Critical Thinking by ecPy2fo


                NURSING EDUCATION

                                 PRACTICUM II
                                        NURS 112

                                  Spring Quarter 2008

  Every effort is made to ensure accuracy in the syllabus at the time of printing. However, the
 Walla Walla Community College Nursing Education Program reserves the right to change any
 provision or requirement that is necessitated by circumstances arising during the course. All
                              changes shall be provided in writing.

Nurs 112 Syllabus Spring 2008                                                                     1
                                              COURSE OUTLINE

Course Identifier:                NURS 112

Title:                            Practicum II

Credits:                          4

Clinical/Lab Hrs Per Wk:          8

Catalog Description:              Application of theory from NURS 102. The focus is on providing care for
                                  clients of all ages in acute care facilities.

Prerequisites:                    NURS 101 and 111

Corequisites:                     NURS 102

Teaching Format:                  Clinical
                                  Client Centered Conferences
                                  Independant Learning Modules

Locations:                        Walla Walla Campus - Skills Practice Lab; Acute Care Hospitals
                                  Clarkston Campus - Skills Practice Lab; Acute Care Hospitals

Course Topics:                    Postpartum Assessment
                                  Newborn Care
                                  NG Tubes (Insertion, Feeding, Medications)
                                  Ostomy Care

Evaluation Devices:               Clinical Evaluation Tool
                                  Written Assignments
                                  Medication Computation/Administration Proficiency
                                  Computer Assignments
                                  Skills Performance Validation

Course Competencies:

                                                 Critical Thinking

           1.    Demonstrate critical thinking in the use of the nursing process.
           2.    Demonstrate use of management/leadership principles in the delivery of client/patient care.


           3.    Perform interventions in a safe and effective manner.
           4.    Use therapeutic communication

                                             Professional Behaviors

           5.    Demonstrate professional behaviors

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                                              NURS 112
                                            Grading Criteria

Name ________________________

Points Earned: _________                 Percentage: _____                  Clinical Grade: _____

                                 Criteria                                       Points          Points
                                                                               Possible         Earned
Journal Entries 3 @ 6 points each                                                  18
**Written Competencies (see criteria page 6)                                       25
Prenatal Family Profile                                                            25
Clinical Tool Points                                                               34
Campus Lab Activities                                                              24
      (bonus points up to two (2) possible)
Math/Dosage Proficiency (P/F) Must have 80% to pass (one retake only)              P/F
Late Point – one point deducted per every business day clinical folder or
family profile late (see handbook p 17)
                                                        Total                      126

Note: All papers/assignments must be accounted for to complete course work.

Practicum: ____ ____ ____ ____ ____ ____ Peds. Workshop: ______

               Attendance/Tardiness - Absence or tardiness will result in zero (0.0) points)

       Failure to notify the clinical agency and the WWCC Nursing Department of absence will be
        reviewed by Level I faculty and may result in the issuance of a special concern.

       Attendance/Tardiness – see handbook policy. Absences from any NURS 112 activity will result in
        zero (0.0) points for missed activities. Absences and tardiness will be tracked. Three episodes of
        tardiness, in any combination of NURS 112 activity, equals one absence. Three absences in any
        combination of NURS 112 activities, equals a letter grade drop from total points earned. Four
        absences constitute a clinical failure.

       Students are responsible for any content missed due to absence or tardiness.

                       Grades are earned by students, not given by instructor.

                                See Nursing Student Handbook for Grading Scale

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Nurs 112 Syllabus Spring 2008   4
Student Self Evaluation: (strengths and areas for growth) complete prior to ICS

Final Instructor Evaluation:

Instructor              Date                  Student                         Date

_________________       _______               __________________              _______

Nurs 112 Syllabus Spring 2008                                                           5
                    (performance issues/timeliness/attendance/professionalism)

An entry on any topic may constitute a concern that could be evaluated by Level I Faculty for additional
action. The action could include issuance of a clinical contract or special concern impacting achieved
clinical grade.

  Date            Concern                                         Incident

Special Concern:

Your clinical grade or progression in the program may be affected by serious problems or
repeated incidences related to unsafe, unethical, or unprofessional practice. Each concern will be
documented, discussed, signed, and dated by student and instructor. Documented instances will
be handled through appropriate channels and may lower the clinical grade.

Nurs 112 Syllabus Spring 2008                                                                              6

Purpose:          To assist the learner in reflective thinking regarding the learning opportunities and clinical
                  experiences that occurred during the clinical week.

Method:           Each student is expected to complete a weekly journal which reflects both days clinical
                  experience. A respiratory or peri-operative experience will replace one days journal

Format:           Word processed using sample format, single space, & not more than one page.

Time Management:    (1 point )
            Describe how you planned to complete required care for your client.
                  What went well and not so well today in terms of time management?
                  What changes did you make on the second day or could you make in the future
                   to improve your time management?

Prioritization:          (1 point)
                  Describe an example of prioritizing.
                      Identify how you made the decision to prioritize (what were your choices).
                      Explain how you met your desired outcome (how did your decision workout?)

Personal Analysis:    (4 points)
               Describe your feelings about the practicum experience for the week.
               Describe you personal accomplishments (may include technical skills accomplished).
               Describe you plan for growth.

      3 points will be deducted from total points achieved for each clinical absence in a week.

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                                SAMPLE JOURNAL FORMAT

                                          Date_____________   Points ___________





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                                    CLINICAL GRADING CRITERIA

Maintain clinical notebook according to preclinical conference directions.
     Additional clinical paperwork is available on the nursing resource page
     Points will be deducted from professionalism for each week papers are received outside the
        notebook or for notebooks turned in without appropriate paperwork filed.
     Completed notebooks must be turned in prior to final ICS with self evaluation completed.

One (1) point will be deducted from the total points earned for each working day any notebook or
prenatal paper, is late. Students are responsible for completeness of notebook.

Clinical Preparation – (required) the following must be completed on all clients prior to providing care.

       Paper will be reviewed during preclinical conference
       Client Data/Projected Plan of Care/Pathophysiology
       Medication/Diagnostic Sheet

Mini Client Data Packet (5 points possible) - Two graded (one due week one and one due week two)
    Packet to be submitted (in notebook) prior to the beginning of class as assigned by faculty

       Mini Packet consists of:
         Client Data / Projected Plan of Care/Pathophysiology (2)
         Physical Assessment (1)
         Medication/Lab & Diagnostic Sheet (1)
             (list all medications you will give during clinical and any PRN medication given in the past
                24 hours. You must be prepared to answer questions on any of the medications you will
               Nursing Care Plan (1)

OB Client Data Packet (5 points possible) – may replace one graded mini client data packet

       Packet consists of:
       OB client Data Sheet (2)
       Newborn Assessment (3)

Major Client Data Packet (17 points possible) – submit one during last clinical week

       Major Packet consists of:
         Client Data / Projected Plan of Care (1)
         Pathophysiology (1)
         Physical Assessment (1)
         Documentation Sheet (1)
         Laboratory/Diagnostic Sheet (1)
         Medication Sheets (2)
            (all medications you will give during your clinical day and any PRN medication given in
               the past 24 hours - must be written up)
         Gordon’s Functional Health Patterns (1)
         Nursing Care Plan (9 points each – score will be averaged) 9 + 9 / 2) - you must identify
           which nursing diagnosis is priority #1 and priority #2

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Clinical Tool Competencies

       Clinical competencies are the way your instructors choose to validate your critical thinking skills.
        All competencies must demonstrate reflective thinking and must be actual examples of your
        clinical experiences
       Clinical competencies constitute approximately 15% of the clinical grade.
       Competencies should be addressed weekly in order to obtain feedback thus allowing an
        opportunity to correct and re due. Turned in with your clinical tool.
       Word process all competencies include:
             o competency number
             o element letter
             o clinical date
             o patient initials if applicable
       Submit in clinical notebook
       All elements identified as @ 100% are to be written as an example. Example is what you did to
        meet the competency. There are a total of 41 elements to be addressed.

            o   If 95-100% ( 40 or more) are actual examples showing critical thinking, 25 points will be

            o   If 90-94% (38 or 39) are actual examples showing critical thinking, 18 points will be

            o   If 85-89% (36or37) are actual examples showing critical thinking, 15 points will be

            o   If 80-84% ( 34 or 35) are actual examples showing critical thinking, 11 points will be

            o   If 75-79% ( 32 or 33) are actual examples showing critical thinking, 5 points will be

            o   If less than 75% (31 or less) are actual examples showing critical thinking, 0 points will
                be awarded

Instructor Validation Items

       No points will be added to tool but failure to complete may result in point deduction (determined
        by level faculty)

Nurs 112 Syllabus Spring 2008                                                                               10
                                                 CRITICAL THINKING

Course Competency 1:                 Demonstrate critical thinking in the use of the nursing

A. Use the nursing              1.      Apply relevant assessment data when planning client       data packet
process to meet                         specific care
psychosocial, and               2.      Develop client specific mini data packet for one          (10) _____
developmental needs of                  client each of first two weeks – An OB packet may
adults and children                     substitute for one of the packets
experiencing normal life
processes or                            _____ _____
illnesses                       3.      Develop client specific major data packet for             (17) _____
                                        selected medical-surgical client (1 @ 17 points)

B. Demonstrate critical         4.      Identify assessment data which reflects a variance        major data
thinking in the provision               from textbook or client baseline                          packet
of nursing care                         (cues highlighted on assessment)

                                5.      Explain the significance of serial (2 or more of the      2 @100%
                                        same value) lab values related to client’s diagnosis
                                        _____ _____

                                6.      Develop client specific pathophysiology for each          data packet
                                        client cared for

                                7.      Integrate knowledge of physiology, pathophysiology,       major data
                                        psychosocial elements, medications and diagnostic         packet
                                        testing (with guidance)

                                8.      Complete a respiratory or perioperative response          journal

                                9.      Describe actions initiated in response to identified      3 @ 100%
                                        client needs for health promotion, health
                                        maintenance and health restoration. (see definition

                                        Health promotion               _____
                                        Health maintenance             _____
                                        Health restoration             _____

                                10.     Explain rationale for therapeutic diet as it relates to   1 @ 100 %
                                        medical condition. (NPO is not a diet)

C. Apply teaching-              11.     Describe a client learning need, including                2 @ 100%
learning principles in                  rationale
addressing client
learning needs                  12.     Provide teaching specific to client needs

                                13.     Describe how learning was evaluated

                                14.     Document client teaching according to agency policy

Nurs 112 Syllabus Spring 2008                                                                                  11
                                Elements 11, 12, 13, & 14 must be described as a unit
D. Complete                     16. Document according to agency policy (include                          instructor
documentation that                  proper terminology, spelling and organization)                        validation
reflects beginning                  _____ ____ _____ _____
organization and meets
agency requirements             17. Complete documentation of initial client assessment                   instructor
                                    within 2 hour following shift report.                                 validation
                                    _____ _____ _____ _____

Course Competency 2:                 Demonstrate use of management/leadership principles in the
                                     delivery of client care

A. Manage care for              1.      Describe a client need for nursing followup                       1 @ 100%
medical-surgical clients
                                2.      Describe how you planned direct care for a client                 journal –

                                3.      Describe revisions of your plan for direct client care            journal

                                4.      Demonstrate organizational and time                               instructor
                                        management skills by:                                             validation
                                          Staying busy throughout the clinical day
                                          Completing client care
                                          Documentation by end of shift

                                         _____ _____ _____ _____

                                5.      Manage complete care with charting for 2 clients                  1 @ 100%

B. Participate in               6.      Report timely changes in client condition to nurse or             2 @ 100%
providing care with an                  instructor (provide an example)
interdisciplinary team
                                7.      Identify the need for a referral to another discipline            1 @ 100%
                                        based on assessment of client needs (including
                                        rationale) – will accept rationale for a client who has already
                                        been referred

C. Access resources             8.       Describe how you manage resources                                2 @ 100%
appropriately, manage                    effectively and efficiently in acute care
them effectively and
efficiently                                  effective (refers to quality of care and
                                              resources other than financial) ____
                                             efficient (refers to money/costs) ____

Nurs 112 Syllabus Spring 2008                                                                                          12
Nurs 112 Syllabus Spring 2008   13

Course Competency 3:                 Perform interventions in a safe and effective manner

A. Administers                  1.      Verbalize rationale, action, nursing assessment and   Instructor
medications safely and                  Implementation factors for medication given (random   validation
evaluates need for and                  instructor selection)
response to medications
with guidance                   2.      Discuss medications with instructor prior to          instructor
                                        administering (random instructor selection)           validation

                                3.      Document a pain assessment on each client,            instructor
                                        (include evaluation of therapy effectiveness)         validation

B. Performs technical           4.     Communicate rationale and protocol for procedures      2 @ 100%
procedures safely and                  performed on selected clients
effectively                            _____ _____

                                5.     Demonstrate accountability for technical               2 @ 100%
                                       competence of previously learned skills
                                           Documented practice
                                           Ability to complete without coaching

                                       _____ _____

                                6.     Demonstrate accountability for technical               2 @ 100%
                                       competency of current quarter skills
                                           Ability to complete with minimal coaching
                                       _____ _____

                                7.     Skill Check Off: IVPB administration with or without        P/F
                                       maintenance IV

                                8.     Skill Check Off: NG/G tube medication
                                       administration                                              P/F

Course Competency 4:                 Uses therapeutic communication

A. Use therapeutic              1.      Describe a therapeutic exchange and techniques        2 @ 100%
communication skills to                 used (review criteria).
meet client needs
                                         _____ _____

B. Identify coping              2.      Describe coping mechanism used by one client          major data
mechanisms used by the                   (Gordon’s Functional – coping/stress tolerance)      packet
client and/or significant
others with guidance

Nurs 112 Syllabus Spring 2008                                                                              14
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                                         Professional Behaviors

*Due to the seriousness of professional behaviors – points may be deducted for inappropriate
professionalism regardless of how well you write to each element.

             Notation of professional breaches noted on p. 4
             Level I faculty will determine point deduction based on breach

Course Competency 5:                 Demonstrate professional behaviors

A. Demonstrate
sensitivity and                 1.      Recognize client needs and respond appropriately      2 @ 100%
attentiveness to the                    in a timely manner
client, family, and others                _____ _____
including their life
experience and                  2.      Demonstrate cultural sensitivity when providing       1 @ 100 %
cultural/social                         client care

B. Demonstrate                  3.      Take responsibility for own learning experience       2 @ 100%
accountability and                       ____ ____
                                4.      Submit data packet for each client cared for          instructor

                                5.      Submit VCE’s as assigned                              instructor
                                                 (points addressed in NURS 102)               validation

                                                                                              1 @ 100%
                                6.      Demonstrate intellectual humility in professional
                                                                                              page 2
                                7.      Identify own strengths and areas for improvement
                                                                                              2 @ 100%
                                8.      Use feedback to improve performance

                                        _____ _____
                                                                                              2 @ 100%
                                9.      Consult with others when client needs exceed the
                                        student’s abilities/experience
                                        _____ _____
                                                                                              (7) _____
                                10.      Attend all clinical experiences and participates
                                11.      Provide safe and effective care in accordance with   validation
                                         established standards of care

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C. Practice within              12.   Follow agency/school policies and procedures,         instructor
ethical, legal, and                   referring to Policy and Procedure manuals as          validation
regulatory guidelines                 needed (with guidance)

                                13.   Maintain confidentiality of information               1 @ 100%

                                14.   Function within legal scope of practice               1 @ 100%

                                15.   Describe an ethical issue encountered in the          1 @ 100%
                                      clinical setting

                                16.   Describe a legal issue encountered in the clinical    1 @ 100%

D. Demonstrate                  17.   Present and conduct oneself in a professional         1 @ 100%
professional behaviors                manner:
                                          conveying professional courtesy
                                          diplomacy
                                          tact

                                18.   Demonstrate self awareness of behaviors               2 @ 100%

                                      _____ _____

E. Participate in               19.   Engage in activities to promote the profession of     1 @ 100%
processes that affect                 nursing or promote health within the
healthcare practice                   community

                                      (permission must be obtained from instructor if not
                                      a school sponsored activity)


Nurs 112 Syllabus Spring 2008                                                                            17

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