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COLLEGE OF SAN MATEO
NURSING 242 SYLLABUS
SPRING 2012
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Can you believe this is your last syllabus?? I am looking forward to being your final
theory instructor at College of San Mateo’s Nursing Program. In these next eight weeks,
as you look forward to graduation and the pinning ceremony, I will help guide you
through the last leg of your journey as a nursing student. We will continue with
leadership issues that will help to prepare you for your “departure” in May. We will
also explore the ever-changing frontier of Neuroscience Nursing. Finally, our last class
will be conducted like a professional round table luncheon.....you will provide the food
and beverages and I will provide you with the professionals. Take note of the Critical
Thinking Activities for each class meeting. Please complete these prior to coming to
class, so that we can all participate in a rich discussion.
I have been honored to be your instructor this past year and wish each and
everyone of you the very best. See you on March 19th as we count the days to the
Pinning Ceremony.
Janis Wisherop RN, MSN
Nursing Professor
#5-373
(650)574-6352
wisheropj@smccd.net
Office hours posted on line
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I. Course Materials
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COLLEGE OF SAN MATEO
N242
TABLE OF CONTENTS
SECTION I:
COURSE MATERIALS
Course Outline……………………………………………………………………………….5
Course Information………………………………………………………………………....10
SLOs………………………………………………………………………………………...11
Clinical Evaluation Tool…………………………………………………………………....12
Nursing 242 Study Guide…………………………………………………………………...19
Grade Tally Sheet…………………………………………………………………………...26
SECTION II:
GUIDELINES FOR ASSIGNMENTS
Resume Writing - Position Inquiry & Interview…………………………………………...36
Resume Critique Form……………………………………………………………………...37
Health Fair Presentation………………………………………………………………….…38
Health Fair Presentation Grading Criteria…………………………………………………..40
RN Leading Experience Guideline……………………………………………………….…41
RN Leading Experience Criteria ………………….…………………………………..…....42
Delegation/Supervisory Skills Analysis ……………………………………………………43
RN Leading Assignment Tree and Critique Grading Criteria………………………………45
RN Leading Rubric……………………………………………………………………….…47
Student-Conducted Patient Care/Multidisciplinary Team Conference Guideline…….…...49
Student-Conducted patient Care /Multidisciplinary Team Conference: Grading Criteria
Sheet………………………………………………………………………………………....50
Performance Based Competency Assessment Day/Clinical Scenario……………………..51
SECTION III:
CLASS OBJECTIVES AND INSTRUCTIONAL GUIDES
Ethics: Ethical Analysis………………………………………………………………………57
Systems that Support Delivering Quality Care: Nursing Service Delivery Patterns, Patient
Classification Systems and Job Classifications……………………………………………….60
Cost Effective Nursing: Managing Yourself, the Environment and People Around You…...66
Effective Communication: Conflict Resolution, Mediation and Negotiation, and Concepts
of Delegation………………………………………………………………………………….71
Leadership Presentation of Self in Person and in Writing…………………………………….75
The Transition: Student to Professional (Reality Shock)…………………………………….78
Neuroscience Review Sheet…………………………………………………………………..80
Review of the Neurological System & Diagnostics…………………………………………..82
Increased Intracranial Pressure………………………………………………………………..82
Neurological Assessment……………………………………………………………………...85
Nursing Care of the Patient with Intracranial Disorders………………………………………88
Interventions for Intracranial Disorders……………………………………………………….93
Nursing Care of the Patient with Cerebrovascular Disorders…………………………………96
Nursing Care of the Patient with Convulsive Disorders………………………………………100
Nursing Care of the Patient with Spinal Cord Disorders……………………………………...106
Nursing Care of the Patient with Infectious, Inflammatory or Autoimmune Disorders………111
Nursing Care of the Patient with Degenerative Neurological Disorders……………………...117
Nursing Care of the Patient with Peripheral and Cranial Nerve Disorders……………………122
Nursing Care of the Patient with (neuro) Endocrine Disorders……………………………….128
Nursing Care of the Patient with Eye Disorders………………………………………………133
Health Care Trends……………………….……………………………………………………134
Professional Trends………………..…………………………………………………………...135
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COLLEGE OF SAN MATEO
COURSE OUTLINE
DEPT. & NUMBER:
COURSE TITLE:
UNITS:
NURS 242
Leadership/Management In Nursing
5
LECTURE HOURS/WEEK 5
LAB HOURS/WEEK 5
OTHER
HOURS/WEEK
LENGTH OF COURSE:
SEMESTER-LONG
X
SHORT COURSE (SPECIFY NO. OF WEEKS
8-9 )
GRADING: X LETTER
CREDIT/NO CREDIT
GRADE OPTION (letter or C/NC)
Open
Entry/Open Exit
1.
PREREQUISITE:
Completion of Nurs 241 or equivalent.
2.
COREQUISITE:
Concurrent enrollment in Nurs 245
3.
RECOMMENDED PREPARATION:
4.
CATALOG DESCRIPTION (Including Prerequisites/Corequisites/Recommended Preparation):
Five lecture hours and 15 lab hours per week for eight-nine weeks. Prerequisite: NURS 241.
Corequisite: Concurrent enrollment in Nurs 245. Transition to the graduate role. Student initiate
the nursing process with emphasis on the determination of priorities, on decision-making
responsibilities, and on personal accountability. Supervised learning experiences corresponding
with classroom instruction in off-campus health care facilities.
5.
CLASS SCHEDULE DESCRIPTION (Including Prerequisites/Corequisites/Recommended
Preparation):
Theory and clinical experience in the care of adults experiencing serious illnesses. Includes
determination of priorities, decision making and personal accountability. Prereq: Completion of
Nurs 241 or equivalent. Corequisite: Concurrent enrollment in Nurs 245.
6.
COURSE OBJECTIVES:
THEORY OBJECTIVES
Note: Objectives for I, II, III, are related to:
1. Regulatory
2. Sensorineural
3. Transportation
At the completion of Nursing 242 the student will be able to:
OPERATIONALIZE THE NURSING PROCESS AND USE CRITICAL THINKING
SKILLS TO PROMOTE HOMEOSTASIS
A. Relate the concepts of anatomy and physiology with emphasis on mechanisms to attain and
maintain homeostasis and an optimum state of wellness in patients of all ages.
B. Evaluate and explain multi-system assessment techniques.
C. Describe possible signs and symptoms in different patient situations.
D. Compare and contrast biological, psychological developmental, age related, social, cultural,
and spiritual responses to stress and illness on a wellness-illness continuum.
E. Evaluate the risk factors for illness related to life styles and environment.
I.
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II.
III.
IV.
V.
F. Compare and contrast acute and chronic illnesses.
G. Differentiate normal/abnormal diagnostic physiological and/or psychological tests and health
histories to specific nursing and medical diagnoses.
H. Relate planned individualized nursing interventions through use of prioritized nursing
diagnoses and therapeutic interventions specific to each nursing diagnoses.
I. Relate accurate and effective nursing interventions that indicate updated scientific findings and
a sensitivity to patient psychosocial and physiological needs.
J. Explain how knowledge, professional preparation, personal qualities, and continual updating
contribute to quality nursing practice.
K. Relate interventions (medical and nursing) to diagnosis(es) (medical and nursing) and varying
states of wellness-illness, including interventions from a pharmacological perspective..
L. Relate means of evaluating the extent of patient goal(s) attainment and success of nursing
interventions for patients of all ages in varied health care settings.
M. Explain how levels of wellness-illness and supportive systems affect sexuality needs.
N. Utilize critical thinking skills when applying the nursing process to actual and simulated
patient situations focusing on Advance Med/Surg concepts.
O. Use the nursing process to operationalize the concept of discharge planning.
P. Compare and contrast different patient needs in the acute vs. sub-acute vs. community
environments.
Q. Applies information competency strategies in researching and preparing to deliver evidenced
based practice to community/patients and families.
ASSUME ROLE AS COMMUNICATOR
A. Evaluate situations that require mediation, negotiation and conflict resolution.
B. Describe how physiological and psychological responses affect communication with patients
of all ages.
C. Explain how to communicate with the family and significant others regarding an illness state,
diagnostic tests and procedures, disease prevention, and patient care.
D. Evaluate and apply the concepts and decision making process of delegation.
E. Discuss the importance of collaborating with members of the health team in providing patient
care.
ASSUME ROLE AS A TEACHER
A. Evaluate the learning needs of patients of all ages.
B. Discuss factors to be included in a comprehensive teaching plan.
C. Explain effective and efficient methods of teaching patients and nursing staff, and health care
personnel.
D. Compare and contrast methods of teaching patients and families according to age, education,
learning styles, cultural or ethical background.
E. Implement the teacher role during patient, peer, staff and community interactions.
ASSUME ROLE AS A LEADER/MANAGER
A. Discuss the following concepts: delegation, supervision, evaluation, problem-solving, decision
making, power and change strategies.
B. Differentiate between types of unit based conferences involving multidiscipline and/or patients.
C. Explain how to utilize available hospital and community resources to assist the patient and
family in attaining discharge goals.
D. Implement the leadership role caring for a group of patients, families and aggregates while
supervising and delegating to others.
E. Describe the nurse’s responsibility within a managed care environment in implementing case
management.
ASSUME ROLE AS A MEMBER WITHIN THE PROFESSION OF NURSING.
A. Compare functions of major nursing organizations.
B. Describe aspects of an employment search.
C. Discuss the role transition from student to graduate.
D. Relate legal and ethical implications of a standard of practice as it pertains to selected patient
situations.
E. Discuss alternatives of health care delivery and their impact on nursing today.
F. Explain the role of the nurse as a patient and family advocate.
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G. Evaluate varied professional nursing roles and the educational/clinical requirements in
attaining these roles.
H. Discuss the trends and changes in healthcare and how these impact nursing.
I.
II.
CLINICAL OBJECTIVES
Upon completion of Nursing 242 the student will be able to apply learning and skills from
previous courses as well as:
OPERATIONALIZE THE NURSING PROCESS AND USE CRITICAL THINKING
SKILLS TO PROMOTE HOMEOSTASIS
A. 1. Utilize the nursing process, with minimal supervision, to effectively provide safe nursing
care for groups of adult patients suffering from complex and life threatening diagnoses
that have predictable and unpredictable outcomes.
2. Collects, organizes and interprets data from a variety of sources regarding physiological,
developmental, psychosocial, cultural, economic and spiritual needs of patient. Identifies
patient needs according to priority.
a. Uses selected screening tools, resource people and records to systematically acquire
data.
b. Identifies deviations from normal in complex situations.
c. Identifies patient status changes in the last 24 hours.
B. Assess patient status
1. Independently identifies and documents overt and covert signs and symptoms that indicate
risk situations.
2. Determines patient’s physical and psychological adaptive mechanism and ability for
assuming responsibility for self care.
3. Completes selective assessment based on patient's priority needs.
4. Makes priority nursing diagnoses independently and with minimal supervision outlines
goals, strategies, plans and expected outcomes.
C. Plan and perform, with minimal supervision, individualized nursing interventions
designed to meet the needs of a group of patients with complex and life threatening illnesses.
a. Develops and contributes to plans of care for assigned patients.
b. Involves patient/family/significant other and health team members in plan of care.
c. Uses existing patient care plans and clinical pathways when planning to meet the needs
of individual patients.
d. Designs an individualized and unique patient care assignment sheet in preparation for
team leading.
D. Consistently performs nursing interventions competently, safely and accurately with minimal
supervision.
1. Adapt and implement nursing care based on nursing diagnoses to safely meet the needs of
a group of patients.
2. Demonstrates knowledge of medications.
3. Administer medications safely and accurately.
4. Correctly utilize principles of asepsis
5. Participate with Staff in providing care to patients in special care areas.
6. Work well under stress.
E. Identify and analyze, independently, the effectiveness of nursing interventions to meet patient
needs.
1. Design and modify nursing care plans independently.
2. Communicate effectiveness of nursing interventions to members of the health care team.
3. Evaluate the outcome of nursing interventions for patient in acute care vs. sub-acute vs. long
term vs. community environments.
4. Participate with staff in providing care to patients in special care areas.
5. Work well under stress.
ASSUME ROLE AS A COMMUNICATOR
A. Use goal-directed therapeutic communications in interactions to assist patients of all ages
experiencing moderate to severe disruptions in homeostasis.
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III.
IV.
V.
B. Establish and maintain effective working relationships with peers and other health team
members and participate in efforts to improve working relationships within a structured health
care agency.
1. Communicates with multidisciplinary staff to share goals and seek clarifications.
2. Gives feedback to staff in regard to behavior (patient, staff and family) that is obstructive
to the achievement of patient/unit goals.
3. Participates in unit staff meeting, walking rounds, and patient care conferences.
4. Delegates to unlicensed assistive personnel in a clear and precise manner, eliciting ongoing
feedback.
5. Communicates assertively.
6. Takes responsibility through positive action to correct miscommunication.
7. Recognize policies and nursing protocols that may interfere with quality patient care and
participate within the frame work of the agency to initiate change.
C. Report and record accurately, objectively, and succinctly with no important omissions patient
assessments, nursing interventions and other significant occurrences throughout shift.
1. Gives and receives change of shift report.
2. Uses policies, nursing protocols and clinical pathways to enhance quality care.
3. Completes a team leading assignment.
4. Carries out the role of team leader.
ASSUME ROLE AS A TEACHER
A. Implement, independently, goal-directed teaching plans based on the individual needs of
patients/families and groups with consideration of age and cultural diversities and evaluate the
results.
1. Identifies needs, prior knowledge, motivation and readiness to learn.
2. Collaborates with other health team members to develop short and long term goals.
3. Selects appropriate subject matter and teaching methods.
4. Organizes a teaching plan.
5. Encourages patient to problem solve.
6. Teaches toward independence in self-care.
7. Documents patient teaching.
8. Delegates components of teaching plan to others when appropriate.
9. Participates in a community team teach. In groups, students will work together on a project
to research demographics of aggregates (consumers of health information) and present
current, priority based topics (identified through Healthy People) at local health fairs.
ASSUME ROLE AS A LEADER/MANAGER
A. Obtain the services of other health team members and independently, access referrals to other
community agencies based on an assessment of the patient's/family's need for such services.
B. Confer and collaborate, independently, with other health team members to ensure continuity
and comprehensiveness of patient care.
1. Implement at least one patient care conference.
C. Determine priorities and provide total care for a case load of patients comparable to an entry
level nurse, within the assigned clinical time.
1. Assume the team leader role in the inpatient care setting.
D. Be accountable for own nursing practice.
1. Cooperates with nursing personnel and plans in advance and makes arrangement to assist
and delegate to others.
2. Takes corrective action when team member(s) or self are having difficulty with
assignment.
3. Implement the role of leader in caring for a group of patients while supervising others.
ASSUME ROLE AS A MEMBER WITHIN THE PROFESSION OF NURSING
A. Practice within the ethical standards and legal framework of registered nursing practice.
1. Maintains patient confidentiality.
2. Describes legal accountability within the framework of Nurse Practice Act.
3. Identifies patient’s rights and supports patient in maintaining/asserting right.
4. Recognizes policies and nursing protocols that may enhance/impede patient care.
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5. Incorporates the policies and protocols of the clinical agency when providing direct and
indirect patient care.
6. Demonstrates accountability and responsibility for patient care assignment, nursing role
and actions.
B. Identify own learning needs and assume responsibility for locating specific experiences or
resources.
1. States clearly and concisely goals for self-directed learning.
2. Selects nursing activities through which goals are to be achieved
3. Uses diverse resources for learning.
4. Is prepared at the start of the clinical day to care for a patient case load.
C. Evaluate learning experiences and objectively assess own progress.
1. Incorporates the role of the RN in the hospital, community and future trends, and is
cognizant of future trends, and the value of the professional organizations.
2. Discusses role of staff nurse, team leader and charge nurse as change agents to improve
patient care.
3. Identifies and discusses past practices and trends in nursing and compares these to current
and future practices and trends.
4. Identifies the major nursing organizations and their functions.
GERIATRIC HOURS: Non specified
7.
COURSE CONTENT AND SCOPE:
A. Ethical Analysis & Information Competent Nurses
B. Systems that Support Delivering Quality Care: Nursing Service Delivery Patterns, Patient
Classification Systems, and Job Classifications.
C. Cost Effective Nursing
D. Effective Communication; Conflict Resolution, Mediation, Negotiation and Delegation
E. Leadership Presentation of Self in Person and in writing
F. The Transition: Student to Professional, Opportunities and Health Care Trends
G. Assessment of the Neurological System
H.
Nursing care of the patient with Intracranial Disorders, Altered Consciousness
I.
Nursing care of the patient being Treated for Intracranial Disorders
J.
Nursing care of the patient with Spinal Cord Injury
K.
Nursing care of the patient with Cebrovascular Disorders
L.
Nursing care of the patient with Infectious Disorders
M.
Nursing care of the patient with Convulsive Disorders
N.
Nursing care of the patient with Degenerative & Neurological Disorders
O.
Nursing care of the patient with Peripheral and cranial nerves
P.
Nursing care of the patient with Endocrine Disorders
Q.
Nursing care of the patient with Disorders of eyes
R.
Professional Trends –Career Exploration Seminar
8.
INSTRUCTIONAL METHODOLOGIES (Instructor-initiated learning strategies):
Critical thinking situations, lecture, multi-media instruction and discussion.
9.
MULTIPLE METHODS OF EVALUATION (Measurements of student achievement):
Exams, written papers, presentations and clinical evaluation. A 5% deduction will be given if taking
an exam late. Late papers will reduce 1 point for every day the paper is late.
Hours by Arrangement: TBA: 2 hours per week and includes patient assignment preparation at the
clinical site the day preceding clinical. Students will record their assignments and instructor will
review prepared work. In addition students will sign in online and practice ATI NCLEX- Style
questions weekly, proctored remotely by the instructor. At the end of the course, all students will
take a 2 hour ATI predictor test that is proctored by the instructor.
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10.
TEXT MATERIALS:
Required:
1) ATI. Advanced Medical-Surgical Nursing. RN Edition 8. Content Mastery Series Review
Module.
2) ATI. Leadership and Management . RN Edition 5. Content Mastery Series Review Module.
3) ATI. Nutrition for Nursing. RN Edition 4. Content Mastery Series Review Module.
4) Newfield, Hinz, Scott-Tilley, Sridaromont & Maramba. (2007). Cox’s Clinical Applications of
Nursing Diagnosis. 5th edition. Philadelphia, PA: F.A. Davis.
5) Ignatavicius, D. & Workman, M. (2010). Medical Surgical Nursing, 6th edition,
Philadelphia, PA: W.B. Saunders.
6) Lilley, L., Aucker, R. & Albanese, J. (2011). Pharmacology and the Nursing Process, St.
Louis, MO: Mosby.
7)
Access online Lilley Pharmacology Code for online testing.
8)
Urden & Stacy. Priorities in Critical Care. (2012). 6th edition, St. Louis, MO: Mosby.
9)
Zerwekh, J. & Claborn, J. (2009). Nursing Today: Transitions and Trends. (6th ed). St.
Louis, MO: Saunders.
10) Nursing 242 Syllabus, College of San Mateo
11)
Nurse Bag #4
Recommended:
All previous texts used in the nursing program may be needed
11.
REQUIRED OUT-OF-CLASS ASSIGNMENTS (Supplemental reading, outside projects):
Online Readings, CD and online AV materials, community projects.
12.
WRITING ASSIGNMENTS/PROFICIENCY DEMONSTRATION:
Written assignments must follow APA format and use correct grammar and spelling (guidelines
available in Student Handbook)
13.
EVALUATION:
Written course evaluations by students, clinical agency evaluation forms completed by faculty and
agency representative, faculty feedback; both formative and summative at team meetings and at end
of semester.
Prepared by: ___________________________
Janis Wisherop,
RN, MSN
Professor
02/12
nur242co.doc
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COLLEGE OF SAN MATEO
N 242
COURSE INFORMATION
COURSE GRADING:
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








The student must achieve a cumulative score of 75% or better on the three theory tests in order
allow for project/ATI test points to be added and counted towards the 75% course grade and to
pass the N242 course.
A passing grade of “C”, that is an overall course grade of 75% is required to advance to graduation.
 The student must have a cumulative score of 190 points or better on the theory tests and a
minimum of 12 points on the projects to achieve the 75% required to pass N242.
Theory tests: A 5% penalty will be imposed for any test taken other than the scheduled date.
The student is responsible to notify the instructor to reset a date within one week to make up the test.
Clinical performance is rated on the basis of Pass and No-Pass. Any student who receives a No-Pass
grade cannot progress to graduation.
Assignments: Failure to complete an assignment/project in N242 will result in a clinical No Pass
(these are double starred criterion ** on the clinical evaluation tool).
All papers are due on designated dates. One point will be deducted for each working day or fraction
thereof if a paper is late. If there are no points assigned to the project, one point, for each day late,
will be deducted from the overall project points.
All project points earned on the first attempt are the points received towards the theory grade. Original
project points earned CAN NOT be changed after the initial assigning of points.
All course project points will be awarded after the student completes the three theory tests with a
cumulative score of 75% or better.
ATI Comprehensive Predictor Test: All students will take the ATI Comprehensive Predictor Test as
scheduled. Course points will be allocated by the following percentage results:
Percentage
0-25
26-50
51-75
76-100

Points
0
1
2
3
Any ATI quizzes or tests will not be included as part of the cumulative score (75% or better
requirement stated above).
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Student Learning Outcomes (SLOs) N242
Red indicates how the SLO is met in the clinical setting
Black indicates how the SLO is met in the classroom setting
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Apply nursing methods, protocols and procedures to appropriate care situations (SLO #1)
o Using critical thinking and research skills, students prepare to deliver direct patient care
to a group of patients with minimal supervision. They use preparation documents to
demonstrate their ability to prioritize the care needs for a patient case load.
o Relate the concepts of neurosensory anatomy and physiology with emphasis on
mechanisms to attain and maintain homeostasis and an optimum state of wellness in
patients of all ages. Applies pathophysiological concepts to the nursing process and best
practices in nursing care delivery.
Prioritize care-delivery on an ongoing basis (SLO #6)
o With the RN Leading assignment and routine deliver of care, students determine
priorities and provide total care for a case load of patients comparable to an entry level
nurse. Each student must implement the leadership role caring for a group of patients
while supervising and delegating to others. Students are expected to confer and
collaborate, independently, with other health team members to ensure continuity and
comprehensiveness of patient care.
o After classroom presentation and discussion the student is able to relate following
concepts: delegation, supervision, evaluation, problem-solving, decision making, power
and change strategies.
Provide compassionate , culturally sensitive care to clients in a variety of settings (SLO #9)
o Students use goal-directed therapeutic communications in interactions to assist the
diverse patient case load experiencing moderate to severe disruptions in homeostasis,
ongoing in the clinical and community setting
o After classroom presentation and discussion the student is able to relate following
concepts: Ethical principles, various neurosensory problems are explored in relation to
provision of compassionate and culturally sensitive care.
Adhere to the ANA Code of Ethics for nurses, treating patients as unique whole individuals
with specific needs, desires and abilities (SLO #10)
o Students demonstrate accountability, responsibility and reliability ongoing in the clinical
and community settings. Ongoing in the clinical setting students practice within the
ethical standards and legal framework of registered nursing practice, maintains patient
confidentiality and ensuring patient/family rights.
o After classroom presentation and discussion the student is able to relate following
concepts: Ethical principles, various neurosensory problems are explored in relation to
provision of compassionate and culturally sensitive care.
o EVALUATION: Students will master ethical based theory questions (test#1)by
answering the questions correctly 80%.
Appraise own professional performance accurately (SLO #13)
o In preparation for the new graduate nursing role, students develop ongoing skills to
identify specific learning needs and assume responsibility for locating experiences or
resources to meet these needs. Through self and faculty evaluation, students are able to
assess their own progress in meeting the necessary clinical and theory objectives.
o EVALUATION: the student will demonstrate improvement in delegation and
supervision by use of the self-evaluation tool. Students will show 90% + improvement
over the 4 day RN Leading Experience. Instructors will evaluate the students success
based on information from this tool.
o After classroom presentation and discussion the student is able to relate following
concepts: Nursing leadership; Presentation of Self, Nursing Delivery Patterns, Cost
Effectiveness, Reality Shock and Communication in nursing leadership.
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COLLEGE OF SAN MATEO
NURSING DEPARTMENT
CLINICAL EVALUATION
NURSING 242
STUDENT__________________________________
CLINICAL AREA_____________________________
DATE______________________________________
CLINICAL GRADE:
PASS_____
NO PASS_____
ABSENCES__________________________________
CODE: P = Pass; NP = No Pass; NI = Needs Improvement
** = 100% Required To Pass; * = 96% of Starred Criteria Required To Pass (37/39)
All “Competencies of Care” from previous courses are to be met.
CLINICAL CORE OBJECTIVES
** A.
** B.
** C.
** D.
** E.
P
NP
P
NP
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COMMENTS - NI AND NP
REQUIRES EXPLANATION
Asepsis
Emotional Jeopardy
Interpersonal Relations
Physical Jeopardy
Professional Behaviors
CLINICAL OBJECTIVES
I. OPERATIONALIZES THE NURSING PROCESS TO PROMOTE HOMEOSTASIS
Utilizes the nursing process, with minimal supervision, to effectively provide safe nursing care
for groups of adult patients suffering from complex and life-threatening diagnosis with
predictable and unpredictable outcomes.
A. Collects, organizes and interprets data from a variety of sources regarding physiological,
developmental, psychosocial, cultural, economic and spiritual needs of patients.
**1. Prepares for clinical assignment prior to implementing care…………..
**2. Identifies patient needs according to priority………………………...
*3. Uses selected screening tools, resource people and records to
systematically acquire data...................................................................
COMMENTS - NI AND NP
REQUIRES EXPLANATION
NI
___
___
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CLINICAL OBJECTIVES
*4. Identifies deviations from normal in complex situations……………….
**5. Identifies patient status changes in the last 24 hours and the significance of these
changes………………………………………..…
B. Assess patient status.
*1. Completes assessment independently, utilizing CSM Nursing care worksheet or
equivalent........................................................................
**2. Identifies and documents signs and symptoms that indicate patient status
improvement, deterioration, or risk situations from a multisystem
framework............................................................................................
*3. Determines patient’s physical and psychological adaptive mechanisms and their
ability for assuming responsibility for self care........................
*4. Makes priority nursing diagnosis independently and states related outcome
criteria...................................................................................
C. Plans, with minimal supervision, individualized nursing interventions designed to meet
the needs of patients with complex and life threatening illnesses.
*1. Develops and contributes to care plan for assigned patients..................
*2. Involves patient/family/significant other and health team members in plan of
care...........................................................................................
*3. Uses and contributes to Agency Standardized care plan or clinical pathway in
planning patient care.....................................................
*4. Designs an individualized unique patient care assignment sheet in preparation for
team leading.................................................................
D. Consistently performs nursing interventions competently, safely and accurately with
minimal supervision.
**1. Adapts and implements nursing care based on nursing diagnosis to safely meet the
needs of a group of patients..........................................
**2. Demonstrates knowledge of medications.............................................
**3. Independently administers medications and treatments safely and
accurately.............................................................................................
**4. Correctly utilizes principles of asepsis..................................................
*5. Participates with staff in providing nursing care to patients in specialty areas (e.g.
ICU, ER).........................................................
E. Identifies and analyzes independently, the effectiveness of nursing interventions meeting
outcome criteria.......................................................
COMMENTS - NI AND NP
REQUIRES EXPLANATION
P
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NP
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NI
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CLINICAL OBJECTIVES
*1. Independently designs/modifies nursing care plans each week..............
**2. Communicates effectiveness of nursing interventions to resource nurse and
instructor.......................................................................................
**3. Uses a variety of skills in actual and simulated patient situations..........
*4. Uses the nursing process to operationalize discharge planning for adult
patients................................................................................................
*5. Compares and contrasts patient needs in the acute – and special care settings vs.
community...………………………………………………..
**6. Works well under stress......................................................................
III. ASSUME ROLE AS A TEACHER
A. Formulates, implements and evaluates with minimal guidance, teaching plans based on
the needs of patients/families and evaluates the results. Examples required for
objectives 1-6
*1. Identifies patient learning needs, prior knowledge, motivation and readiness to learn.
..................................................
*2. Collaborates with other health team members to develop teaching goals based on
individualized discharge planning needs........................
*3. Encourages patient and significant others to problem solve..................
*4. Teaches patient self care......................................................................
*5. Documents patient teaching.................................................................
*6. Delegates components of teaching plan to others when appropriate......
**7. Completes a community team teach Health Fair……............................
II. ASSUME ROLE AS A COMMUNICATOR
A. Utilizes goal-directed therapeutic communications in interactions to assist patients
experiencing disruptions in homeostasis........................................
*1. Demonstrates therapeutic communication during interactions with patients/families
(provide a specific example).
B. Establishes and maintains effective working relationships with peers and other team
members and participates in efforts to improve working relationships within a structured
health care agency.
*1. Communicates with multidisciplinary staff to share goals and seek
clarifications.........................................................................................
COMMENTS - NI AND NP
REQUIRES EXPLANATION
P
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NP
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NI
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16
CLINICAL OBJECTIVES
**3. Clearly communicates delegated tasks to subordinates in the team leading
environment.............................................................................
*4. Communicates using assertive skills.....................................................
COMMENTS - NI AND NP
REQUIRES EXPLANATION
P
NP
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**4. Keeps instructor apprised of patient and unit status..............................
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*5. Uses. policies, nursing protocols and clinical pathways to enhance quality patient
care...............................................................................
**7. Carries out the role of RN Leader…………………………………
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**6. Completes a RN Leading assignment tree ………………………..
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C. Reports and records results of nursing care throughout the shift.
**1. Communicates changes in patient status throughout the shift to resource nurse and
instructor...............................................................
*2. Gives and receives change of shift report.............................................
**3. Records accurately, objectively and succinctly patient assessments, nursing
interventions, and other significant occurrences………………..
NI
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IV. ASSUME ROLE AS A LEADER/MANAGER
*A. Discusses need for referrals to community agencies based on an assessment of the
patient’s/family’s need. (e.g. with Discharge Planning; Social Services)
*B. Confers and collaborates with other health team members to ensure continuity and
comprehensiveness of patient care.......................................
C. Assumes the role of leader/manager in providing patient care in collaboration with a
resource nurse............................................................
*1. Participates in providing patient care through collaboration with a resource
nurse.......................................................................................
**2. Determines priorities and utilizes the nursing process to provide total care for at least
four patients within the assigned time frame using a variety of
skills.....................................................................................
**3. Plans and conducts a patient care/multidisciplinary team conference on
the assigned unit……………………………………………………
17
CLINICAL OBJECTIVES
**4. Implements the leadership role effectively when caring for a group of patients while
supervising and delegating to other personnel...........
**5. Completes the leadership competency…………………………...
V. ASSUME ROLE AS A MEMBER WITHIN THE PROFESSION
A. Practices within the ethical standards and legal framework of the registered nurse scope of
practice.
**1. Maintains patient confidentiality...........................................................
*3. Identifies themes in clinical situations where nurses acted appropriately as the patient
advocate.........................................................................
**4. Independently refers to hospital policies and procedures. (e.g. procedure
manual)...............................................................................
**5. Demonstrates accountability and responsibility for patient care assignment, nursing
role and actions.....................................................
**6. Maintains professional boundaries in caring for patients and significant others
B. Identifies own learning needs and assumes responsibility for locating specific experiences
or resources.
*1. Identifies goals for self-directed learning..............................................
*2. Selects nursing activities/resources through which goals are to be
achieved...............................................................................................
C. Evaluates learning experiences and objectively assesses own progress.
**1. Completes self-evaluation end of course..............................................
**2. Modifies performance based on instructor feedback............................
**3. Takes corrective actions when in error; reports such to instructor and follows through
with appropriate written report...................................
**4. Demonstrates responsibility and accountability for own learning in the clinical setting
and skills lab...................................................................
D. Discusses the role of the nurse in the hospital, and community.
*1. Discusses role of nurse as change agent to improve patient care...........
*2. Gives an example of a method to initiate change utilizing the organizational structure
of the assigned clinical agency........................
E. Is accountable for his/her professional behavior and conducts self in a professional
manner.
*1. Is punctual to the clinical area (cannot be late more than two times.)...
P
NP
COMMENTS - NI AND NP
REQUIRES EXPLANATION
NI
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CLINICAL OBJECTIVES
*3. Is punctual in submitting written assignments......................................
*4. Completes clinical makeup assignments according to CSM Nursing Department
Policy...............................................................................
*5. Follows correct CSM procedure for notifying agency regarding absence from the
clinical area...............................................................
*6. Follows dress code as described in Nursing Student Handbook
**7. Completes a resume and position inquiry letter....................................
**8. Conducts self in a professional manner during conflict………………...
**9. Does not cause disruption to others learning while in the clinical lab and / or setting
(s)……………………………………………………...
NP
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MIDTERM:
________________
DATE
__________________
DATE
COMMENTS:
STUDENT:
FACULTY:
COMMENTS - NI AND NP
REQUIRES EXPLANATION
P
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______________________________________________________________________
STUDENT (Signature indicates only that this evaluation has been read.)
______________________________________________________________________
INSTRUCTOR
NI
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19

FINAL:
__________________
DATE
______________________________________________________________________
STUDENT (Signature indicates only that this evaluation has been read.)
__________________
DATE
______________________________________________________________________
INSTRUCTOR
COMMENTS:
STUDENT:
FACULTY: OVERALL EVALUATION OF STUDENT PERFORMANCE
02/12
242clevl.doc
20
NURSING 242 STUDY GUIDE
SPRING 2012
Monday and Thursday: 1:10-3:30
#5-390
TEST DATES April 12th, April 30th, May 21st
LECTURE
March 19, Monday
Week #1
READINGS
Bring Syllabus to class


Review Syllabus
Advanced Ethical Principles
in Nursing: Decision Making



March 22, Thursday Week #1
 Systems that Support
 Delivery of Quality Care:
Nursing Service Delivery
Pattern; Patient
Classification Systems
ATI: Chapter 3
Nursing Today: pp. 398-411
Online Readings
http://www.nursingcenter.com/library/JournalArticle.asp?Artic
le_ID=817321

ATI: pp. 19-21

Nursing Today: pp. 321-328; 420-421; 458-459; 481-484; 493501
Online Readings
Nursing: Current state of Nursing
http://www.nursezone.com/Nursing-News-Events/morenews/The-Current-State-of-Nursing-Education-Capacity-andDemand_35044.aspx
 Patient Classification Systems Address Nursing Staff….
http://www.healthleadersmedia.com/page-4/TEC-266546/PatientClassification-Systems-Address-Nurse-Staffing-Balance

CLINICAL/LAB FOCUS
Week #1 CLINICAL FOCUS:
 Discuss ethical dilemmas experienced
at the agency or in the community.
 Identify the following
o What type of nursing service
delivery pattern is
implemented on your nursing
unit?
o What is the patient
classification system your
agency uses?
Week #1
N245 FOCUS
 Identify leader qualities
 QSEN project – Root Cause Analysis
Week #1
Open Lab Work- leadership
assignment preparation
Weblink:
http://ce.nurse.com/web41/CoursePage
Review slides 7-39; 51
21
LECTURE
March 26, Monday
Week #2


Cost Effective Nursing
Managing Your time, the
Environment & the People
Around You.
Prioritization!
READINGS




March 29, Thursday
Week #2
 Effective Communication and
Delegation





Readings for Week #2 Monday and Thursday
ATI: Chapters 1-2
Nursing Today: Chapters 11-14; pp. 204-206; 221-234;
305-313
Online Readings
NCSBN/ANA Joint statement on Delegation
https://www.ncsbn.org/Joint_statement.pdf
UAP; BRN statement on line
http://www.rn.ca.gov/pdfs/regulations/npr-b-29.pdf
RN supervisor
http://www.rn.ca.gov/pdfs/regulations/npr-i-12.pdf
Difference between RN vs. LVN practice in CA
http://www.prnatech.org/Portals/0/Documents/Position%
20Papers/RN%20versus%20LVN%20Scop%20of%20Pr
actice.pdf
RN Transition; Staff to Charge Nurse
http://ce.nurse.com/60108/learning-to-lead-from-staffnurse-to-charge-nurse/coursepage/ (note, do not pay for
the course by taking the test at the end – just read the
content)
Conflict resolution
http://www.rnjournal.com/journal_of_nursing/conflictresolution-tools-for-nursing.htm
Cost Containment http://www.medismart.com/nursing-articles/humor/hospital-costcontainment ;)
CLINICAL/LAB FOCUS
Week #2


CLINICAL FOCUS:
Compare actual costs of equipment and
supplies to what is ultimately charged to
the patient.
Discuss and share with each other, both
effective and ineffective communication
skills when delegating to others.
Week #2
N245 FOCUS
 Present Root Cause Analysis Findings;
small groups to present in large group
format
 http://qsen.org/teachingstrategies/nursephysician-communication-exercise/view
Review SBAR communication
Week #2
Open Lab Work- leadership
assignment preparation
 Charge Nurse I and II
22
Spring break
No class April 2 and 5
nd
LECTURE
April 9, Monday
Week # 3
 Leadership Presentation
of Self and in Writing
 The Transition: Student to
Professional
 Guest Speakers
Catch up on your reading requirements!!!
Hint: Study for the test and complete the Neuro Review
Sheet required to be completed by 4/12 (Yes, the test day)
th



READINGS
Nursing Today; Chapters 1 & 4
Online Readings
Transition from Student to New Grad
http://www.rnjournal.com/journal_of_nursing/new_grad
uate_professional_rn.htm
Resume
http://www.aftercollege.com/content/career_resources/e/
resume_writing_guide/
Week #3




April 12, Thursday
Week # 3
 Review of Neurological
System
 Diagnostics
  ICP
Bring your completed REVIEW SHEET found in Section
III of the Syllabus
 Ignatavicius Ch. 43
 Urden & Stacy Ch. 17, pp. 382-387
 ATI; Monitoring ICP pp 762-769
Online Readings
These will help you to answer the review
 Review Neurological Assessment article (scheduled
for next class). BEWARE, it is a large file! You
may not want to print it all out!
 Review the article on Brain Tumors (scheduled for
next week)** focus on anatomy and physiology
Select patients with Neurological
disorders.
Discuss diagnostic tests associated
with neurological disorders & review
nursing considerations.
Identify medications that are indicated
for neurological patients.
Discuss signs & symptoms of  ICP
in post conference.
Week #3

Week #3

CLINICAL/LAB FOCUS
CLINICAL FOCUS:
N245 FOCUS
Staff a Unit
Open Lab Work –
DVD – Intracranial Hypertension
23
LECTURE
April 16, Monday
Week #4



Neurological Assessment
Nursing Care - Comatose
Patient
Nursing Care - Patients with
Intracranial Disorders: Head Aches,
Head Injury and Brain Tumors
April 19, Thursday
Week #4
 Treatment of Intracranial Disorders;
Surgical and Non-Surgical
Interventions
April 23, Monday
Week # 5
 Nursing Care of the Patient with
Cerebrovascular Disorders.












April 26 Thursday

Week # 5
Nursing Care of the Patient with
Convulsive Disorders




READINGS
Ignatavicius, pp. 951-955, 1049-1065
Urden & Stacy Chapt. Pp 359-361, 513-519
ATI; Brain Tumor p 806
Online Readings
Neurological Assessment
http://www.orlandoregional.org/pdf%20folder/Adult%
20Neuro%20Exam.pdf - This is a large file! But very
comprehensive YOU DO NOT NEED TO PRINT IT
ALL OUT
Ignatavicius, pp 1064
Urden & Stacy 376-382
ATI; Head Injury pp. 845-852
Online Readings
Managing Patients with Brain Tumors
http://dynamicnursingeducation.com/class.php?class_i
d=112&pid=10
CLINICAL/LAB FOCUS
Week #4 CLINICAL FOCUS:
 Discuss care for a patient with Altered
LOC/Coma
 Discuss important Nursing Considerations
Concerning the care of a patient who has had a
neurological procedure.
Week #4
N245 FOCUS
 Review and practice the Glasgow Coma Scale
and Neurological Assessment sheets.
 Demonstrate in front of the large group
 Bring:
o Pen light
o Clean unopened tongue depressor,
cotton tip swab (from previous
nurse bags)
Week #4 Open Lab Work –
 DVD Neurological Assessment
Ignatavicius 1029-1048
Urden & Stacy pp. 362-374
ATI; Cerebrovascular Accident pp. 862-871
Online Readings
Stroke and Amphetamine Abuse
http://www.sciencedaily.com/releases/2007/04/070402
233734.htm
Ignatavicius pp 955-961
ATI; Seizures and Epilepsy pp. 781-787
Online Readings
http://www.epilepsy.com/epilepsy/newsletter/sept09/ae
ds (epilepsy medications)
http://www.youtube.com/watch?v=CDccChHrgRA
(seizures – videos)
Week #5 CLINICAL FOCUS:
 Access the agency protocol for “Brain Attack”
 Assess a patient who has experienced a Brain
Attack using the Glasgow and/or Stroke Scale
 Access the policy at your agency for seizure
precautions.
Week #5
N245 FOCUS
 Neuro Fashion Show. *BRING CAMERAS*
Week #5
Open Lab Work –
View NIH CD Rom
http://www.ninds.nih.gov/doctors/NIH_Stroke_Scal
e.pdf (print out your own scale)
24
LECTURE
April 30, Monday
Week # 6

Nursing Care of the Patient
with Spinal Cord Disorders





May 3, Thursday Week # 6
 Nursing Care of the Patient
with Infectious,
Inflammatory, or
Autoimmune Disorders of
the Neurological Systems





READINGS
Ignatavicius pp. 983-1002
ATI Spinal Cord Injury pp. 853-861
Urden & Stacy pp. 519-526
Online Readings
Autonomic Dysreflexia:
http://nursing.advanceweb.com/Article/AutonomicDysreflexia-Crises.aspx
Basics of Spinal Cord Injury - SCI 101
http://www.spinalinjury.net/html/_spinal_cord_101.html
Ignatavicius pp. 961-965, 1002-1007, 1065-1068
Urden & Stacy pp 374-376 (Guillain-Barré)
ATI; Multiple Sclerosis pp. 814-821
ATI; Guillain- Barré pp. 822-829
ATI; Meningitis pp. 872-879
Online Readings
 Clinical Management of Adults with HIV Opportunistic
Infections
http://ce.nurse.com/CE311-60/Clinical-Management-of-Adultswith-HIV-Opportunistic-Infections/
CLINICAL/LAB FOCUS
Week #6 CLINICAL FOCUS:
 Care for a patient with spinal cord disorder/spinal
problems; discuss important nursing considerations
when caring for this type of patient.
 Care for a patient with a degenerative neurological
disorder.
 Discuss the differences between long-term care and
acute care.
What are the legal differences?
Week #6
N245 FOCUS
 Practice NIH Stroke Scale Assessment, report findings
with SBAR format Continue with NIH Stroke Practice
Week #6
Open Lab Work –
 DVD; Just Like You and Me.
 Get your NIH Stroke Assessment certificate
25
May 7, Monday

LECTURE
Week # 7


Online Readings
Check “the Net” for Riluzole


Nursing Care of the Patient with
Degenerative Disorders
**********************************
May 10, Thursday
Week # 7
 Nursing Care of the Patient with
Peripheral & Cranial
Nerve Disorders




READINGS
Ignatavicius pp. 965-980, 1007-1008, 10161022
ATI; Alzheimer’s Disease/Dementia pp 788796
ATI; Parkinson’s Disease pp 797-805
ATI; Myasthenia Gravis pp 814-821
ATI; ALS pp 838-844
Nursing Care of the Patient with
Endocrine Disorders
Nursing Care of the Patient with Eye
Trauma; Glaucoma
Week #7




Ignatavicius pp 1022-1028, Ch.s 65-66,
1095-1098, 1103-1104
ATI; Diabetes Insipidus pp. 542-549
ATI; SIADH pp. 550-556
Sign-Up for Pot Luck
Discuss the long-term and home care needs
of patients with peripheral/degenerative
disorder and cranial disorders.
Discuss data (assessments) necessary to
intervene for DI vs. SIADH

Week #7

*****************************************

CLINICAL/LAB FOCUS
CLINICAL FOCUS:
N245 FOCUS
http://www.bing.com/videos/watch/video/fi
ghting-als-with-courage/6psxlfj?q=als
Watch and discuss – What do you do
when a patient gets “bad news” i.e.,
receives a diagnosis that will impact
them/their significant others.
Mystery Skills Lab
Week #7
Open Lab Work –
 Complete unfinished DVDs, online
certificate etc…
26
LECTURE
May 16, Monday
Week #8
SELF-STUDY NO LECTURE
 Health Care & Professional
Trends
 Health Care Policy, Politics & Changes in
the Years to Come
 ATI COMPREHENSIVE PREDICTOR
EXAM
READINGS
Online Readings
 Spread Your Wings:
http://ce.nurse.com/ce514/CoursePage
 Nursing Salary Trends
http://nursezone.com/Nursing-News-Events/morenews/Nursing-Salary-Trends-Where-the-Money-WillBe-in-2012-(and-Beyond)_38900.aspx
 The future of Nursing Education; Top Ten
Trends to watch
http://www.nln.org/nlnjournal/infotrends.htm
May 19, Thursday
*************************************
 Prepare questions for Guest Speakers
Week #8
 Professional Trends
Luncheon
RESUME`
LEADERSHIP ASSIGNMENT
TEST I
TEST II
COMPETENCY ASSESSMENT
FINAL EXAM…last one ever!!
HEALTH FAIR PAPER DUE May be submitted earlier!!
ATI Predictor Test
CLINICAL/LAB FOCUS
Week of May 19, Clinical Focus
 Discuss leadership experiences in
post-conference.
 What are your plans for the future?
N245 LAB Week # 8


Clean up, donate, say goodbye!!!
Mystery Skills Lab
It’s all up to you now. Take your knowledge
and wisdom gained and make CSM proud
…you are ready to embark on your next
journey and I wish you well.
JW
APRIL 13th/16th CLINICAL
DUE PER ARRANGEMENT - 1 week
after the completion of all Leadership
Days
CLINICAL
APRIL 14th THEORY
May 2nd THEORY
MAY 16TH and May 18th skills lab
MAY 23rd THEORY
MAY 23rd THEORY
May 14th, Building 10 Computer Labs
1-4PM
27
COLLEGE OF SAN MATEO
N242
SPRING 2010
GRADE TALLY SHEET
ASSIGNMENTS
POINTS
AVAILABLE
POINTS
EARNED
Resume and Position Inquiry
Credit
________
Health Fair Project
5 points
________
RN Leader Assignment Tree/Analysis
And care conference
10 points
________
ATI Predictor Test
0-3 points
________ See pg. 12 for description of points
TEST I
60 points
________
TEST II
75 points
________
TEST III (comprehensive final exam)
120 points
________
TOTAL POINTS
270 + (ATI) points
________
Hours By Arrangement
Met/Not Met
________
TESTS