2 of 30 Table of Contents Course Outline... 4 Process... 4 Learning Outcomes... 4 Overview of Concepts... 5 Required Texts... 5 Resources 6 Evaluation

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1 BSN Program Nursing 3145: Family Practice Experience Section 1 and/or 2 Section 1 Section 2 Hana Pecinova, RN, MSN Hana Pecinova, RN, MSN Office: B147b Office: B147b (604) (604) hpecinova@langara.bc.ca hpecinova@langara.bc.ca office hours: office hours: Mondays Mondays [201130]

2 2 of 30 Table of Contents Course Outline... 4 Process... 4 Learning Outcomes... 4 Overview of Concepts... 5 Required Texts... 5 Resources 6 Evaluation... 7 Assignments... 8 Professional Responsibilities... 8 Schedule... 9 Appendix A: Decision-Making for Nursing Practice Framework..10 Appendix B: Clinical Practice Assignment Guidelines...14 Appendix C: Journal/Reflective Writing Guidelines 17 Appendix D: Performance Appraisal Form..19 Appendix E: Evidence Based Nursing Practice Assignment...20 e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

3 Other things may change us but we start and end with family 3 of 30 Anthony Brandt e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

4 COURSE OUTLINE 4 of 30 This course is a practice-based course that includes two distinct parts namely, the Maternal-Newborn and Family Practice Experience (perinatal) and the Infant, Children, Youth and Family Experience Practice (pediatrics). The learners in this course have the opportunity to practice family-centered care nursing, with emphasis on health promotion and illness prevention at the primary, secondary and tertiary levels. Building on previously learned concepts, learners are expected to apply evidence-based theories and concepts unique to the care of perinatal and pediatric populations in selected tertiary health care settings. PROCESS Nursing 3145 is delivered over two days, 15 hours per week for 12 weeks in selected practice settings. The students are assigned to practice for 6 weeks in a perinatal care setting and the other 6 weeks in a pediatric care setting. This course aims to provide the students with opportunities to practice perinatal and pediatric nursing to complement the concurrent theory classes of N3115 and N Students also engage in praxis, which involves the examination of the dynamic interplay between perinatal/pediatric theories and the lived experiences of assigned clients and those of the students themselves. Practice experiences are supported by seminars and other group learning activities to enhance criticalthinking and reflection on the students lived experiences of caring for perinatal and pediatric clients. Students and educators foster collaborative learning while in practice. SEMINAR OR CLINICAL PRACTICE CANCELLATION The nursing department makes every effort to replace a nurse educator when he or she is unable to attend a class or clinical practice. If a nurse educator needs to cancel a class or a clinical practice day, for whatever the reason, information regarding the class cancellation will be posted on Blackboard CE 6 as well as at the Registrar's Office (B-Building). As for the cancellation of clinical practice, individual nurse educators will inform his or her students of how cancellation will be conveyed during orientation week. It is important then to log on to Blackboard the day of class and of clinical practice. LEARNING OUTCOMES Students have the opportunity to: e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

5 5 of 30 Utilize a decision-making framework (DMNPF) in the care of perinatal and pediatric clients. Apply knowledge and skills unique to the care of perinatal and pediatric client populations. Apply principles of prevention and health promotion. Incorporate relevant knowledge of nursing and other sciences (e.g. anatomy/physiology; pharmacology, psychology, sociology) Develop, implement and evaluate health teaching to individuals and groups using relevant teaching-learning theories and principles. Collaborate with clients, health-care professionals, and peers. Access necessary resources within the clinical area and the community. Apply evidence-based knowledge in practice and in critique of health issues and current practice. Utilize pertinent standards of care and care protocols. Engage as an active participant and learner in the practice setting. Demonstrate and emulate the values of the e Department of Nursing OVERVIEW OF CONCEPTS The organization of this course is around the philosophical foundations of the curriculum and reflects the following concepts: Natural sciences (e.g. pharmacology, pathophysiology) Evidence-based practice Health promotion and Prevention (primary, secondary, and tertiary) Family, agency and community as resources Family as context/culture Ethical issues Teaching/learning challenges Decision-making for nursing practice Growth and development REQUIRED TEXTS (Pediatric Nursing) Hockenberry, M. J. and Wilson, D. (2007). Wong s nursing care of infants and children. (8 th ed.). St. Louis, Missouri: Mosby. (Perinatal Nursing) Ricci, S. S. (2009). Essentials of maternity, newborn, and women s health e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

6 nursing. (2 nd ed.). Philadelphia: Lippincott Williams & Wilkins. RESOURCES Nurse Educators responsible for this course: Sandy Atwal RN,BSN, MN Office: C316a (604) Office hours:thursday (by appointment) Surrey Memorial Hospital Sarah Desbiens-Ennis Office: ra.bc.ca Office hours:by appointment Lions Gate Hospital Mary Peters RN, BSN Office:B019p (604) Office hours: Mon/thurs by apt BC Children s Hospital (3M) Sara Miles Office: smile@langara.bc.ca Office hours: RCH Anne-Marie Hummelman RN,BSN,MN Office: C317b (604) amhummelman@langara.bc.ca Office hours: Monday-Friday (by appointment only) Burnaby General Hospital Nancy Woo RN, BSN, MEd Office: B153m nwoo@langara.bc.ca Office hours: BC Women s Hospital Rozana Lee, RN, BScN Office: C316b (604) pgr: rlee@langara.bc.ca Office hours: BC Children s Hospital (3R) 6 of 30 Hana Pecinova RN, MN Office: B147b (604) hpecinova@langara.bc.ca office hours:mondays Richmond General; Lysbeth Cunada RN, BSN, MN lcunada@langara.bc.ca phone: office:: B019o office hours or by apt Children s Hospital (3F) Bal KhunKhun RN, BSN Office: C316b (604) bkhunkhun@langara.bc.ca Office hours: Surrey Memorial Hospital Resources include required texts from previous terms and also: On-Line Canadian Nurses Association. (2008). Code of ethics. Ottawa: Author. College of Registered Nurses of British Columbia. (2008). Professional practice requirements. Vancouver, BC: Author. e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

7 7 of 30 e Nursing Department. (2010). BSN handbook. Vancouver, BC: Author. e Nursing Department, (2008), Proficiency tracking tool. Vancouver, BC: Author. e Nursing Department. (2008). Term 6 Performance Appraisal Form. Vancouver, BC: Author. The Writing Centre, located on the second floor of the e Library. EVALUATION In order to receive a satisfactory (S) grade in Nursing 3145, students must complete and submit all clinical practice assignments. As per College policy, a failing or unsatisfactory (U) grade will be given if a student does not complete all of the course requirements. In addition to the assignments, a student must demonstrate satisfactory performance in all practice domains (see Practice Performance Appraisal Form, Appendix: I), by the Final Evaluation period. Nursing 3145 is comprised of two distinct clinical practice components including Maternal, Newborn and Family Experience (Perinatal) and Infant, Child, Youth and Family Experience (Pediatrics). All students will spend half of the total allocated time for the course in a Perinatal placement area and the other half in a Pediatric placement area. Each student will receive a performance evaluation at the end of both Perinatal and Pediatric clinical experiences. A student s performance evaluation of his/her first half of the clinical experience is the Midterm Evaluation ; and evaluation of the second half is the Final Evaluation. Students are required to achieve a minimum 65% or satisfactory (S) grade in each component to achieve Satisfactory (S) grade, for nursing Satisfactory standing is required in all the domains of practice within the Performance Appraisal Form. In the event that a student receives an Unsatisfactory Midterm Evaluation, the student and educator(s) will plan for ways to enhance learning in the second clinical period (eg.: Learning Contract). The final grade of a student will be the grade he/she obtains during the Final Evaluation. If the student does not demonstrate a satisfactory improvement by the final evaluation period, he/she will receive an unsatisfactory (U) grade. According to Nursing Department policy, 65% or a C+ or S grade is the minimum grade requirement for successful completion of all nursing courses. The grading scale for the Nursing Department is as follows: A % A % A % B % B 75 79% B % e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

8 C % C 60 64% C % D 50 54% F 49% or below ASSIGNMENTS Evaluation of the Learning Outcomes of Nursing 3145 include: Assignments Mark Due Dates 1. Clinical Decision-Making Assignment (DMF) S/U Week 5 (x1 per rotation) 2. Journal/Reflective Writing (x1 per rotation) S/U Week 3/4 3. Midterm PAF S/U Week 6 4. Final PAF S/U Week Evidence Based Project (Part A only) S/U Week 5 6. Post-conferences/Participation (Post-conferences, as much as possible, should be student led. This will be a time to debrief and reflect on practice with a focus on integrating theory with practice.) S/U weekly 8 of 30 Please note that midterm and final evaluation meetings between student and nurse educator occur at e. These are usually scheduled in the 7 th and 14 th week of the semester. PROFESSIONAL RESPONSIBILITIES e requires all members of the College community (students and nurse educators) to conduct themselves in a manner that promotes a learning and working environment characterized by encouragement, free inquiry, integrity, mutual respect, professionalism, recognition of achievement, and social responsibility. The College community respects diversity, is civil, and provides for individual safety ( 1). Every practicing nurse in British Columbia, from the beginning student to the expert nurse, is required to assume full responsibility for knowing and adhering to the professional standards of practice. These standards serve primarily to ensure an acceptable level of professionalism (CRNBC, 2008). One of the College of Registered Nurses of British Columbia (CRNBC, 2008) standards of practice is Professional Responsibility and Accountability. Students are expected to have a e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

9 9 of 30 working knowledge and adhere to the policies of e and those outlined in the e Nursing Department Student Handbook. In particular, the following policies will be reviewed during Week 1 of the semester. 1. ATTENDANCE AND PARTICIPATION 2. SAFE PRACTICE APPRAISAL (SPA) 3. CLASS CONDUCT 4. PROFESSIONALISM & ACADEMIC HONESTY 5. ASSIGNMENTS AND EXAMS EXAM SECURITY WEB NETIQUETTE Students are also required to use appropriate language and APA style for all assignments. Questions relative to the methods of evaluation should be directed to the nurse educator teaching the course section in which students are registered. Any time during the term in clinical practice, a student whose clinical judgment or conduct constitutes a threat to client safety or non-adherence to the CRNBC s professional practice standards, he or she will not be permitted to continue practice in the clinical area and may receive and Unsatisfactory (U) grade. SCHEDULE (THIS IS AN EXAMPLE: DETAILS WILL VARY FOR EVERY CLINICAL GROUP) WEEK CLINICAL PLACEMENT ASSIGNMENTS 1 Orientation week: e NERC & Clinical site 2 Clinical 3 Clinical 4 Clinical 5 Clinical 6 Clinical 7 Midterm Evaluation: e 8 Orientation week: Langara & Clinical site 9 Clinical 10 Clinical 11 Clinical 12 Clinical Clinical Final Evaluation: e e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

10 APPENDIX A Decision Making Framework (DMF) 10 of 30 e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

11 11 of 30 e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

12 DECISION MAKING FRAMEWORK (DMF) 12 of 30 The revised Decision Making Framework (DMF) has been developed for Nursing students with the support of nursing faculty and the nursing curriculum. The framework s purpose is to facilitate student nurses decision making within the realm of their developing nursing practice and client centered care. The framework supports the idea that decision making in nursing is visualized through the lens of cultural safety. Incorporated into the framework are the philosophies that are evident within the e Nursing curriculum. The nursing curriculum is informed by humanistic, phenomenological, social critical and feministic perspectives. In addition, we have recently proposed the adoption of the post-colonial perspective to inform the curriculum. These perspectives provide a solid foundation to guide student nurses' critical thinking and decision-making abilities within their nursing practice. THE COMPONENTS OF THE Decision Making Framework Client Centered Caring the Core of the Framework The main goal of the DMF is Client Centered Caring. Within this central core are three intersecting domains, which consist of: 1) Curriculum 2) Nurse Educator and 3) Students. e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

13 13 of 30 These three domains must be working together in order to achieve the main goal of client centered caring. The outer rim surrounding the central core encompasses the College of Registered Nurses of British Columbia (CRNBC) Standards and Competencies. These include the Competencies in the Context of Entry-level Registered Nurse Practice in British Columbia (2009). The incorporation of these standards into nursing practice is another essential step to the goal of client centered caring. The outside circle of the framework encompasses: Assessment, Analysis, Clinical Impression, Nursing Actions and Evaluation. They are further examined within the context of Coming to Know, Salience, Pattern Recognition, Healing Initiatives and Reflection/Praxis. Participatory Dialogue (PD) between the student nurse and the client is central to the fluid nature of the process, as well the student s learning and understanding of client centered caring. e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

14 14 of 30 COMING TO KNOW: The student with educator support within a culturally safe curriculum comes to know the client by learning of the client s lived experience of health and healing through in-depth, culturally safe, caring interactions. STUDENT NURSE EDUCATOR CURRICULUM The student: identifies questions designed to draw out the client s unique story respects the client s culture, age, and beliefs recognizes that he or she brings his or her own culture and attitudes to the relationship communicates competently with the client in that person s social, political, linguistic, economic, and spiritual realm recognizes and utilizes complementary resources to ascertain the client s story (e.g. family members, documentation, social work, other professionals & paraprofessionals etc.) The educator: models culturally safe practice supports the student by respecting the client's and the student's culture and attitudes integrates the theory of the concepts of the core competencies into clinical practice guides students to collect all pertinent information The curriculum: includes concepts and content that support students and educator to engage in culturally safe practice e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

15 15 of 30 SALIENCE WHAT IS GOING ON HERE? Salience refers to the deliberative process of identifying what is important in a situation, what stands out, what is most critical to attend to: and what has most relevance for the client and student. The client and the student, with educator support are able to mutually discover what is salient by praxis and engaging in critical dialogue, reflection and questioning. Students will apply different ways of knowing: e.g. empirical, personal, ethical and aesthetic to assist the client to discover what is salient. STUDENT NURSE EDUCATOR CURRICULUM The student: asks questions designed to identify what is important in the situation and most relevant for the client respects and assists the client to identify strengths recognizes information needed by clients to build on strengths identifies with the client the challenges in the situation. (e.g. Has a family member attended Residential School or is the client a new immigrant?) asks what other resources would be useful for the client determines knowledge gaps both of client and self (e.g. social or ethical issues, theories, symptoms, A&P, diagnostics, or treatments) identifies challenges The educator: helps the student to identify what is important for the client discusses a specific plan for care with the student, working in collaboration with client and family Discusses student s knowledge gaps. provides examples of critical thinking to the student in order to ask the client the critical questions helps the student to identify appropriate resources that the client feels would be helpful identifies any power imbalances and assists the student to take measures to minimize inequities The curriculum: includes concepts and content that supports students and educators to identify salience and to assist the student to apply various ways of knowing e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

16 within the health care team or the organization that prevent culturally safe care 16 of 30 PATTERN RECOGNITION Pattern recognition builds on salience by discovering the patterns of health issues identified by the student and the client. This pattern discovery is achieved by critical analysis of knowledge gained through the previous phases. STUDENT NURSE EDUCATOR CURRICULUM The student: identifies with the client any patterns related to health issues works with the client to identify possible solutions to decrease the health concern patterns assists the client to identify and decrease any power imbalances that might affect care The educator: reviews with the student about patterns related to the client s health issues identifies with the student the possible solutions to decrease health concern patterns assists the student to work with the client to identify and decrease any power imbalances that might affect care The curriculum: includes concepts and content that inform and enable the student to engage with the client in a culturally safe manner e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

17 17 of 30 HEALING INITIATIVES Healing initiatives arise from the student assisting the client to recognize and understand his/her potential for health and healing as well as specific health issues of concern. It includes the implementation of specific therapeutic, preventive and health promotion strategies. These strategies utilize interdisciplinary collaboration, multiple resources and services, and a harm reduction approach to reduce client vulnerability. Most importantly, healing initiatives need to result in the empowerment of clients to gain control, expertise and autonomy in decision making that influences their health and healing. Through the development of client centered caring, the student together with the client and educator will develop a prioritized and individualized plan of care. STUDENT NURSE EDUCATOR CURRICULUM The student: The educator: The curriculum: identifies what are the reviews how to work includes concepts and client s short and long term health goals identifies resources and collaboratively with clients to identify their short and long term health goals content that inform and allow the student to engage with the client in health and healing referrals/advocacy that identifies with student initiatives in a culturally the client would like to be involved in his/her useful resources for client safe manner care reviews examples of the identifies important elements of the discharge plan with client collaborative process with the student and client for planning discharge discovers with the discusses the standards client the desired outcomes from the health initiatives of practice with the student and how they relate to client care identifies with the identifies examples of client the possible barriers to the evidence based nursing practice with the student implementation of the provides guidance to the health initiatives student in the collaborative development, implementation and evaluation of client care plans. reviews evidence informed knowledge that is guiding nursing e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

18 practice with the student. 18 of 30 REFLECTION/PRAXIS Praxis and critical reflection by the student are central to decision making for nursing practice. In a culturally safe framework, the client should also be given the opportunity to reflect and evaluate whether his or her health goals were achieved. STUDENT NURSE EDUCATOR CURRICULUM The student: The educator: The curriculum: reflects on the client s reviews the evaluation includes concepts and involvement in planning care considers whether the plan with the student to meet the client's short and long term goals content that allow the student to reflect in a culturally safe manner plan addresses the identifies with the client s needs and expectations reflects on ways of knowing used in planning the client s care student specific ways of working collaboratively with the client to evaluate the plan of care reflects on the client s identifies ways of short and long term goals; are they achievable, realistic and measurable? knowing with the student and how he/she connect with nursing practice considers whether discusses the plan with nursing care was effective for the client reflects on evidence informed practice and the student to evaluate the evidence informed practice and the relevance to client care relevance identifies specific ways reflects on measurable outcomes of care reflects on learning from to make care measurable with the student the evaluation process reviews with the student considers how this experience influences future practice how evaluation of nursing practice influences future nursing practice e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

19 References 19 of 30 Aboriginal Nurses Association of Canada, Canadian Association of Schools of Nursing & Canadian Nurses Association (2009). Cultural Competence and Cultural Safety in Nursing Education, A framework for First Nations, Inuit and Métis Nursing. Ottawa, ON: Author. Browne, A.J., Smye, V., & Varcoe, C. (2005). The relevance of postcolonial theoretical perspectives to research in Aboriginal health. Canadian Journal of Nursing Research, 37(4), Browne, A.J. & Varcoe, C. (2006). Critical cultural perspectives and health care involving Aboriginal peoples. Contemporary Nurse, 22(2), College of Registered Nurses of British Columbia. (2009A). Professional standards for registered nurses and nurse practitioners. Vancouver: Author (Pub. 128). College of Registered Nurses of British Columbia. (2009B). The competencies in the context of entry-level registered nurse practice in British Columbia. Vancouver: Author (Pub. 375). College of Registered Nurses of British Columbia. (2009C). Scope of practice for registered nurses: Standards, limits, and conditions. Vancouver: Author (Pub. 433). De, D. & Richardson, J. (2008) Cultural safety: an introduction. Paediatric Nursing. 20,2, e Nursing Department (2006). Decision Making for Nursing Practice. Vancouver, BC: Author. Ramsden I (1992) Kawa Whaitaruruhau: guidelines for nursing and midwifery education. Nursing Council of New Zealand, Welllington. Ramsden, I. (2000). Cultural safety/kawa whakaruruhau ten years on: A personal overview. Nursing praxis in New Zealand, 15(1), Smye, V., & Browne A.J. (2002). Cultural Safety and the analysis of health policy affecting Aboriginal people. Nurse Researcher, 9(3), The Indigenous Physicians Association of Canada and the Royal College of Physicians and Surgeons of Canada (2009). Cultural Safety in Practice; A Curriculum for Family Medicine Residents and Physicians, IPAC-RCPSC Family Medicine Curriculum Development Working Group. Ottawa, ON: Author. e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

20 20 of 30 Young, L.E. & Paterson, B.L. (2007). Teaching nursing: Developing a studentcentered learning environment. Philadelphia, PA: Lippincott Williams & Wilkins. e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

21 BACKGROUND of the Decision Making Framework 21 of 30 The Decision Making Framework (DMF) is a combination of the Decision Making for Nursing Practice Framework of the Collaborative Nursing Program (2006) and The Cultural Competence, Cultural Safety in Nursing Education A framework for First Nations, Inuit and Métis Nursing (Aboriginal Nurses Association of Canada, 2009) document. These two documents provide substantial content to create the new framework. The original Decision Making for Nursing Practice Framework (2006) is an interactive, reciprocal, caring process in which the nurse and client actively participate in the creation of an action plan to achieve mutually desired health outcomes. The framework supports student learning and application of the complex skill of decision making. In practice however, it is limited from the perspective in incorporating concepts that pertain to cultural safety. The underlying components of the Cultural Competence, Cultural Safety Framework (2009), were embedded into our original DMNPF to emphasize a more culturally safe perspective. The Cultural Competence, Cultural Safety Framework (2009) was developed by the Aboriginal Nurses Association, in collaboration with the Canadian Association of School of Nursing (CASN) and the Canadian Nurses Association (CNA). In the new framework, an emphasis is also placed on understanding the College of Registered Nurses of British Columbia (CRNBC) competencies in the context of entry-level Registered Nurse practice in British Columbia (2009) which now include the importance of knowledge of cultural safety, the origins of the health disparities of Aboriginal peoples, and the contributions of nursing practice to the achievement of optimum health outcomes for Aboriginal peoples. The purpose of the new framework is to assist educators and students to foster cultural safety within nursing curriculum. CULTURE Frequently in health care, the concept of culture is applied narrowly and the significance of power relations are diminished (Browne & Varcoe, 2006). When this occurs, culture is trivialized and attention is focused only on traditions that differ from the dominant norm. In this framework, an understanding of culture is conceptualized as extending well beyond notions of cultural beliefs and practices. Smye and Browne (2002) explain, although descriptions of cultural characteristics and practices can be useful to health care practitioners and researchers, they can also reinforce stereotypes and simplistic views of particular ethnocultural groups as outsiders, as different, and as other. (p. 45). Culture in the constructivist sense takes into consideration how race, class, and e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

22 22 of 30 gender intersect, and is conceptualized as being embedded in a historical and socio-political context. CULTURAL SAFETY Cultural safety provides for a new way of working with clients who are culturally different from the dominant population in the health care setting; an emphasis is placed on power imbalances and institutionalized racism in the health care system, while incorporating postcolonial perspectives into nursing practice and education (Browne, Smye & Varcoe, 2005). Implementing notions of cultural safety helps the nurse reflect on his/her own social, economic, and political positioning in relation to the person or group with which he/she is working. The nurse must acknowledge that he/she is a bearer of culture (Ramsden, 2000) and how his/her assumptions affect relationships with clients. e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

23 APPENDIX B Clinical Practice Assignment Guidelines: Decision-Making Framework (DMF) 23 of 30 Use the following guidelines to prepare yourself to care for your patient and family, and to organize your clinical practice patient assignments. Use the DMF to give direction to this assignment. 1. Keep your clinical practice assignments attached together in a folder with your name, student ID, course, educator name and date clearly visible. 2. Use a pseudonym to identify client. Acknowledge on your paper that you have done this. COMING TO KNOW THE CLIENT / ASSESSMENT 3. Client s story as to why the client is in the hospital. Personal health history, family history and any significant previous health challenges that may impact health status, hospitalization and recovery. Growth & Development. Culture/ethnicity- how does the cultural background of the client influence the nature of your nursing care (i.e., communication, diet, values/beliefs, gender interaction, family involvement/role, perspective on health and healing). Allergies to medications, food etc. and reaction(s). 4. Gordon s Functional Health Patterns and Head to Toe Assessment. SALIENCE / ANALYSIS 5. What is important about what is going on here? 6. Describe the diagnosis. How does the diagnosis relate to this client in terms of anatomy and pathophysiology? 7. Surgery and how many days post op. Describe the surgery in terms of anatomy and procedure. Why was the surgery warranted? 8. Related health history (if applicable)- What type of health condition(s) does the client have? How does this relate in terms of anatomy and pathophysiology? What effect does this chronic/episodic health challenge have in relation to this client? e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

24 9. What is happening regarding prevention of further heath challenges (client/family and nursing actions)? 24 of Medications- Use Pharmacology Template to guide your study and write-up. 11. Diagnostic tests -What is the test and why was it ordered for this client? -What were the results? Look for trends as well as extreme high/low values. -What is the significance of the results? 12. Draw or provide a diagram(s) (from the web/literature) of the surgery/medical condition that demonstrates your understanding of the pathophysiology and/or how the surgery/medical condition is intended to address the health challenge. Use of diagrams is helpful to support your explanations. Concept map could also be used. 13. Nutrition (impact on medications, health status and wellness outcome). 14. Equipment What equipment does your client need and Why? (E.g., NG tube, chest tube, tracheostomy, PCA, IV, oxygen therapy, suction, drains etc.) 15. What do I need to know more about? What are my learning needs? PATTERN RECOGNITION / CLINICAL IMPRESSIONS 16. What themes or patterns are you seeing? List 3-5 actual and/or potential clinical Impressions. HEALING INITIATIVES / NURSING ACTIONS 17. What nursing care and teaching is significant in promoting health for this individual and his/her family? 18. Develop an evidenced based plan of care for this client: Based on patterns e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

25 25 of 30 recognized and noted above, what will/did you do in terms of nursing care. Give rationales. REFLECTION / PRAXIS / EVALUATION 19. Reflection and Action. Was the care appropriate and effective? From your evaluation of care, would further changes be deemed necessary. If so, what would you maintain and why? 20. If opportunity allows in clinical practice, evaluate your nursing actions and client outcomes and compare them to current evidenced based (research literature) modalities of care. Developed by D. Yochim, April Revised by S. Calvert, August 06, March & Aug 07, & March 08 e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

26 OVERVIEW APPENDIX C Journal / Reflective Writing (1 per rotation) "...to think critically about issues causes us to reveal what we think about and take for granted related to the human condition; what decisions we make based on our perceptions; and, how justly, ethically, and caringly we perform our actions" (Collaborative Curriculum Guide, March 1997). 26 of 30 Journal writing is an integral part of the Collaborative Curriculum. It is a form of communication and a way of learning. The purpose of your clinical learning journal is to encourage self-reflection and enhance your critical thinking skills. It also promotes a learner-centered dialogue between learner and facilitator and can provide insight into one's own learning. EXPECTED OUTCOMES -Explored personal meaning from your learning. -Examined praxis in action. -Promoted self-reflection and critical thinking skills. -Revealed patterns or themes from your experiences. -Communicated with your clinical practice facilitator. IN PREPARATION Read: Callister, L.C. (1993). The use of student journals in nursing education: Making meaning out of clinical experience. Journal of Nursing Education. 32 (4), p JOURNAL WRITING -Use an appropriate format to record your journal entries e.g. notebook, binder, or duotang with loose-leaf paper or computer printout. -Summarize a significant learning experience -Explore this experience using reflective analysis. -Why was it important to you? What was its impact on you? -Examine your decision-making process. -Was it challenging? -What resources did you use to make the decision? -What alternative did you choose? - -How much time did you have? -What did you finally decide? -How satisfied were you with the decision and Why? e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

27 27 of 30 -What would you do differently if you had to do it over again? -Relate selected concepts to experiences. -What did I learn and how will I apply this learning in my nursing practice? -Write goals and strategies for learning. -Ethical Issues -Assume you are your client and write from this perspective about an experience. EVALUATION To achieve a Satisfactory (S) grade on your journals you must: Submit your journal on the dates that are mutually agreed upon by you and your clinical practice facilitator. Ensure that journal entry is included, dated, and is written or typed in a legible manner. Demonstrate developing critical reflection writing skills. IN REFLECTION Set aside a quiet time following your clinical day to write your journal. What kind of growth have you observed in your critical reflection skills? RECOMMENDED READINGS Brown, H.N., & Sorell, J. M. (1993). Use of clinical journals to enhance critical thinking. Nurse Educator, 18(5), Heinrich, K.T. (1992). The intimate dialogue: Journal writing by students. Nurse Educator, 17(6), Paterson, B.L. (1995). Developing and maintaining reflection in clinical journals. Nurse Education Today, 15(3), Developed by L. Cunada April, Revised August S. Calvert e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

28 APPENDIX D Performance Appraisal Form 28 of 30 Performance Practice Appraisal Use the e Nursing Program Performance Practice Appraisal Form (See PAF Term 6 version, on Blackboard N3145) to evaluate your performance in all practice domains. Your Clinical Nurse Educator will discuss expectations and schedule evaluation-meeting times. (Note: Please note that Performance Appraisal meetings between student and nurse educator occur at Langara College. The 7 th and 14 th weeks of the term are scheduled for the Midterm and Final Evaluation meetings respectively. e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

29 APPENDIX E 29 of 30 Evidence Based Nursing Practice Assignment (Part A: first 6 weeks of term) The purpose of this assignment is to increase awareness of the significance, utilization, and dissemination of the research process and evidence-based practice. LEARNING OUTCOMES Engagement with significant practice issues Developing awareness of the research process. Beginning collaboration in the research process. Involvement in dissemination of current research results in the literature. PURPOSE Identifying, discussing, and disseminating nursing research to support an identified aspect of clinical practice in the maternity setting. This includes analyzing this clinical practice issue based on evidence based practice. This process is intended to validate nursing care by highlighting evidence-based practice seen on the unit. This recognizes and acknowledges the work of the nurses on the unit, and builds and supports methods of teaching by evolving nurse educators. GUIDELINES In collaboration with your clinical peer group and in consultation with the clinical educator, as a group, identify one nursing care issue, procedure, or standard. Groups must be in the same clinical placements and be divided in half. Within the practice group, retrieve 3-4 current research articles for the identified nursing issue. All should be from nursing journals and should not predate One, preferably 2 of these references should include Canadian content. Please submit your articles with your brochure/poster. If using a poster or brochure presentation, ensure that you adhere to relevant policies of the agency or health board where you intend to publicly present your materials. Ensure all references are listed and submit with your presentation, as well as all group member names. e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_

30 Identify a way to present your material: 30 of 30 Collaborate on a poster or brochure to display your evidence based nursing findings. Content can be aimed at nurses, clients, or both. There will be one short presentation (as appropriate) at the clinical site to review/present your research-result dissemination-i.e. nurses, clients, or both in the clinical area. Due dates: Identify issue: Week 3 (due to clinical educator) Presentation at clinical setting: Week 6 e & [Calvert_Cunada_Kim_Pecinova_Tong], Jan_ Revised by Pecinova_ Aug_