caplice
Dr. Gerry Fahy
Dr. Peter Kelly
Dr. Tom McKiernan
Dr. Carl Vaughan
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