TRENT/FLEMING SCHOOL OF NURSING
TRENT UNIVERSITY
NURS 3020H: Clinical Practice Focused on Acute Care
Winter 2015 Peterborough
Course Coordinator:
Catherine Thibeault, RN, PhD
Office: Life and Health Sciences C 162
Telephone: (705) 748-1011 ext. 7067
Email: cthibeault@trentu.ca
Office Hours: By Appointment
Program Secretary: Samantha Perritt
sperritt@trentu.ca
Clinical Faculty:
John Corso (johncorso@trentu.ca) (PRHC)
Jennifer Parris (jenniferparris@trentu.ca)(PRHC)
Ashley Finnegan (ashleyfinnegan@trentu.ca)(PRHC)
Maureen Robinson (maureenrobinson@trentu.ca) (PRHC)
Jan Scott (janetscott@trentu.ca) (PRHC)
Diane Short (dianeshort@trentu.ca) (PRHC)
April Turner (aprilturner@trentu.ca) (PRHC)
Jennifer Massimo (PRHC)
Casey McCallum (PRHC)
Michael Bass-West (PRHC)
Wendy Symons (NHH)
Ann Vongprachanh-Rowsham (NHH)
Learning Centre:
Kelly Hudder, Senior Lab Demonstrator, kellyhudder@trentu.ca
Melissa Farrow, Instructor, melissafarrow@trentu.ca
Susan Koning, Lab Technician, susankoning@trentu.ca
Course Description
The focus for this clinical practicum is that of the adult experiencing acute illness. This clinical practicum is supported by
Learning Centre activities relevant to acute care practice including: medication administration, sterile procedures,
intravenous initiation and maintenance, cardiac resuscitation and assessment (abdominal, glycemic status, neurological,
pre-operative, post-operative, respiratory).
Students are assigned in groups to inpatient units in one of three local acute care hospitals: Peterborough Regional Health
Centre (Peterborough), Ross Memorial Hospital (Lindsay) or Northumberland Hills Hospital (Cobourg). A total of 182
hours of practice are provided through the various elements of this course.
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Course Pre-requisites
Minimum of 60% in all required NURS 2000 level courses and BIOL 2550H.
Co-requisite
Nursing 3000
Course Format
Type
Week Days
Time
Location
Clinical practice
Thursdays,
Fridays,
Saturdays,
Sundays
Two eight-hour shifts per week for 10 weeks
(160 hours), day shift and evening shift, some
weekends, including two hours of postconference seminar per week.
As assigned to
each group
Clinical Learning
Center practice
Mondays OR
Tuesdays
Two hours per week for 11 weeks as per
assigned groups (22 hours)
Learning Centre
Room C 142
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Course Objectives
In order to be successful in this course, learners must meet the following objectives.
By participating in the required period of supervised laboratory practice, clinical practice and seminars, and completing a
learning plan, reflective journals, portfolio entries and clinical evaluations, the learner will be able to:
1. Explain the experience of acute illness in individuals receiving care in acute setting
2. Interpret critical aspects of the person’s experience of acute illness in relation to common signs and symptoms,
responses to treatment, patterns of coping, and impact on individual and family relationships
3. Identify common medical treatments and potential consequences/complications of selected acute illnesses
4. Demonstrate selected nursing and collaborative interventions related to clinical pathways, peri-operative care, IV
medication administration, cardiac assessment and rhythm strips, neurological assessment, wound care, blood
component therapy, TPN and central lines, pulmonary care including chest tubes and tracheotomy, initiating IVs,
rapidly changing conditions, and resuscitation.
5. Under the supervision of a Registered Nurse, demonstrate safe, competent, evidence-based, holistic nursing
practice with clients with acute illness
a. Apply relevant nursing models, philosophical frameworks, theories and evidence
b. Demonstrate therapeutic use of self
c. Engage with patients in an ethical and culturally safe manner
d. Understand and anticipate emerging bio-psycho-social needs of persons with acute illness and apply this
knowledge to care:
i. Plan appropriate nursing care
ii. Predict outcomes of nursing care
iii. Evaluate client response to nursing care
e. Demonstrate health promotion and illness prevention practices
i. Engage with patients and families to identify health-related situational challenges
ii. Work with patients and families to create reasonable and effective solutions
f. Demonstrate patient advocacy
g. Demonstrate accountability
h. Demonstrate reliability
6. Critically appraise own practice in relation to nurse-client/family interactions and as a member of the health care
team
7. Participate in professional development based on reflective practice and critical inquiry
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Recommended Texts
Medical-Surgical Nursing
Lewis, S., Dirkson, S., Heitkemper, M., Bucher, L., & Camera, I. (2014). Medical-surgical nursing in Canada:
Assessment and management of clinical problems. Toronto: Elsevier.
Nursing Fundamentals
Potter, P., Perry, A., Ross-Kerr, J. & Wood, M. (2010). Canadian Fundamentals of Nursing. (4th
ed). Toronto: Mosby.
OR
Kozier, B., Erb, G., Berman, A., Snyder, S., Bouchal, S., Yiu, L., Stamler,L., & Buck, M. (2010).
Fundamentals of Canadian nursing: Concepts, process and practice. (2nd ed.). Toronto, ON: Pearson.
Health Assessment
Jarvis, C. (2014). Physical examination and health assessment. Toronto: Elsevier.
OR
D’Amico, D., Barbarito, C. (2012). Health & Physical Assessment in Nursing: Canadian Edition. Toronto: Pearson
Video Resources
Mosby’s Nursing Video Skills (Clinical Learning Centre)
Intermediate
Advanced
Clinical Practice Guidelines
www.cno.org - Professional Standards of Practice (2002)
 Medication standards (2008)
 Ethics (2009)
 Therapeutic Nurse Client Relationship (2006)
 Documentation (2008)
RNAO Best Practice Guidelines
www.rnao.org
 RNAO BPG- Establishing a therapeutic relationship
 RNAO BPG-Client Centered Care e-learning module
Student Handbook available on intranet (required reading)
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Evaluation
All components are evaluated as either “Satisfactory” or “Unsatisfactory”. The student’s final grade will be either “Pass”
or “Fail”. In order to pass Nursing 3020, a student must receive “Satisfactory” in all components, including laboratory
practice, clinical practice and written assignments.
If a student does not complete and submit all required written components, the student will not pass the course.
1. Student portfolio
Throughout the course, students will continue to develop their learning portfolio. By documenting their progress
in the portfolio, students will integrate theory with clinical practice. The portfolio will include evidence of
learning. The portfolio also includes artifacts that demonstrate the student’s learning process, such as reflective
writing, important articles, and additional examples of written feedback. Evidence in the student’s portfolio helps
the student and the clinical instructor complete the final clinical evaluation.
Students should develop their portfolio throughout the semester. The instructor may review the student’s portfolio
at any time during the semester. The completed portfolio will be submitted by March 15th at 2400.
2. Clinical evaluations
a. Instructor. Evaluation of student performance is an ongoing part of the clinical experience. Mid-term and
final evaluations will be completed by clinical instructors. Evaluations must contain specific evidence
that the student has been successful in meeting the learning objectives as set out in the learning plan, as
well as evidence that the student has met course objectives. An important component of a satisfactory
clinical evaluation is a satisfactory record of attendance. Mid-term evaluations will be completed by
February 28th and final evaluations will be completed by March 29th.
b. Self. Evaluation of one’s own performance is an ongoing part of the clinical experience. Students will
complete mid-term and final self evaluations. Evaluations must contain specific evidence that the student
has been successful in meeting the learning objectives as set out in the learning plan, as well as evidence
that the student has met course objectives. Mid-term evaluations will be completed by February 28th and
final evaluations will be completed by March 29th.
Please Note: Remember that your clinical instructor will need to review your self-evaluation in advance of your final
evaluation. Your instructor may ask you to submit your self-evaluation up to a week before your final evaluation is
scheduled.
3. Reflective journals
Twice during the semester, students will submit an example of reflective writing. This reflective writing must
provide evidence of knowledge synthesis and critical reflection. Students can choose when to submit their
writing, although one must be submitted before January 25th, 2015, and both must be submitted by March 22nd
2015.
4. Pre and post clinical practice tools
Each week, students will complete a pre-post clinical practice tool for each assigned patient. The pre-clinical
portion of the tool must be presented to the clinical instructor prior to the start of shift on the first clinical day of
the week. Pre and post clinical practice tool with collected assessment information may be submitted
electronically to your clinical instructor as directed by clinical instructor.
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5. Student led seminars
Students will lead a one hour seminar related to a patient with whom they have worked. Students will synthesize
current nursing and related evidence and create a comprehensive individualized plan of care. A theoretical
framework of the student’s choice will underpin the plan.
6. Learning Centre participation
Beginning January 12th or 13th and for 12 weeks, students will attend and participate in scheduled Nursing
Learning Centre activities. This is an integral part of the course.
In order to pass the course, students must:
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

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Be present and actively participate in all components of Learning Centre activities; students must have a
satisfactory record of attendance.
Submit evidence of completion of Learning Centre activities to the Learning Centre instructor as required
in each lab
Demonstrate satisfactory completion of all Learning Center activities, including quizzes
Participate in remediation sessions or tutorials when recommended by the course professor or lab
instructor
What is satisfactory completion of requirements? Completion of all lab preparation activities, attentive listening,
active collaboration with lab partners, and completion a return demonstration of newly acquired practice skills
will merit a “satisfactory” rating by the lab instructor. Within each lab, the lab instructor may designate certain
skill demonstrations or learning activities as critical; that is, students must complete these demonstrations or
activities in order for their performance to be considered satisfactory. Students should expect to receive formative
feedback from the lab instructor during most practice sessions. If students are unable to demonstrate satisfactory
level of competency in dosage and infusion calculations, they will be required to attend mandatory remediation
sessions. If students who are required to attend these sessions do not attend, then they will not receive a
“satisfactory” rating in that course component.
What is satisfactory attendance? Students who attend and participate in all required Learning Centre practice
hours will be considered to have satisfactory attendance. Any absence, brief or extended, no matter how
reasonable or acceptable (e.g. serious illness, lengthy illness, bereavement, or injury) may result in an
inability to meet Learning Centre requirements and/or course objectives and a grade of “Fail”, unless the
student is given permission to withdraw from the course. Students should note that there are no scheduled
“make-up” lab sessions. When individual students require remediation due to learning challenges, then the lab
instructor and course professor will work with the student to develop an individual learning plan, which may or
may not involve additional lab practice time. Unwarranted or unexplained absence from lab does not necessarily
qualify a student for remediation with additional practice time. Students who choose to miss a lab for unwarranted
reasons do so at their own risk.
REMEMBER: If students do not demonstrate satisfactory completion of Learning Center requirements or
satisfactory attendance and remediation or coaching is not successful, students will fail the course.
Assignment Guidelines
1. All assignments will be completed as individual work unless otherwise stated.
2. Individual written assignments will be graded as “Satisfactory” or “Unsatisfactory”.
3. All required written submissions (reflections, pre- and post-clinical assignments, portfolios, self-evaluations) must
be submitted in the appropriate Blackboard drop box by the due dates, unless other arrangements are made with
the instructor.
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4. Handing in assignments on the due date and time demonstrates “professional responsibility and accountability”,
which are course outcomes. Failure to do so jeopardizes the student’s ability to be successful in the clinical course
and may lead to grade of “Unsatisfactory” or “Fail”.
5. Instructors will not ask students to resubmit written work more than once.
6. There will be no opportunity for students to redo or complete supplementary, make-up assignments.
University Policies
Please see the Trent University academic calendar for University Diary dates, Academic Information and Regulations, and
University and departmental degree requirements.
Access to Instruction
It is Trent University's intent to create an inclusive learning environment. If a student has a disability and/or health
consideration and feels that he/she may need accommodations to succeed in this course, the student should contact the
Accessibility Services Office (BL Suite 132, 748-1281, accessibility services @trentu.ca) as soon as possible. Complete
text can be found under Access to Instruction in the Academic Calendar.
Academic Integrity
Academic dishonesty, which includes plagiarism and cheating, is an extremely serious academic offence and carries
penalties varying from a 0 grade on an assignment to expulsion from the University. Definitions, penalties, and
procedures for dealing with plagiarism and cheating are set out in Trent University’s Academic Integrity Policy. You have
a responsibility to educate yourself – unfamiliarity with the policy is not an excuse. You are strongly encouraged to visit
Trent’s Academic Integrity website: www.trentu.ca/academicintegrity. Please read the Calendar Supplement to the 20132013 Academic Calendar Academic Integrity Policy p. 2.
Plagiarism. Plagiarism will result in a charge of academic misconduct as outlined in the University policy. Please read
the note below pulled from the University policy on plagiarism, along with the nursing-specific examples**, to ensure
knowledge about the full extent of ways that plagiarism can occur. Ignorance of this policy is not reason to prevent
charges of academic dishonesty.
Plagiarism is knowingly presenting words, ideas, images, data, or any other form of work of another person (including
essays, theses, lab reports, projects, assignments, presentations and posters**) in a way that represents or could be
reasonably seen to represent the work as one’s own. “Knowingly” includes ought reasonably to have known. Plagiarism
includes failure to acknowledge sources correctly and submitting materials copied from the internet without proper
acknowledgement of the source. Draft work submitted for evaluation is subject to the same standard as final work.
** The School of Nursing has determined that these sources also include slides and other course specific materials
designed and presented by course instructors. Adapting, paraphrasing requires citation. Direct quoting requires quotes
and citations per APA, 6th edition.
Similar work in two courses. Except with the written permission of both instructors involved, a student cannot submit
the same work, or work that is similar, for credit in two courses. By doing so, the student is practicing self-plagiarism.
This is an academic offence.
Walk Home Safe
Walk home provides a safe alternative to walking alone at night. Teams of screened student volunteers will walk you
anywhere within 25 minutes of Symons or Traill campus. Walks can be pre-arranged or requested as needed by calling
705-748-1748.
Trent/Fleming School of Nursing Academic Integrity Statement
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Integrity in practice is essential for nurses. The Ethical Framework (CNO, 2009) specifies that Registered Nurses:
“have an obligation to maintain the commitments they assumed as regulated health
professionals.Maintainingcommitmentsmeanskeepingpromises,beinghonest and meeting implicit or explicit
obligations toward their clients, themselves, each other, the nursing profession, other members of the health care
team and quality practice settings”
Ethical Framework, p. 9
Faculty in the School of Nursing is expected to meet this obligation and, in turn, expect students as future members of the
profession to do the same.
For the purpose of interpreting and applying the University’s Academic Integrity policy, the Nursing Program has adopted
the following:
When a student submits a piece of written work in fulfillment of an assignment, she/he implicitly acknowledges
the following: a) that she/he is the sole author of the work; b) that the wording and organization of the work, apart
from acknowledged quotations, paraphrasing or adaptation, is her/his own; and c) that she/he has not and will not
submit this work, either as a whole or in part, to satisfy another course requirement. These basic assumptions will
be reasonably interpreted. They do not preclude collaboration between students upon a single project, by prior
arrangement with the instructor (such as a group assignment), for shared academic credit (either for written or oral
presentation). APA 6th edition is required. Failure to use this standard consistently will result in a deduction of at
least 10% of the total grade for the paper.
Clinical Placement Policies
Department and/or Course Policies:
The Student Handbook (2014-2015), posted on the School of Nursing Intranet, contains substantial information related to
clinical practice settings. All students are accountable for reviewing that material.
Students are required to understand and adhere to all of the policies in the School of Nursing Handbook (204-2015),
including, but not limited to the following:
 Gift policy
 Incident reporting policy
 Dress code
 Instructions for Reporting a Student Injury During an Unpaid Student Placement
 Ethical and Professional Guidelines for Students
 The Nursing Student and Conflict of Interest
Forms and instructions for reporting an actual or potential injury are posted on the SON Intranet site.
Failure to comply with the uniform policy will result in being sent home to change into appropriate attire and may result
in lost clinical practice hours.
Starting times for clinical placements vary. Students should be aware that practicum placements may be scheduled from
0700-1500 or 1400-2200, and each student may be required to do day shift, evening shift, or a combination of both.
Travel time is not included in practice time.
Students may be required to practice at hospitals in Peterborough, Cobourg, and Lindsay. Students are encouraged to take
advantage of the taxi pass which is available for purchase from the TFSON main office. If students participate in group
taxi travel, it is their responsibility to meet at the assigned pick-up site. Drivers will not wait for students who arrive late at
the pick-up site.
Absence from Clinical Placement
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If you are ill or unable to attend due to family emergency, you must:
 Notify the clinical instructor and the unit where you are working at least 30 minutes prior to the
commencement of the shift. You must notify the unit by telephone. You may use other means (text message,
email) to notify your instructor and travel colleagues when necessary as long as each participant agrees.
 If you are taking a taxi to a clinical setting, inform a student with whom you normally travel at least 30 minutes
prior to the scheduled departure, so that the driver knows that you will not be travelling that day.
 Communicate in a timely fashion with the clinical instructor about your estimated return to clinical practice
 Upon your return, meet with the clinical instructor and supply suitable documentation supporting the reason for
your absence.
 Any absence, brief or extended, no matter how reasonable or acceptable (e.g. serious illness, lengthy illness,
bereavement, or injury) may result in an inability to meet the course objectives and a grade of “Fail” unless the
student is given permission to withdraw from the course.
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Weekly Activities
Week 1 January 7th-January 13th Labs begin Monday January 12th or Tuesday January 13th. Watch orientation lecture
(Panopto) and complete quiz. Some groups begin clinical on Friday January 9th or Saturday January 10th. Site-specific
orientation may include ADU, EDOC and/or medi-tech training as required. First clinical practice shift is focused on
orientation to the unit and the instructor. Clinical practice with patients begins on day 2 of clinical.
Week 2 January 14th- January 20th Labs continue; clinical practice begins (for those who did not begin the previous
week) Thursday day shift (0700-1500) or evening shift (1400-2200) or Saturday day shift (0700-1500) or evening shift
(1400-2200). Site-specific orientation may include ADU, EDOC and/or medi-tech training as required. First clinical
practice shift is focused on orientation to the unit and the instructor. Clinical practice with patients begins on day 2 of
clinical.
Week 3 January 21st-January 27th
Labs and clinical practice continue; prepare pre-clinical practice tool; post conference discussions: Group norms and
team building and review of experiences available on acute care unit and debriefing. Reflective journal due not later
than January 25th at 2400.
Week 4 January 28th-February 3rd
Submit pre/post clinical practice tool from previous week at the direction of instructor; labs and clinical practice
continue; post conference discussions: clinical assignment debriefing and “What does the concept of therapeutic
relationship mean in the acute care setting?”
Week 5 February 4th-February 10th
Submit pre/post clinical practice tool from previous week; labs and clinical practice continue; post conference
discussions: “Culture: what does it mean in caring?” and clinical assignment debriefing.
Week 6 February 11th-February 15th (Reading week February 16th-February 20th)
Submit pre/post clinical practice tool from previous week; clinical practice continues; post conference discussions:
“Health teaching and advocacy in acute care” and clinical assignment debriefing; prepare mid-term self-evaluation;
mid-term meeting with clinical instructor to discuss progress
Week 7 February 23rd-March 1st
Submit pre/post clinical practice tool from previous week; labs and clinical practice enter sixth week and halfway point;
post conference discussions: “Discharge planning-what are the challenges for patients and families?” and “Reframing
the experience: What have I learned to now? What do I need to learn for the remainder of the rotation? What do I need
to do to make this happen?” Portfolio due Feb 23rd at 2400.
Week 8 March 2nd-March 8th
Submit pre/post clinical practice tool from previous week; labs and clinical practice continue; post conference
discussions: student led seminars.
Week 9 March 9th-March 15th
Submit pre/post clinical practice tool from previous week; labs and clinical practice continue; post conference
discussion: student led seminars.
Portfolio due March 15th at 2400
Week 10 March 16th-March 22nd
Submit pre/post clinical practice tool from previous week; labs and clinical practice continue; post conference
discussion: student led seminars.
Reflective journal due no later than March 22nd at 2400
Week 11 March 23rd-March 29th
Submit pre/post clinical practice tool from previous week; labs and clinical practice continues; post conference
discussions: student led seminars. Final clinical evaluation meeting including review of electronic portfolio and
completion of faculty and self-evaluation.
Week 12 March 30th-April 3rd
Extra clinical or lab practice if required due to earlier clinical cancellations.
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Nursing Learning Centre Schedule
Please see each week’s lab for required preparation. The focus of a particular lab may change if operational issues force a
change. Students will be informed of any change in topic at least one week in advance of the change.
You will be required to complete at least two quizzes on dose calculation and infusion rate calculation. Be sure you have
reviewed all the content that you have learned in previous courses in relation to these competencies. If you are unable to
demonstrate satisfactory level of competency in this area, you will be required to attend remediation sessions.
Labs
Lab 1
Lab 2
Lab 3a
Lab 3b
Lab 4
Subject Areas
Getting started safely
Reporting, data collection, charting, safety, vital signs review
Head-to-toe assessment review
Care for the client requiring peri-operative care-assessment, pre-op assessment, review of clinical
pathways, anti-embolic stockings, health teaching, post-op exercises, wounds, hydration
Care for the client requiring IV medication administration/ multiple infusions
Care for the client requiring IV medication administration/ multiple infusions
Care of the client with cardiac issues, heart and neck vessel assessment, rhythm strips
Residential Reading Week Feb 16th--22nd
Lab 5
Care for the client with neurological issues-neurological assessment
Lab 6
Care for the client with acute wounds-stitches, staple removal, packing
Lab 7
Care for the client requiring blood component therapy-conservation, TPN, central lines
Lab 8
Lab 9
Lab 10
Care for the client requiring pulmonary care-suctioning, tracheostomy, chest tubes
Care of the client requiring IV initiation
Simulation: Mrs. Weller
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