NORTH HARRIS MONTGOMERY COMMUNITYCOLLEGE DISTRICT

CY-FAIR COLLEGE

Associate Degree Nursing

NURSING STUDENT HANDBOOK 2005

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TABLE OF CONTENTS

PHILOSOPHY OF NURSING EDUCATION...................................................................................................PAGE 3

CONCEPTUAL FRAMEWORK ........................................................................................................................PAGE 5

PROGRAM GOALS.............................................................................................................................................PAGE 8

LEVEL COMPETENCIES..................................................................................................................................PAGE 9

BOARD OF NURSE EXAMINERS DECLATORY ORDER ........................................................................PAGE 10

DEPARTMENTAL POLICIES.........................................................................................................................PAGE 11

Academic Integrity Alternate Learning Experience Appeal Policy

Attendance Children in the Nursing Classroom Clinical Dress College Policies Compliance with Americans with Disabilities Act Confidentiality Course/Faculty Evaluation Committee Representation Criminal Background Employment of Nursing Students Ethical Behavior Grading Impaired Students in Clinical Practice Professional Liability Progression Requirements Readmission Refusal to Provide Care Test Review Testing CODE OF CONDUCT……..........................……………………………..……………………………………..PAGE 17 DOCUMENTATION OF REQUIRED IMMUNIZATION ...…………..……………………………………PAGE 20 STUDENT POLICIES FOR CLINICAL AREAS.……………………..……………………………………..PAGE 21 STUDENT HEALTH POLICIES AND PROCEDURES……………………………………………………..PAGE 23 Appendix A: Forms: Student Acknowledgement Signature Form Medical History and Disclaimer Student Emergency Procedure Information Clinical Cooperative or Internship Program Student Release of Liability Confidentiality Statement Appendix B: Compliance with Americans with Disabilities Act Appendix C: Nursing Program Appeal Procedure Flowchart The provisions in this handbook are subject to change by the ADN Program faculty.

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Cy-Fair College Associate Degree Nursing Program

Philosophy Statement The faculty of CFC Associate Degree Nursing Program holds the following beliefs about the concepts of person, environment, health, nursing, and education. We believe nursing practice lives in the dynamic interaction of these concepts. These beliefs are congruent with the mission and values of NHMCCD and CFC and provide the foundation for the A.D.N. curriculum. Person Person may be defined as individuals, groups, families, and/or communities. Each person is a complex, unique self-determined being that inherently possess dignity and worth, holistic in nature, yet composed of dynamic interactive variables of physiological, psychological, sociocultural, spiritual, and developmental aspects. Each person is an open system capable of interaction with the environment, inspired by his/her own perceptions, values, beliefs, and needs as he/she seeks personal meaning for his/her life. Environment The environment is composed of two interacting open systems, one that is internal in nature and one that is external in nature. The internal component is the environment within the person, which are the bio-psycho-social, spiritual, and developmental variables. The external component is the biophysical and sociocultural variables that are in the environment outside the person. It is the interaction between these open systems that can positively or negatively impact a person’s health (Neuman, 1989). Health Health is a state of being that incorporates all conditions of the human experience. External forces in the environment influence health, which include personal relationships, culture, and the health care industry, yet the internal forces within each person ultimately define health for the individual. It is this personal definition of health that directs care for the individual, whether it is maximizing wellness, assisting in the healing process, managing chronic disease, or palliation of a terminal illness. Nursing Nursing is first and foremost a service to humanity, grounded in the natural and behavioral sciences with caring and compassion as a moral imperative. Nursing is the diagnosis and treatment of human responses to actual or potential health problems (ANA, 1995). Central to nursing is the dynamic partnership between the nurse and client (person) whose purpose is to identify healthcare needs and facilitate the client’s ability to obtain the needed resources, assistance, or support. (Newman, 1994) The nurse practices using a holistic approach within the domains of nursing which are the helping role, the teaching-coaching function, the diagnostic and patient monitoring function, administrating and monitoring therapeutic interventions and regimens, monitoring and ensuring the quality of health care practices, organization and work-role competencies (Benner, 2001). The nursing process of assessing, diagnosing, planning, intervening and evaluating the client responses is utilized within these domains of nursing. Critical thinking is the basis for clinical decision-making within an ethical-legal framework. Nurses are responsible and accountable for their actions and for maintaining competency in their roles as provider of care, coordinator of care and member of a profession. Education Nursing education provides the student with the knowledge, skills, and values for entry-level nursing practice. This includes communication, critical thinking and problem-solving, and technological skills. The experience of working in learning communities utilizing a collaborative learning model provides the basis for interdisciplinary practice that is critical for nursing in today’s healthcare system.

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Adult learning principles provide the foundation for the education process. Acquiring knowledge and skills must be based on the learner’s current knowledge and life experiences. Learning is a continual life-long process and is enhanced when assignments and activities require active participation, are goal-directed, and have purpose and meaning to the learner. It is the charge of faculty to facilitate, guide, direct and evaluate the learner and encourage self-direction, exploration of ideas, development of independent thinking and innovative problem solving. Faculty has an obligation to provide a learning environment that is committed to academic excellence, that is based on integrity and trusting relationships among faculty and students, where dignity and respect is demonstrated to all individuals. Students are responsible for their own learning by demonstrating preparation for class, laboratory, and clinical learning experiences; and actively seeking knowledge and guidance as partners in learning.

Conceptual Model

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CONCEPTUAL MODEL Definitions

Health Promotion A system of interventions of health education, concepts, and activities that individuals and communities

may adopt to attain and enhance a state of optimal holistic health. These interventions focus on the development of behaviors conducive to maximizing wellness, assisting in healing, managing chronic disease, and palliation of terminal illness.

Primary Prevention Interventions designed to occur prior to injury or illness. A reaction has not occurred, but the degree of risk is known. Interventions focus on the protection of health that acts to reduce the possibility of encounter and/or strengthen defenses to possibility of a reaction. The goal is to reduce the incidence of new cases.

Secondary Prevention Interventions designed to detect the early existence of disease or illness and to provide methodologies or treatments that will decrease further development of disease or injury. The goal is health maintenance and reaction reduction. Tertiary Prevention Interventions designed to alleviate the effects of injury, disease, and/or disability. Focus is on readjustment towards optimal stability in health. Goal is to minimize morbidity and maximize overall quality of life. Domains of Nursing (Benner, 1984) a. The Helper Role Competencies:

i. The healing relationship: creating a climate for and establishing a commitment to healing. Assisting the patient to use social, emotional or spiritual support.

ii. Providing comfort measures and enhancement quality of life. iii. Presencing: Being with a patient. Not necessarily doing for the patient. Allowing

patients to ventilate their feelings, going through the experience with them. iv. Maximizing the patient’s participation and control in his or her own recovery.

There is a determined effort to maximize the patient’s control over his life. Nurse serves as a patient advocate.

v. Interpreting kinds of pain and selecting appropriate strategies for pain management and control. Selecting the appropriate strategy at the right time requires nursing judgment.

vi. Providing comfort and communication through touch. vii. Providing emotional and informational support to patient’s families.

viii. Guiding patients through emotional and developmental change: The nurse uses many ways to channel a patient into ways of being that hold more potential for growth.

b. Teaching-coaching Function Competencies: i. Timing: capturing a patient’s readiness to learn.

ii. Assisting patients to integrate the implications of illness and recovery into their lifestyles

iii. Eliciting and understanding the patient’s interpretation of his/her illness. iv. Providing an interpretation of the patient’s condition and giving a rationale for

procedures.

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v. The coaching function: making culturally avoided aspects of an illness approachable and understandable.

c. The Diagnostic and Patient Monitoring Function Competencies: i. Detection and documentation of significant changes in a patient’s condition,

including early warning signs of complications. ii. Anticipating problems: future think

iii. Understanding the particular demands and experiences of an illness: anticipating patient care needs.

d. Administrating and Monitoring Therapeutic Interventions and Regimens Competencies: i. Starting and maintaining intravenous therapy with minimal risks and

complications. ii. Administering medications accurately and safely: monitoring untoward effects,

reactions, therapeutic responses, toxicity, and incompatibilities. iii. Combating the hazards of immobility: preventing and intervening with skin

breakdown, ambulating, and exercising, patients to maximize mobility and rehabilitation, preventing respiratory complications.

iv. Creating a wound management strategy that fosters healing, comfort, and appropriate drainage.

e. Monitoring and Ensuring the Quality of Health Care Practices Competencies: i. Ensure safe, competent client care.

ii. Getting appropriate and timely responses from health care providers to meet client needs.

f. Organization and Work-role Competencies i. Coordinating, ordering, and meeting multiple patient needs and requests: setting

priorities. ii. Building and maintaining a therapeutic team to provide optimum therapy.

iii. Coping with staff shortages and high turnover: contingency planning, anticipating and preventing periods of extreme work overload within a shift, using and maintaining a caring attitude toward patients even in absence of close and frequent contact, maintaining a flexible stance toward patients, technology, and bureaucracy.

Professional Nursing Professional nursing means the performance for compensation of an act that requires substantial specialized judgment and skill the proper performance of which is based on knowledge and application of the principles of biological, physical, and social science as acquired by a completed course in an approved school of professional nursing. The term does not include the acts of medical diagnosis or prescription of therapeutic or corrective measures.” (NPA Section 301.001 Definitions). The role of the nurse is divided into three entities:

a) Provider of Care – utilizing the nursing process as systematic scientific approach in the provision of nursing care to the client;

b) Coordinator of Care – involving the coordination of resources, collaboration with the client, family, and other health care providers, coordination of referrals, and functioning within the organizational framework of the institution; and

c) Member of a profession –assuming accountability and responsibility for quality of nursing care, acts as a client advocate, and participates in promotion of the practice of professional nursing. (Board of Nurse Examiners for the State of Texas & Texas Board of Vocational Nurse Examiners – Differentiated Entry Level Competencies of Graduates of Texas Nursing Programs, 2002).

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PROGRAM GOALS

Upon completion of this program of study, the student should be able to: 1. Utilize the nursing process as a systematic approach to clinical problem solving that reflects caring

and compassion, creative and critical thinking skills. 2. Provide holistic goal-directed, client-focused care utilizing an interdisciplinary approach across the

continuum of health care, which includes meeting educational needs and identifying activities for health promotion and maintenance as well as disease prevention within the community.

3. Demonstrate essential knowledge and skills to provide safe, competent care that is sensitive to diverse cultures, socioeconomic backgrounds, developmental psychological needs, and spiritual aspects.

4. Utilize the domains of nursing practice (Benner) as a guide for nursing practice. 5. Utilize therapeutic communication when interacting with the client, family and other health care

providers that demonstrate caring and compassion, and incorporates the principles of establishing a nurse-client relationship.

6. Assume accountability and demonstrate an understanding of scope of practice, standards of care, best practices, evidence-based practice when providing or delegating care for multiple clients within a legal/ethical framework.

7. Demonstrates an understanding and appreciation of human and material resources when providing or planning client care including agencies and/or community resources and referrals appropriate for the client and family that facilitate the continuity of care.

8. Demonstrate leadership and management skills when managing nursing care for a group of clients with common health problems in a structured setting.

9. Assume an advocacy role for clients and families as needed. 10. Promote a positive imagine of nursing. 11. Develop a plan and demonstrate commitment to professional growth and career development.

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LEVEL COMPETENCIES

The student is required to demonstrate the following competencies by the end of the identified level or year of the program. Clinical evaluation tools have been developed to reflect these competencies and assist the student in meeting these requirements.

Level 1 Competencies 1. Provider of Care a. Addresses the clients’ basic health care needs by demonstrating knowledge and utilizing nursing process as a scientific method of problem-solving and critical thinking in clinical decision-making. b. Demonstrates awareness and utilizes a systematic, holistic approach to multicultural adult client care that incorporates health promotion by maximizing wellness, assisting in healing, managing chronic illness, and palliation of terminal illness. c. Utilizes basic therapeutic communication that is culturally and developmentally sensitive. d. Provides safe, competent care to the adult client in meeting basic health care needs within the domains of nursing practice. 2. Coordinator of Care: a. Utilize an interdisciplinary approach to client care that includes identification of resources and appropriate referrals to meet individualized care needs. b. Demonstrate incorporation of the principles of priority setting and time management within the clinical setting. 3. Member of a Profession: a. Demonstrates awareness of the Nurse Practice Act and the Standards of Professional Nursing Practice which includes internalizing values and professional behaviors of nursing that are guided by an ethical/legal framework. b. Commits to own professional growth and development.

Level 2 Competencies 1. Provider of Care: a. Demonstrates integration of nursing process as a scientific method of problem-solving and critical thinking in complex clinical decision-making. b. Utilizes a systematic, holistic approach to multicultural client care across the life span that incorporates health promotion by maximizing wellness, assisting in healing, managing chronic illness, and palliation of terminal illness. c. Demonstrates therapeutic communication that is culturally and developmentally sensitive in a variety of complex psychosocial situations. d. Provides safe, competent care to diverse clients across the life span that demonstrates complex health care needs within the domains of nursing practice. 2. Coordinator of Care: a. Uses an interdisciplinary approach to client care that includes cost effective utilization of resources across the continuum of care, appropriate referrals, and delegation of care to meet client care needs. b. Manages groups of clients. 3. Member of a Profession: a. Adheres to the Nurse Practice Act and the Standards of Professional Nursing Practice which includes internalizing values and professional behaviors of nursing that are guided by an ethical/legal framework. b. Commits to own professional growth and development.

BOARD OF NURSE EXAMINERS DECLARATORY ORDER

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The Board of Nurse Examiners (BNE) may refuse to admit persons to its licensure examination, may refuse to issue a license or certificate of registration, or may refuse to issue a temporary permit to any individual with lack of fitness to practice by reason of mental or physical health or intemperate use of alcohol or drugs that could result in injury to patients or the public. The Board may also refuse to grant licensure to any individual with a history of a conviction. An individual enrolled or planning to enroll in a basic nursing program who has reason to believe that he/she is ineligible may petition the Board of Nurse Examiners for a declaratory order as to eligibility. Failure to request a declaratory order at least 6-9 months prior to graduation could result in a delay in taking the NCLEX-RN. This delay will adversely affect your ability to gain employment. If you have a situation that may require declaratory orders, please refer to the Texas Nurse Practice Act and/or contact the Texas Board of Nurse Examiners.

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DEPARTMENTAL POLICIES

Academic Integrity NHMCCD is committed to a high standard of academic integrity among its faculty and students. In becoming a part of the NHMCCD academic community, students are responsible for honesty and independent effort. Failure to uphold these standards includes, but is not limited to, the following: plagiarizing written work or projects, cheating on exams or assignments, collusion among students on an exam or project without specific permission from the instructor, or misrepresentation of credentials or prerequisites when registering for a course. Cheating includes looking at or copying from another student's exam, having another person take an exam or complete a project or assignment for you, bringing unauthorized notes, texts, or other materials into class with you for an exam, or obtaining or distributing an unauthorized copy of an exam or any part of an exam. Plagiarism means the unauthorized use of another's writings without proper documentation and includes copying material from another source without clear documentation of the source or submitting a paper, report, project, or care plan that someone else has prepared. These definitions are not exhaustive. When there is clear evidence of cheating, plagiarism, collusion, or misrepresentation, disciplinary action may be taken, including but not limited to: the student's presenting an oral defense, resubmitting the assignment in question, receiving a zero or an F on the assignment, or being withdrawn from the course or expelled. Alternate Learning Experience A variety of learning experiences may be utilized by the faculty to meet course objectives. Such experiences include, but are not limited to alternate time schedules (including evenings or weekends) and/or independent learning projects. Notification will be given in the event of an alternate learning experience. Appeal Policy Initiation of an Appeals Hearing

1. The student should first meet with the instructor involved and attempt to resolve the problem at that level.

2. If the problem is not resolved, the student initiates the appeal process by submitting a letter to the Chair of the Appeals Committee of that campus. The intent to appeal and the nature of the problem and the requested outcome should be clearly stated in the letter. The chair of the committee will give the student a copy of the appeals procedure.

3. The letter must be received within one week from the time of the problem occurrence. 4. The student will be allowed to continue to go to class/clinical until the Appeals Committee meets

and formulates a decision concerning the appeal. 5. The Chair of the Appeals Committee will call an ad hoc meeting within ten (10) days of the appeals

request. The student should be prepared to discuss the problem situation and defend his/her position. The instructor/s directly involved should be prepared to present data related to his/her position concerning the appeal problem. The Appeals Committee decision will be a private vote. A majority vote will be required in order to make an exception to departmental policy. The Chair will inform the student of the committee’s decision. Any special conditions developed by the committee will be communicated to the student in writing. Appeal Committee meeting takes priority over any other meeting. Unresolved issues may be taken to the college’s chief academic officer as outlined in the college catalog. Refer to Nursing Program Appeal Procedure Flowchart in Appendix A.

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Attendance Students are expected to attend all learning experiences, inclusive of class, laboratory and clinical. See course syllabi for attendance requirements. Children in the Nursing Classroom The nursing faculty strongly recommends that children not be brought into the nursing classrooms while class is in session. Children will not be allowed in the clinical or campus lab, for safety reasons. There are occasional personal emergencies when a student has no alternative but to bring a child to class, or miss that class. In that situation, it is the responsibility of the student to inform the faculty member in advance, and to seek approval for that class. It is then up to the discretion of the individual faculty member to decide on the appropriateness of having a child in the classroom, depending on the availability of space, the age of the child, the possibility of distraction, and the appropriateness of language and/or content for the child. If the child becomes noisy or distracting, it is up to the student to leave the classroom, or the instructor will ask them to leave. Every effort will be made to prevent distractions in the classroom, and to prevent the embarrassment of the student involved. Clinical Dress To maintain a professional appearance, as well as maintain infection control, the following guidelines are recommended.

• Unisex scrubs consisting of a white top with dark green pants. • ONLY white shirts may be worn under your scrub uniform. • Uniforms and shoes neat and clean. Excessively tight or loose fitting clothes deemed by the clinical

instructor to impair safety or be distracting will not be allowed. NO colored or patterned underwear.

• White nursing shoes are recommended. All white leather athletic shoes are also acceptable. • A patch identifying the nursing program is required and worn on the left shoulder of the scrub top

and jacket. The jacket must be clean and neat. • Hair secured up and off the collar for infection control. • Fingernails short (fingertip length), neat and clean. Neutral or clear nail polish is acceptable. • No artificial nails. • Plain wedding bands may be worn. • Earrings should be small (studs), not dangling. No rings will be worn in other conspicuous areas of

the body (i.e., nose, lip, tongue, eyebrow, etc). • Cosmetics should be applied conservatively to present a professional appearance. • Eating, drinking, or chewing gum in patient care areas is not acceptable. • Avoid heavy perfumes or after-shave lotions. • Hair color should be a natural color, not necessarily student’s own natural hair color. Pink, green,

blue, or other unnatural colors are not acceptable in the clinical setting. • Tattoos which are visible outside uniform must be covered while in clinical, either with makeup or

a scrub jacket, depending on location of tattoo. College Policies Students are responsible for the information in the NHMCCD College Catalogue and Student handbook. Compliance with Americans with Disabilities Act The NHMCCD faculty subscribes to the Core Performance Standards recommended by the Southern Council of Collegiate Education for Nursing. Nursing students who qualify under the Americans with Disabilities Act are expected to review these core performance standards. If a student believes he or she

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cannot meet one or more of the standards without accommodations, it is the responsibility of the student to inform nursing faculty of the need for a reasonable accommodation at the BEGINNING of the nursing program. Every effort will be made to provide the appropriate assistance and guidance to students who identify potential difficulties meeting these standards. The standards with examples are provided in Appendix A. Confidentiality As a student in the NHMCCD nursing program, you will have access to confidential information during your clinical experiences. Confidential information includes client information, employee information, financial information, other information relating to your duty as a student and information proprietary to other companies or persons. You may have access to some of all of this confidential information through the computer systems of the clinical facilities or through your student activities. Confidential information is protected by strict policies of the clinical facilities and by federal and state laws particularly the Health Insurance Portability and Accountability Act. The intent of these laws and policies is to assure that confidential information, that is, Patient’s Protected Health Information or Individually Identifiable Information provided to students orally or contained in client medical records or maintained on the facility’s electronic information system will remain confidential. As a student, you are required to comply with the applicable policies and laws governing confidential information. Any violation of these laws will subject the student to discipline, which might include, but is not limited to, dismissal as a student and to legal liability. In addition to this statement, each clinical facility will require you to sign an additional statement as you begin your clinical rotation. A sample of the required form is provided in Appendix A. Course/Faculty Evaluation Students are given the opportunity to evaluate nursing courses, faculty and the program. Evaluation forms are given for each course. Constructive student feedback is valued and used to further improve the nursing program. Committee Representation Student representation is requested for the Level I Team Planning Committee, the Level II Team Planning Committee and the Curriculum Committee. Criminal Background Some clinical agencies require Criminal Background Checks for students prior to clinical rotations. If the background check is unsatisfactory for, certain agencies may deny the student access to the clinical facility. If a student cannot attend a clinical rotation, she/he may not be able to complete the course and program requirements necessary for graduation. Employment of Nursing Students The faculty of the Associate Degree Nursing Program supports the mandatory Nursing Practice Act of the State of Texas requiring that persons be licensed to perform specific nursing tasks. Therefore, the faculty’s position regarding employment of unlicensed undergraduate nursing students is as follows:

• Students who accept positions in which they receive compensation for patient care, do so as unlicensed individuals and my not wear the Associate Degree Nursing program uniform, name pin or other insignia of their student status.

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• Students are advised to familiarize themselves with the State of Texas Nursing Practice Act so that they will recognize the full scope and responsibility of nursing practice. Students must realize that they may be held legally liable for their actions, and therefore, should not accept responsibilities nor perform nursing actions beyond their knowledge and skills, nor within the responsibilities of the licensed professional nurse.

• The performance of students when working for compensation is the legal responsibility of the individual student ant the employing agency.

• Students are responsible for preparation for classroom and clinical experiences and for maintaining the required grade point average in the nursing program. The demands of part-time employment upon the student’s time and energies should be carefully considered.

• Night shift employment and employment beyond twenty hours per week is discouraged. The Rules and Regulations Relating to Professional Nurse Education, Licensure, and Practice state:

“Certain nursing tasks may be delegated to professional nursing students working as unlicensed personnel in agencies, facilities, or institutions provided the students are currently enrolled in accredited professional nursing programs or are on semester breaks from such programs, and their course of study has included appropriate instruction to prepare them to perform the tasks which will be delegated.”

Ethical Behavior Students are expected to demonstrate ethical behavior as specified in the ANA Code for Nurses. Grading The following grading system will be utilized in the ADN Program for all nursing courses: Letter Grade Numeric Grade Grade Points Interpretation A 93-100 4.0 Excellent B 84-92 3.0 Good C 75-83 2.0 Satisfactory D 70-74 1.0 Failing F Below 70 0 Failing Grades will be carried to the tenth place throughout a course without rounding and then will be rounded to a whole number at the end of a course to determine the final grade. If the number is five (5) or more, it will be rounded up to the next number. If the number is less than five (5), it will be rounded down. Impaired Students in Clinical Practice Purpose: To protect patient health and safety from students whose performance is impaired by suspected chemical dependency and/or mental illness. Policy: Students whose performance is impaired by mental illness and/or chemical dependency will not be allowed to participate in clinical settings. Students in recovery may participate in all aspects of clinical experience and nursing students will be advised to contact the Board of Nurse Examiners to facilitate eventual licensure and compliance with proposed restrictions, such as TPAPN participation. Procedure:

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1. The student whose performance is impaired by suspected chemical dependency and/or mental illness and would therefore endanger patient health and safety will be prohibited by the instructor from participating in the clinical experience.

2. The on-site instructor will determine whether in his/her judgment, student performance presents a danger to the patient’s health and safety.

3. The student restricted from practice will be required to call a support person/friend to accompany him/her to home or to a treatment provider.

4. The student will be advised to seek treatment and referred to counseling services at the college. 5. The instructor will document the specific behavioral observations that required removing the

student from the clinical area. 6. Impaired behavior negatively affecting performance will result in dismissal from the course and

failure. 7. Student confidentiality will be maintained at all times, with the exception of informing those who

need to know. 8. Faculty will comply with Sec.301.404 of the Nursing Practice Act which states “A professional

nursing education program that has reasonable cause to suspect that the ability of a professional nursing student to perform the services of the nursing profession would be, or would reasonably be expected to be, impaired by chemical dependency shall file with the Board a written, signed report that includes the identity of the student and any additional information the Board requires.”

Professional Liability Insurance All nursing students are required to carry professional liability insurance. Laboratory fees collected at the time of registration cover the cost of the college student blanket policy with a major insurance carrier. Progression Requirements To remain in good standing and progress within the ADN curriculum, a student must attain a “C” or better in each nursing and biology course and maintain an overall grade point average of 2.0 in the college. A student must pass all concurrent nursing courses in a single semester to progress to the next semester. A student who fails or withdraws from one or more concurrent courses will be removed from the program and must apply for readmission. If readmitted, all concurrent courses must be repeated in the semester in which the failure occurred. Standardized testing will be used throughout the nursing program to determine progression. A standardized exit exam will be given in the last semester of the program to determine readiness for the licensure examination. All students are required to complete this exam. All costs for the exams are the student’s responsibility. Readmission Policy A student who withdraws from the Associated Degree Nursing Program is eligible for readmission only one time. Readmission is not automatic. It is based on remediation of a problem area and space available. Students who wish to be readmitted must interview with the program’s Readmission Committee. At this interview the student will be asked to describe what steps have been taken in the intervening months to improve the chance of success and an action plan for improvement of academic and/or clinical performance. The committee will then decide if readmission is advisable. Readmission into the nursing program must occur within three years of non-completion. After that time, previously completed work will have to be repeated. Exceptions to the above readmission policy may be made by the ADN Readmission Committee. Readmission is on a space-available basis.

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Refusal to Provide Care Students in the NHMCCD nursing program are expected to provide care to assigned patients. If refusal to care for a particular patient occurs, faculty will provide a review of the Nursing Code of Ethics and counsel the student. A student who indicates persistent refusal to care for a particular type of patient may be withdrawn from the program. Test Review: All students will be given the opportunity to review their test results within 2 weeks of taking the specific test. Testing: Students are required to take nationally-normed tests throughout the curriculum and to make satisfactory scores on each test. If a satisfactory score is not achieved, the student must complete required remediation prior to enrolling in the next nursing semester. A final exit exam is given at the completion of RNSG 2207. A satisfactory exit exam score must be achieved in order to graduate.

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CODE OF CONDUCT

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One of the goals of the Associate Degree Nursing program is to assist the student in becoming a safe practitioner of professional nursing. The primary mission of the Texas Board of Nursing Examiners and the Board of Vocational Nurse Examiners is to protect and promote the welfare of the people of Texas by assuring that professional nurses are competent and safe practitioners. The Associate Degree Nursing Program’s goal is fulfilled by holding the student accountable for safe, mature behaviors and by establishing a code of ethics and conduct along with professional standards of behavior which will help the student in meeting the Texas Board’s expectation. The following code of conduct has been established to make the student aware of guidelines regarding the department’s expectations, which are in keeping with the general rules pertaining to disciplinary process and procedure found in the College Catalog and ADN Student Handbook. Infraction of the code of conduct whether it occurs in the classroom, on campus or any of the NHMCCD campuses including the clinical sites will result in disciplinary action. Discipline can range from a critical incident to removal from the program depending on the seriousness of the incident. Students should follow the chain of command: Instructor, Team Leader, Program Director, Dean, and Vice President of Instruction. Reasons for disciplinary action may include but are NOT LIMITED TO: 1. Use of alcohol or drugs before or during class or a clinical work shift.

Examples are not all inclusive: a. Alcohol on a student’s person or detected on his/her breath. b. Slurred speech, glassy red eyes. c. Difficulty in maintaining his/her balance. d. Belligerent, combative, irrational behavior. e. Illogical or inappropriate decision-making that could endanger patients or others. f. Possessing articles usually associated with drug use.

2. Impairment by reason of mental or physical health, alcohol, or other mind altering drugs which could expose patients, the public, students, and faculty unnecessarily to risk of harm. Examples:

a. Demonstration of hallucination, delusion, combative behavior. b. Physically or verbally attacking or threatening to attack patients, family, or other

students or faculty. c. Misleading and deceptive comments including slanderous remarks or actions.

3. Unprofessional or dishonorable conduct which may deceive, defraud, or injure patients,

the public, school personnel, other students, and faculty. Examples may include but are not limited to:

a. The brandishing of any kind of knife, firearm, or other instrument that could be used as a weapon or that could frighten others.

b. Informing the charge nurse or faculty member that a treatment, medicine or procedure has been done when in fact it has been omitted.

c. Possessing medications including narcotics which need to be credited to the patient or returned to the narcotic locker or the pharmacy.

d. Omitting the administration of medications, treatments or other necessary activities which could endanger the patient’s life.

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e. Failing to follow instructional directives. f. Falsifying or records. g. Stealing

4. Failure to care adequately for patients or to confirm to minimum standards of acceptable

practice under the supervision of the faculty or the designee of the facility. Examples may include but are not limited to:

a. Failure to follow the plan of care including medications, treatments, and other treatment activities.

b. Failure to administer medications in a responsible manner. c. Failure to follow the physician’s prescribed orders which have been held to be prudent

by other nursing personnel. d. Failure to follow the instructional directives of the faculty member. e. Failure to wait for instructor supervision when directed to do so by faculty or student

policy. f. Disclosing confidential information or knowledge concerning the client except where

required by law. g. Performing any act which is beyond the scope of his/her approval level of practice.

5. Aiding another student in deceiving or attempting to deceive the faculty in obtaining an

exam, care plan grade, or grade on any required paper. Examples may include but are not limited to:

a. Cheating on an exam or allowing another student to copy answers. b. Plagiarizing data for any reason. c. Submitting late papers and then informing the instructor that the paper was previously

submitted. d. Using codes, gestures, or any other types of conduct designed to share or obtain answers

from another student. e. Using “crib” notes or writing answers on the walls or desk tops, etc.

6. Damaging or destroying school or hospital property or equipment or removing property

or equipment from campus or a clinical site. Examples may include but not limited to:

a. Removing limbs, eyes or other body parts from the teaching dolls or torsos. b. Destroying computers, printers, CAI programs, library magazine/journal articles. c. Taking CAI programs without permission.

7. Using profane language or gestures.

Examples may include but not limited to: a. Using four letter words, profane or obscene language or obscenities, or words and

phrases that are derogatory or demeaning. Using language or engaging in conduct that could be construed as sexual harassment under NHMCCD policy on sexual harassment.

b. Demonstrating obscene gesture. c. Making derogatory statements regarding a specific cultural or ethnic group.

8. Being disruptive, habitually late, or absent from class or clinical.

Examples may include but are not limited to:

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a. Arguing with an instructor over an assignment, examination, or other academic/clinical issue. The college recognizes the value class discussion and debate. However, the college will not tolerate students who are knowingly confrontational or who knowingly attempt to embarrass or intimidate, making gestures, slamming down books, or talking loudly when someone else has the attention of the group.

b. Monopolizing class time to share personal family problems, or medical experience. c. Habitually arriving to class late and disrupting instruction that is in progress. d. Excessive clinical or class absences. e. Failing to call the instructor when an absence from clinical occurs. f. Having beepers or cell phones audible during clinical or class time.

9. Physically or verbally assaulting others, demonstrating poor coping mechanisms or

becoming confrontational during the instructional process. Examples can include:

a. Grabbing, hitting or assaulting a student, patient, faculty or other persons affiliated with the college or clinical site.

b. Using menacing, aggressive verbal or physical behavior. c. Shouting obscene or abusive words. d. Being argumentative and menacing. e. Threatening others with physical or personal injury.

10. Refusing to adhere to the specified dress code and code of conduct.

Examples may include but are not limited to: a. Dressing in a garment that is not the designated uniform. b. Refusing to follow the guidelines for hair length. c. Smoking or chewing gum while in uniform. d. Coming to clinical without proper grooming or coming in a dirty or wrinkled uniform.

11. Demonstrating behaviors that could be categorized as harassment.

Examples may include but are not limited to: a. Following or stalking a faculty member around campus or to the faculty member’s home

or other places. Except in an emergency or under conditions previously approved by the faculty member, the proper method to discuss such matter is for the student to visit the instructor during office hours or to make an appointment.

b. Calling faculty/administrators at home without specific permission. c. Making repeated phone calls to the faculty member’s office or home to challenge grade

or assignment. d. Making obscene calls to the faculty member’s office or home. e. Harassing another student or faculty member in violation of the colleges’ policy on

sexual harassment. f. Verbally assaulting faculty/staff during the admissions process.

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North Harris Montgomery Community College District

DOCUMENTATION OF REQUIRED IMMUNIZATIONS

TUBERCULOSIS SCREENING

• Must be Mantoux PPD administered intradermally. • Must be read within 72 hours at site where it was administered. • For a positive PPD, size of induration must be documented in mm. and must have doctor’s statement of

treatment plan attached. • Students with a history of a positive PPD must submit chest X-ray results less than one year old and show

proof of treatment. • All foreign-born students who have received the BCG vaccine ARE NOT EXEMPT from the PPD screening

test. • Documentation of a PPD taken within the past year will be accepted; however, it must be repeated after the

one (1) year deadline. Example: PPD done in 1/02, another is due in 1/03. MEASLES, MUMPS AND RUBELLA

• Can be handled in one of three ways: 1. Doctor verified proof of the disease 2. Titer blood level showing immunity 3. Proof of vaccination (MMR)

• Students born in or after 1957 must show proof of two (2) measles vaccinations (or doctor verified proof of disease or titer level.) These are scheduled one month apart. Measles is also known as Rubeola

• Students born before 1957 must show proof of only one (1) vaccination (or doctor verified proof of disease or titer level)

Td or D/T BOOSTER (DIPTHERIA/TETANUS)

• Must be less than 10 years old • Only a Td (or tetanus shot) is necessary

HEPATITIS

• You must bring proof of ability to complete the series of three (3) injections by the start of direct patient contact (clinical course)

CHICKEN POX

Only required by clinical facility.

• Can be handled in one of three ways: 1. Verified proof of the disease from doctor, parent or guardian 2. Titer blood level showing immunity 3. Proof of vaccination (Varivax)

Health files are reviewed each semester for completeness. All required immunizations follow the Texas Department of Health and the Center for Disease Control guidelines. All required immunizations must be obtained prior to placement in the clinic.

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NORTH HARRIS MONTGOMERY COMMUNITY COLLEGE DISTRICT

ASSOCIATE DEGREE NURSING PROGRAM

STUDENT POLICIES FOR CLINICAL AREA

In order to provide for optimal patient safety as well as consistency in student learning, the Associate Degree Nursing faculty developed the following guidelines for the clinical experience for students. The guidelines have been developed in conjunction with hospital personnel and current agency policies. Should a situation arise where an agency's policy is more restrictive than these guidelines, the agency policy will be followed. 1. Students will report on the status of assigned patients to the designated licensed person prior to

leaving the unit. In the acute care setting he/she will also document the patients' status and the name and title of the person to whom the report was given in the nurse's notes.

2. The student must notify instructor to be “in attendance” for any initial sterile procedure. For

subsequent times on the same skill, the student must have specific instructor approval to be independent or with a designated nurse.

3. Students may not serve as witnesses for any legal documents, i.e., wills, operative permits, narcotic

waste forms, or medications requiring signatures of two licensed personnel. 4. Students who work must have adequate sleep to safely care for assigned patients and be able to

remain awake and alert during pre conference, clinical, and post conference. 5. NHMCCD forbids the use of, or appearance of, the influence of narcotics (opium and derivatives),

hallucinogens (LSD, marijuana, and others), and alcoholic beverages while attending clinical or class. See College Catalog Student Conduct.

Any behavior in the clinical area which exposes any other person to physical or emotional harm may cause a student to be dropped from the nursing program.

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CLINICAL MEDICATION POLICY

1. Students in the acute care setting are to identify patients for medication administration by following

facility policy and cross checking patient name and identification number with patient name band. 2. In sub-acute, home, and alternate clinical settings, students are required to follow facility policy

when identifying clients for medication administration.

3. In situations where a physician’s order is questioned (i.e., automatic stop date, legibility, etc.) and cannot be verified with the physician or by agency policy, the student may not carry out the order.

4. Students may not accept verbal or phone orders. 5. Students may not administer medication to a patient in a psychiatric hospital. This directive

includes the psychiatric units that are located in acute care settings. 6. In the acute care setting, students needing to give a medication to a patient in an area other than

his/her assigned hospital room, i.e., x-ray, etc., must have the nursing instructor present when giving the medication.

7. Students may NOT administer: A IV anti-neoplastic agents B. Intrathecal medications C. Porta-cath medications (unless a portacath is already accessed) 8. Students are NOT to administer blood components that must be typed and/or cross-matched, i.e.,

RBCs, whole blood, platelets, fresh frozen plasma, cryoprecipitate, and plasma products used for coagulation factor deficiencies. Students may assist in monitoring patient responses to such therapies.

9. If medications are given with a nurse, the instructor will “designate” a particular nurse on a case by

case basis. In all cases, the nursing instructor reserves the right to require additional restrictions based on the learning level of the individual student and/or specific patient situation.

10. Students must verify the original physician order before administering any medication. If the

original orders cannot be located, the student is required to notify the clinical instructor. 11. The student must adhere to the policies regarding medication administration in the clinical facility

where he/she is currently assigned. It is the student’s responsibility to read and conform to these specific policies.

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STUDENT HEALTH POLICIES AND PROCEDURES (Source: Texas Dept of Health and NHMCCD Risk Management)

Introduction: North Harris Montgomery Community College District recognizes its responsibility to protect the rights and privileges of students, employees, patients, and the general public against the contact and spread of infectious diseases. NHMCCD is also sensitive to the needs and rights of any of its employees or students who have contracted diseases that might be infectious. In recognition of Human Immune deficiency Virus (HIV), Tuberculosis (TB), and Hepatitis B Virus (HBV) as serious public health threats, NHMCCD has adopted the following procedures. The faculty of the Health Occupations Programs also believes that with proper education, skills and immunizations, students in health careers can be reasonably protected from risks of infection while performing clinical activities. The following procedures related to:

1. Admission of students who have infectious diseases 2. Student immunization 3. Tuberculosis policies and procedures 4. Prevention of exposure to blood and body fluids 5. Exposure to blood or body fluids 6. Pregnancy/temporary disability/mobility assisted devices 7. Impaired students in clinical practice, and 8. Invasive campus laboratory activities for EMS students

Revised: August 2004 READMISSION OF STUDENTS WITH HIV AND OTHER INFECTIOUS DISEASES Purpose: Preventing discrimination against students with HIV or other infectious diseases. No prospective student will be refused admission based solely on a positive diagnosis of an infectious disease. Further, NHMCCD will not require preadmission screening for infectious diseases as a condition of admission. Once admitted, students with infectious diseases, including HIV positive will not be denied access to usual and normal student activities. Procedure: Students will not be required to give information regarding having infectious diseases including HIV or HBV prior to admission into the health occupations programs. STUDENT IMMUNIZAITONS Purpose: To meet the requirements of the Texas Department of Health, and to protect the student and others from the spread of infectious diseases. Upon admission to the Health Occupations Program, students will be required to have current immunizations as required by the Texas Department of Health. In addition, the hepatitis vaccine series is required to be completed prior to the start of direct patient care. (This specific requirement will be fully implemented at a future date.) A PPD skin test for tuberculosis is required upon admission to the Health Occupations Program and yearly thereafter (see tuberculosis policy).

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Procedure: Students enrolled in health career courses that have or will have direct patient contact must show proof of immunizations using the attached from, or they may submit copies of the original immunization record. Students who show serological documentation that they are immune to the Hepatitis B virus are not required to be immunized upon the submission of appropriate medical documentation. These records may be submitted to the division secretary, the clinical instructor, and/or the clinical facility as requested. Students will be responsible for keeping their own records and maintaining currency of immunization status. Students who are not current on immunization may not be allowed to attend clinical, depending on the discretion of the clinical instructor and/or clinical facility. Without valid documentation, students will receive an absence for each day excluded from clinical due to immunization status. TUBERCULOSIS POLICIES AND PROCEDURES Purpose: 1. To document status regarding tuberculosis exposure, both prior to attending clinical activities and following exposure to tuberculosis. 2. How to prevent spread of tuberculosis. TUBERCULIN TESTING Policy: All students, including those with a history of Bacillus of Calmette and Guerin (BCG) vaccination, must receive a PPD tuberculin skin test (a tine test is NOT acceptable) prior to their first day of clinical, unless a previously positive reaction can be documented, or completion of adequate preventative therapy or adequate therapy for active disease can be documented. Initial and follow-up tuberculin skin tests should be obtained and interpreted according to current guidelines. Students with a documented history of a positive tuberculin test or adequate treatment for disease or preventative therapy for infection should obtain a chest x-ray and review the symptoms of TB. They should be exempt from future screening unless they develop symptoms suggestive of tuberculosis. PPD negative students must have PPD’s done according to CDC guidelines. Currently, students must have yearly PPD’s; however, CDC guidelines may change. Students, whose TB status is not current, as evidenced by documentation will not be allowed in the clinical agency for the clinical experience of the class. Procedures: Students are responsible for maintaining current status. It is their responsibility to show documentation to the clinical instructor as well as turn it in to the designated division secretary, and/or clinical facility. Students who are unable to attend clinical due to incomplete immunizations will receive a clinical absence and no alternative clinical will be provided for make-up. EVLAUATION OF STUDENTS AFTER UNPROTECTED EXPOSURE TO TUBERCULOSIS Purpose: Students should be evaluated if they have been exposed to a potentially infectious tuberculosis patient for whom infection control procedures have not been taken.

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Persons with previously known positive skin test reactions who have been exposed to an infectious client do not require a repeat skin test or a chest radiograph unless they have symptoms suggestive of tuberculosis. Procedure: Unless a negative skin test has been documented within the preceding 3 months, each exposed individual (except those already known to be positive reactors) should receive a PPD tuberculin skin test as soon as possible after exposure and should be managed in the same way as their contacts. If the initial skin test is negative, the test should be repeated 12 weeks after the exposure ended. Exposed persons with skin test reactions of 5mm or with symptoms suggestive of tuberculosis should receive chest radiographs. All diagnostic and treatment related expenses are the sole responsibility of the student. EVALUATION AND MANAGEMENT OF STUDENTS WITH POSITIVE SKIN TESTS OR SYMPTOMS THAT MEY BE DUE TO TUBERCULOSIS Students who have positive tuberculin skin tests or skin test conversions but do not have clinical tuberculosis should be evaluated for preventative therapy according to published guidelines. Those with positive skin tests should be evaluated for risk of HIV infection. If HIV infection is considered a possibility, counseling and HIV antibody testing should be strongly encouraged. All persons with a history of tuberculosis or positive tuberculin tests are at risk for contracting tuberculosis in the future, and must be evaluated further. Procedure: These persons should be reminded periodically that they should promptly report any pulmonary symptoms. If symptoms of tuberculosis should develop, the person should be evaluated immediately. Students who test positive or convert to positive must obtain a letter from their physician stating it is safe for them to return to class and the hospital setting. RETURN AND FOLLOW UP CHEST RADIOGRAPHS Routine chest films are not required for asymptomatic, tuberculin negative individuals. After the initial chest radiograph is taken, those with positive skin test reactions do not need repeat chest radiographs unless symptoms develop that my be due to tuberculosis. Procedure: Students with a positive skin test reaction will be required to submit evidence of a clear chest film prior to being admitted into the clinical area. A repeat chest firm will be required if symptoms develop. RESTRICTIONS FOR STUDENTS WITH CURRENT PULMONARY OR LARYNGEAL TUBERCULOSIS Students with current pulmonary or laryngeal tuberculosis pose a risk to patients and other students and staff while they are infectious; therefore, restrictions for these persons are necessary. Procedure: Students with current pulmonary or laryngeal tuberculosis should be excluded from the classroom until adequate treatment is instituted, cough is resolved, and sputum is free of bacilli on three consecutive smears. Individuals who discontinue treatment before the recommended course of therapy has been

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completed should not be allowed to attend class until treatment is resumed, an adequate response to therapy is documented, and they have negative sputum smears on three consecutive days. RESTRICTION FOR OTHERWISE HEALTHY STUDENTS WHO ARE RECEIVING THREATMENT FOR TUBERCULOSIS Students who are otherwise healthy and receiving preventative treatment for tuberculosis infections should be allowed to continue usual class activities. Procedure: Individuals who cannot take or do not accept or complete a full course of preventative therapy should have their attendance in the classroom/clinical setting evaluated. Restrictions may not be necessary for otherwise healthy persons who do not accept or complete preventative therapy. These persons should be counseled about the risk of contracting disease and should be instructed to seek evaluation promptly if symptoms develop that may be due to tuberculosis, especially if they have contact with high risk patients (i.e., patients at high risk for severe consequences if they become infected). CONSULTATION Consultation on tuberculosis surveillance, screening, and other methods to reduce tuberculosis transmission should be available from state health department tuberculosis control programs and infection control employee health affiliates of clinical facilities. Procedure: Faculty and students will consult the policies and procedures at the clinical facilities where they have clinical activities. Policies and procedures will be followed for both the facility and the college whichever is more restrictive. PREVENTION OF EXPOSURE TO BLOOD OR BODY FLUIDS Purpose: To minimize risk of exposure to blood borne pathogens. Students must follow standard precautions when coming into contact with blood or body fluids. Procedure: 1. Prior to practice in the clinical area, student must be given instructions by the clinical instructor in the following areas: a. the most current information on modes of acquiring and transmitting infectious diseases. b. thorough instructions in standard precautions. c. supervised practice in a skills lab. 2. Prior to practice in the clinical area, the student must demonstrate competency in standard precautions. Also, students will be required to sign a communicable disease statement and waiver of liability form (see attached). EXPOSURE TO BLOOD OR BODY FLUIDS: Purpose: To protect the student’s health in the event of an exposure to blood and body fluids. In the event that a student becomes exposed to blood or body fluids, the student must follow the procedures outlined by the college.

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Procedure:

1. Student must report exposure to clinical instructor, authorities in health care agency and his/her program director at North Harris Montgomery Community College District.

2. The student, instructor and facility representative will collaborate to assess the clinical status of the source client who exposed the student.

3. The clinical facility will test the client for evidence of HIV or Hepatitis B as soon as possible after the exposure. His/her private physician must test the student for HIV or Hepatitis B, preferably, within 48 hours of exposure.

4. The student must be re-tested if negative in 6 weeks, then a 3, 6, and 12 month intervals with a private physician.

5. The student must seek counseling throughout the experience. 6. The student must adhere to the recommendations for the prevention of retransmission of any

infectious disease during the testing period of 3 months. 7. In order to ensure the confidentiality of student and patient medical records, information is shared

only on a strict “need to know” basis. Any breaches of confidentiality will be grounds for disciplinary action.

8. Confidential screening for various communicable diseases can be obtained through the local health department.

9. All expenses incurred are the sole responsibility of the student.

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STUDENT ACKNOWLEDGMENT

I have read the Cy-Fair College Associate Degree Nursing Programs Handbook. I understand the policies and procedures and agree to abide by them while enrolled in the Associate Degree Nursing Program. I understand that non-compliance with any of these policies and procedures may be grounds for my withdrawal from the program. Name:

Date:

(Print) Signature: The provisions in this handbook are subject to change by the ADN Program faculty.

NORTH HARRIS MONTGOMERY COMMUNITY COLLEGE DISTRICT

MEDICAL HISTORY AND DISCLAIMER

Personal Information: Name:_________________________________________________________________ Address_____________________________Telephone:________________________ _____________________________ Age:_________________ Height:___________________ Weight:_____________ IN CASE OF EMERGENCY:_________________________________________________ Name of Emergency Contact Telephone Number HEALTH HISTORY: (Please check appropriate box) Never Had Have Had Presently Have Family History Heart Disease Chest pain w/exertion Difficulty Breathing High Blood Pressure Pulmonary Lung Disease Diabetes Epilepsy Thyroid Disease Hypoglycemia Asthma Arthritis Persistent Headaches Dizzy Spells Bursitis Varicose Veins Obesity Allergies Bulimia Anorexia Nervosa Other:

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List any muscle injuries you have had:__________________________________________________ List any bone or joint injuries you may have had:__________________________________________ List any muscle, bone, or joint pain you are presently experiencing:___________________________ Specify any medications you are presently taking:_________________________________________ Specify any activities a physician has advised you to avoid:__________________________________ Specify any activities about which you must be cautious:____________________________________ Do you smoke?: Yes No If yes, how much?____________________________________ Are you pregnant or have had a baby in the last six months? Yes No Do you have any other health condition that might limit your participation in this class?___________

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DISCLAIMER

I accept full responsibility for any injury or accident to myself as a result of my participation in this course. Every reasonable effort will be made by North Harris Montgomery Community College District and its employees to make this course safe and enjoyable. I have read and understand the syllabus, course grading procedures, and the medical history and disclaimer form. Student Signature Date Parent of Guardian Signature (if student under 18) Date Faculty Signature Date

NORTH HARRIS MONTGOMERY COMMUNITY COLLEGE DISTRICT

STUDENT EMERGENCY PROCEDURE INFORMATION

Name: Address: City/State Zip Telephone:

In case of emergency, illness or accident, proceed as indicated: (List order of contact 1, 2, 3, etc.) 1) Name Relationship Telephone 2) Name Relationship Telephone 3) Name Relationship Telephone Take to Hospital Emergency Room Name of Hospital Other Arrangements: Signature of Student Date

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NORTH HARRIS MONTGOMERY COMMUNITY COLLEGE DISTRICT

CLINICAL, COOPERATIVE OR INTERNSHIP PROGRAM

STUDENT RELEASE OF LIABILITY

I, ___________________________________, am a participant in the clinical/Cooperative/Internship Please Print Name Program at __________________________________and/or its subsidiaries (referred to hereinafter as Name of Company or Facility. “Company”). While engaged in my clinical, cooperative, or internship activities, I am not an employee of Company for any purpose. However, I agree to adhere to all policies and procedures as set forth by Company. I release ______________________________ and/or its subsidiaries of any responsibility for any Name of Company or Facility Bodily injury or property damage that I incur while participating in the Program, including any injury while traveling to or from performance of work assignment. I assume full responsibility for my transportation to and from the Program, no matter how arranged. _____________________________________ _________________________ Student Signature Date Printed Name of Student ______________________________________________ ________________________________ Witness Date _____________________________________________ ________________________________ Printed Name of Witness Date The provisions in this handbook are subject to change by the ADN Program faculty.

COMPLIANCE WITH AMERICANS WITH DISABILITIES ACT

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The NHMCCD nursing faculty subscribes to the Core Performance Standards recommended by the Southern Council on Collegiate Education for Nursing. Nursing students who qualify under the Americans with Disabilities Act are expected to review these core performance standards. If a student believes he or she cannot meet one or more of the standards without accommodations, it is the responsibility of the student to inform nursing faculty of the need for a reasonable accommodation at the BEGINNING of the nursing course. Every effort will be made to provide the appropriate assistance and guidance to students who identify potential difficulties meeting these standards. The standards are as follows:

Issue Standard Some Examples of Necessary Activities (not all inclusive)

Critical Thinking Critical thinking ability sufficient for clinical judgment

Identify cause-effect relationships in clinical situations, develop nursing care plan.

Interpersonal Interpersonal abilities sufficient to interact with individuals, families, and groups from a variety of social, emotional, cultural, and intellectual backgrounds

Establish rapport with patients/clients and colleagues.

Communication Communication abilities sufficient for interaction with others in verbal and written form

Explain treatment procedures, initiate health teaching, document and interpret nursing actions and patient/client responses.

Mobility Physical abilities sufficient to move from room to room and maneuver in small spaces

Moves around in patient’s rooms, work spaces, and treatment areas, administer cardio-pulmonary resuscitation procedures.

Motor Skills Gross and fine motor abilities sufficient to provide safe and effective nursing care

Calibrate and use equipment; position patient/clients

Hearing Auditory ability sufficient to monitor and assess health needs

Hears monitor alarm, emergency signals, auscultatory sounds, cries for help.

Visual Visual ability sufficient for observation and assessment necessary in nursing care

Observes patient/client responses.

Tactile Tactile ability sufficient for physical assessment

Perform palpation, functions of physical examination and/or those related to therapeutic intervention, e.g., insertions of a catheter.

Math College level math skills Able to correctly calculate medication dosages without assistance or use of calculator.

Southern Council on Collegiate Education for Nursing, March 1993.