Student Nurse Clinical Resource Manual

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					Student Nurse Clinical Resource Manual
              2011-2012
Welcome to Mayo Clinic Health System
Mayo Clinic Health System (MCHS) is a not-for-profit health care system providing chronic, urgent,
and preventive services to a regional population of over 260,000 people in 13 south central Minnesota
counties. With five hospitals and 17 clinics, MCHS is dedicated to meeting the needs of our patients
by providing exceptional care to every patient, every day. Our growing health care system provides the
region with quality health care backed by a team of highly-trained medical specialists, close to home.
Nursing education programs require their students to apply principles, concepts, and critical thinking
skills learned in the classroom to both inpatient and outpatient settings. Clinical experiences are an
integral part of nursing education and MCHS is committed to supporting these experiences. Our
nursing mission and vision statements appearing below, exemplify MCHS’s commitment to education
and evidence-based practice.
                                         Mission Statement
The Mayo Department of Nursing, in cooperation with interdisciplinary colleagues of Mayo Clinic,
Mayo Foundation and affiliated hospitals, exist to:

  •   Deliver comprehensive nursing care of the highest standard to every Mayo patient through
      professional nursing practice, education, and research. This commitment includes the caring and
      support of patients and individuals important to the patient at any point along the health
      continuum.
  •   Provide educational opportunities in clinical nursing and professional development for nursing
      staff; affiliated students and faculty; and regional, national, and international nursing colleagues.
  •   Improve patient care and advance the discipline of nursing throughout nursing and collaborative
      research.

                                                 Vision
                             To provide the best nursing care in the world.
Mayo Clinic Health System provides a professional work environment of respect and teamwork. Our
nurses work closely amongst an interdisciplinary team of physicians and allied health care
professionals to bring world class care to our patients.
If you choose to work at MCHS, you will be challenged and mentored as you grow in knowledge and
professional expertise. Our nurses are involved in many venues for decision making to assure the care
we provide is based on best practice and evidence. We hope you choose MCHS; and we welcome you
to spend your entire career with us!




       Mark Fratzke, D.N.P., R.N                      Karen Ryan, MS, RN
       Chair of Hospital Operations &                 Director, Nursing Clinical Practice
       Chief Nursing Officer                          & Education

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Table of Contents

Purpose……………………………………………………………………………...4
Scope of Service…………………………………………………………………… 4
General Information………………………………………………………………... 4
Clinical Request Procedures……………………………………………………….. 6
Student Orientation………………………………………………………………….7
Clinical Instructor Orientation………………………………………………………7
Badges……………………………………………………………………………… 8
Clinical Documentation……………………………………………………………..8
Pyxis Access……………………………………………………………………….. 9
CareMobile Access………………………………………………………………….9
Student/Clinical Instructor/Staff Nursing Practice………………………………… 9
Point-of-Care Testing……………………………………………………………….10
Medication Administration………………………………………………………… 10
Pre-Clinical/Post-Clinical Process……………………………………………… 11
Student/Clinical Instructor Dismissal and Conflict Resolution……………………. 11
Assessment of MCHS-MHS Clinical Experiences………………………………….12
Synthesis/Preceptor Clinical Experiences…………………………………………..12
Fairmont Resources…………………………………………………………………13
Mankato Resources…………………………………………………………........... 13
Appendices……………………………………………………………………........ 16

      Student Checklist
      Clinical Instructor Checklist
      Student Assignment Form
      Computer/Badge Access Form Fairmont
      Computer/Badge Access Form Mankato
      Student Nursing Orientation and EMR Post-test
      Electronic Authentication Security Agreement
      Confidentiality Agreement
      Detailed Clinical Request Form
      Security Department Badge Pick-up Times
      Southwest Minnesota Region Map




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Purpose
This manual provides information for clinical instructors and student nurses completing clinical
experiences at Mayo Clinic Health System. In addition, this manual clarifies expectations of students,
staff, and clinical instructors to enhance patient safety and ensure a positive experience for all
involved.

Scope of Service
This manual provides information for student nursing clinical experiences at MCHS. All student nurse
clinical experiences are coordinated by the Academic Coordinator in the Nursing Clinical Practice and
Education Department.

General Information
a. An affiliation agreement between MCHS and each school of nursing must be signed and available
prior to commencement of the clinical experience. All affiliation agreements must be MCHS
agreements and are reviewed every five years. The MCHS affiliation agreement covers all hospitals
and clinics in the Southwest Minnesota Region of the Mayo Clinic Health System (see appendices).

b. The Academic Coordinator is responsible for coordination of student nurses clinical experiences
within the scope of services defined above. Each clinical site/department ultimately decides whether it
can accommodate each request.

c. Nursing student clinical experiences are defined as follows:

       Job shadows allow prospective student nurses to explore careers that may interest them
       whether they are in high school, college, or thinking about changing careers. Job shadowing
       allows you to gain valuable insight into a specific career and may facilitate the career decision-
       making process. Job shadows are often two hours in duration and are unpaid. If you are
       interested in a job shadow experience at MCHS in Mankato, please contact Katy Looft at 507-
       385-6519 or looft.kathryn@mayo.edu. In MCHS in Fairmont please contact Employee
       Experience at 507-238-8147.

       Clinicals at MCHS are associated with an accredited nursing program. The clinical instructor
       is present at all times. The clinical instructor, student nurse, and staff nurse work
       collaboratively to ensure patient safety and create an optimal learning environment. Clinical
       experiences can range from 4-8 weeks.
           a. Alternative Experiences are designed to allow students to gain additional insight and
               exposure to other nursing units related to their clinical experiences and coursework.
               Alternative experiences are scheduled during a student nurse’s scheduled clinicals.
               MCHS permits one alternative experience (1 shift) per clinical per student. These
               experiences are observational only.

       Student Nurse Internship Program (SNI) allows student interns to further their
       understanding of the practice of professional nursing under the direction of a Registered Nurse
       preceptor. These students are typically in their junior year of a BSN program and are paid
       employees of the hospital. SNI program is approximately 10 weeks and occurs every summer.
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       Please contact Sarah Luna, Employee Experience at 507-385-5742 for application information
       or visit www.mayoclinichealthsystem.org (click on Nursing tab) for more information.
       Application deadlines occur in early December for the following summer. A minimum
       commitment of 32 hours per week is required.

       Preceptorships/Syntheses experiences are intensive, culminating experiences occurring in the
       last semester of a student nurse’s degree program. The student nurse works one-on-one with
       an assigned Registered Nurse preceptor. These experiences range from 60-120 hours over the
       course of a semester.

d. The student’s university/college is responsible for ensuring the following:
            • All students are covered by malpractice insurance throughout the entire clinical
                experience either via an individual policy or through the affiliated school’s policy.
            • The affiliated school shall maintain proof of state registration, proof of malpractice
                insurance and current licensure and/or certification of clinical instructors. The school
                is responsible for obtaining, validating and maintaining updated clinical instructor RN
                licenses.
            • Each on-site clinical instructor and student has successfully passed a criminal
                background check before beginning their clinical experience. MCHS is responsible to
                determine a student or clinical instructor’s inability to participate in clinical
                experiences. Criminal background checks will be conducted in the state that the
                student resides. The process for clinical background checks is:
                     o The school initiates the criminal background check.
                     o The school reviews the results. Any student with a felony result is not eligible
                        for MCHS clinical placements.
                     o The school will notify the Academic Coordinator at MCHS of any
                        misdemeanor offense. MCHS makes the ultimate decision if the student can
                        participate in student clinicals. Decisions are based on the Employee
                        Experience’s Policy and Practice Guidelines.

e. Patients and MCHS staff reserves the right to exclude a patient for a student clinical experience or
observation.

f. No more than two schools will be assigned to a clinical area during the same week.

g. Only one group of students will be assigned to a unit during a particular shift.

h. All clinical experiences must occur during regular shift schedules:
            • Day 0700-1530
            • Evening 1500-2330
            • Night 2300-0730
Syntheses/preceptor experiences are scheduled according to preceptor availability.

i. Smoking is not allowed anywhere in the hospital or on hospital grounds. This includes smoking in
your car while parked in MCHS parking lots.

j. Clinical instructors and students may utilize Security to escort them to a vehicle at anytime by
calling 507-385-4801 in Mankato and 507-385-8185 in Fairmont. In addition, Security is available for
vehicle jump starts, provided vehicles are parked in designated parking areas and not on the street.

k. Prior to the clinical experience, the affiliated school will provide MCHS with:

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       1. A Detailed Clinical Request Form including clinical objectives
       2. If needed, an Alternative Request Form and Syntheses/Preceptor Request Form
       3. Attestation form (Computer/Badge Access Form) that all students have received their
          immunizations, have a current Basic Cardiac Life Support certification, have passed a
          reasonable physical examination, background check and have completed MCHS online
          orientation and EMR module and have signed the following forms:
                   a. Electronic Authentication Security Agreement Statement
                   b. Workforce Member Confidentiality Agreement and
       4. The affiliated school is responsible for obtaining and maintaining updated results of
          immunizations and certifications. In addition, the school will maintain records of the above
          documentation for three years and will provide a copy to the hospital within 2 business
          days when requested.

l. Observational and/or alternative experiences may not be coordinated at the departmental level.
Please do not contact individual Patient Care Managers and/or Department Managers.

m. Clinical instructors must be on-site for the entire clinical experience period/shift and have student
emergency contact information available.

n. The clinical instructor does not need to be present for observational experiences and syntheses
experiences in which the student is matched with a preceptor. However, the clinical instructor should
be available during clinical hours by phone or pager.

o. Clinical instructors and students are expected to adhere to MCHS dress code and any additional
school policies. The dress code policy can be found on the MCHS Intranet under the policies tab.

p. MCHS or appropriate identification badges must be worn by students and clinical instructors at all
times when on the MCHS campus. On the last day of the clinical experience, clinical instructors must
collect all badges and turn them into Security Departments of each respected location.

q. If there is a low census on any day of student clinicals, please plan to double-up students for patient
assignments and coordinate workflows appropriately. Do not call other departments directly to seek
out alternative experiences unless previously arranged by the Academic Coordinator.

r. If a student is unable to attend clinicals for any reason, the student must notify the clinical instructor
on his or her cell phone. Please do not call the department directly. If the student is assigned to a
preceptor, the student is expected to contact the preceptor directly or the department in which he/she is
assigned.

Clinical Request Procedures
MCHS nursing clinical requests are prioritized on a first come, first serve basis. However, our
regional partners receive initial priority and these partners include:
                   a. Iowa Lakes Community College
                   b. Minnesota Intercollegiate Nursing Consortium
                       (St. Olaf College and Gustavus Adolphus College)
                   c. Minnesota State University, Mankato
                   d. Minnesota West Community and Technical College
                   e. Presentation College
                   f. Rasmussen College
                   g. Ridgewater College
                   h. South Central College

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The following flow diagram illustrates the process and timeline for nursing clinical requests at MCHS.


One year prior to the academic year all clinical and preceptor requests are made through
StudentMaxx


1 month prior to clinical start date


                       Submit the Detailed
                       Clinical Request                      If applicable, submit the
                       Form                                  Alternative Experience
                                                             Request From
3 weeks prior to clinical start date



                       Submit the
                       Computer/Badge
                       Access From

2 weeks prior to clinical start date


                          Request Pyxis access, unit
                         orientation and meeting with                   Pick up badges
                        Patient Care Manager if needed                  from Security
                                                                         Department


Student Orientation
MCHS offers online orientation modules for student nurses. These modules include:
   • MCHS Student Nurse Orientation
   • EMR Orientation (Electronic Medical Record)
These modules are available online and can be completed outside the classroom. Although not
required, it is strongly recommended that students pass the MCHS Student Nurse Orientation and
EMR Post-test with at least an 80%.

Students are required to complete orientation annually. A new orientation module is uploaded on June
1 of each year. If a student was here in the spring for a clinical experience and will begin another
clinical experience in July, they will be required to repeat the orientation process including all forms.
All online orientation materials and required forms are found at
http://www.mayohealthsystem.org/mhs/live/page.cfm?OrgID=ISJ&pp=locations/freeform.cfm&ID=7
5&AffID=4000200000000145.

Clinical Instructor Orientation
Students do not have access to Pyxis. Therefore, clinical instructors should be acquainted with these
systems along with MCHS orientation information, resources, and EMR processes. Every August and
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January, MCHS-MHS will offer clinical instructor orientation. This orientation will include updates, a
question and answer period and training on the EMR, CareMobile and other associated systems and
processes. Clinical instructors will need to attend orientation annually. For more information please
contact Cherie Pettitt, Academic Coordinator, at pettitt.cherie@mayo.edu or at 507-385-4670.

If needed, clinical instructors are responsible for setting up an orientation on their specific
unit/department at least two weeks prior to the start date of their clinicals. If a clinical instructor is
new to MCHS, they are strongly encouraged to attend Central Nursing Orientation. Central Nursing
Orientation occurs once a month. Contact Sabrina Ehmke at 507-385-5927 or
ehmke.sabrina@mayo.edu for more information.

Badges
Badges permit clinical instructors and students to access supply closets and break rooms. Please limit
the amount of belongings you bring in order to reduce clutter. Badges expire automatically on the last
day of the clinical experience. Each card reader can identify location, day, and time of use for each
student or clinical instructor. All badges must be turned in to the clinical instructor at the end of each
clinical. All lost badges must be reported to Security immediately at 507-385-4801 in Mankato and
507-385-8185 in Fairmont. In addition, if a student is no longer participating in clinicals at MCHS,
clinical instructors are expected to contact Security to have the badge deactivated.

The Academic Coordinator will send the Computer/Badge Access Form to Security within three days
after it is received. The badges are available for pick-up one day prior to the clinical start date. Please
see the appendix of this manual for badge pick-up times in Mankato. It is expected that clinical
instructors will collect the student badges and return them on the last day of clinicals before leaving
the hospital.

Fairmont Badges
Please contact Marlys Brummond at 507-385-8140 to arrange badge access, clinical instructor
photographs, and pick-up. The Security Department is not open 24 hours a day.


Mankato Badges
Security is located next to the Emergency Department registration desk on the first floor of the
hospital. If no one from Security is available, please ask the Emergency Department registration desk
for an envelope. Place the badges in the envelope and drop in the Security Departments drop box
located behind the registration desk. If you are a new clinical instructor, please contact Erik Odegard
in Security to arrange to have your picture taken for your badge by email at odegard.erik@mayo.edu
or by phone at 507-385-4801.

Clinical Documentation
Student nurses and clinical instructors chart in Ad Hoc charting only. They chart in the following five
areas:
    • Intake and Output
    • Ongoing Adult Assessment
    • Medication Administration Record (MAR)
    • Vital Signs
    • Notes

While clinical instructors and all student nurses can navigate to other charting areas, it is strongly
recommended that charting does not occur outside of the five recommended screens without prior
approval from the staff nurse. Students Ad Hoc charting does not remove items off of the staff nurse’s
task list. Staff nurses are encouraged to communicate and partner with their assigned student nurse to
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prevent duplication of tasks. For example, staff nurses can observe a student completing a specific
task and then teach a student to chart that task to complete the task list. Clinical instructors or Staff
nurses serving as preceptors must sign all student ongoing assessments. The clinical instructors and
staff nurses serving as preceptors responsibility includes documentation sign-off at the end of the shift
to ensure “pending validation” has been cleared from the record. If a “pending validation” is not
signed off at the end of the clinical, instructors will be asked to come back into the hospital to sign-off
of all student charting.

Pyxis Access
In order to access medications clinical instructors will need to set up their unique Pyxis access code.
Students are not permitted to access Pyxis for any reason. To obtain access to Pyxis, clinical
instructors in Mankato must email Denise Klatt at Klatt.Denise@mayo.edu or call the pharmacy at
507-385-2760. Please provide your job title, first and last name, middle initial and LAN ID. To
obtain access in Fairmont, please call Marlys Brummond at 507-385-8140.

CareMobile Access
Multiple CareMobile devices are available on each unit. Clinical instructors may carry one
CareMobile device with them for the entire shift. To access the CareMobile device, clinical
instructors and students each will need a LAN ID and password. CareMobile training is conducted at
the clinical instructor orientation every August and January. We recommend students log in to the
CareMobile with his or her own LAN ID.

Student/Clinical Instructor/Staff Nursing Practice
The following information helps us to ensure a quality clinical experience. In addition, it is expected
that all clinical instructors, students, and staff abide by the following during clinical experiences at
MCHS:

1. The student will provide nursing care within the framework of the Minnesota Board of Nursing
guidelines.
2. The student will be held legally to the same level of practice as the licensed nurse and clinical
instructor on the unit.
3. Before the start of the semester or on the first day of clinicals, the clinical instructor will
communicate the following to the Patient Care Manager/precepting nurse:
    • Course clinical objectives and expectations for the student’s role in patient care
    • Criteria for patient selection

4. A student who has not attained competency in a skill or procedure is required to have the instructor
present until the student has demonstrated competency.
5. All plans for patient care will be discussed with the patient’s nurse prior to the delivery of care.
The patient’s nurse always makes the final decision on tasks delegated to the student.
6. The MCHS nursing staff maintains responsibility for patient care. Students should communicate
with the staff nurse as appropriate about their assigned patients throughout the day, before any breaks,
at completion of their shift and whenever the patient’s condition changes. In addition, the staff nurse
is expected to communicate with the student and clinical instructor regarding any changes in orders
and patient status.
7. Students may not sign as a witness on patient consent forms.
8. Students may are not permitted to care for or assist with any patient who is in airborne isolation
precautions.
9. Clinical instructors and students do not make decisions about implementation of patient restraints
or seclusion.


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10. If an error is made in a treatment or administration of medication to the patient, it is the student’s
responsibility to report this immediately to their clinical instructor and the staff nurse assigned to the
patient. Once an error is made your actions should reflect your concern for the patient’s welfare. The
proper reporting of such an incident assures prompt attention to the patient. The concern and honesty
the student exhibits will become part of his or her developing professional role. The student,
instructor, and patient’s nurse must complete a Safety Report. The Safety Report is located on the
MCHS Intranet.
11. The university/college shall provide at least one clinical instructor to coordinate each specific
clinical experience at MCHS facilities. The assigned clinical instructor is responsible for the clinical
education, supervision, and evaluation of students. The staff nurse is not responsible for the
educational guidance of the student; however, they may assist the clinical instructor with teaching
components if previously approved or arranged.
12. When an onsite clinical instructor is absent, the school is to notify the Academic Coordinator of
the assigned unit and provide a qualified replacement. Qualified replacements are those individuals
that meet all the requirements as defined in section d under General Information. Alternatively, the
clinical may be canceled for that day. If so, the clinical instructor must notify the Patient Care
Manager of this cancelation.
13. Clinical instructors and Patient Care Managers are strongly encouraged to meet throughout the
clinical experiences to discuss problems, suggest changes for improvement, etc. regarding a student’s
clinical experience.
14. Before beginning clinicals, clinical instructors are expected to be familiar with the MCHS
electronic medical record downtime policy. You can find this policy in the MCHS Intranet under the
policies tab. Health Unit Coordinators may also assist the clinical instructor with this process.
15. Clinical instructors or preceptors are responsible for orientation of their students to the
unit/department on the first day of their clinicals. In addition, student competency assessment is the
ultimate responsibility of the clinical instructor or precepting staff nurse. Assessment and
reassessment of student competencies occurs on a continuous basis and is inherent in the student
clinical experience.
16. On-site clinical instructors are the primary overseers of a student’s actions and conduct with a
patient unless the student is being precepted by an MCHS staff nurse.
17. Students should consider the on-site clinical instructor as their prime source of information
recognizing that the MCHS staff nurses and hospital staff are available to assist and enhance the
student clinical experience.

Point-of-Care Testing (e.g., blood glucose monitoring)
MCHS Point-of-Care Testing Policy stipulates those conducting point-of-care testing must receive
training specific to the tests they perform and are required to demonstrate competency at least
annually. Consequently, students and clinical instructors are not permitted to conduct point-of-care
testing.

Medication Administration
Students can perform any skill/procedure for which they have received preparation, as designated by their 
clinical instructor or staff nurse preceptor, except for those identified on page two of this document.  For most 
skills, clinical instructors or staff will supervise the student directly or indirectly depending on the student’s 
competency level and instructor or staff discretion.   
 
Oral medications may be administered by students without their clinical instructor or a staff nurse physically 
by their side if the clinical instructor deems the student competent and a review of the “5 Rights of Medication 
Administration” is conducted by the clinical instructor.  Mayo Clinic Health System does not recommend 
allowing students to perform this task until the student has demonstrated competency in this skill.   
 




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The clinical instructor must procure all medications from the PYXIS.  Students are not given a PYXIS access 
code.  The clinical instructor is responsible for reviewing the “5 Rights of Medication Administration” and 
rationale for the medication administration with the student. 
 
All Student Nurses (e.g., Clinical, Synthesis, SNIs) are Not Permitted to Perform the 
Following Tasks under Any Circumstance: 
 
Program a PCA Pump                                        Interpret EKG or Fetal Monitoring tracings 
Administer Chemotherapy via Implanted Venous              Take Verbal or Telephone Orders 
Access Devices                                            Verify Informed Consent 
Discontinue Central Lines                                 Manage Epidural Infusion, Tubing or 
Administer Blood                                          Pump Setting 
Remove Any Type of Wound Drain                            Manage Epidural Infusion, Tubing or 
 (Penrose, JP, Duval, Etc.)                               Pump Setting            
Manage Passey Muri (tracheostomy speaking valve) 
Pediatric Medications except PO medications that are not High Alert (Mankato Only)‡ 
Students Are Not Permitted to Perform the Following Tasks Unless Otherwise Indicated*: 




   * Direct observation by Staff RN or Clinical Instructor at the student’s side. 
‡ High Alert Medications include: Adrenergic agents, anesthetic agents, chemotherapeutic agents, 
concentrated parenteral electrolytes (e.g., TPN), heparin infusions, insulin, liposomal forms of drugs, narcotics 
infusions, neonatal/pediatric medications, neuromuscular blocking agents, sound alike, look alike drugs‡‡ 
‡‡ Please refer to Attachment A of the High Alert Medications Policy for a complete list of sound alike, look 
alike drugs located on the Mayo Clinic Health System Intranet    
 
Pre-Clinical/Post-Clinical Resources
MCHS expects clinical instructors to make patient assignments at least one day before clinicals. This
procedure will allow students ample time to come to clinicals fully prepared to offer the best care for
our patients. Clinical instructors may access Cerner and print a patient list in order to make
assignments. A patient care summary is no longer available to print. Consequently, students are
expected to review patient information before their clinicals at MCHS. Students may take notes
regarding their patient(s) however personal identification information may not be transcribed in order
to ensure patient confidentiality. Students must wear MCHS identification badges at all times while in
the hospital.



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In general, conference space will not be available for pre-clinical or post-clinical meeting space due to
high hospital employee needs. Pre-clinical or post-clinical meetings are not permitted in public areas,
hallways, etc. of the hospital in order to ensure patient confidentiality.

MCHS expects students to know and be capable of the following before beginning a clinical
assignment for each shift:
          1. Primary and secondary diagnoses
          2. Medications and reasons why these medications have been prescribed
          3. Lab values, procedures, and doctor/nurse notes
          4. Developed a plan a care for their entire time with the patient

Student/Clinical Instructor Dismissal and Conflict Resolution
If there is a concern or conflict on the unit, every effort should be made to resolve it by the Patient
Care Manager, clinical instructor and precepting staff nurse as appropriate. If the problem can not be
resolved, it is to be directed to the Academic Coordinator and/or to the Director of Nursing Clinical
Practice and Education.

       a. When a student or clinical instructor with performance problems is unable or unwilling to
       improve, as evidenced by failure to complete designated improvement activities, they shall be
       prohibited from participating in the MCHS clinical experiences. MCHS personnel may require
       that the student or onsite clinical instructor leave the room/unit pending a final determination
       of the outcome of an identified performance problem.
       b. Students and clinical instructors may also be prohibited from participating in the MCHS
       clinical experience in cases where the student’s or clinical instructor’s personal characteristics
       prevent desirable relationships with MCHS or where the student’s or clinical instructor’s health
       status is a detriment to the student’s or clinical instructor’s successful completion of the
       clinical experience or to other persons at MCHS.
       c. Students or clinical instructors who were prior employees of MCHS and whose employment
       was terminated due to unsatisfactory job performance, are prohibited from participating in
       clinical experiences at MCHS.
       d. The school shall process any complaints by MCHS against any student or clinical instructor
       in accordance with its academic policies.

Synthesis/Preceptor Clinical Experiences
Students coming to MCHS for a synthesis experience are required to complete the online Student
Orientation and EMR module and all associated paperwork. Students must go through orientation
annually as it is updated on June 1 of each year. In addition, the clinical instructor must submit a
Computer/Badge Access Form. The student should pick up her/his badge from the Security
Department one day prior to his or her first shift. The student is responsible for turning in their badge
to Security at the end of their last shift. Please review the Badges section of this manual for more
information. Student Nurse Preceptor Resource Documents are available on the MCHS Intranet and is
included as an appendix to this manual.

MCHS strongly encourages students to contact their preceptor prior to beginning to discuss their
clinical experience. It is expected that the student work in accordance with the preceptor’s schedule.
In addition, the student should arrive the first day with the following information:
            1. Clinical objectives
            2. Emergency contact information and their clinical instructor’s contact information
            3. Evaluation form(s) as required by their school

Assessment of MCHS Clinical Experiences

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Clinical instructors are encouraged to electronically distribute the MCHS Nursing Student Clinical
Assessment on the last day of clinicals to all students. The link to the survey will be emailed to all
clinical instructors. These surveys are anonymous and essential to improve student clinical
experiences. We appreciate your support of our efforts to continuously enhance the student clinical
process and experience.


Fairmont Resources
   1. The Harvest Cafe is available for use by clinical instructors and students. Pre-clinical and
      post-clinical meetings may not occur in these areas. The Harvest café is located on the 1st floor
      of the hospital. Hot meals are available between 7 a.m.-6:30 0p.m., Monday-Sunday. Vending
      machines are available 24 hours a day on the first floor by the Harvest Café.

   2. The Computer Training Room located on the first floor of the hospital is available for
      reservation. Please contact Marlys Brummond at 507

Troubleshooting
Pyxis Access-Please dial 507-385-8140
EMR-Please dial extension 507-385-7533
CareMobile-Please dial extension 507-385-7533

Contact Information
Security (7p.m.-7a.m.) dial 507-385-8185 (office) or 507-236-9829 (cell)

Help Desk dial 507-385-7533

Marlys Brummond, Staffing Supervisor
507-385-8140 (office), 507-236-2758 (cell)
Brummond.marlys@mayo.edu
Pat Schmidtke, PCU Manager
507-385-5141 (office), 507-236-4874 (cell)
Ryan Schmidtke, Surgical Services Manager
507-385-8167 (office), 507-236-4141 (cell)
Phyllis Hartwig, OB Supervisor
507-385-5174 (office), 712-330-2328 (cell)

Mankato Resources
  1. The library and cafeteria are available for use by clinical instructors and students. Pre-clinical
     and post-clinical meetings may not occur in these areas. The cafeteria is located on the 2nd
     floor of the hospital. Hot meals are available between 6:30 a.m. - 7:00 p.m., Monday-Friday
     and 6:30 a.m. – 6:30 p.m. Saturdays and Sundays. Vending machines are available 24 hours a
     day on the first floor.

   2. Lockers are available for clinical instructors and students. The lockers are located on the
      ground floor of the hospital. The men’s locker room is room 0106 (Six little metal lockers)
      and the Women’s is room 0108 (metal locker numbers 14-24 are available). Students must
      bring their own padlock each day and take items with them at the end of each shift. No
      overnights, please. Feel free to use these lockers throughout your clinical time at MCHS. The
      lockers are available on a first come, first serve basis.


                                                                                                         13
3. The clinical instructor will post patient/student assignments using the Student Assignment
   Form. This form is at www.mayoclinichealthsystem.org (click on nursing tab). If possible,
   please try to print on yellow/gold paper so that it stands out from all other documents. The
   Student Assignment Form must be posted in the following locations:

           2MS-Center kitchen by back window
           3MS-Lounge
           4MS-Dr.’s Dictation Room # 4608
           OB/FBC-Center desk on bulletin board by nursery window
           PEDS-Next to Pyxis machine on bulletin board (5600 wing)

4. Nurse Clinical Preparation Room #2014

Location
The Student Nurse Clinical Preparation room is located on the 2nd floor of Immanuel-St. Joseph’s-
Mayo Health System (ISJ) hospital room number 2014 (near Le Café).

Access
To access the Student Nurse Clinical Preparation Room you must be participating in clinicals at
ISJ. You may use your academic institution’s access code to gain access to the room. Security
staff members will not open the door for you if you do not have your badge. Access to the Student
Nurse Clinical Preparation room will cease on the last day of your scheduled clinical.

Access Codes
Each academic institution affiliated with ISJ will receive a unique access code. This code will
expire at the end of each semester. Students will receive the access code at the beginning of their
clinicals. Academic institutions will receive their code from the Academic Coordinator at the
beginning of each semester. Students may not call the Academic Coordinator or the Security
Department for their access code as there is no way to verify the student’s standing at each
academic institution. Students are instructed to never share their access code for any reason.

After-Hours Access
After 8 p.m. the main entrance to the hospital (entrance 3) is closed. Students will need to enter
the hospital at the Emergency Department Entrance (entrance 1). Upon entrance to the Emergency
Department (entrance 1), students will need to present their badge and know their academic
institution access code to the security attendant.

Utilization Process
The purpose of the Student Clinical Preparation room is to provide students with 24/7 access to the
ISJ-Mayo Health System electronic medical record to allow for adequate preparation time before
the clinical experience. The room may not be used for pre/post clinical conferences. In addition, a
printer is not available and hard copies of any patient information must never leave the hospital.
Utilization rates will be reviewed at the end of each semester.

The room contains 8 computer workstations and a CareMobile station. Practice patients and
learning modules will be available. It is available on a first come, first serve basis. Please be
considerate to others that may be waiting for a computer and limit your session to 15 minutes.
Also, please give priority to those students needing review patient records the soonest. There is no
overnight storage and all items left in the room will be placed in the lost and found.
Please do not use the room to surf the web or check your email.



                                                                                                  14
Troubleshooting
Pyxis Access-Please dial 507-385-2760
EMR-Please dial extension 4357 or HELP
CareMobile-Please dial extension 4357 or HELP

Contact Information
Security/Badges/Escort Services-507-385-4801
Security is located next to the Emergency Department registration desk on the first floor of the
hospital.
Academic Coordinator
Cherie Pettitt
507-385-4670 (office), 507-380-3925 (cell)
Room #2010
pettitt.cherie@mayo.edu
Director, Nursing Clinical Practice, Education and Quality
Karen Ryan
507-385-4630 (office), 507-381-6080 (cell)
ryan.karen3@mayo.edu
Student Nurse Internship Program Coordinator/ Learning & Development Specialist
Sabrina Ehmke
507-385-5927 (office), 507-382-7927 (cell)
Room#1007
ehmke.sabrina@mayo.edu
Hospital Switchboard-507-625-4043
Director, Patient Care Services, Waseca Medical Center
Open
Director, Patient Care Services, St. James Medical Center
Jenny Kettner
St. James Medical Center
507-723-7706 (office)
kettner.jenny@mayo.edu
Director, Patient Care Services, Springfield Medical Center
Danielle Thate
Springfield Medical Center
507-385-8687 (office)
thate.danielle@mayo.edu
Patient Care Managers                 Office                Cell
2MS          Dennis Eggersdorfer      507-385-4824          507- 779-5378
3MS          Jennifer Guild           507-385-6387          507-381-4466
4MS          Kristin Thooft           507-385-4616          507-469-8207
OB/PEDS      Jennifer Vanberkum       507-385-2667          507-382-2619
ED           Kristi Ball              507-385-6493          507-779-6417
ICU          Linda Prahl              507-385-5726          507-995-9118
BH           Kristin Thooft           507-385-5983          507-380-7480
SDC          Darin Prescott           507-385-2927          507-430-0632
OR           Ann West                 507-385-7006          507-327-9582
                                                                                                   15
APPENDICES




             16
Mayo Clinic Health System (MCHS) Student Clinical Checklist
Orientations and forms can be viewed and downloaded at
www.mayoclinchealthsystem.org (click on Nursing tab).

 Completed MCHS Nursing Student Orientation (Mankato or Fairmont)

 Completed Nursing Student EMR (electronic medical record) Training

 Downloaded, signed, and submitted the following forms to your clinical instructor:

        Electronic Authentication Security Agreement
        Workforce Member Confidentiality Agreement

 Received LANID (computer access code) from clinical instructor
       Note: You will receive your LANID only if you have successfully completed orientation and signed
       all forms stated above

 Received name badge from clinical instructor
       Note: The ISJ-MHS badge must be turned into your instructor at the end of your shift on the last
       day of your clinical experience
Mayo Clinic Health System (MCHS) Clinical Instructor Checklist

All forms can be downloaded at www.mayoclinichealthsystem.org (click on nursing tab)
and must be submitted to Cherie Pettitt, Academic Coordinator at
pettitt.cherie@mayo.edu

        Review MCHS Student Nurse Clinical Resource Manual

        Attend ISJ Clinical Instructor Orientation in August or January

        Submit Detailed Clinical Request Form one month prior to clinical start date

        Collect the two required MCHS forms from students and file. Please do not
        turn these forms into MCHS.
              Note: To ensure students understanding of MCHS orientation materials it is
              recommended that students pass the post-test by at least 80%.

        Submit Computer/Badge Access Form at least three weeks prior to
        clinical start date

               If applicable, submit the MCHS Alternative Experience Request form at
              least three weeks prior to clinical start date (Mankato only)

               If applicable, submit the MCHS Syntheses/Preceptor Request From at
              least one month prior to clinical start date (Mankato only)

        Request Pyxis access code by emailing Denise Klatt at Klatt.Denise@mayo.edu
       for Mankato and Marlys Brummond at Brummond.marlys@mayo.edu for Fairmont.
       Please provide your job title, first and last name, middle initial and LAN ID

        Download and print copies of the MCHS Student Assignment Form (Mankato
        only)
              Note: This form must be posted in the designated areas assigned to each department/unit
              as stated in the MCHS Student Nurse Clinical Resource Manual. It is strongly
              recommended this form is printed on yellow/gold paper.

        Meet with Patient Care Manager before clinicals

        Coordinate picking up MCHS badges with Security Department
              Note: The badges will be available the day before your clinical start date

        Collect badges from students and return to Security Department

        Send MCHS survey link to students
              Note: The link to this survey will be emailed to you.




                                                                                                  18
                                                             Mayo Clinic Health System in Mankato
                                                              STUDENT ASSIGNMENT FORM
Nursing Program:
____MINC (Gustavus & St. Olaf)                                     Level of Students:_____________________
____Minnesota State University, Mankato                            Hours:_____________________________
____Presentation College                                           Instructor:__________________________
____Rasmussen College
____Ridgewater College                                             Phone Number:_____________________
____South Central College                                          Pager Number:______________________
____ Other__________________________
                                                               Date:______________________________
           Student’s Name                        Patient Name & Room No.              Student Skills                 Medications RN/Instructor




Cherie Pettitt, Academic Coordinator, office: 507-385-4670 or cell: 507-779-4069
Form Placement Locations: 2MS-Center kitchen near back window                           OB/FBC-Center desk on bulletin board by nursery window
                          3MS-Lounge                                                    PEDS-Next to Pyxis machine on bulletin board (5600 wing)
                          4MS-Dr.’s Dictation Room # 4608
                               2011-2012 Mayo Clinic Health System in FAIRMONT Computer-Badge Access Form
                  **Do not resend this form when you need to add a new student/instructor to your roster. Please submit a new form.**
School _____________________________________ Instructor ______________________________
Rotation Begins ____/_____/_____      Ends_____/_______/______ (Access to the EMR will end at 23:59 on this day. No exceptions.)
Location of clinical_______________________________________________(if rotating to different units please indicate start and end dates for
each unit)
# of Badges Needed_________________
Days on unit and hours scheduled _____________________________________________________
Level of student (semester/year) __________

                                                                                          Completed                                   Current
                                Other Names                                Instructor                     Date to
 Full Legal Name      Middle                                 Unit/                       Orientation?                  At MCHS as   Employee/F
                                (e.g., maiden    DOB                           or                        Complete                                 LAN ID
   (Last, First)      Initial                              Department                   (Required each                  a student      ormer
                                    name)                                   Student                        Cerner
                                                                                        academic year)                   before?    Employee of
                                                                                                         Orientation
                                                                                                                                     MCHS?

    Jones, Ann,         D.                       9/9/90       3MS           Student       YES/NO          08/25/09      YES/NO         CE/FE




Email a completed electronic (please do not scan) copy of this roster 3 weeks prior to starting clinical to: Cherie Pettitt: pettitt.cherie@mayo.edu, Cindy Slama:
slama.cynthia@mayo.edu,, Karen Neumann: Neumann.karen@mayo.edu, Marlys Brummond: Brummond.marlys@mayo.edu. The submission and electronic
signature of this form verifies that all the students listed have: (1) completed the MCHS Orientation/EMR orientations including signing the following forms:
Electronic Authentication Agreement, Workforce Member Confidentiality Agreement, (2) completed background checks without disqualification (3) met health
requirements (4) read and understood MCHS Student Nurse Clinical Resource Manual. The school will maintain records of the above documentation for three
years and will be able to provide MCHS a copy if requested within 2 business days.
Instructor/Administrator’s Electronic Signature___________________________________________________                             Date_____________________


                                                                                                                                                                20
Home Phone _____________________ School Phone ____________________ Cell Phone________________ Email address
_____________________

**Please Save this File using the following format**: MCHS Computer-Badge Access Form School Name Current Semester Current Year
Instructor’s Last Name
E.g. MCHS Computer Badge Access Form UND Fall 2011 Pettitt



Clinical Instructor Contact Information
****Please copy and paste this section for EACH clinical instructor if you have more than one/multiple locations****
This information is given to unit/department managers to facilitate communication regarding student clinicals.

Instructor’s Name:

Cell Phone:                                         Alt Phone:

Email address:

Course Number and Name:

Rotation Begins ____/_____/_____       Ends_____/_______/______

Location of clinical:

Days of the week on unit:

Hours on unit:




                                                                                                                                  21
                                2011-2012 Mayo Clinic Health System in MANKATO Computer-Badge Access Form
                   **Do not resend this form when you need to add a new student/instructor to your roster. Please submit a new form.**
School _____________________________________ Instructor ______________________________
Rotation Begins ____/_____/_____      Ends_____/_______/______ (Access to the EMR will end at 23:59 on this day. No exceptions.)
Location of clinical_______________________________________________(if rotating to different units please indicate start and end dates for each
unit)
# of Badges Needed_________________
Days on unit and hours scheduled _____________________________________________________
Level of student (semester/year) __________

                                                                                       Completed                                   Current
                               Other Names                              Instructor                     Date to
 Full Legal Name     Middle                                Unit/                      Orientation?                  At MCHS as   Employee/F
                               (e.g., maiden   DOB                          or                        Complete                                 LAN ID
   (Last, First)     Initial                             Department                  (Required each                  a student      ormer
                                   name)                                 Student                        Cerner
                                                                                     academic year)                   before?    Employee of
                                                                                                      Orientation
                                                                                                                                  MCHS?

    Jones, Ann,        D.                      9/9/90       3MS          Student       YES/NO          08/25/09      YES/NO        CE/FE




Email a completed electronic (please do not scan) copy of this roster 3 weeks prior to starting clinical to: Cherie Pettitt: pettitt.cherie@mayo.edu, Cindy Slama:
slama.cynthia@mayo.edu, and Karen Neumann: Neumann.karen@mayo.edu. The submission and electronic signature of this form verifies that all the students listed
have: (1) completed the MCHS Orientation/EMR orientations including signing the following forms: Electronic Authentication Agreement, Workforce Member
Confidentiality Agreement, (2) completed background checks without disqualification (3) met health requirements (4) read and understood MCHS Student Nurse
Clinical Resource Manual. The school will maintain records of the above documentation for three years and will be able to provide MCHS a copy if requested within
2 business days.
Instructor/Administrator’s Electronic Signature___________________________________________________                             Date_____________________
Home Phone _____________________ School Phone ____________________ Cell Phone________________ Email address
_____________________
**Please Save this File using the following format**: MCHS Computer-Badge Access Form School Name Current Semester Current Year Instructor’s
Last Name
E.g. MCHS Computer Badge Access Form UND Fall 2011 Pettitt



Clinical Instructor Contact Information
****Please copy and paste this section for EACH clinical instructor if you have more than one/multiple locations****
This information is given to unit/department managers to facilitate communication regarding student clinicals.

Instructor’s Name:

Cell Phone:                                         Alt Phone:

Email address:

Course Number and Name:

Rotation Begins ____/_____/_____       Ends_____/_______/______

Location of clinical:

Days of the week on unit:

Hours on unit:




                                                                                                                                               23
Mayo Clinic Health System Nursing Student Orientation and EMR Post-test

1) Mayo Clinic Health System’s primary value is:
   a) All waste is discarded in appropriate receptacles
   b) Each report is completed in black ink
   c) The needs of the patient come first
   d) Cases should not be discussed in public

2) Which aspect of your communication translates the most to patients?
   a) Your words (i.e., what you say)
   b) Your style
   c) How you dress
   d) Your body language

3) What is the primary reason for keeping a patient’s information confidential?
   a) It’s against the law to disclose patient information
   b) It’s against the law to disclose patient information
   c) It’s against the law to disclose patient information
   d) All of the above

4) Tablets or capsules dropped on the floor:
   a) Can be washed and reused
   b) Should be disposed of in the nearest trash receptacle
   c) Should be given to your clinical instructor for disposal
   d) Is considered hazardous waste and must be disposed of in a pharmaceutical waste bin

5) Which of the following statements accurately characterizes Mayo Clinic Health System’s policy on hand washing?
   a) Must be washed daily
   b) Must be washed after using the rest room
   c) Must be washed after meals
   d) Must be washed before and after coming in contact with every patient

6) SBAR was created to remind staff:
   a) How to eliminate errors occurring during patient handoffs
   b) About handling blood borne pathogens
   c) The procedures for reacting to a Code Grey or Code Pink
   d) Patient priority during triage

7) A student is permitted to administer medications to a patient if:
   a) Given permission by a physician
   b) They are under the direct guidance of their clinical instructor
   c) Approved by the Health Unit Coordinator
   d) The student has received previous formal classroom education on the drug

8) Mayo Clinic Health System’s expects every nursing student to prepare for their clinicals by:
   a) Developing a plan of care
   b) Researching all medications
   c) Following HIPAA regulations when discussing patients
   d) All of the above

9) Mayo Clinic Health System’s policies, procedures, and nursing practice guidelines can be found:
   a) In the nursing guidelines manual located on each floor
   b) MCHS Internet
   c) MCHS Intranet
   d) In all nursing break rooms

11) How do you select the right encounter for a patient?
    a) Double click on the patient
    b) Double click on the encounter.
    c) Both A and B
    d) Correct encounter will automatically be pulled when opening a patient chart

12) Which is not one of the following is not one of the areas that student and clinical instructors may chart in:
    a) Ongoing Adult Assessment
    b) Vital Signs
    c) Notes
    d) Focused Assessment-Neurological

13) Where will nursing students and clinical instructors perform their charting?
    a) Off of the Task List
    b) Out of the AdHoc function
    c) Both A and B
    d) None of the above. Nursing students and clinical instructors do not chart on a patient in their clinical experience.




                                                                                                                        25
                                                     Mayo Foundation


                              Electronic Authentication Security Agreement Statement

University/College Students (“Students”) and University/College Faculty (“Faculty”) with authorized access to
electronic clinical applications who need to authenticate documents electronically will be issued a User ID and will
select a password that uniquely identifies them after competency has been demonstrated. This protects the database
and maintains the privacy of patient information. The selected password should be kept confidential and should not be
compromised for any reason.

Students and Faculty are accountable for any transactions associated with their password and User ID.

If at any time a Student or Faculty have reason to believe that the confidentiality of his/her password or confidential
information has been compromised, Clinical Facility’s Data Security Officer should be notified immediately so that
appropriate action can be taken.

I, therefore, understand and agree:

1.      My User ID/password is the equivalent of a legal signature.
2.      In order to protect the security and integrity of Clinical Facility’s electronic data, I agree to approved Data
        Security Policies and Standards.
3.      I will not attempt to access information by using a User ID/password other than my own.
4.      I understand that failure to do any of the above may constitute a violation of the Data Security Policies and
        Standards and may result in disciplinary action by Clinical Facility as well as external regulatory bodies.


Student Name:


Student Signature:

Date:

OR

Faculty Name:


Faculty Signature:

Date:




                                                                                                                          26
                                                 CONFIDENTIALITY


TO:            University-College Students and Faculty

FROM:          Mayo Foundation Board of Governors

SUBJECT:       Confidential Information

The Board of Governors calls your attention to Mayo Foundation’s Confidential Policy. In connection with the
activities under the Master Clinical Education Agreement between Mayo Foundation and Rochester Community and
Technical College all Students and Faculty Participants have an obligation to conduct themselves in accordance with
the policy and hold in confidence all information concerning patients, employees and business information.
Confidential information includes all material, both paper-based and electronic, related to the operation of Mayo
Foundation including, but not limited to:
         • financial information
         • patient names and other identifying information
         • patient personal and medical information
         • patient billing information
         • employee names including salaries and employment information
         • proprietary products and product development
         • marketing and general business strategies
         • any discoveries, inventions, ideas, methods, or programs that have not been publicly disclosed
         • any information marked “confidential”
Only physicians, or other authorized individuals, may access, use or release patient personal and/or medical
information. Such matters are confidential between the health care provider and the patient.

Students and Faculty must also refrain from revealing any confidential information concerning employee records or
business operations. Any carelessness or thoughtlessness in this respect, leading to the release of such information, is
not only wrong ethically but may involve the individual and Clinical Facility legally.

I heard or read the above statement, understand the contents and agree, unless authorized, not to access, use or release
confidential information regarding patients, employees and business operations. I also understand that my unauthorized
access, use or release of any and all confidential information at Clinical Facility may be cause for my immediate
termination from the clinical experience. In addition, I understand that I may be personally liable for any
disclosure, misappropriation or use of confidential information.

SIGNATURE:_______________________________________DATE:_____________
PRINT NAME:________________________________________




                                                                                                                           27
                                             Mayo Clinic Health System
                                            Detailed Clinical Request Form

School:

Course Number and Name:

Student Type: ___LPN ___ADN ___BSN ___Other (specify):_________________________

Level of course in program (i.e. first semester):

Length of Experience: Start Date: _________         End Date: _________

Day            Shift Requested
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Type of Experience: ___Hands on care ___Observational Experience

Number of Students: _________

Faculty/Instructor Name:
Phone:                                Alt Phone:
Email:

Back-up Contact Information (will be used only when the clinical instructor can not be reached-prefer Chair of the
Department)
Name:
Title:
Phone:                      Alt Phone:
Email:



Will there be an instructor present with the student during the days and times of clinical experience? ___Yes ___No




Course Name:
Course Clinical Objectives:




                                                                                                                     28
Expected type of patient care/interventions students will provide:




Clinical skills students are competent to perform (interventions validated in skills lab):




Are alternative experiences during this clinical experience desired? ___Yes ___No
Note: A separate alternative experience request form will be required.




If alternative experiences are desired, please describe type and rationale for these experiences.




                                                                                                    29
                      Mayo Clinic Health System in Mankato

                                 Security Department’s
                             Badge Processes for Instructors

•   Instructors are responsible for distributing badges, reporting lost badges to Security immediately and collecting
    badges at the end of the term and returning them to Security. Any badges kept will no longer work.

•   All Student information needs to be submitted to Security 2 weeks prior to the beginning of the term to ensure
    that the badges will be ready on time. Any request within the 2 weeks prior to the term start date is subject to
    not being ready in time for the start of the term.

•   Any Security officer has the ability to deny or reschedule any badge requests based on security call level or if
    the badge information is incorrect or late.

•   All Student Badges have an expiration date set on them. This is the scheduled end date of the clinical. If you
    need access past this date, a new Computer-Badge Access Form must be filled out.

•   Instructors will be emailed once their badge request is complete. At that point, instructors came come to the
    security office during the posted badge hours and pick up their badges. Please call Security just prior to picking
    up your badges to ensure that an officer is available.


                               Available badge pick times are as follows:
                                           Monday-Friday
                                          11:00am - 12:00pm
                                           2:45pm - 3:45pm
                                 10:45pm - 11:45pm (at Security Desk)
                                       Saturday and Sunday
                                           8:00am – 9:00am
                                 10:00pm – 11:00pm (at Security Desk)


                                      Security Cell Phone Number
                                             507-385-4801




                                                                                                                       30
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