UNM EMS Academy Policies

Transcription

1 UNM EMS Academy Policies A. AFD Satellite Paramedic Program Handbook Anne B. Policy on Technical Standards for Admission, Continuation and Graduation C. Professional Conduct Policy D. Professional Appearance Policy E. Paramedic Program Tardy and Absentee Policy Paramedic Program Tardy and Absentee Procedure F. Professional Conduct and Test Ethics Policy G. Inclement Weather Policy H. HP & PHP Due Process Policy I. Drug and Alcohol Policy J. Paramedic Program Clinical Manual The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

2 Page 1 THE UNIVERSITY OF NEW MEXICO, SCHOOL OF MEDICINE, EMS ACADEMY POLICY ON TECHNICAL STANDARDS FOR, ADMISSIONS, CONTINUATION, AND GRADUATION Applicants for admission to The University of New Meico School of Medicine Emergency Medical Services Academy (UNM SOM EMSA) and current students must possess the capability to complete the entire emergency medical services (EMS) curriculum, achieve the level of Emergency Medical Technician Certification or Bachelors of Science in Emergency Medical Service for which they are enrolled or seeking enrollment, and practice paramedicine with or without accommodation. The University recognizes that otherwise qualified candidates for the EMS programs may be able to meet the technical standards described in this document if provided reasonable accommodation. It should be noted however that the use of a trained intermediary is not acceptable in situations where the candidate s judgment is impacted by the intermediary s powers of selection and observation. Accommodations which cannot be applied in the course of the work, or which would compromise patient care, including accepting slower performance or lower standards of competency than would normally be epected would not be considered reasonable. Thus the use of personal aids, assistants, care-- givers, readers, and interpreters may not be appropriate, particularly in clinical education settings. Students must also be aware that approval for, and the provision of, reasonable accommodations at UNM SOM EMSA does not mean that similar accommodations would be granted elsewhere or by national licensing review boards. In accordance with the Americans with Disabilities Act (ADA), The University of New Meico School of Medicine Emergency Medical Services Academy will implement policy and procedures to ensure equal access to educational opportunities for persons with disabilities. Because graduates of EMS programs must be prepared to assume care for patients in a wide variety of clinical disciplines the education for the paramedic program is, of necessity, broad in nature. An avowed intention to practice only a narrow part of the curriculum does not alter the requirement that all students take the full curriculum. TECHNICAL STANDARDS REQUIRED TO PERFORM THE ESSENTIAL FUNCTIONS OF THE EMS SCHOOL CURRICULUM The EMS curriculum requires demonstrated proficiency in a variety of cognitive, problem--- solving, manipulative, communicative, psychomotor, and interpersonal skills. To achieve these proficiencies, the School of Medicine Emergency Medical Services Academy requires that each student be able to meet the following Technical Standards*. A. Observation: Through independent observation the student must be able to acquire information in the basic medical sciences, including that obtained from demonstrations and eperiential activities. The student must also be able to observe and accurately acquire and interpret information directly from the patient as well as from other sources including written documents, images, slides, videos, and films. This level of observation and information acquisition requires the functional use of vision, hearing, and somatic sensation. B. Communication: Students must be able to effectively speak, hear, read and write in a tutorial, classroom, and assessment setting. Student must be able to speak, hear and observe patients in a clinical setting. A student must be able to record The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

3 Page 2 information accurately and clearly, fluently speak and write English, and communicate effectively and in a sensitive manner with patients. A student must also be able to appropriately and professionally communicate with members of the healthcare team in oral and written form and in patient care settings where clinical decisions may depend on rapid communication. C. Motor Coordination: Students must be able to elicit information independently from patients by palpation, auscultation, percussion, and other diagnostic maneuvers. Students should be able to respond to emergency situations in a timely manner and provide when necessary, or direct, general emergency care to the level of their education such as airway management, CPR, placement of intravenous catheters, medication administration, simple wound repair, and basic obstetrical procedures. Such activities require sufficient physical mobility coordination of both gross and fine motor neuromuscular function, functional use of the sense of touch, vision, hearing, and balance and equilibrium. D. Physical Demands (NHTSA Functional Job Analysis) a. Strength: Standing (47%)/Walking (50%)/Sitting (3%): Walking and standing are major components of the paramedic job analysis. Sitting is necessary for certain elements of clinical care and for transportation to and from the scene of an emergency. i. Lifting/Carrying/Pushing/Pulling: The EMT is required to assist in lifting and carrying injured or sick persons to ambulance and from ambulance into hospital. May be required to engage in pushing and/or pulling to assist other EMS providers to etricate patient from scenes to include, but not limited to, closed upright vehicles, patient in closed overturned vehicle, patient pinned beneath vehicle, pinned inside vehicle, in vehicles with electrical hazards. ii. iii. Climbing/Balancing: Climbing and balancing may be required to gain access to site of emergency, i.e., stairs, hillsides, ladders, and in safely assisting in transporting patient. Stooping/Kneeling/Crouching/Crawling: Patients are often found injured or sick in locations where assessment of patient is possible only through the EMT stooping, kneeling, crouching, or crawling. iv. Reaching/Handling/Fingering/Feeling: Required for clinical maneuvers such as: assessing pulse; assessing breathing; blocking nose and checking ventilation; lifting chin, head, or jaw for opening airway; following angle of ribs to determine correct position for hands after each ventilation; compressing sternum; assisting in lifting of patient; administering medications through intravenous therapy or other means; and handling of advanced life support equipment such as mirror airway devices. Etension of arms to use hands and fingers to assess vital signs, feel and touch patients skin to assess body warmth, handle limited equipment, and transport patient are important aspects of this position. Finger deterity needed to insert needles, prepare fluids/medications for administration, and to operate equipment. The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

4 Page 3 b. Hearing: Verbally responding to dispatcher s messages on phone or radio is necessary for quick, efficient service that can be vital to life in emergency situations. Communication on scene is critical for interviewing patient and in some instances, significant others, and in relaying this information in most epedient manner. Sounds of vehicles may alert the EMT that additional help is on the way. Other sounds can alert the EMT that other persons may be hurt or injured, i.e., someone thrown behind a bush in a vehicle accident who cannot be seen and whose voice may be barely audible. c. Seeing: Acuity, Near/ Acuity, Far/ Depth Perception/ Accommodation/ Color Vision/ Field of Vision --- Sight is used to drive ambulance to scene of injury or illness, to visually inspect patient and area, to read maps and navigation systems, to read small print on medication/prescription containers, to read drug reference manuals, and to administer treatment. E. Intellect: Students must be able to identify, define, and solve problems in a timely and effective manner. This critical skill demanded of EMTs requires the ability to: work effectively with measurements and calculations; learn and reason in a variety of settings including formal lectures, small group discussions, individual teaching sessions, clinical teaching sessions and independent learning activities; self--- evaluate; and integrate, analyze, and synthesize data concurrently in a multi-- task setting. In addition, the students must be able to comprehend three-- dimensional relationships and to understand the spatial relationships of structures. F. Behavioral and Social Attributes: Students must possess the emotional health and the self-- discipline required for full use of their intellectual abilities, the eercise of good judgment, and the timely and safe completion of all tasks and responsibilities. They must be able to adapt to rapid change, to display fleibility, and learn to function in the face of stressful situations and uncertainties. Students must consistently demonstrate honesty, integrity, altruism, empathy, and concern for patients, their families, colleagues, members of the healthcare team and the community at large. The determination of whether an applicant or current student meets the above standards will be done on an individual, case by case basis utilizing the eisting committee structure of the School of Medicine Emergency Medical Services Academy (i.e. Committee on Admissions, Advisory Committee on Students with Disabilities, Promotions and Evaluations Committee [PEC]). * Technical standards shall mean those minimum standards for EMTs that must be eamined and enforced in the admissions process and in the determination whether a recommendation for certification. SPECIAL ACCOMMODATIONS Technical Standards and the Policy and Procedure for Requesting Special Accommodations Policy on Technical Standards for Admissions, Continuance, and Graduation (Abbreviated) The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

5 Page 4 In accordance with the Americans with Disabilities Act (ADA), the University of New Meico School of Medicine Emergency Medical Services Academy will implement policy and procedures both in the spirit and the letter of the law to ensure equal access to educational opportunities for persons with disabilities. Applicants for admission to the University of New Meico School of Medicine Emergency Medical Services Academy and current students must be able to complete, with or without reasonable accommodations, the entire EMS curriculum to achieve the recommendation for Emergency Medical Technician certification. The determination of whether an applicant or current student meets the Technical Standards with or without a reasonable modification will be done on an individual, case by case basis utilizing the UNM School of Medicine Committee on Students with Disabilities. Procedure for Students Requesting Accommodations in the EMS Academy Curriculum and/or Evaluation The following procedure is written to be consistent with the UNM-- SOM EMSA Policy on Technical Standards for Admission, Continuance, and Graduation and to guide the student and the representatives of the institution through the process for requesting and evaluating students requests for reasonable accommodations. The student will self-- disclose their disability if the student can reasonably anticipate the need to request a reasonable accommodation to perform the essential functions of the course of study. The student will request an accommodation from the UNM-- SOM Office of Academic Resources and Support (OARS), either prior to matriculation or, in the case of a disability acquired after matriculation, as soon as a disability, for which a reasonable accommodation will be sought, is known or evident. UNM-- SOM-- OARS will help guide the student in providing or acquiring the documentation needed by the Committee on Students with Disabilities in their deliberations. It is the responsibility of the student to obtain the necessary documentation as requested by the committee. This initial documentation will: 1. Be current, within the last year. 2. Be detailed, comprehensive and include justification pertaining to the requested accommodations based upon two considerations: a. The specific nature of the student s functional impairment of a major life activity. b. The education or testing environment in which the disabled but "otherwise qualified" individual will be functioning. 3. Contain credible supporting evidence from appropriately licensed health care professionals. 4. Include a diagnosis by a competent professional with appropriate epertise who must provide a rationale for any recommended accommodations and must eplain how those adjustments or technical aids would cancel or ease the impact of the impairment on the task for which it is sought. The Committee on Students with Disabilities will determine if the: The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

6 Page 5 1. Student has an adequately documented medical disability that affects the students major life activity. 2. Requested modifications are appropriate and "reasonable." 3. Accommodation is consistent with the Technical Standards of the institution. 4. Accommodation requested does not compromise the integrity of the educational program. The Committee on Students with Disabilities will deliberate regarding the four issues noted above with the following determination and make one of the following three decisions: I. The Committee on Students with Disabilities will deny the request for disability determination if the disability is not adequately documented. The student may appeal the decision of the Committee to the Associate Dean of Student Services who will review the decision against the four criteria specified above. The Dean of the School of Medicine will consider any appeal of the Associate Dean s decision. All appeals must be made in writing within 10 days of the Committee s written decision. II. The Committee will deny the request for accommodation if the disability is sufficiently documented but the accommodation is determined to be unreasonable in the contet of the technical standards or an undue burden to the school. The committee s decision that the accommodation is not consistent with the Technical Standards may be appealed to the Education Counsel by the student or student s advocate. This determination is independent of the validity of the student's claim of a disability and can be done while maintaining the student's confidentiality. If the denial is based on the burden to implement the accommodation, it may not be possible to maintain student confidentiality. The Education Council may make the determination or may defer to a vote of the UNM School of Medicine Faculty. If the student desires to appeal the decision, the Dean of the School of Medicine will be the final point of appeal. All appeals must be made in writing within 10 days of the written decision that is the subject of the appeal. If the accommodation is not granted, the student s options include: 1. Continue in the educational program without the requested accommodation OR 2. Not matriculate OR 3. Withdraw from the educational program. 1. The Committee on Students with Disabilities will grant the accommodation if the disability is a) adequately documented, b) the accommodation is both consistent with the disability and reasonable, in accordance with the Technical Standards, and c) the accommodation does not cause an undue burden and it does not unacceptably compromise the integrity of the educational program. If an accommodation is granted, the committee shall: a. Place the specifics of the accommodation granted in a confidential file in the EMSA Administrative office. b. Determine whether the accommodation granted will be included in the director s letter and, if so, how it will be worded. The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

7 Page 6 c. The student will notify the program director in writing when he/she wishes to implement the accommodation. The director will contact the EMSA Staff and Faculty concerned regarding the specifics of the accommodation. d. When the Committee on Students with Disabilities grants the overall accommodation, the deadline for notifying the program director will be specified. In general, the following guidelines will be used: i. 4 weeks in advance for etended time for a written eamination. ii. iii. 8 weeks in advance for performance-- based eams, which may include formative, summative, practical, and comprehensive eams. 8 weeks in advance prior to the start of an internship or course for accommodations that impacts the daily activities within the program. e. If the student does not make the request for the accommodations granted by the committee within the stipulated time frame, the student will forfeit the right to have that accommodation during that particular course or internship. f. Once granted, the accommodation will be arranged, if requested by the student, for all core courses, and internships. However, if an elective or sub--- internship is unable to provide the accommodation, an alternative educational opportunity will be designated by the Committee. The Committee on Students with Disabilities will be available to assist clinical coordinators in developing appropriate mechanisms to provide the accommodations. g. If the student wishes to eercise his/her accommodation during a visiting elective away from UNM, the student must notify the host school during the original scheduling period to verify that the host school is willing and able to provide the accommodation approved by the Committee. The Committee on Students with Disabilities will consist of individuals who are knowledgeable about both specific disabilities as well as the requirements of paramedic education and should include, but not be limited to, representation from university counsel, educational diagnostics, neuropsychology, psychiatry, neurology, general/primary care, surgery, and the Assistant Dean of Admissions. The Chair of the Committee of Students with Disabilities will be appointed by the Dean for three years. Members of the Committee will be appointed by the Chair for staggered terms of two years. The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

8 Page 1 Professional Conduct Policy Students are epected to display professional behaviors that are consistent with the public's and employer's epectations of paramedics. You will be evaluated by instructors and preceptors to ensure that your comportment is always appropriate. The EMS Academy has a responsibility to the public to up hold the professional standards of the EMS field. Students are responsible for adhering to the following policy any time they are at the Academy, while participating in any EMS Academy program activity, and while in EMS Academy uniform, whether or not they are actively engaged in a EMS Academy program. As students at the University of New Meico, the UNM Student Code of Conduct also applies to EMS Academy students. You are encouraged to review the UNM Student Code of Conduct, which is found in the Pathfinder, the UNM Student Handbook at policies/student-- code-- of-- conduct.html#studentcode. In addition to the UNM Pathfinder Student Code of Conduct, the following infractions will result in referral to the PEC. They may result in immediate dismissal from the program. Ingestion of drugs or alcohol prior to or during any program activity. Carrying a weapon while engaged in any program activity or while wearing an EMS Academy student uniform. Note: This does not include multitools, or pocket knife with 3 blade or less. Unauthorized use or possession of any EMS Academy property, or the property of any hospital, EMS service, or other organization or institution with which the Academy is affiliated, including testing materials. Unprofessional behavior in any aspect of EMS education. Teamwork and Personal Effort: It is one of the primary goals of the EMSA to instill a commitment to teamwork among its EMS students. Therefore, the students shall cooperate, support and assist each other whenever necessary. The student's best effort is epected at all times. Courtesy At all times students will demonstrate compassion, respect, concern for others, teamwork, leadership, and a commitment for ecellence. Students shall always ehibit courteous behavior and professionalism toward all patients, staff, instructors, fellow students, members of the EMS service, Hospital staff, and other individuals they encounter. Students will initiate a polite greeting to all individuals they encounter and they will respond appropriately to any greeting directed to them. Students will refer to EMS Academy faculty and staff, preceptors, and clinical staff by their last name with the appropriate prefi (Dr., Professor, Mr., Ms., etc.). Respect for Others Respect will be shown to all members of the Instructional staff, staff, fellow students, preceptors, clinical staff, and anyone the student encounters. Disrespect or abusive language toward any individual or group shall be considered unprofessional behavior. Students shall respect the rights of all individuals and will not engage in The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

9 Page 2 discrimination, oppression, or favoritism. Smoking on university or clinical site grounds in designated areas only. Electronic Devices Laptops, Pads, PDAs or other electronic data devices are allowed only with epressed permission of the instructor. Lectures may be recorded only with the instructors eplicit permission. All cell phones and pagers will be turned off at all times during class. Appropriate breaks will be provided. The EMS Academy main telephone number (see front desk for number) can be used as emergency contact. Ecessive disruption of class due to cell phone or pager use may be grounds for disciplinary action. Cell phones that ring during an eam will result in the student being asked to leave the room and a score of zero will be awarded. During testing times students will not look at any electronic device. UNM student Code of Conduct will be in effect at all times while a student participates in the EMS Academy offerings. Detailed information can be found at policies/student-- code-- of-- conduct.html#studentcode The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

10 Page 1 Professional Appearance Policy This section establishes specific regulations for wearing uniforms and related equipment. EMS Academy students shall wear only those uniform items officially sanctioned by the EMS Academy, and are required to be in uniform any time they are at the Academy and while participating in any EMS Academy program activity. Official Uniform and Equipment --- The EMS Academy requires the neat and uniform appearance of all students during clinical education. EMS academy instructors and preceptors may dismiss students from the clinical site at their discretion for appearance outside the requirements of this dress code. The instructor and the preceptor has sole discretion on appropriateness of attire and may dismiss students from class or clinical for inappropriate attire or appearance. Violations of this dress code may result in disciplinary action. Uniform Black EMS pants or BDUs Black or dark blue socks at least mid-- calf high. No anklets no skin showing between top of footwear and bottom of pants Black boots or shoes with appropriate ankle support -- boots above the ankle are required for pre-- hospital shifts no heels higher than one inch Black belt EMS Academy polo uniform shirt (to be purchased from EMS Academy), worn tucked in Hats may be worn, if they are EMS Academy approved/accepted Sunglasses may be worn only when class meets outdoors Optional: Plain turtleneck, vest or jacket, of a color eactly or closely matching with the uniform shirt, without identifying writing Underclothing Plain white or black t-- shirts with no graphic or writing on them may be worn as part of the uniform. The T-- shirt sleeves shall be no longer than the uniform shirtsleeves. Other appropriate personal underclothing shall be worn. Equipment Watch that counts seconds (digital or analog a cell phone may not be used) Stethoscope Penlight EMS shears Approved Protective eyewear (with clear lenses) Note: Students are required to comply fully with all clinical sites policies on piercing, tattoos, and grooming standards. Variations of this dress code may eist at specific medical facilities or within particular units, such as the Operatiing Room (OR) and Office of the Medical Investigator (OMI). In these cases students will receive instructions from an EMS Academy instructor, or the preceptor, and be directed to the changing area. Uniform Maintenance Students shall be responsible for keeping all uniform articles clean and in good The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

11 Page 2 repair. Uniform shirts are to be kept clean and pressed. Uniform pants will be kept clean and pressed. They will be plain bottom leg, hemmed no shorter than to the top of the back of the shoe. Pants will be worn at the natural waistline, not on the hips. Personal Appearance and Grooming Standards These standards will apply to both men and women unless otherwise specified. These standards are for both classroom and clinical settings, and during any EMS Academy program activity, regardless of location. No ecessive cologne or perfume No ecessive make-- up Piercings will be limited to modest ear studs or clear gauges/plugs, worn in the lobe of the ear. No dangling Piercings. All piercings will be in compliance with clinical site policies. Hair will be clean, neat, well trimmed, and properly combed at all times. Hair will not contain ecessive amounts of grooming aids such as grease, creams, oils, and sprays. Hairstyles shall be within the following restrictions: o Hair that touches the shoulder or is longer must be pulled back during all skills and clinical rotations. o Hair may be dyed, tinted or frosted only in colors naturally occurring in human hair. Facial Hair: will be clean, neat, well trimmed, and properly combed at all times when reporting for class and clinical. o Sideburns will be kept neatly trimmed shall not be flared, bushy or a similar style (such as "muttonchops") shall not etend lower than one-- third the way down from the top of the ear, and shall end in a clean horizontal line All personnel will have fingernails that are clean and neatly trimmed so as not to etend more than 1/2" beyond the fingertip. Nails are not to interfere with the efficient operation of medical equipment and patient care. Overlay, such as acrylic or solar or other "false" nails shall not be worn during clinical rotations due to infectious disease concerns. No necklaces or bracelets are allowed. Tattoos must be in compliance with clinical site policies for clinical rotations The field of prehospital medicine epects a high standard of comportment from students. The preceding policies, in practice, ehibit the following professional values, which are epected from students at all times. Integrity Professionalism Leadership Empathy Teamwork The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

12 Page 3 Diplomacy Effective time management Confidence Respect for others Effective communication The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

13 Page 1 Paramedic Program Tardy and Absentee Policy Student attendance is required at all scheduled classes, mandatory study sessions, labs, clinical assignments and internship. You are to report to class, clinicals and internship shifts 15 minutes before the beginning of the class/shift start time, and ready to work at the beginning of your scheduled shift. Violations of this policy may result in corrective and/or adverse action, up to and including, program dismissal. This policy is a minimum requirement. If the policies of the Service where a student s clinical or internship is being held are more stringent than the Academy s policies, the Service s policies prevail. This holds true for any section of this policy that refers to clinical and/or internship shifts. Absenteeism Absenteeism will be addressed with either a verbal or written warning or, in the case of ecessive violations (eplained in detail below), referral to the Promotion and Evaluation Committee (PEC) for review of the student s status in the paramedic program. If a student misses any class, study hall, clinical shift or internship shift s/he is responsible for the material covered in that session as well as any missed eaminations or assignments. Any course work due on the date of a scheduled absence remains due on that date unless otherwise stipulated by the course faculty and indicated on the required absence record form (see absence record form). Tardy A student reporting, and ready to work, to a class, study hall, clinical shift or internship shift later than the scheduled start time is considered tardy. If a student misses 25% or more of a class, study hall, clinical shift or internship shift, that student is considered absent for that class, study hall, clinical shift or internship shift. Occurrences of tardiness will be addressed with either a verbal or written warning or, in the case of 5 or more violations in any one class, study hall, clinical shift or internship shift, referral to the PEC for review of the student s status in the paramedic program. Absenteeism Up to 4 days total of absence allowed per class, study hall, clinicals and/or internships per semester may be granted by the course faculty for etenuating circumstances. Occurrences of 5 absences or greater in any class, study hall, clinical shift or internship shift will result in referral to the PEC for review of the student s status in the paramedic program. Absence Due to Temporary Illness For absences due to temporary illness greater than 4 consecutive days due to illness, refer to leave of absence policy. Absence Record Form Students must submit an Absence Record form in advance, unless not possible, completed and signed by the faculty responsible for the class, study hall, clinical shift or internship shift missed every time they are, or epect to be, absent. Forms not submitted in advance must be submitted on the first day of return to the program. If the appropriate faculty member is not on-- site at the Academy that day, turn in your form to the paramedic program administrator for The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

14 Page 2 appropriate signature. Submission of absence record forms past the first day of return to the program automatically renders the work missed with a grade of zero. Ecessive Absenteeism 5 non-- consecutive absences for any one class, study hall, clinical and/or internship shift will result in referral to the PEC for review of the student s status in the paramedic program. Medical Leave of Absence / Light Duty Medical leave of absences from the program or requests for light duty may be granted by the PEC. Absences of 4 days or less are not eligible for medical leave of absence request. Leave of Absence Leave of absences from the program may be granted by the PEC for etenuating circumstances. Absences of 4 consecutive days or less are not eligible for leave of absence request. Paramedic Program Tardy and Absentee Procedures Tardy 1. First and second Tardy occurrence: Verbal warning for each occasion. 2. Third and fourth Tardy occurrence: Written warning for each occasion. 3. Fifth occurrence: Referral to the PEC for review of student s status in the Paramedic Program. If a student misses 25% or more of a class, study hall, clinical shift or internship shift, that student is considered absent for that class, study hall, clinical shift or internship shift. Absence Student must submit an Absence Record form, in advance unless not possible, completed and signed by the faculty responsible for the class, study hall, clinical shift or internship shift missed. Absence Due to Temporary Illness On the day of returning to the program, students submit an Absence Record form, completed and signed by the faculty responsible for each class, study hall, clinical shift or internship shift missed. Absence will be recorded by the Program administrator. For absences greater than 5 consecutive days due to illness, refer to medical leave of absence procedure. Ecessive Absenteeism If a student reachs the threshold of any combination of 5 absences for any one class, study hall, clinical and/or internship shift that student will be The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

15 Page 3 notified in writing that they are being referred to the PEC for review of the student s status in the paramedic program. Leave of Absence / Limited Participation To be eligible for light duty or a medical leave of absence from the program the student must: 1. Submit an Absence Record form for each class, study hall, clinical and/or internship shift to be missed, signed by the faculty responsible for that class, study hall, clinical and/or internship shift, and indicating that this is for Leave of Absence. Additional supporting documentation may be required to thoroughly eplain the reasons for the request. Note: The PEC must approve or disapprove the request for leave of absence and the student will be informed in writing. If the request is approved, the PEC will determine when the leave is effective, and when the student must report back to the program. Any changes in the leave of absence must be reported to the EMS Programs Director and may require review and approval by the PEC. If the leave of absence or light duty request eceeds the ability of the student to adequately continue in ALL courses, the PEC may direct the student be recycled in the net available equvilent course(s). Retesting and competency verification may be required for a recycled student. 2. If the request is due to a medical condition, in addition to the Absence Record form, the student must: a. Present a licensed provider certificate (Doctors note) to include: MD, DO, NP, and PA (No other medical practicionares certificate will be accepted) detailing the light duty restrictions and requirements or the reasons for the medical leave of absence, including beginning and ending dates. b. The student must complete a HIPAA release form available at the Academy. c. To return to the program after a light duty or medical leave of absence, the student must present to the EMS Programs Director a Fit for Duty form, available at the Academy, completed and signed by a licensed provider to include: MD, DO, NP, and PA. No other medical practicionares will be accepted. The provider must indicate the student is eligible for a full return to duty. No student will return to the program without the required approved documentation. The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

16 Page 1 Professional Conduct and Test Ethics Policy Students are epected to abide by the Honor Code signed upon entering medical school. Behavior which subverts the integrity of the eamination process for oneself or others is unacceptable. Such behavior includes but is not limited to: Before an eamination 1. Seeking and/or obtaining access to eamination materials prior to test administration. 2. Unauthorized entry into the area where test materials are being prepared. 3. Unauthorized reproduction and/or dissemination of test materials. During an eamination 1. Sharing information about any of the test materials including simulation (electronic, human or mechanical) and paper cases. 2. Possessing unauthorized materials during an eamination. This includes reviewing instructions on outer doors for standardized patient encounters more than 5 minutes before the scheduled testing time. 3. Leaving the test area without authorization. 4. Possessing and/or using recording devices. 5. Possessing and/or using unauthorized study aids. 6. Giving or receiving information during the eamination. 7. Sharing information, resources or reasoning on problems meant to be solved by individuals. 8. Theft of eamination materials. 9. Disruptive behavior which affects other eaminees, standardized patients, or staff. Communication and signaling devices must be off. 10. Making reference notes of any kind during the eamination, ecept on paper provided. All written notes must be deposited in the designated area before moving forward to the net testing activity. 11. Unauthorized reproduction and/or dissemination of test materials. After an eamination 1. Sharing information about any of the test materials including simulation (electronic, human or mechanical) and paper cases. 2. Altering or misrepresenting eamination scores. 3. Unauthorized reproduction and/or dissemination of test or copyrighted materials. IRREGULAR BEHAVIOR WILL BE INVESTIGATED AND REVIEWED. The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

17 Page 1 Inclement Weather Policy The University and EMS Academy make every effort to conduct class as scheduled, but recognize that inclement weather may make holding class impractical or impossible. This issue is complicated by the fact that students complete clinical rotations as a part of the paramedic program throughout the area and that weather conditions can vary widely in the area. The UNM inclement weather number is SNOW. Students can also sign up to receive tet alerts regarding the University, which includes closings, at If the radio or TV has announced that the University is closed due to inclement weather, clinical attendance will not be required by the program. You may complete your scheduled clinical shift if the weather in that area permits. If classes have not been cancelled but severe weather conditions prevent you from safely reaching your assigned clinical site, please contact the clinical coordinator. The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

18 Page 1 UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE HEALTH PROFESSIONAL AND PUBLIC HEALTH PROGRAMS STUDENT DUE PROCESS POLICY I. Introduction This University of New Meico Health Professional and Public Health Programs Student Due Process Policy (hereafter Due Process Policy ) outlines for students, faculty and administers in the School of Medicine Health Professional and Public Health Programs (HP/PHP), the course of action that is available to a HP/PHP student should his or her individual program take either an adverse or corrective action against the student for failure to maintain the academic, professional and/or ethical requirements and standards of the program. The individual programs that make up the HP/PHP and that follow this Due Process Policy are: Occupational Therapy, Physical Therapy, Emergency Medical Services and Emergency Medical Services Academy, Medical Laboratory Sciences, Public Health, Physician Assistance Program, Radiologic Sciences and Dental Hygiene. Each of these individual programs must have a student guide/handbook made available to its students that includes, at a minimum, the program s (1) academic requirements; (2) professionalism and/or ethical requirements and standards; (3) a description of the program s process for dismissing a student or otherwise sanctioning a student for failing to meet program requirements; and (4) a copy of this Due Process Policy. The individual programs that make up the HP/PHP are responsible for monitoring their students performance and compliance with academic, professionalism and ethical requirements and standards. The individual programs decide whether to dismiss or suspend a student or take other action for unsatisfactory performance pursuant to program policies and procedures. As discussed below, a student can appeal the program decision pursuant to this Due Process Policy. II. Adverse and Corrective Action Defined The distinction between an adverse and corrective action is important. Adverse actions are those that separate the student from his or her HP/PHP and include dismissal and suspension. Also, requiring a student to repeat a significant part of the program s curriculum so that completion of the program will be delayed by more than one semester is an adverse action. A corrective action involves the program imposing an educational prescription that, in the opinion of designated program faculty, is necessary in order to improve the student s performance. Corrective actions include, but are not limited to, requiring a student to take a specific course, narrowing the choice of elective courses, mandating a student meet with a The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

19 program advisor regularly, and mandating additional professionalism training. Page 1 Adverse actions are subject to being appealed by the student as provided for in Sections III through VI herein. Corrective actions cannot be similarly appealed by the student, but may be reviewed at the student s request as provided for under Section VIII of this Due Process Policy. III. Appeal of Program Decision Imposing Adverse Action A student who disagrees with the HP/PHP decision imposing adverse action is entitled to appeal that decision to HP/PHP Evaluation Committee. The request for appeal must be made in writing to the Assistant Dean for HP/PHP, stating the reasons why the student disagrees with the HP/PHP decision, and must be received by the Assistant Dean within fifteen (15) days after the student receives the program s written letter imposing adverse action. If the student fails to notify the Assistant Dean within fifteen days, this shall be considered a waiver of his/her right to appeal the adverse action and the HP/PHP s decision shall be final for the University of New Meico. IV. Formation of a HP/PHP Appeals Committee When an appeal is timely made by a student, the Assistant Dean for HP/PHP will form a HP/PHP Appeals Committee consisting of four (4) faculty members from the HP/PHP Evaluation Committee and one (1) student in good academic standing from the same program but a different class/cohort than the student bringing the appeal. The HP/PHP Evaluation Committee will consist of one faculty member from each program appointed by the director of the program and up to three (3) members appointed by the Assistant Dean for HP/PHP. Evaluation Committee members serve a 3-year term which may be renewed for one additional 3-year term. Ideally, the Evaluation Committee will have a miture of eperienced and new members. Members will receive an orientation when appointed to an Appeals Committee, including a review of this Due Process Policy and any relevant policies from the appealing student s program. The Assistant Dean of HP/PHP will review the composition of the Appeals Committee with the student making the appeal. If the student objects that any member is biased against the student or otherwise may not be a fair Appeals Committee member, the Assistant Dean will consider the student s objections and decide whether to remove the members. The Assistant Dean s decision is final. If a Committee member is removed for cause, the Assistant Dean will appoint a new member if one is available from the HP/PHP Evaluation Committee. If a new member is not available, the Appeals Committee will proceed to hear the appeal with three faculty and one student member. The Appeals Committee will select one of its faculty members to serve as chair. V. Review of Appeal by HP/PHP Appeals Committee The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

20 Page 1 The Appeals Committee will accept relevant documentary evidence for review from the student and the director of the program that took the adverse action. Each party will be provided with a copy of the other s submission. The Appeals Committee will conduct individual interviews with the student, director and faculty from the program that took adverse action and others with relevant information. The Appeals Committee will decide who will be interviewed. These interviews will be tape recorded and the student will be offered an opportunity to listen to the tapes. The student will not attend the actual interviews. After the Appeals Committee concludes its interviews, if it has additional questions for the student and/or if the student wants to respond to statements from any of the witnesses, the student will be offered another opportunity to meet with the Appeals Committee. After all of the interviews have been completed, including the final interview with the student, the Appeals Committee will deliberate in closed session. Within thirty (30) days of completing the interviews, the Appeals Committee will decide the appeal by a vote (simple majority) of its members and issue its written decision, which will include its rationale. The final decision will be to uphold or overturn the adverse action imposed on the student by the program. The student and the program director will each be sent the Appeals Committee s decision. In arriving at its decision, the Appeals Committee shall not overrule the academic judgment of a faculty member in the program on the assignment of grades to the student. The Appeals Committee should, as appropriate in the case, consider: (1) whether the program followed its own policies governing student performance, advancement and program completion; (2) whether the evidence supports the program s decision; and (3) whether the student has significant new information that bears on the program s decision that was not available to the student when that decision was made. If the Appeals Committee finds that the student has significant new information, the appeal shall be referred back to the student s program for reconsideration of the adverse action in light of that information. If the program affirms the adverse action, the student may request review by the Appeals Committee. The Appeals Committee will consider any additional relevant evidence and/or witness interviews and issue its written decision within thirty (30) days. VI. Appeal to the Assistant Dean of HP/PHP If either the student or the program director is dissatisfied with the decision of the Appeals Committee, he or she may appeal to the Assistant Dean of HP/PHP in writing within thirty (30) days of receipt of the Committee s decision. Failure to submit a timely appeal means that the student and/or program director waive their right to appeal and the decision of the Appeals Committee shall be final for the School of Medicine. The Assistant Dean of HP/PHP will review the appeal, the student s academic record, the program s decision imposing adverse action, the Appeals Committee s decision and any other documents in the student s program file. Additionally, the Assistant Dean may meet with the student and/or the program director. The Assistant Dean of HP/PHP will issue a The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

21 Page 1 written decision on the appeal and send a copy to the student and the program director. VII. Appeal to the Dean Either the student or the program director may appeal the decision of the Assistant Dean of HP/PHP to the Dean of the School of Medicine in writing within thirty (30) days of receipt of the Assistant Dean s decision. Failure to submit a timely appeal means that the student and/or program director waive their right to appeal and the decision of the Assistant Dean shall be final for the School of Medicine. The Dean will review the student s academic record; the decisions of the program, HP/PHP Appeals Committee and Assistant Dean and any other documents in the student s program file. Additionally, the Dean may meet with the student and program director. The Dean s decision is final for the School of Medicine. The student may request discretionary review of the Dean s decision by the President of UNM and the Board of Regents. The President and the Board of Regents will normally accept review only in etraordinary cases, such as where proper procedures have apparently not been followed, where the decision appears to be unsupported by the facts, or where the decision appears to violate University policy. VIII. Review of Corrective Action As stated in Section II herein, a student is not entitled to go through the appeals process described above to dispute corrective action imposed by his or her program. If the student believes that the corrective action is fundamentally flawed, unfair or otherwise inappropriate, the student may request review by the School of Medicine Senior Associate Dean of Education. The student shall present his or her reasons for disputing the corrective action in writing. The Senior Associate Dean of Education may meet with the student and may discuss the matter with the program director and faculty and the Assistant Dean of HP/PHP, as the Senior Associate Dean deems appropriate. The decision of the Senior Associate Dean of Education is final for the University of New Meico and is not subject to discretionary review by the President or the Board of Regents. IX. General Provisions Minor decisions from this Due Process Policy are permitted so long as they do not substantively impact the due process rights of the student. For good cause, the time limits for written decisions to be made can be etended. Good cause includes the fact that a deadline falls during school holidays, vacations or summer session if parties or decision makers are absent. Any such time etensions should be communicated in writing to all interested parties and the decision will be made thereafter as epeditiously as possible. The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

22 Page 1 The University of New Meico HP/PHP reserves the right to make changes to this Due Process Policy as it deems necessary, with the changes applicable to all students then in attendance in a HP/PHP. The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

23 Drug and Alcohol Policy Page 1 Use and Possession of Alcohol on University Property University policy strictly governs the use of alcohol on University property. Ecept for specific places and events identified, the use of alcohol is prohibited on University property by students, employees and visitors. Using or possessing alcohol on campus is a violation of state law if you are under the age of 21 years and subjects you to possible arrest by UNM police. It is also a violation of the UNM Student Code of Conduct and subjects you to possible disciplinary action by the Dean of Students Office. You can review UNM s Use of Alcohol on University Property Policy at Illegal Drugs and Alcohol UNM s complete policy on Illegal Drugs and Alcohol can be found at Briefly stated here: The unlawful manufacture, distribution, dispensing, possession or use of controlled substances or alcohol on UNM property or as part of any of its activities by any member of the University of New Meico community --- faculty, staff or student --- is strictly prohibited. As a condition of continued registration and enrollment, any student of the University of New Meico shall abide by this policy. This Policy on Illegal Drugs and Alcohol is adopted pursuant to federal laws and because of the commitment of the University of New Meico to an environment for the pursuit of its educational mission free of drugs and the illegal use of alcohol. Drug and alcohol abuse on campus and in the clinical and internship setting poses a serious threat to the health and welfare of faculty, staff and students; impairs work and academic performance; jeopardizes the safety and well-- being of employees, students and members of the general public; and conflicts with the responsibility of the University of New Meico to foster a healthy atmosphere for the pursuit of education, research and service. In addition to UNM s policy, the EMS Academy also reserves the right to require students to undergo drug and/or alcohol testing at any time. Students who violate the Illegal Drugs and Alcohol policy, refuse to be tested, provide false information, or fail to cooperate in a investigation regarding drug or alcohol use shall face disciplinary action, up to and including epulsion. For more detailed information, students should refer to the Student Code of Conduct and related policies printed in The UNM Pathfinder and/or contact the Dean of Students Office. The UNM School of Medicine, EMS Academy reserves the right to make changes to any of the policies, procedures, codes, standards, requirements or services as it deems necessary, with the changes applicable to all students taking course from the EMS Academy, or Satellite Program.

24 Page 1 Paramedic Program Clinical Course Manual Course Description The Clinical/Internship is designed to allow the paramedic student the opportunity to observe/treat patients in a supervised clinical setting. Students will attend shifts in both an In---Hospital and Pre---Hospital setting, which may include but is not limited to: Emergency Room, Pediatrics, Labor and Delivery, and other units. Students will be eposed to a variety of patient encounters. Students may be presented with an opportunity to apply both their Didactic and Psychomotor skills in assessing/treating patients. Teaching-- Learning Methods Teaching---learning methods in this course may include, but are not limited to, presentations, discussion, assignments, case study reviews, documentation review, and applying various forms of communication. Evaluation procedures include quizzes, homework, and daily shift paperwork grading as described in the syllabus. Additional readings, homework and quizzes may be given on an announced or unannounced basis. Course Meeting Times and Location Various times based on availability of shifts Course Objectives Upon completion of this course, the student should be able to: 1. Obtain patient history 2. Determine appropriate Field/Differential Diagnosis based on patient presentation 3. Identify appropriate treatment/transport decisions based on patient presentation 4. Direct other team members as Lead Medic and multi---task to manage scenes 5. Show competency as entry level paramedic Paramedic Program Objectives 1. Adhere to the highest standards of professionalism in all duties as an EMS specialist. 2. Perform the roles and responsibilities of a paramedic within an EMS system.

25 Page 2 3. Patient first attitude that consistently demonstrates selfless responsibility and compassion. 4. To demonstrate epertise in all of the required basic, intermediate, and paramedic competencies. 5. Integrate principles of the medical sciences with a systematic and thorough assessment to formulate a differential diagnosis, and develop and implement an effective management plan for all patients. 6. Perform as a team lead on any call, and safely manage the scene and directing good patient care. Etiquette and Standards Regarding Quizzes, Eams, and Homework Quizzes, Eams or Homework may be given at the discretion of the clinical instructor. The intent of these items is to re---enforce learning principles, and not detract from the clinical/internship learning environment. Issue/Turn---in of these items is at the discretion of the clinical instructor. Etiquette Regarding Attire and Appearance Students will be in proper clinical uniform at all times while working in clinical/field setting. Etiquette Regarding Electronic Devices Students are limited to essential use only of ipads, cellular phones, pagers, radios, ipods, MP3 players, or other such electronic devices during Clinical/Internship. Video, photo, or audio recording is not permitted. Comportment Students are epected to conduct themselves in accordance with the standards of the University of New Meico Handbook. Students are reminded that they are representatives of the EMS Academy, the University of New Meico, and their respective EMS agencies whenever and wherever they are involved with course---related activities. Professional conduct is essential to a successful course eperience and EMS career. Given the nature of the course material and advanced procedures it is understood that this course does not epand the student s scope of practice or condone the use of any advanced skills. These skills are for educational purposes only and the students are epected to follow their independent medical direction and protocols. Academic Dishonesty Academic dishonesty in any form will not be tolerated and is grounds for immediate dismissal from the program and other administrative action by the University. Eamples include, but are not limited to: Cheating in any form

26 Page 3 Falsification or forgery of academic documents, applications, clinical evaluations, lab evaluations, etc. Plagiarism (including copying and pasting of electronic tet into assigned work) Emergency and after hours Contact Information This information is to be used only in the event of an important and emergency situation outside normal business hours. Eamples of emergency events include student injury or student error resulting in patient injury, unprofessional attire or behavior, removal of a student from a clinical setting. In the event of an emergency, please contact the designated Clinical Educator. If the Clinical Educator is not available, you may also contact the Clinical Coordinator or the Paramedic Program Director. 1) UNM EMSA Clinical Educator: TBD prior to start of Clinical/Internship Rotation 2) UNM EMSA Clinical Coordinator Lindsay Eakes Cell: lireilly@salud.unm.edu 3) UNM EMSA Paramedic Program Director Jason Williams Cell: Communications with the Clinical Coordinator The role of the clinical coordinator is to arrange and oversee the quality of the clinical education program. This is done with the highest regard for guiding and evaluating the student eperience in an educationally sound manner. All questions and concerns regarding the clinical education eperience should be brought to the attention of the clinical coordinator. The goal of clinical education is that you have a positive and constructive eperience upon which to build your practice as a paramedic. Therefore, don t hesitate to discuss matters that will maimize the value of this eperience. Pre-- requisites Students must be currently certified in CPR through a nationally recognized course at a level appropriate for health care providers and must be currently state certified at the level of EMT---B or higher. Clinical sites may have particular pre---requisites such as confidentiality statements, competencies, drug screening, site specific immunizations, or waivers that must be on file prior to attendance. Immunizations and Illnesses

27 Page 4 Students must have immunizations records on file at the EMS Academy prior to any clinical education. These are the same immunization documents submitted by the first day of school that is sent out in the acceptance packet. Students that are infected with any contagious illness (chicken po, measles, shingles, etc.) are not permitted to attend any clinical education. Insurance Coverage Health insurance is mandatory during the duration of clinicals, and internship. Students are responsible for their own medical epenses. The University of New Meico does NOT cover you for accidents, medical emergencies, or workers compensation. We suggest that you check with your health insurance carrier to determine if you can be covered during training. The UNM Student Health Center insurance is available to enrolled UNM degree students. Needle stick insurance will be provided for all paramedic students through UNM Student Health Center. Malpractice Insurance As part of the program, you are provided with malpractice insurance for training activities that are performed under the direct supervision of a qualified preceptor. Students are NOT covered for any activities that are not specifically approved by the program, activities not performed during scheduled clinical education or activities not performed under the direct supervision of a preceptor. Student Identification Security has become an increasing concern for the public and for all healthcare facilities. For this reason, all clinical sites require proper student identification. An EMS Academy ID badge may be provided for each student. Students should also carry with them a second form of identification and their current EMT license. Some clinical facilities require a site specific ID badge or parking permit for security purposes, these facilities will provide a process for obtaining these items. Description and Purpose of Clinical Education Clinical education is the segment of your professional education that takes place in the work environment under the guidance of eperienced clinical educators, or preceptors. It is in the clinical setting that you will translate the knowledge, skills and professional attributes learned in the classroom and lab into professional practice. The goals and purposes of clinical education are to guide the learning eperience to give the student the opportunity to: Develop proficiency in practice Gain eposure to the EMS environment Develop professional standards and ethics Observe professional role models

28 Page 5 Learn from eperienced providers Apply concepts to the realities of practice Develop clinical problem solving & critical thinking skills Develop independence Develop work organization skills Develop decision---making skills Assume professional responsibility Develop compassion and communication skills Become socialized into the profession Learn not just the skills of a paramedic, but the professional attributes of a paramedic It is the responsibility of the clinical education program and clinical preceptors to guide and direct the eperiences of students, to encourage and guide reflection on these eperiences, and create optimal conditions for learning. However, it is up to the student to process the input received in order to learn. Epectations for Productivity & Teamwork Students are epected to make productive use of their time in clinical settings, to practice teamwork, and learn the job functions of a healthcare provider. Therefore, the program has the following epectations for students: Demonstrate initiative and interest in all learning activities. Assist with all duty assignments, including pre---shift equipment checks, ambulance cleaning, housekeeping and other duties as needed. Make effective and responsible use of down time. Become familiar with equipment and supplies prior to use. Report on time, rested, in uniform (with ID badge if needed) and prepared to work and learn. Review the epectations, specific tasks, and objectives with your preceptor at the beginning of each shift. Clinical Attendance Student attendance is required at all scheduled clinical rotations. Absences and tardiness reflect poorly on our program and jeopardize the relationship we have established with the clinical facilities. Ecessive absences and tardiness will result in disciplinary action, up to and including dismissal from the program. The clinical coordinator must be notified in advance of any absence, tardiness or schedule change. The student may also be required to notify the clinical facility or preceptor. Tardiness

29 Page 6 Students should arrive at the clinical facility and report to the designated unit 15 minutes prior to the start of the shift. Arrival at or after the start of the shift will be considered tardy. More than 2 occurrences in the program will be considered ecessive and may result in disciplinary action, up to and including dismissal from the program. Absences Ecused absences: An ecused absence is any cancelled shift or absence that has been approved in advance by the clinical coordinator at least 72 hours prior to the assigned shift. Unecused absences: An unecused absence is any cancelled shift or absence with notification to the clinical coordinator less than 72 hours before the start of the assigned shift. More than 2 occurrences in the program will be considered ecessive and will result in referral to the PEC and can result in dismissal from the program. No shows: A no show is any absence that occurs without prior notification of the clinical coordinator. This will not be tolerated. Any failure to report to the scheduled clinical facility without prior notification of the clinical coordinator will result in disciplinary action, up to and including dismissal from the program at the discretion of the PEC. Parking and Transportation Epenses and Liability As a student, you will be epected to pay for parking and transportation epenses for all class related activities. Some clinical sites provide parking free of charge or at a discounted rate. The University assumes no responsibility for damage to any student s vehicle or injuries that may occur during transportation to and from class related activities. Patient Care Errors If an error in patient care occurs at any time during clinical education, the preceptor must be informed and the clinical coordinator must be notified immediately. An incident report must be filed with the clinical coordinator at the earliest possible opportunity. The clinical site may also require students to complete an incident report. All patient care errors will be investigated by the clinical coordinator, the clinical educator and the ALS program director by collecting information from the clinical facility, preceptor, student, crew, patient and other involved individuals. The investigation may also be reviewed by the EMS Academy Medical Director.

30 Page 7 Significant Biohazard Eposure including Needle Sticks Any student that is eposed to a potentially infectious material or environment must seek medical treatment and inform the preceptor and the clinical coordinator as soon as possible. The student should follow the post eposure procedures for that clinical site. For any biohazard eposures the student should be evaluated in the Emergency Room of the facility where the eposure occurred or where the patient has been transported to. It is essential that any appropriate patient information be gathered to assist in follow up and infection risk assessment. The student will then meet with the clinical coordinator or clinical educator to go over paperwork that needs to be completed. If a needle stick occurs while on a clinical or internship shift the student needs to go to UNM Student Health Center and after hours go to UNM Hospital, and then call the clinical coordinator. All other health incidents need to be reported to the students own insurance company and the student will go to their own medical facility for treatment. Clinical Procedures Report only to clinical sites for which you have been scheduled. If for any reason the clinical facility turns you away, contact the clinical coordinator; do not report to another site without prior approval from the clinical coordinator. Upon arrival at the clinical site, report to the assigned preceptor, unit manager or charge nurse. At field sites, report to the assigned preceptor, officer, or supervisor. Arrive 15 minutes early, in appropriate attire, with required paperwork, contact numbers and necessary equipment (ID badge, pen, stethoscope, etc ). You must complete the entire shift for which you are scheduled. If circumstances require you to leave early, you must contact the clinical coordinator as soon as possible. Failure to contact the clinical coordinator for approval will result in an unecused absence. A 30 minute lunch break is permitted when possible during in---hospital clinical education. Obtain approval from the preceptor prior to leaving the unit. During your clinical education, serve as a member of the patient care team, perform as many skills as possible, be proactive and request opportunities to learn or perform skills when necessary. Only perform skills while directly supervised by your preceptor. Never eceed your scope of practice. Any incidents, such as treatment errors, eposures, needle stick injuries, etc, must be reported to the clinical educator/coordinator as soon as possible. Communication problems or conflicts with preceptors should be reported to the clinical coordinator as soon as possible. Have all required paperwork completed by the end of the scheduled shift. Cell phones must be on vibrate or silent mode when in patient care areas. No pictures will be taken during clinical rotations/internship

31 Page 8 Patients Rights The patient or parent/guardian has the right to refuse student participation in their medical care. The patient or parent/guardian must be informed that you are a student and are working under the direct supervision of a preceptor. Additionally, patients have specific rights under the Healthcare Insurance Portability and Privacy Act (HIPPA). Although the program is not a covered entity under HIPPA legislation, we do provide generic HIPPA training. Each clinical facility has specific policies for HIPPA compliance. It is the responsibility of the student to obtain this information if necessary. Confidentiality of patients protected health information must be maintained. Clinical sites have the right to deny student s access to protected health information. Performing Clinical Skills Paramedic students may observe and/or perform the following skills. BLS skills may be performed according to the BLS scope of practice. ALS skills may only be performed after students have been formally cleared by a lab instructor. Students will receive written documentation when they are cleared to perform these skills. Students must still only perform these skills as ordered and under the direct supervision of a preceptor. If a clinical facility, service or region does not allow specific procedures the student can not perform them. Skill BLS Skills Vital Signs & Pulse Oimetry Lifting and Moving Pts. Patient Assessment (Medical) Patient Assessment (Trauma) Bleeding control/ Bandaging C---Spine Short Board Long Board Traction Splint Splinting/Immobilization Oral Suction CPR/AED/BLS obstruction Manual airway maneuvers Basic airway adjuncts Oygen administration Burn Scale (rule of 9) Bag Valve Mask (BVM) Combi/King/LMA Triage Occulsive sucking chest Assessment ALS Trauma Assessment ALS Medical Assessment ALS Pediatric Assessment ALS Neonatal Assessment Stoke Scale STEMI protocol Observe only Observe only Perform when cleared Perform when cleared BLS skill BLS skill Assist only Assist only

32 Page 9 GCS Revised Trauma Scale APGAR scoring Cardiac Skills Observe only Perform when cleared BLS skill EKG monitoring 12---lead EKG acquisition Transcutaneous pacing Manual/Pads defibrillation Synchronized cardioversion Transthoracic pacing Vagal maneuvers Blood Chemistry analysis NG/OG tube insertion Gastric lavage Foley (bladder) catheterization LVAD OB Skills Observe only Perform when cleared BLS skill Vaginal delivery (Normal) Vaginal delivery (Breech) Vaginal delivery (Caesarian) Placental Previa Uterine Rupture Prolapsed Cord/Uterine Pre/Eclampsia Etopic Pregnancy Abortion Fundal massage Ped/NeoManagement & Ventilation Observe only Perform when cleared BLS skill Endotracheal intubation (ETT) Digital/Blind intubation Endotracheal suctioning Magill Forcepts ETCO2 Needle Cricothyrotomy Thoracic decompression CPAP/BPAP Ventilator (pressure) Ventilator (Volume) Meconium Suction Airway Management & Ventilation Observe only Perform when cleared BLS skill Endotracheal intubation (ETT) Nasal intubation Digital/Blind intubation Endotracheal suctioning Magill Forcepts ETCO2 Needle Cricothyrotomy Transtracheal jet insufflation Surgical Cricothyrotomy Thoracic decompression CPAP/BPAP Ventilator (pressure) Ventilator (Volume) Phlebotomy & IV Therapy/IO Observe only Perform when cleared BLS skill Phlebotomy Heel sticks/finger sticks Glucometer Assist only Assist only Assist only Assist only Assist only

33 Page 10 IV Peripheral IV Eternal Jugular (EJ) Central Line (access only) IV Pump Pressure Bag Blood Products ABG sampling Adult IO/Easy IO Pediatric Intraosseous (IO) Parkland Formula Medication Administration Meds by mouth (PO)/(SL) Meds Topical Meds Intra Nasal Meds Rectal Meds Nebulizer Meds IM/SQ Meds IV push Meds IO Meds Central Line Meds IV Infusion Approved Drug List Required Certification ACLS PALS Airway (Optional) Operations/Communications Verbal or radio report ICS Hazmat awareness Mass Casulty Incident (MCI) Rescue Operations Special Proceedures Chest Tube Morgan Lens/Eye irrigation Suturing Central Line Placement Wound Irrigation Restraints Dressing Changes Casting/Advanced Splinting Observe only Observe only Observe only Perform when cleared Perform when cleared Perform when cleared BLS skill BLS skill BLS skill Assist only Assist only Assist only X

34 Page 11 Clinical Dress Code The EMS Academy requires the neat and uniform appearance of all students during clinical education. EMS academy instructors and preceptors may dismiss students from the clinical site at their discretion for appearance outside the requirements of this dress code. Violations of this dress code will result in disciplinary action. Uniform Black or dark blue EMS pants or BDUs Black or dark blue socks Black boots or shoes with appropriate ankle support o Boots above ankle are required for pre---hospital shifts Black belt EMS Academy issued (Delete color) polo uniform shirt EMS Academy ID badge clearly displayed Optional: Plain turtleneck, vest or jacket of coordinating color, without identifying writing Equipment Watch with second hand (digital or analog) Stethoscope Penlight EMS shears Approved Protective eyewear (with clear lenses) Grooming Clean body with no noticeable odors Clean, neatly groomed hair, tied back if long No strong perfumes or colognes No ecessive jewelry Clean, well fitting uniform Clean, polished footwear Note: Variations of this dress code may eist at specific medical facilities or within particular units, such as the OR and Labor and Delivery. In these cases, students will receive instructions from an EMS Academy instructor or the preceptor and be directed to the changing area. Clinical Scheduling Students will be provided with their clinical schedule from the clinical coordinator and students will not be authorized to make changes without the approval of the clinical coordinator. Students will utilize the FISDAP online scheduler to view schedules and input required clinical data. Each student will be given a FISDAP account as well as specific instructions for logging in and using their account. Students can access FISDAP

35 Page 12 from any internet connected computer. Scheduling shifts will occur on the needs of EMSA. Due to the high number of students it is the student s responsibility to notify the clinical coordinator of any scheduling conflicts in accordance with the clinical attendance policy stated above. There must be sufficient time to allow for at least 8 hours of rest between clinical rotations and classes. The program and each of its clinical sites must accommodate a large number of students with limited shifts, therefore canceling, trading and rescheduling will only be allowed after clinical scheduler approval (see clinical attendance policy). The Clinical scheduler may allow shift trading between students to meet scheduling needs and approval from Clinical Coordinator or Clinical Scheduler. The shift trade must be made through FISDAP and approved by the clinical Scheduler. Students not at their scheduled shift will incur an unecused absence. Requirements For Program Completion Successful completion of clinical courses is determined by a combination of time---based and competency---based requirements. Students will also have to meet the stated competencies of the program. Failure to complete clinical requirements by the end of the clinical rotation can include a failing grade or dismissal from the program. Minimum Performance of Competencies The required competencies are based on the recommendations of the 1998 Paramedic National Standard Curriculum, the New Meico State Scope of Practice, and the current National Scope of practice. Although opportunities to obtain the required skills may not be distributed equally throughout the program, it is epected that students attempt to make adequate progress toward the program competencies. Students are required to perform and document many skills throughout the program. In order to make appropriate progress toward that goal and others, a minimum of 15 patient assessments must be performed during each Emergency Room shift. Students will make every effort to achieve this goal for all other training locations. In the event that the program determines an adequate opportunity to perform skills was present but the student shows an inadequate number of skill performances, the student may be required to do additional hours. Additional shift specific guidance will be given to the student based on individual performance and progression. The program recognizes the limited opportunities to obtain endotracheal intubations. Although each student is epected to make every effort to obtain the 5 required live intubations, in the rare instance that a student is unable to attain this number, alternative methods of verifying competency may be offered at the discretion of the program. Approved alternatives may include but are not limited to cadaver or manikin intubations.

36 Page 13 UNM Paramedic Clinical/Internship Minimum Clinical Hour and Internship Requirements Pre Hospital shifts (Internship) 320 ER Shifts 120 Pediatric ER 24 Psych ER if available 12 Operating Room if available 8 ICU 12 Labor & Delivery 24 PROGRAM TOTAL 520 Hours *Please note that these are minimum hours only and students may be assigned additional clinical time for reasons including, but not limited to: skill numbers not being met, inadequate progression, limited team lead eperience etc.

37 Page 14 Minimum Competency Requirements (Program Total) Age---Based Assessments Pediatric (0 17) 30 Adult (18 65) 100 Geriatric (65+) 30 Pathology---Based Assessments Obstetric 10 Trauma 40 Psychiatric 20 Complaint---based Assessments Cardiac / Chest Pain 30 Respiratory / Dyspnea Syncope 10 Abdominal Complaints 20 Altered Mentation 20 Psychomotor Skills Medication administration 15 Endotracheal intubation 5* BVM ventilation 5* Venous access EKG s OG/NG Tube 2 Foley Catheter 2 Witnessed births 2 Team Leads ALS, pre---hospital (*) Indicates this skill is not a terminal competency 20 (Every effort should be made to achieve an additional 8 pediatric Respiratory/Dyspnea assessments) 40 (Every effort should be made to achieve at least 50 IVs/Blood draws) 50 ( lead; lead or lead) 40 (Every effort should be made to achieve at least 50 lead ALS calls)

38 Page 15 Team Leads --- Definition Team lead constitutes any call when the student initiates patient contact, obtains patient history, determines adequate field diagnosis, directs patient care, and directs the team. It is epected the student will make every effort to run calls as team lead as soon as possible during their clinical training. In the event the preceptor assists the student in any of the above mentioned areas, the student may still document as team lead. ALS Call Definition An ALS call is defined by any patient who requires advanced level care to include but not limited to EKG monitoring, IV therapy, drug therapy, or advanced airway procedures. EMS calls should not be considered an ALS call if the patient could be managed with BLS care. Patients should not be placed on a cardiac monitor just for the purposes of claiming it as an ALS call. Preceptor Assists Definition It is understood students will require some preceptor guidance on calls as they progress through their clinical training. An assist is any time the preceptor needs to prompt or intervene to help the student with either history taking, initiating a patient intervention, coming up with primary field diagnosis or differential diagnosis, identifying need for transport, or directing team. Documentation and Paperwork for Clinical/Field shifts All clinical shifts and performed skills must be documented on the EMS Academy clinical forms. To receive credit, all required paperwork must be complete, signed by the preceptor and received by the clinical coordinator/ UNM instructional personnel no later than 2 days following the clinical shift and must be entered into FISDAP within 2 days as well. Paperwork from each clinical shift should be stapled together in the following order:

39 Page 16 Paperwork Needed For Each Shift The order that the paperwork is listed in is the order that it should be stapled and turned in Fire Shifts: Preceptor Evaluation 1, Preceptor Evaluation 2, Clinical Journal (front only), Skills Verification (don t forget to mark lead), and a DCHARTE for every patient ER Shifts: Preceptor Evaluation 1, Clinical Journal, Skills Verification, 15 PT Assessments, and 2 DCHARTE/Soap notes Peds ER: Preceptor Evaluation 1, Clinical Journal, Skills Verification, 15 PT Assessments, and 2 DCHARTE/Soap notes Labor & Delivery: Preceptor Evaluation 1, Clinical Journal, Skills Verification (if you witnessed a delivery mark the baby down as well as mother), an L&D form for every PT you assess, and 2 DCHARTE/Soap notes ICU: Preceptor Evaluation 1, Clinical Journal, Skills Verification, 15 PT Assessments, and 2 DCHARTE/Soap notes OR: Preceptor Evaluation 1, Clinical Journal, Skills Verification, and the assessment form but only with the skills that you did on it Psych (Albuquerque only): Preceptor Evaluation 1, Clinical Journal, Skills Verification, 15 PT Assessments, and 2 DCHARTE/Soap notes Paperwork Overview Preceptor Evaluation 1: Fill out all blanks at the top of page, have your preceptor fill it out, give comments on the back of the page, and have your preceptor sign it Preceptor Evaluation 2: Fill out all blanks at the top of page, have your preceptor fill it out, give comments, and have your preceptor sign it Clinical Journal: Fill out all blanks at the top of page, and unless specifically stated for the shift, fill out both sides Skills Verification: Fill out all blanks at the top of page, if you do an assessment mark either adult, geriatric, or pediatric, and only one spot between trauma and altered LOC, if all you did was a skill on this patient just mark the skill (don t mark adult, geriatric, or pediatric), always write the patients age and gender, where it says totals add everything up, get your preceptor to initial it, write comments if they want, and sign it L&D sheet: Fill out everything that you can, if witnessed delivery fill out APGAR score on the back Assessments: Don t leave anything blank, if it doesn t apply then write N/A DCHARTE/Soap Notes: Fill out everything at the top of the page, fill out the patients age gender and chief complaint, the rest of the front is for your notes because all this info needs to be on the back side of this sheet in your actual soap, get your preceptor to

40 Page 17 write comments and sign it (If your instructor has already graded a soap note then turn in the grade sheet with the soap) EKG strip interpretation: If it is a 3 lead then it needs to be attached to the interpretation sheet, if it is a 12 lead then the interpretation can be written on the ekg itself and turned in by itself Additional Paperwork: Additional paperwork may be required based off of a specific clinical site, the Clinical Educator will notify students under such circumstances. **Eamples of all paperwork and evaluations are located on page 19 Clinical Objectives Emergency Department and ICU During emergency department and ICU clinical rotations paramedic students are epected to do the following: Perform patient assessments on patients of all ages to include history taking, physical eamination and vital signs. Participate in the management of traumatic injury by performing hemorrhage control, bandaging, splinting. Perform intravenous cannulation for the purposes of blood specimen collection and venous access. Perform intraosseous access. Monitor intravenous/intraosseous fluid and medication administration. Administer or assist with the administration of medications by all routes. Formulate clinical impressions and verbalize treatment plans. Perform CPR. Perform basic and advanced airway skills including endotracheal intubation. Perform oropharyngeal and endotracheal suctioning. Administer oygen. Initiate cardiac monitoring and perform 12---lead EKGs. Analyze and interpret cardiac rhythms. Perform electrical cardiac interventions to include defibrillation, synchronized cardioversion and transcutaneous pacing. Insert or assist with insertion of NG/OG tubes and urinary bladder catheterization. Observe or assist with suturing, central line placement, cricothyrotomy, transtracheal jet ventilation, arterial blood gas specimen collection. Integrate information obtained via invasive monitoring into on---going patient assessment. Observe any other procedures as the opportunity arises. Labor & Delivery During clinical rotations on obstetric/l&d units paramedic students are epected to do the following:

41 Page 18 Obtain historical and physical data to identify labor, false labor, complications of labor and delivery, and imminent delivery. Assist in the control of post---partum hemorrhage, to include fundal massage. Assist in support of the patient and family. Assist with normal cephalic delivery. Insert IV s. Assist with neonatal assessment and resuscitation, to include obtaining APGAR scores. Assist with delivery of the placenta. Observe or assist with venous access, blood gas sampling, and airway management in the neonate. Pediatrics When performing clinical rotations in pediatric care settings the paramedic student is epected to: Perform age---appropriate patient assessments to include vital signs, physical assessment and history---taking. Practice communication skills appropriate to patients of various ages. Interact with the patient s family members. Assist with general care, to include IV and IO insertion, medication administration, endotracheal intubation, CPR, and defibrillation. OR/Recovery if available While performing clinical rotation in OR/Recovery settings the paramedic student is epected to: Observe and assist with airway maintenance in the unconscious/sedated patient by using manual positioning, basic airway adjuncts, intubation, and LMA insertion. Ventilate intubated and non---intubated patients. Monitor unconscious/sedated patients, including vital signs, neurological assessment and EKG monitoring and oygenation/ventilation status. Observe surgical procedures. Identify the indications for and perform etubation. Assist with patient moving and positioning. Insert IV s. Pre---hospital Clinical Rotations and Field Internship During pre---hospital clinical rotations and the final field internship paramedic students are epected to: Participate as directed in house duties and maintenance of vehicles and supplies. Observe/assist with all aspects of the job functions of a paramedic. Act as a member of the team.

42 Page 19 Perform scene size ups. Perform patient assessment to include vital signs, physical eamination and history taking. At the discretion of your preceptor act as team leader, beginning with BLS calls and progressing to ALS calls. Formulate clinical impressions and treatment plans. Evaluate the effects of treatment interventions. Perform all skills in the paramedic s scope of practice as authorized by the programs lab instructors and under direct supervision of your preceptor. Communicate with the receiving facility and medical control for notification and orders. Sample Paperwork The following pages contain eamples of paperwork previously referenced under Paperwork needed for each shift

43 Page 20 Daily Performance Evaluation Form Evaluation date: PARAMEDIC STUDENT NAME PRECEPTOR S NAME (Indicate Rating by placing an or filling in the appropriate bo that corresponds to the chart below) 1. APPEARANCE/PREPARDENSS Standard: Appropriate uniform and hygiene. Student arrived on time, with ID badge, necessary equipment and paperwork Ecellent Outstanding Satisfactory Needs Improvement Poor 2. CRITICAL THINKING. Standard: Analyzes problems skillfully; uses logic and good judgment. Critically evaluat es mistakes made in patient care and doesn t repeat mistakes. Student is able to manage ca re while accommodating patient limitations Ecellent Outstanding Satisfactory Needs Improvement Poor 3. APPLICATION. Standard: Evaluates and assesses patients skillfully and recognizes stable vs. serious/critical; uses logic and good judgment to combine classroom knowledge with hands on application related to a prehospital setting. Has initiative and helps to deter mine and resolve patient and scene needs. Utilized resources effectively and does not waste time or resources Ecellent Outstanding Satisfactory Needs Improvement Poor 4. KNOWLEDGE. Standard: Appropriately informed and educated in the areas of pharmacology, pathophysiology, BLS care, ALS care and scope of practice Ecellent Outstanding Satisfactory Needs Improvement Poor 5. TEAMWORK. Standard: Coordinates own work with partners and others to includ e patient turnover reports to other providers. Student seeks opinions, communicates well, in cluding while under pressure; and values working relationships. Listens attentively and res ponds professionally to patients, their families, bystanders as well as other agencies. Consis tently provides a positive attitude and collaborative spirit to work Ecellent Outstanding Satisfactory Needs Improvement Poor

44 Page PATIENT CARE --- BLS. Standard: Consistently provides proper/appropriate BLS patient care Ecellent Outstanding Satisfactory Needs Improvement Poor 7. PATIENT CARE ALS. Standard: Consistently provides proper/appropriate ALS patient care Ecellent Outstanding Fully Needs Improvement Poor 8. SKILLS PERFORMANCE. Standard: Performs in a safe and efficient manner Ecellent Outstanding Satisfactory Needs Improvement Poor 9. TEAM LEAD. Standard: Student must demonstrate the ability to serve as a team leader in a variety of prehospital settings Ecellent Outstanding Satisfactory Needs Improvement Poor Preceptor s Comments By my signature below I acknowledge that I have received the EMS Academy PRECEPTOR S SIGNATURE DATE

45 THE UNIVERSITY OF NEW MEXICO + HEALTH SCIENCES CENTER SCHOOL OF MEDICINE EMERGENCY MEDICAL SERVICES ACADEMY Performance Evaluation - Part II Studentnmne: Date: _ Clinical site: Preceptor: _ Preceptor: Please use the rating scale below to give an objective observation of the student's performance. Circle the correct score: Total Calls on this Shift: How many patients did the student require prompting to obtain patient history? 0 ASSISTS 1-3 ASSISTS 4-6 ASSISTS 7-10 ASSISTS GREATER THAN How many patients did the preceptor interject to help the student in taking the patients history? 0 ASSISTS 1-3 ASSISTS 4-6 ASSISTS 7-10 ASSISTS GREATER THAN How many patients did student require assists in identifying appropriate field/differential diagnosis? 0 ASSISTS 1-3 ASSISTS 4-6 ASSISTS 7-10 ASSISTS GREATER THAN How many patients did student require assistance in coming to appropriate transport decision? OPATIENTS 1-3 PATIENTS 4-6 PATIETNS 7-10 PATIENTS GREATER THAN How many patients did preceptor assist student in directing team as lead medic? OPATIENTS 1-3 PATIENTS 4-6 PATIETNS 7-10 PATIENTS GREATER THAN I 0 Additional Comments: Preceptor signature: Date: _ 11/08 1

46 Page 23 Clinical Journal Student name: Date: Clinical site: Preceptor: A. Describe your overall eperience in this unit today, include your interaction with staff, interaction with patients, things you learned, skills you performed, etc (Complete section B) 1

47 B. Select one patient from this clinical eperience and describe the following: (Field clinicals and internship complete section A only) Page Patient s age: Gender: Diagnosis: 2. History of present illness or reason for admission: 3. Diagnostic tests performed in this unit: 4. Treatment performed in this unit: 5. Treatment plan and prognosis: 2

48 Page 25 Skills Verification Student Name:_ Date: Clinical site: Preceptor: #of Hours Pt Number Age and se of Pt LEAD:Check if applies PEDS 0-1 PEDS 2-6 PEDS 7-17 ADULT GERIATRIC > 65 Trauma Obstetrical Behavioral Cardiac/Chest Pain Resp/SOB/Allergic RX Syncope/Medical Totals Competent? Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ No No No No No No No No No No No No No No No No No No No No No No No No No No preceptor Initials Abdominal Altered LOC/Neur Witnessed Births Intubation Ventilation IV Access Blood Draw IM/SQ PO/SL/Neb IV Medication OG/NG Tube Foley Cath Chest Decompression Miscellaneous Preceptor's Comments: Preceptor's Signature:_ Date:_

49 Page 26 Skills Verification Pt Number Age and se of Pt LEAD:Check if applies PEDS 0-1 PEDS 2-6 PEDS 7-17 ADULT GERIATRIC > 65 Trauma Obstetrical Behavioral Cardiac/Chest Pain Resp/SOB/Allergic RX Syncope/Medical Totals Competent? Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ Yes/ No No No No No No No No No No No No No No No No No No No No No No No No No No preceptor Initials Abdominal Altered LOC/Neur Witnessed Births Intubation Ventilation IV Access Blood Draw IM/SQ PO/SL/Neb IV Medication OG/NG Tube Foley Cath Chest Decompression Miscellaneous Preceptor's Comments: Preceptor's Signature:_ Date:_

50 ljnm 1 "'a,'-'.,.11, y,\ 1 cd i coi Assessment Notes/Procedure Notes \CII< )(!I \lf I!WI';/ S c n icc,.\,-_,rf, n l)' Page 27 Student Name: I Date: Service or Hospital: Preceptor: Time: l illient IAge: Se: M/F I A v p u Medications: Patients Chief Complaint: BP: P: R: BGL: LunQ Sounds: S: 0: A: P: M: Q: P: R: Allergies: L: S: E: T: Procedure Note: '.,.. ' '. j"d.,.f..,<.;.''/. t i '!Patient 10#: IAge: Se: M/F I A v p u Medications: Patients Chief Complaint: BP: P: R: BGL: LunQ Sounds: S: 0: A: P: M: Q: P: R: Allergies: L: S: E: T: Procedure Note:J r n \, < r"!::':i<,;< 1 ; ;i,1.i].h?\j:;;')'w:; ;;<:.: ' ' - i ;;wcr+v'tr; ::.ttt ;,;_;;t "'' c '" L ' y:: c J : F < CiiftiY./: 7t. rpat1ent 10#: IAge: Se: M IF I A v p u Medications: Patients Chief Complaint: BP: P: R: BGL: Lung Sounds: S: 0: A: P: M: Q: P: R: Allerqies: L: S: E: T: Procedure Note: :-...,._,.',. :;,_ ",... (./. ;- ',.,,.!Procedure Note:!Procedure Note: rrocedure Note: I I I

51 ljnm I,Ill L'r,l.'. e 11n,\led 1c.1/ Assessment Notes/Procedure Notes '>( II< l( ll '.\\I Ill\ 1 '-:I Scn it"c's. \ ti(/, ;"Y Page 28 Student Name: I Date: Service or Hospital: Preceptor: Time: Paf1ent TO#:!Age: Se: MIF I A v p u Medications: Patients Chief Complaint: BP: P: R: BGL: LunQ Sounds: S: 0: A: P: M: Q: P: R: Allergies: L: S: E: T: Procedure Note: '... ',.,,.. ;. " [Pat1ent ID#: IAge: lse: M IF I A V P U Medications: Patients Chief Complaint: BP: P: R: BGL: LunQ Sounds: S: 0: A: P: M: Q: P: R: Allergies: L: S: E: T: [Pat1ent ID#:!Age: Se: M IF I A v p u Medications: Patients Chief Complaint: BP: P: R: BGL: LunQ Sounds: S: 0: A: P: M: Q: P: R: AllerQies: L: S: E: T: Procedure Note:,>.. "i J ',., '' :.! 3 ' '., IP-r-o-ce_d_u_r_e_N_o_t_e_= rrocedure Note:.! I

52 Page 29 Patient Care Report Student name: Date: Clinical site: Preceptor: Patient #: Patient Age: History: Past Medical History (from skill verification form) Gender: Presenting Problem: Medications Allergies Vital Signs: Time LOC Skin Pupils Pulse Blood Pressure Respiratory SpO 2 GCS AVPU Temp Moist Rate Quality Rate Quality Time LOC Skin Pupils Pulse Blood Pressure Respiratory SpO 2 GCS AVPU Temp Moist Rate Quality Rate Quality Time LOC Skin Pupils Pulse Blood Pressure Respiratory SpO 2 GCS AVPU Temp Moist Rate Quality Rate Quality Time LOC Skin Pupils Pulse Blood Pressure Respiratory SpO 2 GCS AVPU Temp Moist Rate Quality Rate Quality Treatment: Time Treatment Description (List all treatments in chronological order, first to last; describe all devices, sizes, routes, doses, etc ) 1

53 DCHARTE/SOAP Narrative: Page 30 Student Signature: Date: Preceptor: Please read and evaluate the students chart. Evaluate the content, continuity and language. Identify their strengths and weaknesses and give recommendations for improvement if necessary. Record any comments below. Preceptor Signature Date: Please rate the Student s DCHARTE on a scale of 1 to 10 below and initial: Inititals 2

54 STUDENT PCR CLINICAL Clinical day Patient Page 31 Incident Location: UNMH PRES DT PRES K LOVE VA Unit: ER Peds ER ICU OR Cath Lab OB Medical Psych Incident Date: Patient Age: Unknown Gender: Male Female Disposition: Admission Discharge AMA Still in unit at end of shift TRAUMA MEDICAL CARDIAC Student Medic: Preceptor: Physician, R/N, Tech : Chief Complaint: Onset of Illness/Injury: ALLERGIES: LATEX Acetaminophen Aspirin Codeine Contrast Dye Food Product Insect Bite / Sting Iodine Lidocaine NSAID Penicillin Sulfonamides Other: NKA MEDICATIONS: Left with / at: Patient Family ED Staff Home / Scene PMH: None Asthma Bleeding Disorder CAD Cancer CHF COPD CVA / TIA Diabetes - Type I II Dialysis Hepatitis A B C History of Head Injury HIV / AIDS Hyperlipidemia Hypertension Pacemaker / ICD Implanted Psychiatric Disorder Pulmonary Embolism Seizure Disorder Smoker Pack(s) per day for years Substance Abuse Ulcer Disease Other: Last Meal_ Events Leading up to Illness/Injury_ VALUABLES: Cell Phone Glasses Jewelry Keys Medical/Insurance Information Money $ (amount) Pager PDA Purse / Wallet Other: Left With / At: Patient Family Friend Co-Worker ED Staff Other Home Vehicle LE_ LUNG SOUNDS Clear to Auscultation Comments:_ A = absent C = clear D = diminished R = rales Rh = rhonchi S = stridor W = wheeze Not Assessed PUPILS Equal Unequal Reactive Non-reactive Pinpoint Midrange Dilated Pt. Blind Orbit Swollen Prosthetic Not Assessed Sclera/Conjun L Clear R L Jaundice R L Bleeding R L Injected R SKIN TEMP Normal Warm Hot Cold / Cool SKIN COLOR Normal Pale Flushed Cyanotic Jaundice Skin Cond Normal Dry Moist Diaphoretic Palmar Dorsal X = abrasion G = GSW B = bruise P = pain F = fracture S = stab OF = open f Bn = burn = HEAD AND FACE: Unremarkable Trach/Stoma Crepitus Tenderness Deformity Bleeding Asymmetry Wounds Absent gag refle Airway compromise Other Nose: unremarkable Bleeding Discharge Deformity Wounds NG Tube ET Tube Other Ears: Unremarkable Bleeding Discharge Amputation Battles Sign Other Neck: Unremarkable Trach Deformity Wounds Tenderness Crepitus Tracheal Deviation JVD Other Chest: Unremarkable Chest Pain Implanted Device Wounds Deformity Bruising Unstable Crepitus Scars Tenderness Asymmetry Air Leaking from Wounds Other Abdomen: Unremarkable Distention Bruising Wounds Organ Protrusion Rigidity Tenderness Scars Pulsating Mass Colostomy Other Pelvis: Unremarkable Bruising Wounds Deformity Lateral Pelvis Rims Tender or Unstable Symphysis Pubis Tender or Unstable Foley Other Back: Unremarkable Decubitus Wound Deformity Unstable Tenderness Bruising Other Upper Etremity Unremarkable Tenderness L R Protruding Bone L R Pitting Edema L R Other Bruising Crepitus Sensation Absent Amputation L R L R L R L R Wounds L R Limited ROM L R Distal Pulse Absent L R Paralysis L R Angulation Weakness Contractures Decubitus L R L R L R L R Lower Etremity Unremarkable Tenderness L R Protruding Bone L R Pitting Edema L R Other Bruising Crepitus Sensation Absent Amputation L R L R L R L R Wounds L R Limited ROM L R Distal Pulse Absent L R Paralysis L R Angulation Weakness Contractures Decubitus L R L R L R L R 23 November 2011 This document is for educational purposes only and is not an official patient care record Page1

55 STUDENT PCR INTERNSHIP Page 32 Times AVPU/GCS Blood Pressure Heart Rate Respiratory/BVM Rate Oygen Sat (SpO 2 ) ECG (Limb lead) Pain Scale End Tidal (Colorimetric) Y P Y P Y P Y P Y P Y P Y P Y P End Tidal mmhg mmhg mmhg mmhg mmhg mmhg mmhg mmhg Patient Weight: kgs. lbs. Blood Glucose: Initial: Repeat: Temperature F PO PR AX ECG Limb Lead: NSR, SB, ST, A-FIB, A-FLUTTER, SVT, A-TACH, 1 BLOCK, 2 TYPE-1, 2 TYPE-2, 3 BLOCK, IDIOVENTRICULAR, JUNCTIONAL, V-TACH, V-FIB, ASYSTOLE, WITH PVCS, WITH PACS, WITH PJCS OTHER Advanced Airway ET Tube Size Depth cm Supraglottic Airway Type Size Orotracheal ET Nasotracheal ET RSI Needle Cric. Surgical Cric. # Attempts By Blood/Vomit in Airway Y N Anatomical Distortion Y N Cords Visualized Y N Chest Rise Y N Condensation in tube Y N Equal Breath Sounds Y N Epigastric Sounds Y N End Tidal co 2 Y N SaO 2 increase Y N Reassessed q 5 or after moving Y N Neck immobilized Y N 12-Lead: None Normal MI Unconfirmed Ischemia Unconfirmed ST Depression: avl avf avr V1 V2 V3 V4 V5 V6 (Initial) LBBB RBBB Paced Rhythm LVH RVH ST Elevation: avl avf avr V1 V2 V3 V4 V5 V6 MEDICATION/INTERVENTION DOSE/ AMT ROUTE ECG TIME RESPONSE BY Vascular Access IV EJ IO Initial access at: # 1 NS LR Other Rate/Amount Site: by: Attempts: # 3 NS LR Other Rate/Amount Site: by: Attempts: # 2 NS LR Other Rate/Amount Site: by: Attempts: # 4 NS LR Other Rate/Amount Site: by: Attempts: TRAUMA INFORMATION Patient Located: Driver Pass Rear Truck bed Seat Belt? Yes No Unk Lap belt shoulder Airbag Deploy? Yes No driver pass side Child Seat? Yes No Unk N/A rear fwd Helmet? Yes No Unk N/A Removed PTA Etrication? Yes No Length of etrication: TRAUMA TYPE Auto Bus / RV Truck / SUV MC Train Air Bike Water Fied object ATV Auto-Ped Fall ft GSW Stabbing Assault Eplosion/Fire Industrial Electrical - Voltage (if known) Intrusion (in inches) Left Front Right Front Right Rear Left Rear Right Side Left Side Impaction Type Head-On Lateral / Side Rear-End Angled Roll-Over > 90 Roll-Over < 90 P = Patient CS = Car Seat = DOS OBSTETRICAL / EMERGENCY DELIVERY LMP:_ Due Date: G P_ AB_ # Living Children Prenatal Care? Yes No Unknown Rupture of Membranes? Yes No Unknown Meconium Stain? Yes No Suctioning Required? Yes No Resuscitation Required? Yes No Delivered at: Placenta APGAR: 1 minute 5 minutes Spontaneous abortion Postpartum hemorrhage DOS / OOH-DNR Pronouncement time:_ Physician: Hospital: OOH-DNR? Yes No DNR Honored? Yes No If No, Eplain Why In Narrative FIRST RESPONDER TREATMENT Agency AED Shocks Bandaging BVM Assist Cardio/Defib. Initial ECG CPR ETI Capnography Fluid Bolus ml IV / IO (site) 12-lead ECG STEMI Yes No Medications: Oygen Lpm CPAP Pleural Decompression Cric Spinal Immobilization Tourniquet Time applied Splinting Other:_ By:_ 23 November 2011 This document is for educational purposes only and is not an official patient care record Page 2

56 Narrative Page 33 Narrative: Signature Date / / 23 November 2011 This document is for educational purposes only and is not an official patient care record Page 3

57 PCR Resources and Grading Page 34 Cincinnati Prehospital Stroke Scale GCS Glasgow Coma Score Adult Child Eye Opening.. 4 Spontaneous Spontaneous 3 To Voice To Voice 2 To Pain To Pain 1 None None Verbal Response 5 Oriented Coos, Babbles 4 Confused Irritable Cry, Consolable 3 Inappropriate Cries/Screams to Pain 2 Incomprehensible Grunts/Moans to Pain 1 None None Motor Response 6 Obeys Commands Normal Movements 5 Localizes Pain Withdraws to Pain 4 Withdraws to Pain Withdraws to Pain 3 Decorticate to Pain Decorticate to Pain 2 Decerebrate to Pain Decerebrate to Pain 1 None None Parameter Finding Assess facial droop both sides of face move equally normal one side of face does not move as well as the other abnormal arm drift both arms move the same or both arms do not move normal at all one arm does not move or one arm drifts down abnormal compared to the other speech correct words spoken without slurring of words normal slurs words says wrong words or unable to speak abnormal Apgar Score Score Appearance Blue or Body pink; hands and Completely pink pale feet blue Pulse (Heart Rate) Absent Less than 100 beats per minute More than 100 beats per minute Grimace (Refle Irritability) Absent Grimace Grimace and cough or sneeze Activity (Muscle Limp Some fleing of arms Active motion Tone) and legs Respiration Absent Slow, irregular; weak Good; strong cry cry 3 or below Severely depressed infant Moderately depress infant Good and healthy infant NORMAL VITAL SIGNS IN THE PEDIATRIC AGE GROUP AGE PULSE Avg./min. RESPIRATIONS Breaths/min. Premature Newborn mo yr yr yr yr BLOOD PRESSURE Systolic mm Hg 1 Blank areas, inaccurate documentation, illegible, gross misspelling, no narrative, no times 2 Inappropriate abbreviations, more than 3 crossed out errors, vague narrative, any section that is incomplete 3 More than 2 crossed out errors, narrative needs to epand on details 4 More than 1 crossed out error, narrative complete but lacks minimal details 5 Complete no error, legible, no spelling errors, narrative detailed Demographics SAMPLE Assessment Vital Signs Score 1-5 for each section PCR Score Treatment Narrative Supporting Doc 23 November 2011 This document is for educational purposes only and is not an official patient care record Page 4