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NURSING STUDENTS
&
TEACHERS
HANDBOOK
Professional Practice Research & Education
Revised
April 2012
Mohini Pershad Professional Practice Leader, Nursing
2
Table of Content
Preface 3
Mission, Vision & Values 4
Getting Started at NYGH 5
o Orientation / Credentialing
o ID Badges
o Computer Training
o Observation Experience
End of term responsibilities 8
o Post Clinical Evaluation
Clinical Instructor Expectations 9
Managing Clinical Issues 10
Guidelines for students 11
Guidelines for Nurses 13
Appendix A
NYGH Student Assignment Sheet 14
Appendix B
Clinical Instructor Evaluation 15
Appendix C
Post Clinical Evaluation 16
Appendix D
Preceptor Evaluation 17
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PREFACE
Clinical Instructors/ Teachers & Preceptored Students
This handbook has been developed by the Professional Practice, Education and Research,
Professional Practice Leader Nursing, based on feedback from point of care nurses,
management, Clinical Instructors, nursing students and using the College of Nurses
practice guidelines as a foundation.
Nursing students and Clinical Instructors (CI) are required to follow the rules and
regulations that pertain to employees of NYGH. NYGH’s corporate policies and
procedures are accessible on the intranet, whereas Unit specific policies and procedures
are found on the unit.
NYGH reserves the right to intervene in any instance where a student or Clinical
Instructor may be functioning in a manner considered by NYGH to be potentially
dangerous or harmful to the well-being of the patient (s), or contrary to NYGH policies
and procedures. If in the reasonable opinion of the Management and Professional Practice
Leader your behavior is unacceptable, NYGH has the right to terminate your placement.
The school is responsible to have instructed all students and CI on responsibilities and
expected behaviors in relation to confidentially, intellectual property, ethical practice and
workplace safety. NYGH is committed to protecting the privacy, confidentially and
security of all personal information.
All information related to patients, employees or hospital business whether this
information is written, verbal or in other form, is confidential in nature, misused of
information may be cause for termination of placement.
NYGH is committed to a free from harassment and discrimination environment.
Students/ teachers who violate this policy may be denied placement or expelled from
NYGH.
Harassment Policy III-c-30 can be found on the Intranet – Under Policies &
Procedure – Chapter III
http://www.nygh.on.ca/nygh_test/III_c_30_Harrassment_Policy.pdf
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Mission
Providing exceptional care to our diverse communities
Our Vision
To lead the pursuit of excellence through learning, innovation and partnership
Our Values
Our patients come first in everything we do
Respect: we embrace the strength in our diversity and treat everyone with respect
and dignity
Integrity: Every day, we act in a professional and ethical manner
Excellence: We strive to achieve better outcomes in everything we do,
collaborating with patients, families and partners
Compassion: We provide an exceptional care to our patients and their families
with empathy, sensitivity and understanding
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GETTING STARTED AT NYGH
USE OF FACILITIES Every effort will be made to provide venues for clinical conference/debriefing sessions at
requested times. It is expected that both students and Clinical Instructors will take due
care of hospital facilities, return borrowed equipment and/or keys, be conscious of not
disturbing others and will not take food or drink into the conference rooms.
IDENTIFICATION (ID) BADGE ID badge will be obtained from Security office as soon as possible. In order to obtain
NYGH ID, you are expected to provide one piece of photo ID.
NYGH identification badge is to be worn and visibly displayed at all times. The
University or College identification logo must also be visible.
Badge Office is located on the Ground Floor (East) - Room # 86
Hours 10:00 – 10:30am & 1:30 – 2:00 pm
UNIFORMS are compulsory in areas of direct contact with patients and the public.
IMMUNIZATION & MASK FIT TEST
The Ontario Hospital Association Communicable Disease Protocol clearly indicates that
it is the responsibilities of the educational facilities to provide appropriate education,
vaccination and follow-up of their students and the maintenance of immunization records.
Each student and Clinical Instructor must sign our Registration and confidentially form
declaring the immunization and mask fit test (mask fit test should be re-done every two
years). Seasonal influenza vaccination is current, up-to-date and cover the period of your
placement at NYGH.
CRIMINAL REFERENCE CHECK
Regardless of the type of placement, students are required to have an up to date Criminal
Reference Check. Please visit our external website at www.nygh.on.ca – go to
Learning and Innovation – to Nursing Student Education
Work/ Education Placement Agreement (WEPA) form is to be completed by the
student/school and submitted to North York General Hospital before the clinical
placement begins. This form is provided by your academic institution
ORIENTATION
All students and new Clinical Instructors must attend corporate Nursing Student
orientation. As well, it is expected that new Clinical Instructor must spent Buddy
shift(s) on the relevant unit, to familiarize with the patient population, care team and
needs of the unit. Failure to do so will result in students’ experience being delayed until
such orientation is completed. Please contact the Clinical Team Manger or Clinical Nurse
Educator to set up your unit orientation.
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It is imperative that Clinical Instructor and student be knowledgeable of policies and
procedures at NYGH and be familiar with the functioning of the unit to which they are
assigned.
Your orientation date is provided to your College/ University Placement
Coordinator. Please contact your Placement Coordinator/ Faculty Advisor for assigned
orientation and Computer training dates
All forms and required documentation must be submitted at the Nursing student
Orientation session or prior to clinical placement. Please submit to the Professional
Practice Office -6N-630
LOCKERS will be provided at the orientation session. Students are expected to share
lockers. Lockers must be vacated at the end of each shift.
Locks are the property of NYGH and must not be removed from the hospital.
COMPUTER TRAINING is mandatory for CIs & Students
Clinical Instructor
o Complete the online CBTs before your training session
o Print out the CBT quiz results as proof of completing the CBTs
o Attend the scheduled one day in-class session.
Students
o Complete the online CBTs before your Objective Structured Clinical Evaluation
session o Print out the CBT quiz results as proof of completing the CBTs
o Attend the scheduled Objective Structured Clinical Evaluation Session
Instructor & student please ensure, when completing the Computer Based Training
Modules (CBTs) Quiz, you are working on a computer with a printer. You will be
required to print the quiz results screen. If you do not print the result quiz screen at the
end of the CBT, the results will be lost.
Please note, all CIs will be expected to assist with the Objective Structured Clinical
Examination (OSCE) sessions by hosting one of the stations.
Please visit our external website at www.nygh.on.ca – go to Learning and
Innovation – to Nursing Student Education and navigate our site
POLICIES & PROCEDURES MANUALS are available on the NYGH Intranet site –
Under Policies and Procedures – Chapter II and on each unit
CAFETERIA meals and snacks are available at your own expense.
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CLASSROOM & TUTORIAL ROOMS: Rooms are subject to availability and must be
arranged on a weekly bases with Room Booking office, please email
CAR PARKING is available at a moderate cost per day provided identification is shown
to the cashier.
LIBRARY facilities are available to students.
PHOTOCOPYING facilities are available from the LIBRARY at minimal cost.
CELL PHONES & PAGERS
Cell phones and pagers must either be turned off or placed in silence/vibrate mode during
clinical. Use of phone for personal use should be confined to breaks and away from the
patient care area
COMPUTERS/ WORKSTATIONS
Computers and workstations are to be used for business activities.
OBSERVATION EXPERIENCE – will be accommodated if possible
When a student is following a patient through an observation experience, the assigned
Clinical Teacher must be contactable.
Observation in Perioperative, Emergency Department, Critical Care Unit and
Labour & Delivery can be arranged for the student who wishes to follow a patient.
Please contact Mohini Pershad Professional Practice Leader, Nursing for guidance
Students on an observation experience must have some introductory theory and
fundamental knowledge that will prepare them for the clinical experience.
Students must have clear objectives for observation placement
Students will be matched with a preceptor who will also conduct the assessment.
The CI will provide an appropriate assessment tool to the applicable Clinical
Nurse Educator with the objectives at least one week prior to the Observation
placement
RESUSCITATION MANNEQUIN may be borrowed from Professional Practice office.
However, requests must be sent via email 2 weeks in advance. Mannequin will be
provided based on availability
For further information please contact Mohini Pershad, Professional Practice Leader,
Nursing [email protected]
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CLINICAL INSTRUCTORS END OF TERM/PLACEMENT
RESPONSIBILITIES
o All identification badges must be returned to Security office located on the Ground
Floor
POST CLINICAL EVALUATION
o We want to know how we can improve. CI at the end of your placement please have
each student complete the post clinical evaluation and return to Professional Practice
Research and Education – 6N-630. Please see the Post Clinical Evaluation form in
Appendix C
o In addition- Consolidation/ Preceptor student will complete the Preceptor Evaluation-
see Appendix D Preceptor Evaluation and returned to Professional Practice office –
6N-630
o Clinical Instructor Evaluation will be sent to the Clinical Team Manager/ Clinical
Nurse Educator/ delegate of the unit in which the clinical placement has occurred.
The Clinical Instructor Evaluation will be returned to Professional Practice – 6N-632
Please see the form in Appendix B
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Clinical Teacher/ Professor/ Clinical Instructor/ Faculty Liaison - Expectations
The Clinical Instructor (CI) is expected to inform staff on a regular basis of the students’
level of preparation (both theory and practice) and the learning/ clinical objectives to be
achieved during the students experience on the unit. Specific experiences will be planned
in consultation with the Clinical Team Manager or Clinical Nurse Educator or the
Delegate.
A copy of the students’ objectives must be posted on the units for all nurses to read. See
Appendix A – An example of an Assignment sheet
For preceptorship/consolidation experience, the faculty liaison is required to
communicate directly with the assigned preceptor prior to the student arriving on the unit.
The faculty liaison should share the clinical objectives for the experience and the
appropriate evaluation forms and processes to be used by the preceptor in evaluating the
student’s performance.
The faculty liaison should be available at all times to answer the preceptor’s concerns.
The following applies to the Faculty liaison
o the faculty/ liaison is expected to provide each preceptor with a 24/7 contact number
o establishes an initial contact with each preceptor to orient him/her to the clinical
expectations
o Establishes contact during and at the competition of the clinical experience, to discuss
student progress.
Failure to do so may jeopardize the school’s working relationship with NYGH
Clinical Instructor with a Group of Students is expected to:
o Provide direct supervision of students
o Be physically present at all times while students are on the unit.
o Be directly involved in the teaching process and consulting with the nurses
o Provide patient care in a collaborative manner; working towards goals of the
patients
o CI is expected to consult and work collaboratively with the staff on the unit,
especially sharing of information.
Collaborative Assignments
o Students’ assignments will be arranged in a collaborative and consultative process
between the Clinical Team Manager or delegate and the Clinical Instructor. All
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efforts should be made not to assign a student to a nurse supervising a new
graduate and or preceptoring another student or a new hire.
o Student must be assigned to a Nurse (RN or RPN) and patient(s). The student will
keep the nurse informed of the patient (s) condition and status. Similarly, the
student will inform the assigned nurse of any unusual occurrences and changes in
the patient condition. The student will provide a verbal report at the end of the
shift.
o The nurse, who is co-assigned to the patients, is ultimately responsible for the
patient care. The nurse is expected to understand and fulfill his/her professional
role in the educational process of the students (i.e providing timeline feedback to
the CI, guide and assist the student)
o The Clinical Instructor assumes primary responsibility for the teaching
Clinical Instructor - Absence/ Late
If the schools cannot replace an instructor who is ill, the students shift will be cancelled.
The school is responsible to ensure the Clinical Team Manager is notified
If the CI is late, the students will not be allowed to participate in direct patient care.
Clinical Issues:
When an error is made by a student, the context of the situation is taken into account. A
nurse working with the learner is not accountable for the learner’s actions if the nurse has
fulfilled her/ his responsibilities as outlined (e.g learning plan, appropriate supervision)
and if the nurse had no way of knowing that the error was going to occur.
In keeping with the responsibilities of safe patient care, Professional Practice Leader,
Nursing will act as a liaison for NYGH staff and management to address nursing students
and Clinical Instructor issues and concerns in a timely manner.
It is expected that the Clinical Instructor/ Faculty liaison and the Clinical Team Manager
attempt an early resolution of any clinical problems that may arise. If the problem
continues the Clinical Team Manager will liaise with the Professional Practice Leader,
Nursing.
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Guide for Student
Accountability of the Students: College of Nurses of Ontario (CNO) does not
regulate all learners, such as diploma or undergraduate nursing students. However,
nursing students are accountable for their own actions, to the client and educational
institution. As a result, students are expected to follow NYGH expectations as
outlined below:
A skill that falls within the scope of practice as identified by the CNO can be performed
by the Nursing student if:
1. The student has received the theory behind the skill
2. Competency has been established by a nurse ( Clinical Instructor/ Preceptor/
Educator)
In specialty areas (i.e Critical Care Unit)
Specific skills identified in specialty areas may not be taught as part of the basic curricula
in the schools. Hence, student in a consolidation/ preceptorship may perform these skills
under direct supervision if
1. The theory behind the skill is taught by a nurse ( Preceptor/ Educator)
2. The student competency has been established by the said nurse ( preceptor/
educator)
** ****At NYGH the Clinical Nurse Educators’ primary focus is the education of
Clinical Staff. Their role does not include teaching/ educating Nursing Students,
unless they deem it necessary and are able to include it as part of their support of the
staff in their program ********
Communication:
o Student must find assigned nurse at the beginning of shift, introduce self and share
level of competency and objectives
o Student should have a dialogue with the staff nurse in relation to skills levels and
competency (eg: skills you are comfortable with, those which you had theoretical
education on and skills you will need supervision with).
o Student is aware of her/his responsibility to notify the CI and assigned nurse, if she or
he is not achieving expected objectives
o Student must report off before leaving the unit, relay all pertinent information to the
staff nurse including care provided
o Student must wear NYGH identification and school logo at all times
Responsibility
o Student must attend orientation, be responsible for information provided including
hospital policies and procedures
o Student is responsible for the care they provide
o Student is expected to be on time for each shift
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o Student is expected to be knowledgeable and apply basic infection control principles,
basic assessment and provide basic hygienic care (eg: normal ranges for vital signs;
baths, oral care, therapeutic communication)
Coordination
o Student must discuss and prioritize plan of care with the assigned nurse; seek
guidance and assistance as needed
o Student should use clinical time efficiently; we encourage coordinating the patient
care and activities with the assigned nurse to avoid duplication and redundancy of
service
o Student should be aware of assigned nurse patient care assignment, be proactive in
offering assistance with tasks you are competent to perform (eg: if you are available,
provide the client therapeutic communication)
Overall Clinical Objectives
Although the University / College will have specific objectives and procedures for each
placement, regardless of your year or level, it is expected that your objectives will cover
areas of nursing practice related to:
o Patient safety (i.e. falls assessment and prevention)
o Assessment (holistic)
o Documentation
o Hygiene
o Prevention of pressure ulcers
o Prevention of infection
o Nutrition
o Communication
o Time management and organization
Knowledge, skills and attributes, that is, competence, related to these fundamental areas
of nursing practice are built up over time. Just because you have done something a few
times does not mean you are competent.
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Guide for NYGH Staff Nurse
The staff nurse primary responsibility is to the patient. When learners participate in
providing patient care, a nurse supporting the learner is responsible for ensuring client
safety, while facilitating a positive learning experience (CNO, 2002)
Accountability of the staff nurse supporting the Student:
In supervising the student, a nurse is accountable both for sharing appropriate nursing
knowledge and for maintaining safe, effective and ethical patient care in accordance with
the standards.
When an error is made by a learner, the context of the situation is taken into account. A
nurse working with the learner is not accountable for the learner’s actions if the nurse has
fulfilled her/ his responsibilities as outlined (e.g learning plan, appropriate supervision)
and if the nurse had no way of knowing that the error was going to occur
Nursing Responsibilities
o the nurse will place the safety and well being of the patients above all other objectives,
including fulfilling learning obligations
o the nurse will endeavor to understand the learner level of preparation, objectives of
the experience and specific assignment, knowledge, skills and abilities of the learners
o the nurse will communicate with the learner and CI in an open, respectful manner
o the nurse will provide feedback to the student and CI – in relation to the student’s
performance, professional relationship, skills and level of competency
o the nurse will act as a role model and mentor for students
o the nurse will be a role model for professional nursing practice
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Appendix A
NYGH Nursing Student Assignment Sheet
School:_______________________________________
Clinical Instructor: ___________________________Contact Number:______________
Date _______________ Time on Unit _______________ Time Leaving Unit _________
Student/ Patient Responsibilities Comments
Student:
Patient/ Room #
Bath Personal care
Bed Assessment
Oral Meds Treatments
Documentation Ambulation
Student:
Patient/ Room #
Bath Personal care
Bed Assessment
Oral Meds Treatments
Documentation Ambulation
Student:
Patient/ Room #
Bath Personal care
Bed Assessment
Oral Meds Treatments
Documentation Ambulation
Student:
Patient/ Room #
Bath Personal care
Bed Assessment
Oral Meds Treatments
Documentation Ambulation
Student:
Patient/ Room #
Bath Personal care
Bed Assessment
Oral Meds Treatments
Documentation Ambulation
Student:
Patient/ Room #
Bath Personal care
Bed Assessment
Oral Meds Treatments
Documentation Ambulation
Student:
Patient/ Room #
Bath Personal care
Bed Assessment
Oral Meds Treatments
Documentation Ambulation
Student:
Patient/ Room #
Bath Personal care
Bed Assessment
Oral Meds Treatments
Documentation Ambulation
Student:
Patient/ Room #
Bath Personal care
Bed Assessment
Oral Meds Treatments
Documentation Ambulation
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Appendix B
Clinical Nursing Instructor Evaluation
To be completed by Manager or Clinical Nurse Educator or Designated staff member
School: Instructor:
Unit: ________________ Evaluator: _____________________ Date:______________
Please indicate which response best reflect your experience with the above clinical instructor
5= Strongly agree 4 = Agree 3 = neutral 2=disagree 1= Strongly Disagree
__________________________________________________________________________
Maintained communication with the Nurse in-charge and staff nurse 5 4 3 2 1
__________________________________________________________________________
Maintained professional demeanor 5 4 3 2 1
__________________________________________________________________________
Organized and well prepared for clinical 5 4 3 2 1
__________________________________________________________________________
Post clear and specific patient assignment prior to clinical 5 4 3 2 1
_________________________________________________________________________
Actively sought learning opportunities for students 5 4 3 2 1
_________________________________________________________________________
Able to manage students’ workload 5 4 3 2 1
_________________________________________________________________________
Student issues handled in a professional manner 5 4 3 2 1
_________________________________________________________________________
Collaborates & communicates with staff (patient’s concerns and findings) 5 4 3 2 1
_________________________________________________________________________
Readily available to student at all times 5 4 3 2 1
__________________________________________________________________________
Excellent rapport maintained with unit staff 5 4 3 2 1
__________________________________________________________________________
Comfortable with computerized system 5 4 3 2 1
__________________________________________________________________________
General comments:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Thank – you
Please return to Mohini Pershad, Professional Practice Leader Nursing – 6N -632
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Appendix C
POST EVALUATION FOR CLINICAL PLACEMENT Date of commencement of placement ___________________ Date of completion of placement_________________ Name of University/College (optional) _________________________________________________________________
Preceptored Student Student (Group) Year 1 Year 2 Year 3 Year 4
Teacher I have been a Clinical Teacher for _____________ years.
I have worked at North York General Hospital as a Clinical Teacher _____________ times in the past year. Please circle the response that you feel is most appropriate: 1 2 3 4 5 STRONGLY DISAGREE DISAGREE NEITHER AGREE NOR DISAGREE AGREE STRONGLY AGREE
1. The Student orientation was useful and informative 1 2 3 4 5 (Please comment) ______________________________________________________________________________________________________ 2. The computer based training module was useful and informative 1 2 3 4 5 (Please comment) _____________________________________________________________________________________________________ 3. The information package was useful and informative (Preceptored students/Teacher) 1 2 3 4 5
(Please comment) ______________________________________________________________________________________________________
4. The Unit was appropriate for the student’s / my learning needs 1 2 3 4 5 (Please comment): ______________________________________________________________________________________________________ 5. Unit staff were approachable and supportive 1 2 3 4 5 (Please comment):
______________________________________________________________________________________________________
6. The Unit staff were familiar with the objectives for the student’s/ my experience 1 2 3 4 5 (Please comment): ______________________________________________________________________________________________________
7. The placement has met the student’s/ my expectations and standards 1 2 3 4 5
(Please comment): ______________________________________________________________________________________________________
8. List any aspects in which the clinical placement could be improved (Please comment):
_______________________________________________________________________________
9. What would make it easier for you to teach/ learn at North York General Hospital? (Please comment):
_______________________________________________________________________________
10. Would you choose North York General Hospital as a place to work? Yes No
(Please comment): ______________________________________________________________________________________________________
Over all how would you assess the clinical experience? Please check only one
Excellence, you would not hesitate to recommend this placement to other students Time well spent, would recommend to other student Some good learning experiences Not adequate learning experiences
Thank you, Mohini Pershad, Professional Practice Leader, Nursing- 6N-632
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Appendix D
Preceptor Evaluation To be completed by nursing consolidation/ preceptored student
Preceptor Name:_________________ Unit: ________________
Student Evaluator: _____________________ Date:______________
Please indicate which response best reflect your experience with the above clinical instructor
1= Strongly agree 2 = Agree 3 = neutral 4=disagree 4= Strongly Disagree
Teaching Effectiveness 1 2 3 4 5 Reviews my work thoughtfully, carefully, and constructively
Promotes original thinking and analysis
Offers specific suggestions for change that I can put into practice
Guides me in developing learning objectives
Listens to comments and questions
Supports my efforts to learn and understand
Stimulates my interest in the subject matter
Assists in developing critical thinking
Makes me feel comfortable about raising concerns and asking for help
Follows my course work progress
Describe how feedback is used by the Preceptor 1 2 3 4
Gives me constructive feedback on my patient care
Gives me constructive feedback on my written documentation
Gives me constructive feedback on my daily perfromance
Describe how your preceptor evaluated your performance during your training:
Professional Relationship 1 2 3 4 5 Serves as a good role model of professionalism
Helps me network with professional colleagues in my area of interests
Facilitates the progression of my learning objectives
Helps me understand and enhance my nursing skills
Helps me understand the social, political and financial implications of nursing
Overall, provides good support for my development as a nurse
Comments:________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Thank – you
Please return to Mohini Pershad, Professional Practice Leader Nursing – 6N -632
