University of South Alabama College of Nursing

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University of South Alabama College of Nursing Dual Role (FNP/AGACNP) Frequently Asked Clinical Questions What is the procedure for establishing a clinical agreement with a preceptor? Please go to the USA College of Nursing home web page at http://www.southalabama.edu/colleges/con/students/forms.html where you will find both the Letter of Notification and Appreciation and the Two Page Agreement. Review the Clinical Affiliations Lists from this page for the facilities with whom the University has an affiliation agreement. Please see Appendix A for an easy to read flow chart on how to establish a clinical agreement. 1- If an agency of interest is on the Clinical Affiliations List, they will sign the one page Letter of Notification and Appreciation. Please check the Affiliation list for any additional Agency Requirements. If there are agency requirements by the USA Faculty, please send an email request to your Faculty Facilitator or Program Coordinator. The Coordinator for AHN 549 and 551 is Dr. Emily Sawyer at esawyer@southalabama.edu. The Coordinator for AHN 553 or 555 is Dr. Maryanne Bolton at mbolton@southalabama.edu. 2- If an agency of interest in your area is not on the list, ask if the agency will sign the two-page agreement for you to complete your clinical rotation there. Do not submit the two-page agreement with any changes, and do not request that any additions or deletions be made. 3- If the agency is not on the Affiliation List AND not willing to sign the two-page agreement as is, the student (not the agency) must submit a Request to Establish an Affiliation Agreement (a pdf fillable form). Students entering AHN 549 or 551 should forward the completed request to Dr. Emily Sawyer at esawyer@southalabama.edu. Students entering AHN 553 or 555 should forward the completed request to Dr. Maryanne Bolton at mbolton@southalabama.edu. Once the request has been submitted, our Affiliation Coordinator will contact the agency. Establishing an affiliation agreement may take several months, so always ask if the agency will sign the two-page agreement if it is not on the list. While a student is awaiting the establishment of an affiliation agreement with an agency, it is strongly recommended to continue the search for preceptors at other agencies. Please do not continue to contact the agency while awaiting an affiliation agreement. Continuing to contact the agency may delay or hinder negotiations. All forms must be completed, submitted, and approved before a student can begin clinical rotations. All forms will be submitted no sooner than the first day the class is open in Sakai and no later than 2 weeks after the first day of class Students should contact the faculty facilitator (assigned during the first week of class) with any individual questions regarding a particular preceptor or agency.

What are the preceptor requirements? The majority of clinical hours for each component of the pathway (i.e., FNP and AGACNP) should be completed with nurse practitioners, but some hours may be completed with MDs, DOs, and PAs. Preceptors and clinical sites must be approved by faculty prior to students starting a clinical rotation. This will be done during the first week of class by your faculty facilitator. Potential preceptor specialties for all states except Louisiana and Oregon include: ACNP, AGACNP, ANP, AGAPNP, CNM, FNP, WHNP, PNP, MD, DO, & PA. Louisiana and Oregon students may only use FNP for the FNP component/acnp for acute component, an MD, or a DO. Preceptors must have: (a) at least one year of independent practice experience in the appropriate population-focused clinical area, and (b) a current state authorization (license) to practice (i.e., physician or advanced practice nurse) in the state of practice. Preceptors must NOT be related to the student. Employees, relatives, and friends of students are not to be utilized as preceptors. If the student is found to have managerial/supervisory power over the preceptor and has not disclosed this, the student will receive an F for this course. Please contact the course coordinator if you have questions. A preceptor cannot serve for more than one specialty rotation in the same clinical semester (i.e., Family Practice and Pediatrics). How can I secure preceptors/clinical sites? Students are responsible for securing preceptors/clinical sites in their local communities, but they must be approved by faculty. Helpful tips include using your current networking resources and joining your local/state NP organization. Students should contact the faculty for assistance if the student has searched diligently and experienced difficulty. A listing of the contact name, agency, city, state, and telephone number from each potential preceptor approached along with the response will be required. How soon do I need to begin securing preceptors/clinical sites? It is very important that students begin securing their preceptors/clinical rotations up to a year prior to the beginning of the semester for many reasons. Such reasons may include the shortage in preceptors and clinical sites; competition between NP, PA, and physician students attending other universities; and delays in processing an affiliation agreement if necessary. Agreements may be signed up to six months prior to the beginning of the semester. Students will upload all completed clinical paperwork as soon as access to the course is granted at the beginning of the semester. A student may not begin a clinical rotation until receiving WRITTEN approval from faculty after review of all required paperwork submitted by the student during the first week of class. The student is MUST return the completely signed contracts to the agency for their files ON OR BEFORE THE FIRST DAY OF THE CLINICAL ROTATION. What paperwork am I required to submit to receive faculty approval for a clinical rotation? The following paperwork is required for EVERY preceptor with whom a student would like to obtain clinical hours. You will submit everything in two separate packets as shown into assignment drop boxes in the clinical course as soon as you have access to that course. Arrange each packet as one Adobe Acrobat (pdf) document in the order shown below. If required paperwork is completed and submitted correctly initially, then the approval process will go much more smoothly and quickly. Faculty really like this (and students will too!) All paperwork must be submitted no later than two weeks after the first day of class each semester. While faculty strive to expedite clinical rotation approvals, students should allow one week for processing. Please keep this in mind when planning the projected schedule.

Compliant Castle Branch Report A compliant Castle Branch report must be submitted every semester and BEFORE any clinical rotations will be approved. The student is also responsible for resubmitting a compliant Castle Branch report whenever an item on the to-do must be renewed. Students who continue to complete clinical hours with an OVERDUE Castle Branch report may have those hours penalized. Clinical Affairs Document 1. Agreement (typed pdf fillable) completed by student and signed and dated by student, preceptor, and appropriate agency official (administrator, office manager, preceptor if also serves as administrator). The agreement is one of the following: a. Letter of Notification and Appreciation for agencies on the Clinical Agency Affiliation list OR b. Two-Page Agreement for agencies not on the Clinical Agency Affiliation list 2. Preceptor CV or resume 3. Preceptor state license verification (a scanned copy of license card is no longer acceptable); must be obtained within 30 days of the start of the semester from the state board of nursing or board of medicine website or from the PA license lookup at the following site: http://www.healthguideusa.org/physician_assistant_license_lookup.htm 4. Student state license verification (same guidelines as those for the preceptor license) II. Practicum Process Document 1. Practicum Process Approval Form with top portion completed by student 2. Projected Clinical Schedule The student must complete the forms and secure signatures on all signature lines EXCEPT for the USA appropriate signature (password-protected Adobe digital signature are acceptable). Once the clinical rotation is approved by faculty, s/he will download a copy of the agreement, sign it, then upload the signed copy in the course and notify the student of approval in the Sakai assignment communication box. The student will then print or forward a digital copy to the preceptor/agency. This step is non-negotiable. Students are not allowed in the clinical setting without the agency receiving a copy of the completed LON or Two-page agreement. Students are also not allowed in the clinical setting outside of the dates listed on the LON or Two-page agreement or if the University is officially closed. LON or Two-page agreement experience dates should not begin prior to the first day of the semester or extend past the last day of the semester. Any student in the clinical setting without providing this documentation or is in the clinical setting outside of the timeframe described above is subject to academic misconduct which may include failure of the course or program expulsion. Note: Some state boards of nursing and clinical agencies require additional documentation/approval in order for students to complete clinical rotations within their state/agency. All such required documentation must be completed and returned to the appropriate party before approval to begin the clinical rotation will be granted.

What beginning and ending dates should be recorded on the agreements? It is required that students list the beginning date on the agreement as the first day of the semester and the end date as the last day of the semester. Clinical hours must be completed by the last day of classes each semester. Any extension of the clinical time beyond the last day of class must be approved in advance by faculty and a new agreement will need to be signed by all parties. Again, only extenuating circumstances such as noted above will be considered. What student and preceptor e-mail addresses should be provided on the agreements? Please list the student jaguar e-mail address on agreements and not a personal e-mail address. All e-mail communication with faculty and the facility/preceptor should be through the student jaguar e-mail account. The preceptor s current e-mail address and a telephone number where he/she can be reached are required for faculty/preceptor communication. What format should I use for my projected clinical schedule? A sample Projected Clinical Schedule will be provided for your use. All students must take at least a 30 minute lunch break during each clinical day totaling more than seven hours. Clinical days may NOT be longer than 12 hours. Students in the acute care component may complete clinical rotations on the day or night shift. How many days in a row must I schedule with each preceptor? Students should schedule at least two to three consecutive days with preceptors to maximize learning and so the preceptor can adequately evaluate the student s growth in knowledge, skills, and behaviors. Do I have to complete all the clinical hours for one specialty rotation before I can start clinical hours for another specialty rotation? Students do not have to complete one specialty rotation at a time. For instance, students may complete two consecutive days with the family practice preceptor and then complete three consecutive days with the pediatric preceptor during the same week. How many preceptors can I have in one semester? A maximum of three preceptors is allowed UNLESS a student has separate preceptors for the obstetric practicum and the gynecological practicum. In those circumstances, four preceptors in the AHN 549 semester are allowed. What is the dress code for clinical experiences? The dress code for the clinical experience is business attire except in cases where the preceptor may instruct the student to wear scrubs. A longsleeve white lab coat with USA patch and ID badge and closed toe/heel shoes should be worn. What is the breakdown for each of the clinical rotations? For each rotation, students will have a quota of patients to see broken down by age, diagnoses, and gender particular to the rotation. The hours listed are the MINIMUM number of hours required. If a student has not met the quota on a particular patient population after completing the minimum number of hours, the student will need to complete more hours in that rotation in order to reach the quota.

AHN 549 Family Primary Care Nurse Practitioner I Practicum Complete and clearly document a minimum of 240 clinical hours in the role of a Family Nurse Practitioner Student in Family Practice, Pediatric, and Women s Health outpatient clinic settings. Attendance at all practicum rotations is mandatory for the entire number of required hours. The required hours must be spent in direct patient care. All rotations must be approved by faculty in advance. Setting Required Hours Family Practice 120 Pediatrics 60 Obstetrics (30 hours)/gynecology (30 hours) may be 60 obtained with the same preceptor Total 240 Note: Students may count a total of 8 hours of rounding in the hospital with a preceptor provided an agreement is in place with the hospital. AHN 551 Family Primary Care Nurse Practitioner II Practicum Complete and clearly document a minimum of 300 clinical hours in the role of a Family Nurse Practitioner Student in Family Practice and Adult Health Internal Medicine outpatient clinic settings. Attendance at all practicum rotations is mandatory for the entire number of required hours. The required hours must be spent in direct patient care. All rotations must be approved by faculty in advance. Setting Required Hours Family Practice Note: Students who are required or 200 desire to complete more clinical time in pediatrics or women's health may request to complete up to 40 hours in each of these specialties. These hours (40 pediatrics &/or 40 women s health) can be counted toward the 200 family practice hours. Internal Medicine 100 Total 300

Urgent Care Settings Students may complete a MAXIMUM of 120 of the 320 total family practice (FP) hours in an urgent care clinic. In the Fall, students will need 120 FP hours, and in the Spring students will need 200 FP hours. Therefore, students may do all 120 hours of urgent care this Fall, which would fulfill the FP hours requirement for the semester. Or, students may complete up to 120 hours of urgent care in the Spring (but if a student chooses this option, the student would need an additional 80hrs of primary FP to complete the 200 FP hour semester requirement). Students may not complete more than 120 hours total for Fall and Spring combined. Urgent care is certainly not a requirement, but it may give some students who are struggling to find preceptors (or who are interested in urgent care) an additional opportunity to fulfill requirements. These Urgent care clinics may be located in a retail store; however, FP, Pediatric, and OB/GYN hours must be in an outpatient setting. AHN 553 Adult-Geron Acute Care Nurse Practitioner I Practicum Complete and clearly document a minimum of 240 clinical hours in the role of an Adult-Geron Acute Care NP Student caring for young adults aged 18 and older (including late adolescents and emancipated minors), adults, and older adults (including young-old, old, and old-old adults). Attendance at all practicum rotations is mandatory for the entire number of required hours. The required hours must be spent in direct patient care. All rotations must be approved by faculty in advance. Setting ACUTE CARE SETTING: use a Hospitalist or an Intensivist (ALL hours MUST be IN the hospital setting) SPECIALTY CLINIC WITH ROUNDING IN THE HOSPITAL AND/OR EMERGENCY DEPARTMENT: may complete the following specialties during the Fall semester-cardiology, Pulmonology, Neurology, Endocrinology. In these cases, an agreement must be completed with the clinic and the hospital. Required Hours 160 80 Students may complete two specialties (40 hours each) OR choose to complete one specialty (40 hours) and one-40 hour ED rotation OR may complete an ED rotation for 80 hours. Total 240

AHN 555 Adult-Geron Acute Care Nurse Practitioner II Practicum Complete and clearly document a minimum of 300 clinical hours in the role of an Adult-Geron Acute Care NP Student caring for young adults aged 18 and older (including late adolescents and emancipated minors), adults, and older adults (including young-old, old, and old-old adults). Attendance at all practicum rotations is mandatory for the entire number of required hours. The required hours must be spent in direct patient care. All rotations must be approved by faulty in advance. Setting ACUTE CARE SETTING: use a Hospitalist or an Intensivist (ALL hours MUST be IN the hospital setting) Required Hours 220 SPECIALTY CLINIC WITH ROUNDING IN THE HOSPITAL AND/OR EMERGENCY DEPARTMENT: may complete the following specialties during the Spring semester-gastroenterology, nephrology, hematology/oncology, infectious disease, or orthopedics. Note: In these cases, an agreement must be completed with the clinic and the hospital. 80 Students may complete two specialties (40 hours each) OR choose to complete one specialty (40 hours) and one-40 hour ED rotation OR may complete an ED rotation for 80 hours. AFTER STUDENTS COMPLETE THE REQUIRED HOURS THIS SEMESTER, students may also request to complete up to 24 hours in radiology and/or anesthesia if they feel they need more experience reading x-rays, inserting invasive lines, or performing advanced airway skills (if permitted by the state BON). Total 300 What type of computer is required for coursework, and what technical information is provided? Current technologies used by the College of Nursing are not properly supported by Mac/Apple or Linux based computers. In order to make the most of the online learning experience, there are several technical requirements which need to be fulfilled. Refer to the guidelines in the Technical Information link to help ensure online success. The USA Online Technical Information link can be found at http://www.southalabama.edu/colleges/con/techreq.html

What is the chain of command for the Dual Role (FNP/AGACNP) pathway if I have a problem or concern? If students have a particular concern, please contact the faculty facilitator so he/she may assist you. If a student feels the situation warrants further consideration, please follow the chain of command shown below. Only in rare instances should the chain of command ever reach the Dean because other people in the chain are able to assist students with their needs. If you have questions specific to clinical preceptors &/or sites, please direct them to your faculty facilitators if assigned or to the appropriate component coordinator if not.

Appendix A. CLINICAL AGREEMENT FLOWCHART STEP 1: Find clinical forms & see if USA has a current affiliation agreement with the facility where you plan to do your clinical hours by following the links below: Go to the CON website http://www.southalabama.edu/colleges/con/students/forms.html Clinical Affiliations List Clinical Affiliation Agencies by State find your state see if your facility is on the list STEP 2: Follow the Clinical Agreement Flowchart below: