The following information is a compilation of answers to the most frequently asked questions about the clinical experience for the graduate nursing student. Additional information can be found on the website or by contacting the Program Chair at 812-492-7807.
Preceptors
All preceptors must have and retain an unencumbered license in the U.S. state or territory they practice, be certified in their specialty area, and have a signed and approved agreement with the University of Southern Indiana College of Nursing and Health Professions to function in the teaching role with Graduate Nursing Students.
Alternate or Additional Preceptors
If other licensed practitioners have an opportunity to precept the student in the office or facility of the primary preceptor an additional Preceptor Agreement form must be completed and approved by USI prior to the experience. Students may participate as observers without a preceptor agreement. An observer may not assess a patient or implement a plan of care.
Student Orientation
Orientation to the routine of the agency and introduction to the staff will benefit both the student and the preceptor. Students are encouraged to request 8 (eight) hours of observation experience with the preceptor prior to seeing patients on a progressively independent basis. Students should not use clinical sites for workplace orientation.
Student Performance/Competency
Student evaluation occurs formally twice during the fall and spring semesters (once at midterm and again at the end of each semester) and at least once during the summer semester. A written evaluation is completed by each preceptor at each evaluation using the Preceptor Clinical Evaluation form and is essential for the educational and evaluation process. Preceptors are encouraged to discuss the evaluation with the student, but this is not required. Additional methods of clinical evaluation will be used throughout the semester. Faculty, students, and preceptors may request telephone and/or email communication in addition to the written formal evaluations.
Preceptors are expected to intervene directly and immediately should the student provide unsafe or inappropriate behavior in the clinical agency. Faculty is to be notified by phone of any such occurrence through the Graduate Nursing Office at 812-492-7819. Students may be requested to come to campus for clinical evaluation. Faculty are responsible for the finial clinical grade.
Number of hours the student will require supervision
The number of hours needed in any one office or clinical site will vary according to the individual preceptor agreement and the type of experience required. The student will inform the preceptor about the expected number of hours required for the program in which he or she is enrolled.
The student is expected to progressively develop competence and independence in taking histories, performing physicals, identifying diagnosis’ with appropriate differentials, and developing a treatment plan. The preceptor must be physically present in the office or clinical facility while the student is practicing in this student role. As the student develops competency, the preceptor should allow the student to assess the patient independently, verbally report the assessment results, the need for additional data and a plan of care. The preceptor should then verify findings and concur or revise the plan of care.
Recording/Dictating
Students need to know the policy for recording on patient records in the practice. If the students are not allowed to record or dictate on the patient record, they will be keeping their own notes for faculty review. Every patient managed by the student should have corresponding documentation. HIPAA will be respected on all unofficial records.
Documentation of Care
The method of documentation of care will typically vary from setting to setting. Regardless of the documentation format used in the clinical agency, the student must thoroughly and accurately document each client encounter. The clinical preceptor will review all entries made by the student on the client’s record. The student’s entry will be co-signed by the preceptor as appropriate for the clinical site. It is recommended that the preceptor’s co-signature document agree with the history, physical, and plan of care.
Notation of only the preceptor’s signature after the student’s entry implies that the entire client visit was observed and the associated documentation has been approved without amendments. The following examples are methods to document the client encounter:
- H&P Observed. Record reflects documentation of encounter
- H&P not observed. Agree with above documentation and plan of care.
- Reexamined positive findings. Agree with above
- Reexamined patient. Also advised _______
- Signed MD, DO, NP, RN
Malpractice Insurance
Students are covered in the student role of advanced practice nurse by University malpractice insurance. The University of Southern Indiana’s malpractice insurance does not cover the preceptor.
Exposure
Any percutaneous or mucous membrane exposure must be reported to the nursing faculty immediately following emergency procedures. The faculty will assume responsibility to complete the required USI documentation as required by policy. Infection Control Policies and Forms may be located at: https://www.usi.edu/health/handbook
STUDENT RISK IN CLINICAL ENVIRONMENTS
Students are responsible to remove themselves from clinical environments where they perceive risk for harm. In this situation, clinical faculty should be notified the same day the incident occurred.