MPN 2050 - Clinical II for CMA

1. Accept the role of the beginning Practical Nurse by:
   • Demonstrating knowledge of legal and ethical responsibility and limitations when administering patient care
   • Demonstrating confidences by initiating patient care and by performing tasks with minimal supervision
   • Consulting clinical instructor regarding learning needs.
   • Utilizes constructive criticism to improve clinical performances.
   • Demonstrate successful time management skills in delivering patient care.
2. Utilizes appropriate verbal and nonverbal skills while participating in the communication process with patients and colleagues by:.
   • Identifying barriers to communication and adapt to changing needs of the patient.
   • Recording information obtained from a head to toe assessment on the patient’s chart legibly and concisely.
   • Relating pertinent information to colleagues and discussing appropriate nursing action.
   • Establish therapeutic nurse/client relationship.
   • Respond to culturally specific requests/needs according to facility policy.
   • Demonstrates professional, empathetic and therapeutic communication skills in all learning situations.
   • Demonstrate effective and appropriate interactive/communication skills with other members of the healthcare team, as well as the patient and family.
3. Utilize the nursing process in providing care for individuals by:
   • Performing a head to toe assessment.
   • Developing a nursing care plan with the client, family and interdisciplinary healthcare team members, including assessment, short and long term goals, nursing interventions, implementation, and evaluation.
   • Applies the nursing process as a basis for clinical decision-making in classroom activities and in clinical experiences.
   • Constructs and implements safe, effective, patient-centered nursing care using nursing knowledge, information technologies and research evidence.
   • Assist with the admission of a patient: obtaining and recording data on appropriate forms.
   • Taking client history using a structured assessment tool.
   • Applies the nursing process to patient learning needs.
   • Assist the Registered Nurse (RN) in formulating nursing diagnosis.
4. Demonstrate a personal/professional attitude by:
   • Participating in clinical experience by attending, reporting promptly, and staying the entire assigned time.
   • Utilizing appropriate hygienic measures to present a professional appearance.
   • Demonstrating a desire to learn by actively interacting with colleagues.
   • Observe HIPPA guidelines at all times.
   • Applies principles of collaboration and advocacy to safely provide and manage patient care.
   • Emulates professional behavior in all clinical settings.
   • Demonstrate knowledge of the leadership role and personal attributes of the PN.
   • Consider appropriate delegation of duties to non-licensed personnel.
   • Applies ethical and legal principles and professional standards to nursing practice.
5. Demonstrate scientific principles when caring for individuals in various states of the life cycle by:
   • Utilizing principles of microbiology and anatomy to contrast between normal body function and disease process. Plan and perform nursing care on assigned clients recognizing physical, psychosocial, multicultural diversity, and developmental needs.
   • Utilizing basic concepts of nutrition to assist patients to comply with and understand their dietary regime.
   • Utilizing principles of normal growth and development to appropriately care for individuals in various states of the life cycle.
   • Complete an assessment on a geriatric client’s cognitive processes (memory, communication, orientation, problem solving).
   • Assist with activities of daily living (ADL’s) of the geriatric client.
   • Use observational, assessment, and communication skills with the geriatric client.
   • Incorporate patient teaching and reinforcement as needs indicate.
   • Assist with a complete physiological assessment on a geriatric client’s common clinical problems including:
     • Impaired Mobility
     • Alteration in Elimination
     • Risk for Impaired Skin Integrity
     • Risk for Fall or Injury
     • Sleep Pattern Disturbances
     • Altered Nutritional Status
6. Demonstrate ability to:
   • Identify conflicts between the nursing plan of care and the plan of interdisciplinary health team members.
   • Participate in discussing the plan of care with interdisciplinary healthcare team.
   • Implement the plan of care taking into consideration ethical and legal parameters including scope of education with the client and interdisciplinary healthcare team.
   • Assist in discharge planning for assigned clients.
   • Identify health related learning needs.
   • Displays organizational skills by planning and completing patient care in a reasonable time.
   • Implement a teaching plan for clients with common health problems and well- defined learning needs.
   • Implement nursing measures, psychosocial concepts, and assists with diagnostic studies as indicated in the care of patients with health alterations.
   • Document and report care and treatments given and other pertinent observations accurately and completely according to facility policy and clinical procedure
7. Assist in promoting a safe effective care environment conducive to optimal health and dignity.
   • Implement plans of care to meet basic needs including circulation, activity, elimination, comfort, pain management, rest and sleep.
   • Implement nursing interventions to promote health and rehabilitation.
   • Applies sound nursing judgment to nursing situations using standards of care, critical thinking, clinical reasoning, and evidence-based practice.
   • Applies a range of knowledge to promote health and well-being and prevent complications in adults experiencing illness and disease.
   • Initiate basic emergency interventions as needed.
   • Initiate basic nursing interventions to foster client’s social well-being and effective coping mechanisms.
   • Demonstrating appropriate care and teaching to meet patient’s safety needs.
   • Utilize basic therapeutic communication.
   • Assist interdisciplinary healthcare team members with exams and procedures.
   • Observe and communicate Patient’s Bill of Rights.
   • Report unsafe practices.
   • Utilize current technology to enhance client care.
8. Integrate previous nursing knowledge and skills in the prevention and treatment of diseases, including but not limited to:
   • Anatomy and Physiology
   • Nutrition/Diet Therapy
   • Pharmacology
   • Nursing Fundamentals
   • Mental Health

CLINICAL/LAB/SIMULATION COMPETENCIES:

Upon completion of this course, the student under the supervision of the instructor will be able to accomplish the following objectives. The student must receive a satisfactory evaluation during med-cart rotation for progression. An unsatisfactory evaluation will result in the student not being able to progress regardless of the academic average.

1. Utilize drug information sources and be able to identify the generic/trade names, dosage forms of pharmaceutical preparations, the expected local and systemic actions of the drugs special considerations and, side effects/ interactions. Suggested activity: student will complete a drug card on each drug administered.
2. Administer medications per the “Rights” of administration.
3. Document accurately the administration of medications given, including controlled substances, according to the procedure of the facility and program guidelines.
4. Safely calculates and/or converts dosages according to prescribed standards.
5. Evaluate the effectiveness of drugs administered and utilize pain scale when indicated.
6. Implements appropriate safety measures.
7. Selects and demonstrates appropriate use of equipment/supplies for administration of medications.
8. Demonstrate ability to interpret and transcribe the drug order accurately.
9. Demonstrate correct use of the medication administration record, controlled substance record or other records required for the safe administration of medications.
10. Apply critical thinking to the principles of administration of medications.
11. Demonstrate effective use of the time management skills with administration of medications.
12. Assess patients for conditions and factors that are likely to influence drug effects, including age, weight, health status, and lifestyle.
13. Obtain a medication history about the patient’s use of prescription, over-the-counter (OTC), and social drugs as well as herbal and dietary supplements.
14. Identify nondrug interventions to prevent or decrease the need for drug therapy.
15. Observe patients for therapeutic and adverse responses to drug therapy.
16. Teach patients and family members how to use prescription and OTC drugs safely and effectively.
17. When indicated, teach patients about the potential effects of herbal and dietary supplements.
18. For patients who use herbal and dietary supplements, provide-or assist them in obtaining-reliable information.
19. Apply evidence-based data about patients and therapeutic drugs in all steps of the nursing process.
20. Student will demonstrate proper hand washing technique prior to medication preparation and before and after patient contact.
21. Student will demonstrate proper handling of medication to prevent contamination.
22. Student will look up the action and side effects of a new drug prior to administration.
23. Student will calculate correct drug dosage.
24. Student will identify the patient correctly (according to facility policy).
25. Student will administer the correct drug, correct dosage, via correct route, at the correct time.
26. Student will identify correct landmarks and use correct technique in administering medication.
27. Student will demonstrate accurate and timely documentation according to facility policy.
28. Assess level of consciousness and respiratory status before and after administering opioids.
29. Teach patients about safe, effective use of opioid analgesics.
30. Teach patients interventions to prevent or decrease adverse effects of aspirin, other NSAIDs, and acetaminophen.
31. Teach patients guidelines for rational, safe use of antianxiety and sedative-hypnotic drugs.
32. Teach the patient about safe, effective use of adrenergic drugs.
33. Teach patients about safe, effective use of antiadrenergic drugs.
34. Assist patients or caregivers in learning how to manage diabetes care, including administration of medication agents used to manage diabetes mellitus.
35. Collaborate with nurse diabetes educators, dietitians, pharmacists, and others in teaching self-care activities to patients with diabetes.
36. Assess and monitor patients’ conditions in relation to diabetes mellitus and their compliance with prescribed management strategies.
37. Teach parents about recommended immunizations and record keeping.
38. Assist patients/caregivers in preventing or managing symptoms associated with chemotherapy regimens

CLINICAL/LAB/SIMULATION COMPETENCIES:

Upon completion of the mother and infant care clinical rotation, the student under the supervision of the clinical instructor will be able to accomplish the following objectives. The student must receive a satisfactory clinical rotation evaluation for progression. An unsatisfactory clinical rotation evaluation will result in the student not being able to progress regardless of the academic average.

Labor and Delivery:

1. Assist the laboring mother with relaxation exercises.
2. Observe and assist with monitoring of fetal heart tones (FHT).
3. Participate in timing uterine contractions.
4. Observe procedures performed in labor room to prepare for delivery.
5. Observe administration of anesthetics.
6. Observe and assist positioning for delivery.
7. Observe episiotomy and identify type performed.
8. Determine position and presentation of neonate.
9. Observe delivery of neonate.
10. Observe third stage of labor and identify delivery of placenta.
11. Observe identification and/or assist with immediate care to neonate in delivery room.
12. Identify prophylactic measures performed on neonate.
13. Note one and five minute Apgar scores.
14. Observe the alternative methods of delivery as available.
15. Observe and assist with emergency delivery as available.
16. Identify medications given in the labor room and delivery room, their actions, and nursing implications.
17. Effectively and appropriately interact/communicate with all others on the healthcare team.

Postpartum:

1. Assist client with personal hygiene and care measures as ordered (i.e., shower, bed bath, partial bath, peri-care, sitz bath, etc.).
2. Assist with instructing the client on the proper postpartum care.
3. Assess and document: perineal appearance, condition of breasts, amount, color, and consistency of lochia, vital signs, etc.
4. Assess and assist with massage and document condition of fundus (check hospital policy for fundal massage on cesarean section patients).
5. Observe the psychosocial behavior of the family during the postpartum period.
6. Assist with various types of infant feeding.
7. Observe and assist parents in bonding techniques.
8. Assess for and assist with emergency measures in hemorrhage.

Newborn:

1. Take and record: temperature, heart rate, respirations and report abnormal values according to facility policy.
2. Weigh and measure infant.
3. Observe and assist in completing newborn assessment.
4. Provide care for the normal newborn including but not limited to:
   • Cord care
   • Bath
   • Transporting infant to client for feeding
   • Feeding and burping infant (i.e. breast or bottle)
   • Diaper care
5. Observe infant male circumcision.
6. Assist with instructing client on care of newborn.
7. Identifies and implements security measures for newborn.

CLINICAL/LAB/SIMULATION COMPETENCIES:

Upon completion of the mental health nursing clinical rotation, the student under the supervision of the clinical instructor will be able to accomplish the following objectives. The student must receive a satisfactory clinical rotation evaluation for progression. An unsatisfactory clinical rotation evaluation will result in the student not being able to progress regardless of the academic average.

1. Identify characteristics of bipolar behavior.
2. Identify characteristics of psychotic behavior.
3. Distinguish between hallucinations and delusions.
4. Observe/identify the therapeutic techniques used in the nursing care of psychiatric patients.
5. Observe/identify nursing management of the patient with dementia.
6. Identify precautions used with the suicidal patient.
7. Identify resources available for the patient with a chemical dependency.
8. Identify the current trend of care of the psychiatric clients.
9. Identify mental health community resources available to the client and family.
10. Observe HIPPA guidelines in the care of the psychiatric client.
11. Utilize observational, assessment and communication skills.
12. Assist with crisis intervention as indicated.
13. Observe appropriate safety measures related to the therapeutic milieu in daily nursing care.
14. Identify mental health community resources available to the client and family.
15. Maintain a professional attitude and appropriate interventions at all times.
16. Be familiar with DMI/DSM.
17. Participate in group activities as permitted.