Collaborative Bachelor of Science in Nursing Program
(University of Windsor, Lambton College, St. Clair College)
Clinical Nursing Experience
63-378
August 2007/May 2008
Professors:
Susan Fox (Lead teacher)
Room 322, Health Education Centre
519-253-3000 ext. 2284
sfox@uwindsor.ca
Pat McKay
Room 317, Health Education Centre
pmckay@uwindsor.ca
Clinical Instructor: __________________________________________
Telephone #: ________________________________________________
Email: _____________________________________________________
© FACULTY OF NURSING: COLLABORATIVE NURSING PROGRAM 2004
ALL RIGHTS RESERVED
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63-378 - Clinical Nursing Experience
I. COURSE DESCRIPTION
This course is a clinical practice course. The focus is on assessment, goal orientated interventions
and outcomes associated with clients with complex or multi system health disruption within the
context of family and community, within medical, surgical, acute care, oncology maternal/child, and
pediatric settings. Prerequisites: 63-374, 63-375, 63-377. Offered on a Pass/Non Pass basis.
II. COURSE INTENT
The purpose of this course is to provide students with the opportunity to learn the knowledge and
skills that are necessary to provide nursing care to clients experiencing complex or multi system
health disruption within the context of family and community.
III. PROGRAM COMPETENCY OUTCOMES
By the completion of the program, graduating students will be able to:
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Implement behaviours to promote personal and professional self-development.
Integrate the ethical, legal, professional and regulatory parameters into nursing practice.
Formulate clinical judgements that are based on critical inquiry and analytical reasoning.
Integrate nursing and multidisciplinary knowledge into nursing practice.
Integrate research findings into clinical practice, education and management.
Implement the nursing process to promote, maintain, and restore the health of individuals,
families, groups and communities.
Use of teaching/learning process to promote health of individuals, families, groups and
communities.
Collaborate with clients, their families, communities, and members of the health team and
other organizations for the promotion, achievement and restoration of optimal health.
Integrate leadership and management roles into the delivery of health care.
Engage in activities to promote the development of the profession of nursing.
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IV. COURSE COMPETENCY OUTCOMES 63-378
By the end of this course the student will be able to:
1. Build positive personal, interpersonal, group, community and professional relationships to
foster the health of families experiencing crisis due to complex health problems
Critical Elements
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Demonstrate personal strategies using reflective journaling, that will support professional
practice
Integrate feedback from the health care team to set goals to improve one’s own practice
Develop a personal learning plan to support the continued development of professional
practice
Integrate leadership skills and the principles of group process in professional practice
Integrate standards of professional practice as they apply to issues of care for complex
health problems
Critical Elements
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Implement strategies that advocate for the rights of clients in the provision of care to clients
with complex health problems
Use the College of Nurses of Ontario Standards of Practice in the care of client/families with
complex health problems
Adhere to the policies of the Collaborative Nursing Program and participating agencies,
when caring for clients with complex health problems
Anticipate ethical dilemmas encountered in the care of clients with complex health problems
Demonstrate responsibility for continued professional competency
Document client care according to CNO standards
3. Formulate clinical judgments based on the complex health needs of clients
Critical Elements
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Demonstrate diagnostic reasoning skills
Generate strategies, in collaboration with the client to promote health
Demonstrate evidence-based clinical judgments
Critically evaluate community resources appropriate to the needs of an identified client
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4. Integrate selected theoretical frameworks to promote health for clients who are
experiencing complex health problems and for their families
Critical Elements
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Integrate selected theoretical models/ frameworks (health belief model, change theory, crisis,
loss) to promote health in families experiencing complex health problems
Compare / contrast the health status of clients in W/EC with provincial and national data
Integrate systems theory to the provision of complex care
Analyze the relationship between the health, maturation, and adaptation that a client and
his/her family experiences and the experience of a complex health problem/ high stress.
5. Use evidence based nursing and research strategies to promote the optimal well-being of
clients and/or families experiencing complex health problems
Critical Elements
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Demonstrate evidence based practice with clients and families with common complex
problems
Formulate researchable questions to promote the health of clients and families experiencing
complex health problems
Provide rationale for evidence based nursing care for clients and families experiencing
complex health problems
6. Apply the nursing process to promote health and well-being and prevent illness/injury for
clients and families with complex health concerns
Critical Elements
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Take appropriate health histories
Perform focused physical assessments
Collaborate with clients and families to formulate outcome criteria
Integrate selected Evidence-Based Practice Guidelines related to clients with complex health
problems
Implement counseling interventions which meet client and family needs when there is a complex
health problem
Apply selected criteria/formats to develop and implement comprehensive care plans for
individuals, families/groups and communities
Use various health decision-making strategies related to the provision of complex care
Evaluate client and family outcomes and modify the plan of care as required
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7. Implement teaching/learning plans to assist clients with complex health problems
Critical Elements
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Perform client assessments to determine teaching/learning needs
Collaborate with a client with complex health problems to identify learning needs
Mutually develop outcome criteria with a client with a complex health problem
Implement effective learning plans to promote client centered health during a complex
health problem
Evaluate effectiveness of teaching strategies with clients with complex health problems
Modify teaching/learning plan as required for clients and families experiencing a complex
health problem
8. Collaborate with clients experiencing complex health problems, their families, and the
health care team, in developing empowerment strategies to achieve optimal health
Critical Elements
Analyze the effective use of therapeutic and professional communication techniques in selected
situations
 Respect clients/families and apply the principles of a helping relationship
 Use strategies that protect the rights of the client and family during a complex health
problem
 Integrate strategies that promote client and family autonomy
 Collaborate with members of the health team and related agencies to promote optimal health
 Use therapeutic and professional counselling and communication techniques with clients and
families experiencing complex health problem
 Advocate for a family’s plan of care during crisis
9. Integrate leadership and management skills in the care of clients with complex health needs
Critical Elements
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Use leadership strategies, that optimize client health
Use social action skills to advocate for the rights of clients
Develop client/family/group partnerships that support health care networks and coalitions
Demonstrate time and resource management in the care of clients with complex health
problems and for their families
Lead discussions on a health care issue relevant to a family experiencing a complex health
problem
Analyze the leadership and management roles of nurses who work with clients with
complex health problems and with their families
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10.
Influence Nursing’s role in the promotion of health for clients with complex health
problems
Critical Elements
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Demonstrate professionalism, ethical care and competence in complex care situations
Participate in clinical group conferences on health promotion and illness/injury
prevention on clients and/or families with complex health needs
Demonstrate effective communication skills with other members of the health care team
Articulate the role of nursing in advocating for the client by increasing available
choices
Course Competencies:
Ten Core Practice Competencies and Universals will be applied to selected human health care needs.
Nursing interventions and application of critical thinking to the Nursing Process will be performed.
Clinical experiences may include simulated, virtual (computerized) and real individuals in the
“client” role.
A Universal Competency (UC) is an outcome that nurses must continue to demonstrate in any
nursing activity or action. Critical elements are defined as single, discrete, observable behaviours
that are mandatory for designated target elements. As such, all critical elements must be
demonstrated safely, professionally and knowledgeably for the designation of practice
“competence”. All course competencies must be demonstrated in this course for a “pass” indicating
the first/beginning/novice practitioner level of achievement in this course.
Technical elements/skills are psychomotor activities that integrate universal competencies into
care/interventions. 63-378 Course Competency Outcomes are derived from the program competency
outcomes. Critical Elements are developed to guide experiences and learning activities throughout
the semester to provide learning opportunities as students strive to master Universal Competencies
and CPEs, and to apply knowledge through CPE activities. Students must integrate theoretical
components and rationale, safety, critical thinking, and current CNO Standards and therapeutic
interactions as well as the level of expectation of 10 core competencies by the end of the first
semester.
V. COURSE REQUIREMENTS, EVALUATION METHODS, GRADING SYSTEM
63-378 will be offered on a Pass/Non Pass basis
All critical elements must be met. All universal competencies must be consistently demonstrated.
At midterm the student will receive a formative evaluation. If there is no opportunity to assess
a specific competency, it is to be left blank at midterm. All competencies must be evaluated on
the final evaluation.
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CPEs:
Methods of Student Evaluation
1) Learning Plan
Due Date
During the first scheduled week
of the clinical experience
During the first scheduled week
of the clinical experience.
2) Medication Quiz – All students must
achieve 100% on this quiz before
permission will be given by the clinical
instructor to dispense medications
3) Reflective Practice Activity – As
designated by the assigned clinical
instructor, all students will be expected
to maintain ongoing (daily)
documentation of self-reflection
regarding their perceptions of progress
during the clinical experience
4) Mid-term written student selfevaluation and instructor evaluation of
student using CPE tool and summary
form.
5) End-of-term written student selfevaluation and instructor evaluation of
student using CPE tool and summary
form.
6) All students are expected to be
prepared for patient assignments. The
clinical instructor may ask a student to
submit verbal patient care plans in
written form and/or related nursing
documentation as required
Students are expected to bring
their reflective tool to the clinical
setting for each scheduled day
and be prepared to share the
entries completed to date with
their clinical instructor upon
request.
As established by the assigned
clinical instructor at a mid-point
in the scheduled clinical
experience.
As established by the assigned
clinical instructor at the
conclusion of the clinical
experience.
Ongoing
Failure to meet the expected assignments as designated by the clinical instructor as requested
may lead to a student’s removal from the clinical area, as the instructor’s ability to evaluate
the therapeutic relationship between student & client may be limited.
All written assignments will be considered as evidence of professional documentation.
Policy regarding Medication Administration tests
Regular medication administration tests will be administered throughout the program.
a. Pass mark for the test will be 100%
b. Students will have a maximum of 3 opportunities to pass the test
c. Use of calculators will not be permitted. Students should show their calculations on the test
sheet (e.g. long division)
d. A student will not be permitted to administer medications in the clinical area until 100%
has been achieved on the test
e. Students who do not achieve 100% by the third test will be deemed to have not met
the Universal Competency of patient safety and are unsuccessful in the clinical course.
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VI. FACULTY OF NURSING POLICIES
No supplemental examinations or assignments will be offered in this course.
Clinical
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Students must attend all clinical nursing experiences and laboratories unless they have prior
permission from the professor and/or a medical certificate to account for their absence.
Student nurses in the clinical setting are to be punctual (if going to be late notify
agency/instructor as directed in Course Outline).
In the event of absence, students must notify the clinical setting prior to the scheduled start
time. It is assumed that students will return for the next day of experience unless the
instructor/agency has been otherwise notified.
In the case of prolonged absence due to illness, students may be required to provide medical
clearance before returning to the clinical setting. This clearance should be obtained from your
own physician or nurse practitioner or through the University of Windsor, St. Clair College
or Lambton College Health Centre.
Students with casts or wounds are not permitted on some hospital units. Check agency
policies for each setting.
Professional Conduct and Appearance
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Nursing students are offered experiences in a variety of settings. As members of the nursing
profession, conduct and personal appearance should be congruent with professional
expectations of the College of Nurses of Ontario.
Nursing students are required to demonstrate behaviours consistent with the following
College of Nurses of Ontario documents:
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Professional Standards for Registered Nurses and Registered Practical Nurses
The Standard for the Therapeutic Nurse - Client Relationship
The Ethical Framework for Nurses in Ontario and Explanation of Professional
Misconduct
The failure of any nursing student to conform to the principles of these documents and the
policies of the Faculty of Nursing, University of Windsor, may result in dismissal from the
nursing programme.
Anyone demonstrating dishonesty, plagiarism, cheating or unethical behaviour in relation to
any aspect of this course will receive an F grade and will be dealt with in the severest manner
allowed by University policy.
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Dress Code Policy
A dress code policy is necessary for the purpose of infection control and the conveyance of a
professional, well-groomed appearance.
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Hair must be neat, clean and worn above the collar; moustache and beards must be neatly
groomed.
Hands: Nails must be short, clean and well manicured. Clear or pastel polish may be worn
but must not be chipped.
Make-up may be used conservatively, but must be scent-free. Proper hygienic practices are
expected.
Jewellery is restricted to a plain wedding band, watch and only a small earring worn in one
or both ears. Tattoos must be concealed wherever possible.
Equipment: Students must follow medical asepsis practices to care for their equipment; i.e.,
bandage scissors and stethoscope.
Uniforms
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Students provide their own uniform, white lab coat, white duty shoes, white stockings or
socks, watch with a second hand, bandage scissors, penlight, stethoscope and photoidentification name tag.
Uniforms are to be clean and sized appropriately. They may be either white or a solid colour.
Students must follow the uniform policies for specialty areas (Labour and Delivery, Renal
Dialysis, NICU, Psychiatry and the Operating Room).
Students’ nametags should be clearly visible.
Solid white, closed, athletic shoes are acceptable in lieu of duty shoes.
Students are to be dressed in casual-business attire (no jeans) when uniforms are not
required, i.e. Psychiatry, community agencies, seminars or field trips. Refer to agency’s
policy and professional guidelines.
Lockers are generally not available. Areas for coat and boots will be identified. Keep
valuables on your person or in designated areas. Uniforms should be worn only while on
duty. Changing after duty, though recommended, may not be feasible; therefore, cover your
uniform when it is necessary to wear it home to maintain infection control.
When doing clinical research, students must wear appropriate professional attire, for
example, a lab coat over street clothes and photo-identification badge.
VII REQUIRED TEXT(S)
C.N.O. Standards of Practice: Therapeutic Communications, Ethical Guidelines, Medication
Guidelines, Consent, Behavioural Interventions, Role Models and Preceptorship, Advocacy.
Publication manual for the American Psychological Association 5th Edition. (2001). Same.
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Craig, Gloria (2001). Clinical Calculations Made Easy: Solving Problems Using Multi- dimensional
Analysis (2nd ed.), Philadelphia: Lippincott
Lewis, S., Heitkemper, M., & Dirksen, S. (2006). Medical-Surgical Nursing in Canada:
Assessment and Management of Clinical Problems (1st ed.). Toronto: Mosby
Various Health Reports, Website content, Videos, Other pamphlets and materials as provided or
posted on the web and Articles as indicated each week.
R.N.A.O. Best Practice Guidelines (as directed).
Jarvis, C (2000). Physical examination and health assessment (3rd ed.). Philadelphia: W.B.
Saunders.
Karch, A. (ed.) (2003). 2003 Lippincott’s Nursing Drug Guide. Philadelphia: Lippincott (or similar
drug book) or other current medication reference book
Perry, A. & Potter, P. (2002). Clinical Nursing Skills and Techniques (5th ed.).
St. Louis: Mosby.
Ross-Kerr, J. & Wood, M. J. (ed.) (2001). Potter & Perry Canadian Fundamentals of Nursing (2nd
ed.). Toronto: Mosby
VIII
PREPARATION
Each student is expected to be well-prepared for each clinical experience. He/she must be prepared
to discuss the diagnoses, medications, procedures, treatments and related care plan activities
associated with the care of his/her assigned clients.
IX
LEARNING PROCESS
Tutorial sessions may include:
1.
Discussion/clarification of unit material
2.
Case discussions
3.
Demonstration / return demonstration
Clinical experiences will include:
1.
Practice in obtaining health histories
2.
Practice in performing physical examinations
3.
Practice in integrating significant health history and physical examination data into diagnostic
statements and initial diagnostic &/or therapeutic &/or education plans.
4.
Observation and practice of clinical skills
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Teaching/learning strategies may include:
1.
Reading/group discussion of unit material
2.
Demonstration
3.
Return demonstration
4.
A-V material/models
5.
Hands on experience
Teaching/learning modalities may include:
1.
Home study
2.
Tutorials
3.
Group learning
4.
E-mail
5.
Clinical Placements
Clinical Experience
The purpose of the clinical experience is to give you the opportunity to demonstrate all critical
elements associated with each of the 10 Core Practice Competencies.
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