Clinical Expectations

Attendance

Shift work is an integral part of this occupation. Learners are expected to meet industry standards by being prepared to work days, evenings, nights, weekends, and holidays during their clinical experiences. Physical demands include moving and lifting clients as well as spending long periods of time on one’s feet. Emotional demands include frequent stressful and occasional emergency situations. Learners are expected to demonstrate physical and mental wellness.

Additionally, learners are expected to be on time for all clinical placements. Learners should anticipate early morning start times (for example 0630) and have a plan in place for travel to and from clinical placements. Childcare and any other necessary family care should be arranged prior to the clinical rotations.

Practical Nursing learners are responsible to report all absences from clinical to their faculty and contact the clinical agency as per industry standards.

Dress Clinical Placement

The School requires a consistent policy across all campuses for Practical Nursing (PN) programs regarding the practice of wearing uniforms and appropriate footwear in the clinical settings. This is aligned with the preparation of learners for safe and professional practice in an employment setting.

PN learners are required to wear navy blue uniforms and appropriate footwear. Included in the classroom discussion will be an outline of the results of non-compliance. Compliance with this policy is linked to the Professional Conduct Outcome and Student Community Standards Policy.

• Clean navy-blue uniforms are to be worn in long-term care, acute care, and community settings unless otherwise indicated by the agency.
• Uniforms are to be laundered daily as per infection control practices.
• Scrub pants are to be hemmed above the heel and not hitting the ground and/or floor.
• A lab jacket or coat may be worn for times where the learner is cold. It must be removed when care is being provided.
• You may choose to wear a white or navy-blue shirt under their scrub top for extra warmth. This shirt cannot have long sleeves.
• A NSCC name tag must be worn as well as agency identification (if applicable).
• A NSCC Practical Nursing Program crest is required as part of the uniform (available at NSCC Bookstore). Crests are to be sewn on the left sleeve/shoulder area. The faculty will discuss any alternative arrangements during Orientation week.
• Shoes: In keeping with Occupational Health and Safety, non-slip sole, closed toe, and closed heel, clean and in good repair made of impermeable material (waterproof). Shoes that are used for clinical are not to be worn outside the clinical agency.
• Watch with a second hand. No Smart watches are permitted in the lab.
• Cell phones are not permitted in the clinical setting which includes travelling to clients’ homes in the community clinical rotation. Learners are NOT permitted to take photos of wounds, rashes, etc. on their personal electronic devices. Learners may use their cell phones during breaks and lunch break.
• Learner ID will be required at Nova Scotia Health (NSH). These will be arranged by the faculty.
• Scent free policy is strictly followed.
• For injury prevention and infection control purposes of self and clients, it is strongly encouraged to minimize jewelry. For example, consideration should be given to hooped earrings or nose rings, rings, bracelets, necklaces, etc. (these also can become lost or damaged).
• Fingernails are to be kept short and clean. Nail polish or artificial nails are not allowed.
• Hair is to be kept neat and off the face. If below shoulder length it must be tied back and put up. Beard length should be considered.
• Stethoscopes are optional and can be purchased if the learner wishes. Exception: Sydney Waterfront Campus students must purchase a personal stethoscope. When stethoscopes are not in use, they need to be placed in your pocket. Sydney Waterfront Campus Faculty will discuss the purchase of stethoscopes with the learners in the first few weeks of classes.

Clinical Guidelines

• Clinical rotations may be scheduled on days, evenings, nights, weekends, and holidays. Your faculty will advise you of the clinical start and end dates for each semester.
• Clinical evaluation tools are utilized for each clinical rotation.
• Clinical courses cannot be completed in the learners’ place of employment.
• Clinical experiences must be completed within the weeks outlined in the schedule. No extensions will be offered.
• Current certification in Standard First Aid and CPR level C, as well as completion of all milestones is required.
• Attendance is mandatory to reflect industry standards and SOP. Clinical make up time may be possible in extenuating circumstances but may incur additional costs to the learner.
• Any travel, parking fees and accommodation requirements are the responsibility of the learner.
• Clinical absences that have not been reported to the faculty as per guidelines will result in making up those hours at a later date. Corrective action will be determined by the Academic Chair.
• Learners are expected to adhere to the scent free policy of the clinical agencies.
• Learners are not allowed to leave the clinical site for breaks except with specific permission of the faculty.
• Evaluation is a component of each clinical course. The rating for clinical is a Pass/Fail rating. Learners will be evaluated in a formative / summative manner using the Practical Nursing Evaluation Tools.
• Any learner with a “Fail” rating will be referred to the Academic Chair/ Clinical Coordinator (faculty) to discuss appropriate interventions/strategies prior to repeating the clinical course. If a learner is deemed unsafe, their clinical experience will be stopped at any time at the discretion of the clinical coordinator, faculty and/or Academic Chair.
• If a learner is absent for a clinical shift, they must notify their faculty and the clinical unit prior to the beginning of shift. If a learner misses more than one shift during their clinical, they may not be able to make up that time and will not be successful in their clinical rotation.
• Learners in any clinical setting (group or preceptor) must maintain regular contact with their faculty, clinical instructor, or preceptor. Any concerns or issues must be brought to your faculty, clinical instructor, or preceptor immediately.
• Learners must never carry the Narcotic keys during ANY clinical rotation.
• Learners CANNOT witness ANY legal consents/documents (surgery, treatment, consents, etc.)
• Learners are not to be directly involved in any Medical Assistance in Dying (MAiD)

Learners must be successful in the program (including successfully demonstrating skills in the skills lab setting) to date (prior to the start of the clinical rotation) to attend any clinical practicum.

Learners move from simple to complex skills and competencies as they progress in the program. Learners must provide organized, safe, competent, ethical, and compassionate care for more than 1 client as well as develop increasing independence. Learners are required to document all client care in the client’s medical record or electronic chart.

Learners’ documentation in the chart must be reviewed by your clinical instructor /preceptor unless you have been directed to complete it on your own. You will progress in your documentation abilities as you progress through the course. You must follow agency guidelines regarding documentation and use agency specific forms. All documentation must be accurate, legible, and timely.

This program prepares graduates to practice according to the professional practice and ethical standards and competencies required for beginning practitioners as set out by the regulatory body, NSCN. Therefore, learners must demonstrate professional behaviors with other students, faculty, staff, clients, and families always. This professional behavior includes verbal discussions, text or email, social media postings or messages as well as non- verbal communication.

In addition, learners must always maintain the confidentiality of all clinical settings and facilities. This includes, but is not limited to, discussing their current or previous clinical rotation on any social media site or with those who are not involved in the care of the clients. In addition, learners are not permitted to take pictures of staff, other learners, or faculty unless permission has been obtained, regardless, photos must not contain pictures of clients even if they are in the background.

Unsafe Clinical Practice

There are times when a NSCC PN learner may be deemed “unsafe” in the clinical setting by faculty, or clinical instructor. “Unsafe practice is defined as an occurrence, event, or a pattern of repeated behaviour where the patient, family or others are placed at an unacceptable level of risk for emotional, psychosocial, or physical harm and may include intentional breaches of practice standards and codes and practice violations (Martinez et al., 2017, Maurits et al., 2016).” Nurses’ recognition and response to unsafe practice by their peers: A qualitative descriptive analysis – ScienceDirect

Behaviors that may be indicators of unsafe clinical practice can be directly related to the expected Scope of Practice and Entry Level Competencies (ECLs) of the profession as outlined by NSCN. Please review the NSCN document: EntryLevelCompetenciesLPN.pdf (nscn.ca).

Although ELCs are expectations for licensed practical nurses, students should demonstrate an understanding of and growth within these guidelines as learners move through the program.

Each province and territory are responsible for ensuring that graduates of practical nursing programs in Canada and nurses educated in other countries applying for licensure as a practical nurse meet an acceptable level of competence before they begin to practice. Entry-Level Competencies for the Practice of Registered Nurses | Nova Scotia College of Nursing (nscn.ca)

Nursing Care Plans

Learners will be required to complete nursing care plans (Orem’s theory) while in the clinical setting. Each clinical rotation builds on the previous one and the expectations will vary as you progress. As previously stated, learners move from simple to complex skills and competencies as they progress in the program. Learners must provide organized, safe, competent, ethical, and compassionate care for more than 1 client as well as develop increasing independence. A part of that safe care is the completion of nursing care plans for the clients that you are assigned to.

Nursing care plans provide learners with an overall summary of the client’s biopsychosocial and spiritual status. This allows for specific and individualized client care. It ensures care is prioritized and relevant to the clients’ needs. The theory of the nursing care plans will be introduced in Semester one and will be incorporated throughout all clinical courses as well as in the skills lab setting.

The completion of comprehensive research on each client is required and you must have your plan of care ready for your first shift (completed on your research or designated day). You will utilize your course theory, as well as your Nursing diagnosis handbook, to guide you in the completion of your care plans. If you are not prepared and have not completed your research, you will be sent off the unit and may be sent home.