Clinical Facilitators and Preceptors

Transcription

1 Bachelor of Nursing Guide for Clinical Facilitators and Preceptors School of Nursing and Midwifery Nathan Logan - Gold Coast

2 BN Guide for Clinical Facilitators Table of Contents INTRODUCTION... 2 SCHOOL OF NURSING AND MIDWIFERY... 3 The Bachelor of Nursing Program... 3 Clinical Placement Roles and Responsibilities... 4 Academic Staff... 4 Professional Practice Office Staff... 4 Contact Information... 5 MODELS OF CLINICAL SUPERVISION... 6 Various models are in use for supervising students on clinical placement... 6 THE CLINICAL FACILITATOR... 6 Representing Griffith University... 7 Clinical Placement Expectations... 7 Administrative and Practical Matters... 8 Absence from Placement... 9 Employment Conditions... 9 Clinical Facilitator Workshops... 9 Payment Details... 9 Incidents in the Workplace Work Schedule and Pay Information SURVIVAL GUIDE FOR CLINICAL FACILITATORS Before the Clinical Placement Orientation Day on Clinical Placement During the Clinical Placement PERFORMANCE AND ASSESSMENT Scope of Practice Getting the most out of Clinical Placement The Assessment Tool Domains of competence The Assessment Process Identifying poor performance: Challenges on Clinical Placement Feedback about Clinical Placement STUDENT MANAGEMENT Conflict Resolution Strategies Communication Styles Appendix 1: Goal Setting Sheet Appendix 2. Australian Nursing Standards Assessment Tool (ANSAT) Appendix 3: Behavioural Cues for Domains... 6 Appendix 4: Formative Review Appendix 5: Anecdotal Notes G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 1

3 INTRODUCTION BN Guide for Clinical Facilitators Clinical Placement is an essential and fundamental component of the Bachelor of Nursing program. Our nursing students regard their clinical placements as a highlight during the course of their education. We value the relationships we foster with health care facilities in which our students are placed. We need their support and cooperation and to that end expect all Griffith employed staff work collaboratively and respectfully with our industry partners. We respect your knowledge, experience, and enthusiasm. As a Clinical Facilitator or Preceptor, your support of students on their clinical placement is an essential and valued service. This guide has been prepared to assist you in the role of Facilitator / Preceptor of our nursing students. It provides guidelines for assessment and processes to manage situations you may encounter. We recommend you review this guide before commencing every clinical placement. If you are unsure about any of its contents, or aspects of the role, please seek clarification by contacting the Professional Practice Coordinator on the campus where your students are located. While it is our responsibility to provide you with the necessary information, it is your responsibility to access and use the resources provided and notify the appropriate staff within the School of Nursing and Midwifery without delay, if you become aware of any difficulties. We hope you will find the information helpful, and wish you the very best during your association with our students. Professional Practice Office School of Nursing and Midwifery G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 2

4 SCHOOL OF NURSING AND MIDWIFERY BN Guide for Clinical Facilitators The Bachelor of Nursing Program The aim of the Bachelor of Nursing (BN) program is to produce graduates who are safe, competent and confident Registered Nurses, able to engage locally and globally. The themes running through the program are based on the premise that high quality care is always: Client and family focused Driven by information and based on evidence Organised for quality and safety The Bachelor of Nursing award will be granted following the successful completion of six full time semesters of study (or part-time equivalent) including all clinical components (240 credit points). The graduates will be eligible for registration in Australia. Curriculum updates: 2016 marks the first year of the Curriculum, beginning with first year students. Continuing students will be completing the previous curriculum ( ). Foundations of Safe and Effective Nursing In the first year students learn the language of nursing and begin to experience what it is to be a registered nurse. The clinical focus is on key concepts that underpin the practical role of the nurse such as health assessment, effective communication, patient safety and teamwork 1809NRS Effective Nursing Practice o 2 weeks clinical placement Client and Family Focused Nursing Care During the second year the emphasis is on reinforcing technical knowledge, skill and attributes of nursing. The clinical focus is on clinical decision making for clients with a range of acute and chronic conditions. 2801NRS Nursing Clients with Medical/Surgical Conditions o 3 weeks clinical placement 2802NRS Nursing Clients with Chronic Conditions o 2 weeks clinical placement 2976NRS Mental Health Nursing o 2 weeks clinical placement Delivering and Coordinating High Quality Care Third year students develop advanced clinical decision making skills and the capacity to delegate, supervise and educate more junior team members. 3978NRS Aged Care Nursing o 2 weeks clinical placement 3979NRS Community Nursing o 2 weeks clinical placement 3801 Advanced Clinical Decision Making o 8 weeks clinical placement Details of topics covered and full course profiles for a particular course in the BN program can be accessed on the Griffith website at: G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 3

5 BN Guide for Clinical Facilitators Clinical Placement Roles and Responsibilities Students enrolled in the Bachelor of Nursing (BN) program undertake a number of clinical courses during their program. Clinical placement in an appropriate health care facility or service area is a requirement of each clinical course. A Course Convenor on each campus oversees and coordinates the delivery of content, and oversees student performance for each course. For clinical courses, this included overseeing student performance on clinical placement. The Professional Practice Office staff co-ordinate the clinical placement of students and support the Course Convenors in their role. Academic Staff Program Director Responsible for the quality and delivery of the BN program BN Program Advisor Responsible for the quality and delivery of the BN program on each campus Works collaboratively with Program Director, Course Convenors and Professional Practice Office Staff. Course Convenor Manages the academic progress of students in their particular course Communicates with health care facilities and supervisory staff during clinical placement Advises and assists with any knowledge and learning deficit issues Guides and directs the progress of student management issues such as Formative Reviews. Professional Practice Office Staff Professional Practice Coordinator (PPC) Liaises with industry partners and co-ordinates the securing of placements for students Oversees the allocation of clinical placements Liaises with industry partners regarding allocation of clinical facilitators / preceptors Engages Clinical Facilitators and allocates clinical facilitation. Co-ordinates Clinical Facilitator education, feedback and performance development Educates and advises in the use of Clinical Assessment tool Advises and assists with any professional practice issues Assists with Formative Reviews when Course Convenor requests collaboration Professional Practice Liaison Officer (PPLO) Allocates nursing students to clinical placement Administers the processes relating the clinical placement Forwards placement information to the health care facilities and Clinical Facilitators Oversees / checks all records entry related to students placement. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 4

6 Contact Information BN Guide for Clinical Facilitators The following is the generic for the Professional Practice Coordinators. In particular, it is used for all communication related to the allocation of clinical placements and administrative details for Clinical Facilitators. Professional Practice Office Key Personnel Contact details Professional Practice Coordinator Professional Practice Liaison Officer Professional Practice Coordinator Professional Practice Liaison Officer Professional Practice Coordinator Professional Practice Liaison Officer Nathan Campus Kate Barnewall Judy Underwood Logan Campus Judith Needham TBA Gold Coast Campus Danny Sidwell Lisa Lowe Phone: (07) Mobile: Office: N Phone: (07) Office: N Phone: (07) Mobile: Office: LO Phone: (07) Office: LO Phone: (07) Mobile: Office: G Phone: (07) Office: G As circumstance changes, so may these staff and positions. However the generic s will remain the same and your will always be answered in a timely manner. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 5

7 MODELS OF CLINICAL SUPERVISION BN Guide for Clinical Facilitators Various models are in use for supervising students on clinical placement. Facilitator model A competent RN, independent of a particular workplace, oversees a small group (6-12) students Preceptorship A RN in the workplace works in partnership with one student for the duration of placement There are variations or hybrids of these models such as the Integrated Professional Practice Models (IPPM) and Cluster Model where students work with RNs in the workplace with appointed facilitators or clinical associate staff co-ordinating and providing support for the clinical staff in their role with students During their time with Griffith University, students may experience various models of supervision on clinical placement. It is important, therefore that you understand you role, and clarify with students what that role is, what they can expect of you as a Clinical Facilitator (or Preceptor) and what you expect of them. THE CLINICAL FACILITATOR The Clinical Facilitator is an experienced registered nurse appointed to supervise, support learning, and evaluate undergraduate student nurses undertaking courses that include a clinical practice component. As such the role of the Clinical Facilitator also includes the functions of Supervisor, Coach and Mentor. The primary role of the Clinical Facilitator is to: Act as a professional role model Be a guide and mentor to the workplace Act as an educator by: o assessing learning needs o facilitating the learning experiences o evaluating learning performance The Clinical Facilitator is a Registered Nurse who has the following attributes: Displays a positive attitude and has a professional commitment to nursing Demonstrates effective interpersonal communication skills, a non-threatening approach, is flexible, open minded, has a sense of humour and a self-confident attitude. Identifies and works within professional boundaries and maintains confidentiality Demonstrates clinical competence and evidence based practice Demonstrates problem solving and critical thinking and clinical reasoning skills Exhibits leadership qualities role modelling and reflection Demonstrates the ability to introduce and interpret protocols, policies, and standards to assist learners in building the necessary skills for professional practice Demonstrates accountability in professional practice Participates in continuing education by engaging in in-service programs, conferences independent study and reflection Works collaboratively and respectfully within a team environment Demonstrates the ability to teach others by identification of learning needs, planning and evaluation of learning activities G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 6

8 The responsibilities of the Clinical Facilitator are: BN Guide for Clinical Facilitators To ensure they are familiar with the students course requirements and expected outcomes To ensure they meet mandatory requirements for the clinical workplace and are prepared for placement including facility orientation To ensure students are welcomed and valued: Introduces them to the rules, customs, culture and norms of their co-workers and workplace To understand the relevance of the student s background and learning needs To assist the students to become familiar with the work environment including: o Physical facilities o Ward procedures and policies o Patient allocation processes o The permanent healthcare facility staff To promote competence in clinical practice by: o Motivating and encouraging enthusiastic behaviour o Provide access to learning opportunities that meet clinical objectives o Promoting theory to practice links To demonstrate and supervise practice of clinical skills To monitor theoretical and clinical progress on a regular basis. To act as a resource person To recognise and effectively manage interpersonal difficulties and mediate where necessary To encourage and support independent growth. To work in collaboration and cooperation with facility education and clinical staff Representing Griffith University Clinical Facilitators represent Griffith University, School of Nursing and Midwifery. Therefore as both a representative of the University and as a role model for the nursing profession, it is very important that a high standard of professional conduct is maintained. Refer to the Griffith Code of Conduct at: Clinical Placement Expectations On clinical placement and at any time within a healthcare facility aligned with the University, Clinical Facilitators are expected to adhere to the following requirements: Demonstrate a professional standard of behaviour in accordance with the Nursing and Midwifery Board (NMBA) Code of Conduct and Code of Ethics, as well as Griffith Code of Conduct Demonstrate a professional standard of dress while there is no specific uniform requirement, professional work-wear is expected. Griffith Polo and cotton shirts may be purchased from the Griffith shop on campus Clothes, jewellery, hair and appearance generally must align to that required of nursing students (comply with all policies) Griffith University ID badge must be worn at all times and be clearly visible (badges may be obtained from Student Services on any campus) Provide contact details to students and healthcare facility staff in each area Demonstrate a clear understanding of the NMBA National competency standards for the registered nurse Maintain clear communication with the Professional Practice Office and Course Convenors Maintain communication with facility staff G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 7

9 Administrative and Practical Matters 1. We ask that you provide current Curriculum Vitae (update every 3 years). BN Guide for Clinical Facilitators 2. In an attempt to keep in line with current public and private industry partner guidelines, Griffith University requires that facilitators provide us with evidence of up to date mandatory requirements. Mandatory requirements include: AHPRA registration (Annual) CPR or ALS (Annual) Manual handling (Annual) Medication competency (Annual) National Police Check (valid for 3 years in acute settings or 12 months if in aged care) Hand Hygiene (on commencement and every 3 yrs) Blood safe competency (on commencement and every 3 years) Please find links below (note: you must complete all modules + the 2 case studies to get the final certificate. Submit final certificate only) In addition to the above: It is now a requirement that all Non QHealth employed Clinical Facilitators (Supervisors) working in a QHealth facility complete the following prior to commencing in the role and annually: 1. Read the Essential Placement Requirements for Students: 2. Complete the Student Orientation Checklist: 3. Also complete the Workplace health and safety Modules. 4. Once the above have been completed the Clinical Facilitator (Supervisor) is to then complete and sign the Supervisor Deed Poll If you are having problems with LEO more detailed instructions can be found in the placement essentials link below. (Log on as a student) Site Specific information: The Royal Brisbane and Women s (RBWH) require CF s to undertake an additional orientation package. Information will be forwarded if allocated to that facility Hospital specific orientation is to be completed each calendar year by students. It is expected that CFs ensure they familiarise themselves with site specific orientation information See also the Non-Metro North declaration form Please attach all certificates and send by to sonmnursingcc@griffith.edu.au at your earliest convenience. It is the responsibility of the staff member to ensure records are updated each year. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 8

10 Clinical Placement Hours BN Guide for Clinical Facilitators Bachelor of Nursing students are on clinical placement for 8 hour days across morning and afternoon shifts. It is essential that the students complete the full shift as these hours are collated as a legal requirement for nursing registration. The main meal break is in excess of the 8 hours. On occasion shift times or a specific roster arrangement may be in place for a particular placement. Specific details will be provided for the relevant placement. Absence from Placement Clinical Facilitators are required to give as much notice as possible if they are unable to attend their allocated clinical placement. The Professional Practice Coordinator (Logan) can be contacted on their mobile phone for all Clinical Facilitator absences. Students are required to follow a strict protocol for notifying absence from clinical placement for any duration of time. This must be done for each and every day of absence. This has been clearly stipulated in the BN Professional Practice Policy. Employment Conditions Clinical Facilitators are employed on a casual basis usually from one to four weeks duration each time. The Logan campus Professional Practice Coordinator allocates Clinical Facilitators for clinical placements across the three BN campuses, with consideration for preferred locations as much as possible. A specific amount of work cannot be guaranteed. While every attempt is made to book you in advance, last minute requests or unavoidable cancellations may occur due to unforeseen circumstances. The clinical placements usually have students from one particular campus but this may not always be the case. The students and the Clinical Facilitator communicate with the Course Convenor at the campus at which the student is enrolled as per students Scope of Practice. Clinical Facilitators are expected to be present for the whole time nursing students are on site at a healthcare facility during clinical placement (except where specific agreement and details are in place). It is not permissible to work for any other agency at the same time as clinical placement times with students. However, it is possible to work for another entity outside these hours but it is unacceptable to arrive late or leave early to attend another job. Clinical Facilitator Workshops The School of Nursing and Midwifery supports professional development and learning opportunities for all the staff, for the advancement of nursing practice. The Clinical Facilitator workshops provides learning and skill development opportunities, program and industry updates as well as an opportunity to network and liaise with other Clinical Facilitators, academic staff and, on occasion, industry partner staff. Updates and further information will be disseminated throughout the year as needed and additional resources are provided on line through the Griffith SoNM website at: Clinical facilitators are considered an important part of the teaching team and we hope you find the information and resources helpful. Your feedback is welcome and is used to inform improvements. Payment Details Clinical Facilitators are paid at a casual rate. This rate of pay incorporates loadings for costs associated with fulfilling the role such as phone and internet costs, as well as associated activities outside clinical placement hours. These may include, but are not limited to, healthcare facility visits prior to clinical placement, the completion of students assessment and other documentation and reports, meetings with University staff for any reason, Workshops and education sessions related to clinical placements. Griffith University pays and schedules are completed online. This is detailed in the section on Schedule and Pay Information. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 9

11 BN Guide for Clinical Facilitators Incidents in the Workplace From time to time incidents involving a student occur whilst on clinical placement. Students are legally indemnified through Griffith University insurance policies and agreements. In addition to ensuring the safety and well-being of all involved, including appropriate medical attention if required, the Clinical Facilitator must ensure: That appropriate staff at the facility are notified That the policy of the health-care facility is followed including completion of any workplace health and safety forms That Griffith documentation is also completed (see link below). The relevant Course Convenor is informed The following link contains the GSafe reporting site for all incidents. Clinical Facilitators may find it useful to document the incident in a hardcopy format in the first instance (a form can be downloaded from the website). This can then be ed to the university (clinical office). However, it is important that the record is completed in GSafe. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 10

12 BN Guide for Clinical Facilitators Work Schedule and Pay Information Clinical Facilitators are employed as Sessional Staff. All sessional engagement forms, employment information and payment advice is online. The following web links may be useful Ask HR about Payroll Sessional Staff o There is a list of frequently asked questions which may be helpful Activating a Sessional Schedule If you have been a student or previous employee of Griffith University, the Griffith ID number previously generated will be reactivated for you. Otherwise an ID number will be generated by Human Resource Management (HR). The following steps need to be worked through in order to activate this process: Provide your Griffith ID to Maree Dempsey, School Secretary Logan Campus or Provide your Date of Birth to Maree Dempsey if you require a new Griffith ID A Sessional Schedule will be initiated on your behalf. This sets out the dates and hours you will be working and the pay rate assigned. To review and submit the Schedule for approval you are required to follow these steps. Activate a password if you have not previously been employed by Griffith University or if your current password is not active o Contact Library and IT Help on +61 (0) who will generate a password o You will require your Griffith ID and some questions will be asked to verify your identity Login to the Griffith Portal Username is derived by adding a lower case s to your Griffith ID and excluding any leading zeros; eg ID becomes s Password as initiated by IT Help or previously activated On the right side menu Click on My Staff Page link Click on the Time and Absence tile Click on the My Sessional Schedules tile Click on the "Create/View Schedule" button in the Currently Active Sessional Schedules grid for the appropriate o The Schedule will open in a new browser window (Ensure the pop-up blocker on the internet browser is disabled). Check all the details Click Submit at the bottom of the screen The Sessional Schedule was submitted successfully message will appear Click OK Click Return at the bottom of the screen and Logout at the top right hand side of the screen. If you have any queries or require assistance in relation to submitting your schedule, please contact HR Staff Services on , option 1. If you have any questions or concerns about the schedule content, please contact Maree Dempsey on or m.dempsey@griffith.edu.au Important Information You will not be considered to have been engaged until the process above has been completed. You cannot be paid until the schedule has been submitted by you. You will receive an to your Griffith to advise that you have a schedule to submit. The hours to be worked are entered into the system in advance. Therefore a reduction in hours or any absences will be in the system as a minus value. These hours need to be submitted by you prior to the pay period cut-off date. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 11

13 SURVIVAL GUIDE FOR CLINICAL FACILITATORS BN Guide for Clinical Facilitators Before the Clinical Placement An offer of a clinical placement allocation will be conveyed by the Professional Practice Coordinator. The Professional Practice Office at the relevant campus will prepare the Pre-Brief information. This is usually sent out in an format but may be posted or found online through sonia. The Professional Practice Office endeavours to convey the information in a timely manner. However, the timeframe may vary as some student allocations and clinical placements can change quite close to the commencement date. The Pre-Brief information contains: The name of the healthcare facility The clinical placement dates The meeting place and arrangements for Orientation Day The shift allocations The list of the students attending The course summary and the scope of practice. The following web link contains the documentation required on clinical placement: The Healthcare Facility Healthcare facilities appreciate the Clinical Facilitators arranging a visit prior to the first day of clinical placement. It gives everyone an opportunity to become familiar with the expectations and requirements of those concerned. The healthcare facility staff and the NUM in particular, value a face to face meeting at a time when communication may be less disrupted. An orientation to unfamiliar areas is required providing beneficial information including: the location of resources, rooms and dining facilities, assists the students in feeling expected and welcome on the first day of placement. It is also important to be aware of the policies and procedures related to the particular facility or how to access them. Swipe cards or key codes are in place in some areas and prior knowledge is useful. Students are advised to visit the healthcare facility so they are aware of parking arrangements and the meeting place. However they are not allowed to contact the facility prior to orientation day. Orientation Day on Clinical Placement Every healthcare facility has different arrangements and it is important to be cognisant of their expectations. Some facilities will not allow a student to continue the clinical placement if they are not present on orientation day. The prearranged meeting place is clearly stipulated and everyone is expected to be present on time. The rest of the day will proceed according to the local arrangements. However the following points should be covered: The Clinical Facilitator should: Welcome the students to clinical placement Orientate the students to the facility, the area in which they are working, and the staff facilities for personal possessions, dining and rest rooms Introduce the students to the NUM and key staff in their placement area Provide the students with the facilitator s contact information and that of the healthcare facility as required Ask the students to provide the facilitator with contact details in case of an emergency Give clear guidelines regarding their expectations during the placement Ensure the students are aware of the facilitator s availability, the occasions for feedback and the debriefing sessions. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 12

14 The students should: BN Guide for Clinical Facilitators Be appropriately prepared for placement: o Be appropriately dressed including wearing their ID badge at all times o Have completed all on line orientation, learning and requests outlined in the Prebrief of the facility, and provided documentation as required Be aware of their Scope of practice Be aware of the importance of notifying any absences on a daily basis Be aware of the importance remaining in their allocated areas other than for breaks or as directed, and the importance of attending their breaks in a timely and prompt manner Be aware of mobile phone arrangements, social networking precautions and confidentiality issues. Provide the Clinical Facilitator with a goal setting sheet Healthcare Facility Unit Orientation Each area will be designed differently and students need time to find their way around. The provision of a guide, such as a Seek and Find sheet, which assists them in locating different areas and items can be helpful. In particular the Emergency Trolley and Fire Safety procedures and equipment should be identified. Sometimes the nursing staff in the area will be available to show students the location of patient information, the use of the handover sheets or daily shift planners and the process for handover. The students may be allocated to their RN buddy and continue the shift with their guidance. Supervision and Medication Administration on Clinical Placement Students are able to work with Enrolled nurses as they are still under in-direct supervision of the Registered Nurse (RN). However for medications, all students must have direct supervision by a registered nurse at all times with any medication administration. Direct supervision is when the supervisor is actually present and personally observes, works with, guides and directs the nursing student who is being supervised. NMBA A national framework for the development of decision-making tools for nursing and midwifery practice (2007, p 19). Guidelines.aspx#dmf Students are advised to use approved, contemporary and scholarly resources to guide their practice such as MIMS, the Injectable Drug Guide or other electronic sources for drug information. It is helpful to encourage them in the use of a small notebook to keep important information and quick reminders for use in their practice. During the Clinical Placement Work with students on an individual basis over the clinical placement time and form your own assessment. Discussions with the RN buddy are important for an overview of the student s performance. Prioritise and give adequate time to those who need more guidance. A daily journal, or notes in another format, is a useful adjunct to guide assessment and to validate actions and decisions. Ensure you are always contactable by both staff and students. Regular and ongoing feedback is essential for the student to guide and reassure them. Mid-placement feedback is carried out in a more formal manner with each individual student, using the Assessment tool as a measure and guide for performance. Use the time to review goals. Debriefing sessions: It is suggested that you spend a short time at the end of each week with the student group to recap on the week. More structures debriefing may be needed if a critical incident or situation has occurred. The Course Convenor should also be informed. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 13

15 PERFORMANCE AND ASSESSMENT BN Guide for Clinical Facilitators There are several aspects of professional performance that are assessed. These include clinical knowledge, skills and performance, behaviour and fitness for the role. Refer to: which includes: Feedback Fitness for placement Unsatisfactory performance including: o Inappropriate conduct or behaviour o Criminal conduct o Medical fitness o The consequences of unsatisfactory performance. Scope of Practice The scope of practice for an undergraduate nursing student is that which a student is educated, competent and authorised to perform for safe, professional practice. The scope of practice for an individual registered nurse or undergraduate nursing student is influenced by the: Context in which they practice Patients and client s health needs Level of competence and education of the individual registered nurse or nursing student and qualifications of the registered nurse Service provider s policies. As undergraduate nursing students progress through their degree program, their scope of practice will change. The Course Convenor of all clinical courses will be explicit about what constitutes a student s current scope of practice. Students must work within their current scope of practice and any student who practices outside their current scope of practice may receive a fail grade for clinical placement. Health services have strict policies on medication administration. Students are advised to ensure they read, understand and conform to the School of Nursing and Midwifery s policy on Administration of Medication by Students on Clinical Placement in the Professional Practice Policy. The Nursing and Midwifery Board of Australia (NMBA) document NMBA National Framework for the Development of Decision Making Tools for Nursing and Midwifery Practice contains information about scope of practice and the decision making framework. This is available at: Guidelines.aspx#decisionmakingframework Getting the most out of Clinical Placement Students have an obligation to make the most of each and every learning opportunity. This may include: Taking the time to effectively communicate placement goals, personal strengths, expectations, rights and responsibilities. Actively demonstrating that they work safely and professionally, are able to make decisions and take actions in line with their theoretical preparation and scope of practice. Asking questions and seeking further information in situations which are unfamiliar to them. Clinical Facilitators/Preceptors and academic staff from the School of Nursing and Midwifery have the right to expect respect from students. They have clinical and theoretical expertise and will be making judgments about students clinical performance based on the NMBA National competency standards for the registered nurse. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 14

16 BN Guide for Clinical Facilitators The Assessment Tool The Australian Nursing Standards Assessment Tool (ANSAT) is used by Clinical Facilitators and Preceptors to assess students skills and competence during clinical placements. Clinical Facilitators/Preceptors must be familiar with the tool and the Nursing and Midwifery Board of Australia (NMBA) National competency standards for the registered nurse. Documenting the Assessment: For the most part the ANSAT will be completed on-line. Should the need arise, the Formative Review, will be completed in collaboration with the Course convenor and student. It is recommended that Facilitator s document Anecdotal notes for their personal reference. Specific details and guidelines to complete the on-line process will be circulated. (NOTE: Electronic versions of forms may appear different in layout and format because of the electronic platform. However, the information remains the same) In some circumstances hardcopy forms may need to be used. Students are required to take a hard copy of the ANSAT form with them for all placements, along with their Goal sheet. Hardcopy of all forms can be accessed through the Placement Essentials web page. GOALS: All Nursing students are required to provide a copy of their Goals (either typed or hand written) for each placement and provide for the Clinical Facilitator / Preceptor. Failure to do so will indicate that the student is not adequately prepared and a Formative Review may be required, for discussion with the course convenor and student. Domains of competence The Clinical Assessment Tool (Appendix 2) encompasses the four domains of the Nursing and Midwifery Board of Australia National competency standards for the registered nurse. Guidelines.aspx#competencystandards The four domains are: Professional Practice Critical Thinking and Analysis Provision and Coordination of Care Collaborative and Therapeutic Practice. These four domains are adapted for each clinical placement within the Bachelor of Nursing program to reflect the evolving scope of practice of undergraduate nursing students. The NMBA Framework for assessing national competency standards for registered nurses, enrolled nurses and midwives provides a useful resource to guide the assessment of students. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 15

17 BN Guide for Clinical Facilitators The Assessment Process Competency is assessed in each of the four domains of the ANSAT. The Clinical Facilitator/Preceptor structures their continual and collective assessment by considering the student s knowledge, skills and conduct in relation to the four domains. It is the student s responsibility to present to clinical placement with well thought out goals documented on the goal setting sheet. These goals can be modified or added to in line with learning opportunities for a particular placement. The following section provides an outline of Griffith University SoNM Assessment processes for Clinical Placement. For specific details about managing poor performance will be covered in the Managing Student Performance section. Also refer to the Student Assessment Flow Chart. Assessment in the clinical setting is a continuous process to facilitate early identification of challenges or learning needs: o Ad Hoc Assessment: Structured assessment done, as needed, if, at any time early warning signs are identified that a student is performing poorly. Where specific issues are identified, a Formative Review may be required. o Mid Placement Assessment: Structured assessment using the Assessment tool to evaluate the student s progress and performance to date and support ongoing development for the remainder of the placement. Students are encouraged to selfevaluate and provide examples of their performance. The student s Goals are to be reviewed and may be used to document ongoing learning and strategies. o End of Placement (Summative Assessment) Structured assessment to document the student s achievement for that placement. Student is encouraged to self-evaluate and provide examples of their performance. Comments may be included on the tool. For a summary of the assessment process, please refer to the Student Assessment Flow Chart on page 18: Identifying poor performance: There may be occasions on clinical placement when a student s performance is not reaching the expected standard. Early identification facilitates early intervention to support the student s learning. In the first instance, an Informal discussion may be all that is needed. o Use the student s Goal sheet to update goals and strategies for improvement o Document Anecdotal notes for your record (see Appendix 5). In the event that the issues are more serious or the informal discussion has not been effective (allow a day or two), then a more structured process is required: The Formative Review (see Appendix 4) is proactive a two-part tool that provides for both Assessment and a learning plan: o Section 1 Assessment: Documentation of a structured assessment to provide clear structured feedback including specific details of where the student s performance is below the standard. The issues are identified specifically in terms of the domains of the NMBA National competency standards for the registered nurse as outlined on the on the ANSAT. o Section 2: Learning Plan: A written plan detailing what the student is expected to demonstrated for each of the identified issues and strategies to achieve the desired outcomes. A specific timeframe is to be given and the student should continue to receive feedback and direction to support their outcome as necessary. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 16

18 BN Guide for Clinical Facilitators The main aim of the Formative Review process is to ensure that any professionalism, behaviour or clinical practice deficits are identified and a corrective action plan developed. This maximises the success rate for the student. As such, students should look upon the review process as a positive learning strategy. A student who is unable to successfully achieve the plan outlined in the Formative Review and is unable to demonstrate appropriate levels of knowledge, skills or conduct within the four domains outlined in the NMBA National competency standards for the registered nurse will fail the clinical placement. The student will be notified and asked to attend a meeting with the Course Convener. They may then wish to meet with the Deputy Program Director to discuss future options. Safety Issues: Note: If at any time there is a safety concern regarding: o o o The student themselves The patients / clients Other staff The student must be supported somewhere safe, and the Course Convenor and facility staff must be notified immediately. They will advise on course of action. Student Attendance records: Students are required to attend all days on placement as per the Professional Practice Policy. Attendance is recorded on the Assessment tool. Any absence from clinical placement will lead to Result Withheld being marked on the Assessment Tool. Final sign off is managed by the Course Convenor including decisions about completion of missed clinical hours is required once the Assessment tool and hours have been reviewed. Student must advise all relevant parties as per the policy of any absences from placement. Student must show a copy of any medical certificates to the Clinical facilitator: Note: the Clinical facilitator / Preceptor does not need to collect medical certificates the student are responsible for uploading these to their file. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 17

19 STUDENT ASSESSMENT FLOW CHART BN Guide for Clinical Facilitators The following chart provides a guide for Facilitators / Preceptors for the assessment of student nurses on Clinical Placement. The undergraduate contact person at the facility is also to be kept informed of students progress and significant safety concerns reported. First Week: - Early Indicators: Is the Student performing to the required standard (safe, ethical practice)? Yes No Identify specific issues & discuss with student. Identify strategies for student on Goal sheet Write Anecdotal Notes for your record Advise Course Convenor Provide regular feedback and encouragement Issue resolved Yes No Midpoint of placement: Complete Half-Way feedback Discuss, & R/V goals Provide regular feedback and encouragement In final week: Discuss student selfassessment Complete Final Assessment Section on Assessment tool Discuss with Student SUBMIT for Electronic tool (Hardcopy - return promptly via post to relevant campus) Finalise Anecdotal Notes Yes Issue Resolved Complete Outcome section on Formative Finalise Anecdotal Notes Return to normal assessment path No Escalate to Formative Review: Document specific issues & develop plan linked to domains in liaison with Course Convenor Specific time period for Review Discuss with student. & Both sign Inform Facility Educator (Refer to Privacy policy) Complete Outcome section on Formative Review Discuss with Course Convenor for further guidance Advise Facility Educator as needed Document Final Assessment If at any time there is a significant safety concern, please contact the relevant Course Convenor (as per Scope of Practice documents), as soon as possible. If not available, contact the Professional Practice Office. It is also appropriate to inform the host facility G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 18

20 BN Guide for Clinical Facilitators Challenges on Clinical Placement Generally, clinical placement is both inspiring and rewarding and most students value the experience and opportunities presented to them. However, there can be situations which arise where a student feels there are issues of concern. In every situation there are channels of communication and it is important that these are adhered to in a professional manner. Student Concerns RN Buddy issues Clinical Facilitator/Preceptor conflict or other issues Facility concerns Speak with Clinical Facilitator Speak with Clinical Facilitator Speak with Professional Practice Coordinator at your campus There are processes for further appeal should the channel of communication outlined above not resolve student concerns. Refer to information about Griffith University s Student Appeals and Grievance Policy available at: Feedback about Clinical Placement We are grateful for and appreciate feedback. Bachelor of Nursing students will be provided with the opportunity of online evaluation following each clinical experience. Students will be asked for feedback on their Clinical Facilitator/Preceptor and the facility (ward/unit) at which they were placed. This is an important way for students to rate and offer constructive feedback about their experience. The Professional Practice Office will use feedback constructively and endeavour to address any areas of concern identified by students. Feedback from Clinical facilitators is also welcomed and can be provided via the generic G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 19

21 STUDENT MANAGEMENT BN Guide for Clinical Facilitators Document uncontrolled When Printed Managing students within the clinical environment will require you to draw upon a broad range of skills including effective communication, resolution of conflict, supportive feedback and objective assessment. For process concerning Assessment, refer to the Performance Assessment section As a Clinical Facilitator, part of your role is establishing and maintaining a trusting therapeutic relationship with students and facility staff members. From time to time you may be faced with conflict situations between yourself and students, the student and the facility, or between two students. Interpersonal conflict occurs whenever an action by one person prevents, obstructs or interferes with the actions of another person. People often mistakenly believe that a good relationship is one where no conflicts are present. However, skilfully managed conflicts facilitate change and improvement, and should not be avoided as many opportunities may be missed. Griffith University policy and procedures are at: Conflict Resolution Strategies Approach the other person o Make sure you gather information about the situation from all parties involved and ascertain everybody feelings about the incident Do not hit and run o An example of hit and run is when somebody gives you their views about conflict then disappears o Address issues with people involved in the conflict when you have the time and appropriate venue to discuss it o Timing is important; always ensure there is enough time so that the other person can respond Communicate openly o Express your perception of the issues in conflict and try to do so in a nonthreatening way o Focus any anger onto the issues at hand, not on the other person s behaviour, character or personality Consider the other person s point of view about the situation o Be a good listener, remain objective and factual, and avoid emotional responses Only ask for change when change is possible o Distinguish between behavioural change that is possible and modification of a personality trait which may be a more difficult o Always suggest and negotiate changes in behaviour. Communication Styles The manner in which you present yourself verbally and physically in a conflict situation will greatly affect the outcome. Try some of these approaches and suggest that both parties do likewise: Describe the other person s actions Do not label or insult each other with stereotyping or name calling Define the conflict in the most specific way possible Focus on your feelings (I phrases) such as When you do / say I feel. Statements starting with you.. are perceived as accusations Define the conflict as a mutual problem to be solved not as a lose/win situation Describe the actions of yourself and the other person that may resolve the conflict. G:\nrs-gc\Clinical\FACILITATORS\BN Guide for Clinical Facilitators. Final_2016V1.2.docx 20