Montgomery College Associate Degree Nursing Student · Montgomery College Nursing Program To Provide: ... • Development across the Life Span The developmental process is a continuous,

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Montgomery College

Associate Degree

Nursing Student

Handbook

2006-2007

PREFACE

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This student handbook contains both general policies for all nursing students in NHMCCD, which

includes both the ADN integrated and block programs, as well as specific policies for the

Vocational Nursing programs. Please note any specifics for your nursing program.

ADA STATEMENT

It is the policy of NHMCCD College to comply with requirements of

the Americans with Disabilities Act (ADA) unless such action shall

pose an undue burden or would result in a fundamental alteration of

programs of the district.

Individuals requesting assistance under the letter or spirit of ADA should

contact Angela Martin at 936-273-7239 or [email protected].

ACADEMIC ACCOUNTABILITY

Although participation and sharing of experience is an integral part of the

Nursing Program, responsibility for learning must be assumed by the

individual student.

Certain learning experiences are designated under the Academic Integrity

guidelines. Under these guidelines, the student will neither solicit, accept,

nor give help on exams. At all times the student will honor his/her

responsibility not to take credit for work that is not his/her own. See

Statement of Academic Integrity in this Handbook.

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TABLE OF CONTENTS

ASSOCIATE DEGREE NURSING PROGRAM MISSION AND PHILOSOPHY ................... 6

CONCEPTUAL FRAMEWORK ..................................................................................................... 8

PROGRAM OUTCOMES .............................................................................................................. 20

ENTRY LEVEL COMPETENCIES ...................................................................... 21

LEVEL ONE COMPETENCIES ........................................................................... 22

VOCATIONAL NURSING EXIT OUTCOMES (MEEP) ................................... 23

ADN PROGRAMS: LEVEL 2 COMPETENCIES ............................................... 24

COMPETENCIES OF NEW GRADUATES ......................................................... 27

STUDENT ACCOUNTABILITY FOR MEETING REQUIREMENTS OF DEGREE PLAN ...... 31

BOARD OF NURSE EXAMINERS DECLARATORY ORDERS ............................................. 31

BOARD OF NURSE EXAMINERS REQUIREMENT FOR LVN LICENSURE .................... 32

DEPARTMENTAL POLICIES ..................................................................................................... 33

ATTENDANCE ........................................................................................................ 33

APPEALS .................................................................................................................. 33

CLINICAL ASSIGNMENTS .................................................................................. 33

CONFIDENTIALITY STATEMENT .................................................................... 33

CODE OF CONDUCT ............................................................................................. 34

CRIMINAL BACKGROUND CHECKS ............................................................... 36

PROFESSIONAL LIABILITY INSURANCE ...................................................... 36

PROGRESSION REQUIREMENTS ..................................................................... 36

READMISSION........................................................................................................ 37

REFUSAL TO PROVIDE CARE ........................................................................... 37

STUDENT REPRESENTATIVES ......................................................................... 37

TRANSFER OF NURSING CREDITS .................................................................. 37

GRADING AND EVALUATION ........................................................................... 37

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EXAMINATION REVIEW ..................................................................................... 38

ACADEMIC SUPPORT, STUDENT SERVICES ................................................ 38

NHMCCD TRANSFER OF NURSING STUDENTS ........................................... 38

CHILDREN IN THE CLASSROOM ..................................................................... 38

STUDENT HEALTH POLICIES & PROCEDURES ................................................................. 39

STUDENT ADMISSION WITH HIV & OTHER INFECTIOUS DISEASES .. 39

STUDENT IMMUNIZATIONS .............................................................................. 39

TUBERCULOSIS POLICIES AND PROCEDURES........................................... 40

PREVENTION OF EXPOSURE TO BLOOD OR BODY FLUIDS ................... 42

STUDENTS WITH TEMPORARY DISABILITY ............................................... 43

IMPAIRED STUDENTS IN CLINICAL PRACTICE ......................................... 44

DRUG AND ALCOHOL ABUSE ........................................................................... 44

COMPLIANCE WITH AMERICANS WITH DISABILITIES ACT ....................................... 46

STATEMENT OF ACADEMIC INTEGRITY ............................................................................. 46

STUDENT POLICIES FOR CLINICAL AREA .......................................................................... 48

CLINICAL MEDICATION POLICY .................................................................... 48

CLINICAL DRESS GUIDELINES ........................................................................ 50

GUIDELINES FOR THE EMPLOYMENT OF NURSING STUDENTS ................................. 51

GLOSSARY OF TERMS IN THE CURRICULUM .................................................................... 52

APPENDIX A NURSING HONORS CONTRACT ..................................................................... 58

APPENDIX B COMPLIANCE WITH AMERICANS WITH DISABILITIES ACT .............. 60

APPEALS PROCEDURE ........................................................................................ 62

APPEALS PROCEDURE FLOWCHART ............................................................ 63

CONFIDENTIALITY STATEMENTS AND SIGNATURE FORMS ................ 64

CHEMICAL DEPENDENCY POLICY FOR CAUSE ........................................ 66

HESI EXIT EXAM OPTIONS ................................................................................ 69

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APPENDIX C STUDENT ACKNOWLEDGEMENT SIGNATURE FORMS ......................... 70

DRUG & ALCOHOL ABUSE POLICY / SIGNATURE FORM ........................ 71

DOCUMENTATION OF IMMUNIZATION FORM .......................................... 72

STATEMENT OF ACADEMIC INTEGRITY ..................................................... 73

STUDENT EMERGENCY PROCEDURE INFORMATION ............................. 74

STUDENT RELEASE OF LIABILITY ................................................................. 75

APPENDIX D ................................................................................................................................... 76

DIFFERENTIATED ENTRY LEVEL COMPETENCIES (DELC) - WWW.BNE.STATE.US.TX

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Mission Statement Montgomery College Nursing Program

To Provide:

•••• The communities of northern Harris and Montgomery counties in the state of Texas with quality nursing

education through partnerships with healthcare affiliates.

•••• An innovative, flexible, multi-entry-exit nursing education program to fulfill the changing needs of the

local community which we serve and strive for continuous improvement of the program.

•••• Culturally and ethnically diverse nursing graduates, who possess the technical and critical thinking skills

necessary to adapt to an ever-changing nursing profession through lifelong learning.

•••• Nurses who are committed to developing a caring, holistic environment, treating clients with respect and

dignity, and who are committed to serve their communities through volunteerism, mentorship, and

stewardship by providing healthcare information and treatment.

•••• A work environment that values faculty and staff, fosters team-work, collaboration, innovative problem-

solving, respect for peers and students, and provides excellent role models for the nursing profession.

Philosophy

Montgomery College Nursing Program

The nursing faculty supports a curriculum that develops student learning holistically across the life span through

progressive and integration of learning. The faculty believes that this dynamic approach reduces the

“compartmentalization” of knowledge and facilitates student retention of nursing knowledge into long-term-

memory and the development of critical thinking skills. The nursing faculty values the student-teacher

relationship in which the teacher uses self as an expert to teach novice student learners about human beings, the

environment, health, nursing and the teaching and / or learning process.

• Human Beings - “Human beings” (refer to and include) individuals, families, and communities. Growth

and development, culture, family dynamics, and community influence human beings. Each individual

possesses the potential for learning and developing over the life span. They have inherent worth and

dignity as well as being unique. They also have the right to optimal health.

• Environment - The sum of internal and external environmental factors affects health along the wellness-

illness continuum, utilizing the concepts of primary, secondary, and tertiary care. Environment is

inclusive of technological advances utilized in the delivery of healthcare needs.

• Health - Health is perceived as a continuum of wellness-illness across the life span. It is manifested by

continuous interaction and adaptation within internal and external environments.

• Nursing - Nursing synthesizes knowledge and skills gained from previous courses in the arts, sciences,

and nursing to create a theoretical base for the provision of individualized, holistic care for individuals,

families, and communities. Emphasis is placed on health promotion, prevention of illness, restoration,

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and maintenance of optimal functioning. Nursing is a unique profession that blends scientific knowledge

and caring.

• Teaching-Learning - Learning is a lifelong, dynamic process of personal and professional growth.

Teachers and learners take active roles to collaborate in the process that prepare the students for the

practice of nursing. Nurse educators must be proactive and visionary in providing educational

experiences and opportunities that will assist students by stimulating intellectual curiosity, social

responsibility, and skills and knowledge to support a productive life.

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Conceptual Framework

The conceptual framework utilizes two central themes as the basis for developing the nursing educational

program: (1) healthcare consumer, and (2) the practice of nursing. In addition, there are several concepts which

are unifying threads throughout the curriculum.

Healthcare Consumer

• Basic Needs

An individual's behavior is a result of striving toward meeting needs, beginning with those essential to life

and progressing toward creative self-realization. Needs are communicated through a wide variety of

behaviors. Nursing needs to be knowledgeable about various behavior patterns in society to develop an

understanding of individuals and assist them in maintaining health and coping with illness and other crises.

• Development across the Life Span

The developmental process is a continuous, lifelong progression through definable stages that begin with

conception and end with death. Human development is the outcome of the individual's response to a variety

of intrinsic and extrinsic forces: biological, psychological, social and environmental. Nursing practice as it

relates to the developmental process focuses upon an identification of the stages of the human life cycle to

promote the factors that permit attainment of the individual's optimal potential.

• Social Organization

The individual, the family, and the community are interacting with components of the social structure.

Nursing practice utilizes a broad biological and behavioral science background, as well as an awareness of

diverse cultural influences, as a prerequisite for the nursing focus on the individual, the family, and the

community.

• Health

As the individual interacts and responds to the internal and external environment, varying degrees of health

are experienced. The wellness continuum is a symbolic representation of the varying degrees of health

experienced by the individual, the family and the community through time and space. The changing status of

health, on a continuum, is influenced by both the maintenance and promotion of wellness and the alleviation

of illness. The nurse relates the totality of a person's life to those factors affecting health maintenance. A

broad range of biological, psychological and social factors are considered in helping a person formulate

programs for health maintenance.

Practice of Nursing

Nursing Role Development

A role can be defined as a cluster of those functions a person performs when occupying a specific position within

a particular social context. In response to a dynamic society, nursing is continually redefining nursing roles to

provide more individual and comprehensive healthcare. Nursing roles identified by the National League for

Nursing are Provider of Care, Coordinator of Care, and Member of the Profession. Standards of care for each

level of nursing as well as competency statements guide the nurse in fulfilling the roles of Provider of Care,

Coordinator of Care, and Member of the Profession.

The graduate nurse demonstrates competencies in these roles, depending on the educational level completed, for

example:

• The Certified Nursing Assistant practices in structured settings and provides basic nursing care under the

direct supervision of a licensed nurse.

• The Licensed Vocational Nurse is an accountable member of the healthcare team and collaborates in

providing basic preventative, therapeutic, and rehabilitative measures for clients of all ages and cultural

backgrounds in a variety of structured settings.

• The Associate Degree Nurse is an accountable member of the healthcare team, providing preventative,

therapeutic, and rehabilitative measures for clients and families of all ages and cultural backgrounds,

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coordinating care for a group of clients and families through use of the problem solving process, and

supervising other healthcare providers in a variety of community based settings.

• The Baccalaureate of Science Nurse is an accountable member of the healthcare team, developing and

applying nursing research and theory, implementing comprehensive nursing care for a variety of clients

in various settings, coordinating care for individuals, families, aggregates and communities, and

supervising other healthcare workers.

Provider of Care

• Nurses of all educational backgrounds provide preventative, therapeutic, and rehabilitative measures for

clients in a variety of settings.

• Nurses use critical thinking to make appropriate nursing decisions, based on a specific knowledge base,

experience, competencies, attitudes, and standards. Nurses incorporate knowledge from nursing

literature and advancing technology to provide relevant and safe nursing care.

• The nursing process is an organized, systematic method to assess health needs, plan, administer, and

evaluate care given to individuals or groups in various settings.

• Nursing requires effective use of communication skills to function in interviewing, teaching/learning, and

counseling situations.

• Communication of empathy, respect and care facilitate effective delivery of nursing care.

Coordinator of Care

• Nurses organize and facilitate the delivery of comprehensive services to clients.

• Collaboration with the client, significant others, and members of the multidisciplinary healthcare team is

essential to nursing care.

• Nursing services are provided in a variety of healthcare settings. Because disease is only one aspect of

the wellness continuum, problems of health promotion, maintenance, and restoration are encountered in

many different settings (home, community, school, work, recreation, and institutions). The nursing

education program is designed to provide exposure to a variety of disciplines and clinical experiences in

diversified settings to enhance the learner's understanding of man and his environment.

Member of the Profession

• As increasing scientific and technological progress and social change result in consumer demands for

more comprehensive healthcare, nursing must respond by redefining and expanding nursing roles to meet

the needs of a dynamic, diverse, and multicultural society.

• Responsibilities of the nurse should include: commitment to the profession through active participation in

those political and professional organizations designed to promote the development and practice of

nursing, accountability and responsibility in nursing practice, legal and ethical nursing practice, and

assurance of high standards in the practice of nursing.

Other organizing concepts incorporated throughout the nursing curriculum are:

• The Teaching Learning Process for The Adult Learner

Learning is an active process that utilizes the thinking and perceiving abilities and knowledge previously

acquired to gain new knowledge in explaining events, facilitating change, and solving problems. Nursing

utilizes learning theories in conjunction with a broad scientific foundation to promote the development of

critical thinking and the synthesis of learning. Through partnership in learning, both students and faculty are

active participants in the learning process. In addition, the content flows from simple to complex.

• The Development of the Nursing Role

Through a multiple entry - exit system, the nursing program addresses the needs of the adult learner in the

community. The unified nursing program provides the following: entry through tech-prep with preparatory

courses in local high schools, preparation as a certified nurse assistant through the continuing education

department, entry into the LVN program at various sites, entry into the ADN program with an elective to take

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the LVN licensing exam, a transition for currently licensed LVN's and Paramedics into the ADN program,

courses to prepare for a higher degree at local universities, a transition for ADN graduates into the

baccalaureate program available at the University Center at the Montgomery College site, and continuing

education courses at various sites. Each component of the nursing program has been designed to promote a

seamless educational journey which encourages and expedites mobility between the levels of nursing.

• The Decision Making Process

Decision making, the end product of the problem solving process, is utilized to fulfill needs and reach goals.

The decision making process, in addition to being a part of the nursing process, is an inherent aspect of daily

living. Critical thinking is essential to the decision making process in nursing, incorporating information

from a specific knowledge base, experience, competencies, attitudes, and standards. Decisions are also based

on knowledge from research and advancing technology.

• The Communication Process

Communication is the means through which social interaction and learning take place. It is the process by

which ideas, attitudes and knowledge are transmitted and received. Nursing requires effective use of

communication skills to function in interviewing, teaching-learning, and counseling situations.

• The Process of Health Promotion

The promotion of health is an integral component of nursing practice. This includes promotion, maintenance

and restoration of optimal health.

• The Process of Developing a Caring Relationship A caring relationship between nurses, clients, and their families begins with self-awareness on the part of the nurse. The

nurse must then recognize the other person's worth, dignity, and frame of reference, within the diversity of experience,

lifestyle, and culture. The nurse-client relationship progresses to the giving of self while providing competent nursing

care to clients and their families. A caring relationship develops as the nurse becomes empathetic and responds to the

needs of the individual, family, and group. Interaction with clients in a humanistic, empathetic manner is the artistic

activity of caring in nursing.

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Threads Threads II III IV

Role of the Nurse Intro to RN Roles (NLN)- Legal; BNE; Licensure; Provider of care to client with basic needs;

Provider of Care to Client with Predictable outcomes;

Provider of Care to Complex client; Coordinator of Care; Introduction to delegation

Provider of Care; Coordinator of Care; Member of Profession; Team Manager

Communication (concepts of caring and teaching learning are also included)

Intro. Medical Terminology / abbreviations; Intro. Concepts of therapeutic communication; Intro basic documentation of stable or well client; Intro caring – trust relations

Medical terminology of acute care; Therapeutic communication with clients acutely ill; preparatory teaching; periop documentation; crisis intervention

Medical terminology of complex care; Therapeutic communication of complex; Teaching plan (formal)

Management – delegation; conflict resolution; interview and hiring, disciplining; Resume / resignation; Quality control CQI

Community / Culture (environment and social organization)

Types HC facilities (LTAC, Office, Hospital); Patients Rights; Multiculturalism – Beliefs; Student Nurse Organization; Professional Organizations; c Responses to local Healthcare needs → Basic Care

Introduction community resources; acute care; volunteerism; Response to local healthcare needs → First aid, therapeutic communication

Complex care - Cost / benefits / rights; PT / nurse ratios; Bioterrorism / disaster Response to local healthcare needs → Triage, nursing interventions

Communication resources utilization / referral / management / Team management Response to local healthcare needs → Coordination and mobilization of resources

Health / Wellness Introduction to H / W continuums; Influencing factors, perception; Primary prevention – nutrition, sleep, exercise, immunizations; Chronic and Wellness

Acute care; Pre-op; Recovery; Secondary Prevention

Complex Care; Rehabilitation

Rehabilitation; Complex Chronic Geriatrics

Basic Needs ADLs, none sterile – non invasive nursing skills

Sterile – non invasive nursing skills, perioperative care

Sterile – invasive nursing skills, critical care

Community needs and resources

Life Span Pediatric, adults and geriatrics; response to stress, age specific communication; primary prevention

Normal newborn, maternal labor and delivery, post partum; acute adult and geriatric care; acute adolescent and adult psychiatric care; and secondary prevention

Complex high risk maternity, neo-natal intensive care, complex Pedi adults and geriatrics.; complex psychiatric, Pedi adolescent and adult; Tertiary preventions;

Complex chronic and genetic community care across the life spans including mental retardation

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Montgomery College Associate Degree Nursing Program

Summary of Implementation of Conceptual Framework

Threads (Topics Across Curriculum) Practice of Nursing

RNSG 1119

�Vital Signs � Infection Control �Activities of Daily Living ��Introduce Medical Terminology

Overall Curriculum The Workforce Education Course Manual Directed Flow of Content

RNSG 1523 RNSG 2504 RNSG 2514 RNSG 2535

• Primary Disease Prevention

• Health Promotion (diet, exercise, immunization)

• Nursing Assessment

• Normal Deviations

• Begin – Nursing Process (Maintenance of basic functioning with in the systems as they are introduced)

• Common Healthcare Needs in acute care

• Apply Nursing Process

• Perinatal Care (normal NB,LD, PP)

• PeriOp Care

• Frequently occurring Diseases (i.e. Aging, chronic secondary prevention, predictable outcomes)

• Secondary Prevention

• Acute Complex Healthcare Needs

• Client Advocate and Coordinator of Care

• Health Maintenance

• Collaboration

• Tertiary Health Restoration

• Chronic Complex Health Problems

• Leadership

• Management

• Delegation

• Decision Making

• Trends

• Values

• Community

Introduction – Role of the Professional Nurse


• History of Nursing

• Roles defined (provider and coordinator of profession

• Levels of prevention

• Nursing process overview with a focus on assessment

• Critical thinking

• Intro to Legal and Ethical issues

• Introduction to NPA

• Theorists (Orem, Erickson, Maslow, Kubler Ross)

• Teaching / learning intro

• Documentation - systems

• Professional Organizations

• Professional Growth

• Personal Growth

• Teaching Plan

• Application of the nursing process, goal setting and

• Role of the Nurse

• Provider

• Coordinator of Care (COC)

• Member of Profession

Collaboration (NPA) – advocate nurse as a manager

• Application of the nursing process, evaluation and revisions

• Member of a profession

• Case Management

• Transition student nurse to profession

• Professionalism / Boundaries

• Leadership

• Group dynamics

• Change theory

• Conflict resolution

• Management of Patients

• Delegation

• Application of legal / ethical

• Legal / Ethical (NPA)

• Communication – public formal

• Trends / Issues

• Research

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Nursing Management of Maternal Child Health


• Prepregnancy

• Antepartum

• Age related

• Normal sexuality

• Birth Control

• Normal labor vaginal delivery

• Postpartum

• Fetal Assessment

• Newborn Assessment

• Parenting

• Support System

• Well fetal monitoring

• Biopsy - Uterine growth

• Breast feeding

• Bottle feeding

• Treatment STD

• PIH

• DM / GD

• Bleeding (late/early), PPH, PP, PA

• Dysfunctional labor

• Premature labor

• Age extremes – maternal, infant

• Fetal Distress

• Instrument Delivery / CS

• Brachial - Plexus

• Gestational age assessment

• HIV in pregnancy

• Maternal / fetal demise

• Substance abuse (alcohol, smoking and drugs) FAS

• TORCH (Herpes, G-BetaS, Heb B)

• Multiple gestation

• Cardio – Valvular, chronic

Nursing Management of: Mental Health


• Intro Therapeutic Communication

• Ego Defense Mechanisms

• Death and Dying

• Substance Abuse

• Anxiety Disorders

• Mood Disorders (depression)

• Crisis intervention

• Anger/hostility/aggression

• Situational/Maturational crisis

• Suicide

• Antidepressants

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• Bipolar

• Schizophrenia

• Somatoform disorders

• Personality disorders

• Medications

• ADHD/ADD

• Abuse (sexual, child, domestic)

• Mental retardation (PKU, fragile X, autism, down syndrome)

• Eating disorders

Nursing Management of: Neurological Health


• Ears – hearing deficits

• Eyes – visual deficits

• Basic Neuro assessment

• Headaches

• Dementia (Alzheimer’s)

• Delirium

• Pain, comfort, stress, sleep

• Basic Gerontology

• Disc Problems

• Spinal abnormalities

• Peri-neuropathy

• Febrile Seizure

• CVA

• Brain trauma (bleeds, ICP, herniation)

• Brain infection (meningitis, encephalitis)

• Brain Tumor

• Advanced neurological assessment

• Epilepsy

• Spinal cord injuries

• Spinal cord tumors

• Chronic Neurological disorders (MS, MG, Parkinson, ALS, CJD, Gillian Barre)

• Congenital Problems

• Hydrocephalus

• Myelomeningocele

Nursing Management of: Respiratory Health

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• O2 transport

• O2 Therapy

• ABG’s basic

• URI

• Respiratory Allergies

• COPD

• Asthma – Bronchitis, Emphysema, Epigotlitis

• Reactive Airway

• Pneumonia

• RSV

• TB

• Application of ABG’s

• RF (RDS, others)

• ABGs advanced interpretive

• Chest Trauma (pneumo / hemo thorax, flail chest)

• Pulmonary Edema/embolism

• Cystic Fibrosis

Nursing Management of: Circulatory Health


• Vascular Disease

• HTN

• DVT

• Peripheral Vascular Disease

• Intro Basic EKG (brady/tachy/sinus)

• Intro CBC: H & H RBC WBC Platelets

• CHF Intro and chronic mgmt.

• Inflammatory Heart Disease

• Application of EKG – ID of pacer

• Hypertension

• Vascular disease

• CAD (angina and MI)

• CHF Acute Management

• ECG – Dysryhthmia management

• Advanced MIs (CABG, angioplasty, cardiac caths,

• Thrombocylics, tamponade, aneurysms

• Abdominal aneurysms

• HTN crisis

• Valvular disease

• DIC / HELLP

• Sickle Cell

• MSOF Type

• Cardiomyopathies

• Shock Type

• Congenital Heart defects

• Blood transfusions

Nursing Management of: GI Health


• Hemocult screening

• Constipation

• Diarrhea

• Impaction

• Stool collection

• GERD

• Peptic Ulcer

• Cholecystitis / Cholelithiasis

• Infections and inflammatory (Crohns, Colitis, Gastritis, gastroenteritis)

• Obstructions – Colostomy

• small and large bowel

• Peritonitis

• Eppendcytitis

• Liver (Hepatitis, Cirrhosis, CA)

• Pancreatitis (CA, chronic and acute)

• Tumors

• Biliary atresia

Nursing Management of: GU Health


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• Dehydration status

• Electrolytes

• Incontinence

• UTI (upper and lower)

Male and Female wellness check-ups

• BPH - TURP

• Prolapse

• Menopause

• Hysterectomy

• Renal Calculi

• Renal Failure (Acute/Chronic/infections)

• Dialysis

• Transplants

• Wilms tumor

Nursing Management of: Endocrine Health


• Diabetes

• Basic Nutrition

• Thyroid

• Parathyroid

• Gestational diabetes

• Cushing’s syndrome/disease; Addison’s disease

• Pituitary tumors

• Pheochromocytoma

• DKA – Somogyi and Dawn phenomena

• HHNK

• Diabetes insipudus / SIADH

Nursing Management of: Musculoskeletal Health


• Basic mobility

• Immobility

• Osteoporosis

• Contusions

• Strains

• Sprains

• Hips / Joint Replacements

• MD Muscular Dystrophy

• Osteoarthritis

• Neurovascular assessment

• Birth defects – club foot, DHD

• Spinal deformities

• Tractions

• Amputations

• Multiple trauma

• Scleroderma

• Infection (Osteomylitis Rhabdomyolis

Nursing Management of: Immune Health


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• Infections

• Immunizations

• Infectious Diseases of childhood

• CA: Treatment and effects (top 5)

• Arthritis’ types (gout, rheumatoid)

• Lupus

• Blood / Lymph disorders (leukemia, Hodgkin, non-Hodgkin, hemophilia)

• HIV

• Blood Products, advanced Hematology

• Aplastic Anemia / Thallasmia

Nursing Management of: Integumentary Health


• Rashes / pressure ulcers

• Skin infections

• Wound assessment

• Burn / grafts

Nursing Management of: Perioperative Client


• Preop

• Intraop

• Postop

• Hospital Diets

Introduction to Emergency Management


• Emergency Management

• Toxic substances / poisons / OD

• Bioterrorism

• Emergency OR

• Legionnaires

Clinical Focus

1361 1362 2361 2362

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• Identifies, interprets and begins utilizing effective and appropriate communication skills.

• Collects the appropriate data necessary to provide safe and effective nursing care.

• Discusses the nursing process in relation to clinical situations.

• Identifies complete and accurate documentation of care with beginning involvement.

• Demonstrates competency in basic clinical skills.

• Demonstrates time management and / organizational skills in assisting clients with activities of daily living.

• Collaborates effectively with other healthcare members

• Functions within the healthcare setting as a novice team member.

• Associates critical thinking skills with clinical decision-making.

• Demonstrates effective and appropriate communication skills.

• Utilizes the appropriate data necessary to provide safe and effective nursing care.

• Applies the nursing process to clinical situations.

• Provide complete and accurate documentation of care.

• Demonstrates competency in intermediate clinical skills.

• Demonstrates time management and / organizational skills.

• Administers medications in a safe and competent manner.

• Administer PO medications independently by the end of the semester.

• Cares for two clients each clinical day.

• Demonstrates critical thinking skills in clinical decision-making.

• Demonstrate the ability to utilize critical thinking skills.

• Develop / implement a plan of care for diverse client / family with complex healthcare needs.

• Working knowledge of the Nurse Practice Act.

• Use therapeutic communication skills.

• Recognize opportunities for client advocacy and professional development activities.

• Collaborate in multidisciplinary planning to provide complex healthcare needs.

• Evaluate the effectiveness of the plan of care.

• Organize care for a group of clients utilizing available human and material resources.

• Demonstrate the ability to make safe and ethical collaborative clinical decisions.

•Incorporate clinical data, current literature, accountability and critical-thinking skills.

• Develop, implement, and evaluate a plan of care for clients whose health needs may be difficult to predict.

• Incorporate clinical data, current literature, accountability and critical thinking skills.

• Provide care for multiple clients and their families.

• Analyze the implications of the Nursing Practice Act.

• Demonstrate leadership and management skills.

• Use collaboration and communication techniques.

• Implement and analyze the effectiveness of clients with long-term healthcare needs.

• Serve as a positive role model.

• Use current technology and literature to enhance client and family care.

• Coordinate human and material resources for the provision of care for clients and families.

• Make safe and ethical clinical decisions

Student will apply the theory, concepts, and skills involving specialized materials, tools, equipment, procedures, regulations, laws, and interactions within and among political, economic, environmental, social, and legal systems associated with the occupation and the business/industry and will demonstrate legal and ethical behavior, safety practices, interpersonal and teamwork skills, and appropriate written and verbal communication skills using the terminology of the occupation and the business/industry. (Workforce Education Course Manual).

Lab Skills

RNSG 1105 RNSG 1144 RNSG 1170 No Lab Course

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• Legal Issues

• Therapeutic communication

• Infection: standard precautions/transmission based isolation

• Head to toe assessment

• Documentation

• Meds PO Tubes and General principles

• Meds eyes, ears, topical, inhalation, vaginal and rectal

• Blood sugar checks and specimen collection and non-pharm pain management

• Tube feedings, types of tubes, intake and output, enemas

• Oxygen and Mobility

• IV assessment and Discontinuing

• Wounds Pressure ulcer/ Medical aspesis / Types of Dressings

• Ostomy

• LPE Check offs

• Surgical Asepsis

• Urinary Catheter Insertion

• Sterile Dressing Change

• Intravenous Access Therapy

• Intramuscular Injections

• Subcutaneous Injections

• Intradermal Injections

• Insulin Administration

• Documentation

• Nasogastric Tube Insertion and Regulation

• Heart and Breathe Sounds

• Neurovascular/Neurological Assessment

• Hemodynamic monitoring

• Chest tubes

• IV: insertion, HL, SL, IVPB, IVP and Phlebotomy

• Central lines

• Ventilators

• ECG/ rhythms

• Trachea Care / suctioning

• TPN/PPN

• Blood administration

ENTRY

Tech Prep

CNA

LVN GRADUATE BOARDS/WORK

PARAMEDIC CERTIFICATE/MILITARY ACE

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MASTERS ADVANCED PRACTICE

BSN/WORK

BSN PREREQUISITES

BOARDS/WORK

ADN PREREQUISITES

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NORTH HARRIS MONTGOMERY COMMUNITY COLLEGE DISTRICT

ASSOCIATE DEGREE NURSING

PROGRAM OUTCOMES

At the completion of the Associate Degree Nursing program at NHMCCD, the graduate will be able to:

1. Provide individualized health care, based on the nursing process and a commitment to caring, to culturally

diverse clients and families across the life span and wellness-illness continuum.

a. Determine the health status and health needs of clients and their families based upon interpretation of

health data, incorporating biological, psychological, social, and spiritual needs.

b. Formulate goals and plan of care for clients and their families based on a multidisciplinary problem

solving approach.

c. Implement the plan of care within legal and ethical parameters and demonstrate caring behavior to

assist clients and their families to meet health care needs.

d. Participate with the individual client and family members in the evaluation of the individual's progress

toward meeting identified goals and responses to therapeutic interventions.

e. Use clinical data, current literature, critical thinking, and accountability as a basis for decision making

in nursing practice.

f. Provide for the care of multiple clients and their families in a variety of structured settings either

through direct care or assignment and/or delegation of care to other members of the health care team.

2. Use communication techniques effectively with clients, families, and health care team members.

3. Develop and implement teaching plans for clients and their families concerning promotion, maintenance and

restoration of health.

4. Coordinate human and material resources for the provision of care for clients and families, in collaboration

with clients, families, and other health care professionals.

a. Refer clients and their families to appropriate sources of assistance when necessary to meet health

needs.

b. Function within the organizational framework of various structured health care settings.

c. Establish priorities for nursing care for a group of clients.

5. Contribute to the improvement of nursing practice by serving as a role model and by adhering to high legal,

ethical and professional standards.

a. Assume accountability and responsibility for the quality of nursing care provided to clients and

families.

b. Act as an advocate to promote the provision of quality health care for clients and their families.

c. Participate in activities that promote the development and practice of nursing.

6. Assume responsibility for personal and professional growth to enhance knowledge and skills for self and

others through participation in continuing education activities.

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ASSOCIATE DEGREE NURSING PROGRAM

ENTRY LEVEL COMPETENCIES OF TEXAS GRADUATES OF:

A. Provider of Care:

1. Determine the health status and health needs of clients* based upon interpretation of health data

and preventive health practices in collaboration with clients*, their families and interdisciplinary

health care team members.

2. Formulate goals/outcomes and plan of care based on nursing diagnoses in collaboration with

clients*, their families and interdisciplinary health care team members.

3. Implement plan of care within legal and ethical parameters, including scope of practice, in

collaboration with the client* and interdisciplinary health care team to assist client* in meeting

health care needs.

4. Develop and implement teaching plans for clients* concerning promotion, maintenance, and

restoration of health.

5. Evaluate clients’* responses and outcomes to therapeutic interventions.

6. Provide for the care of multiple clients* either through direct care or assignment and/or

delegation of care to other members of the health care team.

7. Use critical thinking approach to analyze clinical data and current literature as a basis for

decision making in nursing practice.

B. Coordinator of Care:

1. Coordinate human and material resources for the provision of care for clients* and families.

2. Collaborate with clients*, families and the interdisciplinary health care team for the planning and

delivery of care.

3. Refer clients* and families to resources that facilitate continuity of care.

4. Function within the organizational framework of various health care settings.

C. Member of a Profession:

1. Assume accountability and responsibility for the quality of nursing care provided to clients* and

families.

2. Act as an advocate to promote the provision of quality health care for clients*.

3. Participate in activities that promote the development and practice of professional nursing.

*VN – Client = individual

ADN – Client = individual and family

Reference: Differentiated Entry Level Competencies of Graduates of Texas Nursing Programs, Sept 2002

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LEVEL ONE COMPETENCIES

At the completion of the Nursing I and II courses, the student will be able to:

1. Provide individualized health care, based on the nursing process and a commitment to caring, to culturally

diverse clients across the life span and wellness-illness continuum.

a. Determine the health status and health needs of individual clients based upon interpretation of health data,

incorporating biological, psychological, social, and spiritual needs.

b. Formulate goals and plan of care for individual clients based on a multidisciplinary problem solving

approach.

c. Implement the plan of care within legal and ethical parameters and demonstrate caring behavior to assist

individual clients to meet health care needs.

d. Participate with the individual client in the evaluation of the individual's progress toward meeting

identified goals and responses to therapeutic interventions.

e. Use clinical data, current literature, critical thinking, and accountability as a basis for decision making in

nursing practice.

f. Provide for the care of individual clients in a variety of structured settings either through direct care and/or

delegation of care to Certified Nursing Assistants.

2. Use basic therapeutic communication techniques effectively with clients, families, and health care team.

3. Implement established teaching plans for clients concerning promotion, maintenance and restoration of health.

4. Use human and material resources for the provision of care for clients, in collaboration with clients, families,

and other health care professionals.

a. Identify appropriate sources of assistance when necessary to meet health needs.

b. Function within the organizational framework of various structured health care settings.

c. Establish priorities for nursing care for an individual client.

5. Contribute to the improvement of nursing practice by serving as a role model and by adhering to high legal,

ethical and professional standards.

a. Assume accountability and responsibility for the quality of nursing care provided to clients.

b. Assume accountability and responsibility for own learning activities.

6. Assume responsibility for personal and professional growth to enhance knowledge and skills for self through

participation in nursing education activities.

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VOCATIONAL NURSING EXIT OUTCOMES -

Multiple Entry – Exit Program (MEEP)

At the completion of the Vocational Nursing program and/or completion of VN/ADN exit option, the

graduate will be able to:

1. Provide nursing care for clients in structured health care settings who are experiencing common, well-

defined health problems with predictable outcomes. This care is based on utilization of the nursing process

and a commitment to caring for culturally diverse clients across the life span and wellness - illness

continuum.

a. Assist in the determination of the health status and health needs of clients based upon interpretation of

health-related data, incorporating biological, psychological, social, cultural, spiritual and overt learning

needs; in collaboration with clients, their families, and other members of the health care team.

b. Assist in the formulation of goals and a plan of care for the client to determine nursing priorities and to

plan nursing care accordingly; in collaboration with the health care team to develop nursing care plans,

preventative and long-term health goals/plans.

c. Implement the plan of care within legal and ethical parameters in a non-discriminatory and non-

judgmental manner in collaboration with the health care team.

d. Support the implementation of nursing care by applying a working knowledge of client’s rights,

protecting the rights and dignity of the client and respecting the rights of others to have their own

value system.

e. Assist in the evaluation of the individual client’s responses to nursing interventions and evaluation of

established long-short term client goals.

f. Use the problem-solving approach as the basis for decision making in practice, based on application of

scientific principles, clinical data and acceptance of accountability of care.

g. Provide direct basic are to assign multiple clients in structured settings.

2. Apply communication techniques effectively with clients, families, and health care team members.

a. Communicate significant findings to the health team, reporting and recording objective and subjective

(as related by client) results of nursing actions.

b. Recognize and communicate ethical and legal concerns through established channels of

communication.

3. Contribute to the development and implementation of a teaching plan for clients with common health care

problems.

4. Assist in the coordination of human and material resources for the provision of care for assigned clients.

a. Participate in discussions relating to the evaluation of client care with health team.

b. Aid in identifying others who can assist in client care.

c. Participate in the identification of client needs for referral to appropriate sources of assistance,

communicate these needs to family and appropriate members of the health team.

d. Participate in activities that support the organizational framework of structured health care settings.

e. Implement established cost containment measures in direct client care.

5. Actively promote the improvement of nursing practice by serving as a positive role model and by adhering

to high legal, ethical, and professional standards.

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ADN PROGAMS: LEVEL 2 COMPETENCIES

The second semester of the ADN program addresses a variety of basic skills and competencies. These

competencies include those identified by SCANS (the Secretary’s Commission on Achieving Necessary Skills) as

basic skills for all college students, Core Competencies identified by NHMCCD as important for students within

the college district, and DELC (Differentiated Entry Level Competencies), which delineate the competencies of

VN, ADN and BSN graduates. Refer Appendix D of the Nursing Student Handbook for a detailed description.

The following is a list of the competencies addressed in this course.

BASIC SKILLS READING:

• Locate, understand and interpret information presented in nursing journals, reference and textbook.

• Read information in client charts in order to gather data.

WRITING: Written assignments in this course involve:

• Research a topic, organize ideas, critique and analyze data for a paper.

• Use language correctly, organize information, and present materials with accuracy and purpose in an

appropriate delivery style for audience comprehension..

• Document resources, use correct grammar, spelling and punctuation.

• Document nursing care on client charts within the clinical setting.

• Submit nursing care plans.

MATH:

• Apply mathematic principles to medication calculations.

• Demonstrate competency on separate math exams, with 90% correct on one of four opportunities.

• Calculate dosages and amounts of medications correctly in the clinical setting.

SPEAKING:

• Present in-post conference at the end of each clinical day.

• Communicate professionally with clients, families, and members of the health care team.

• Utilize therapeutic communication techniques with clients who have been diagnosed with alterations in mood

and thought patterns (also communicate with their families while in community mental health facilities).

LISTENING:

• Listen to information presented by other health professionals in the clinical setting.

• Listen attentively to clients and their families, and responding appropriately.

THINKING SKILLS ORGANIZING INFORMATION:

• Organize and synthesize information from a variety of resources which include: lectures, textbooks,

professional journals, computer programs, videotapes, and material available on the Internet.

KNOWING HOW TO LEARN:

• Organize ideas and information while analyzing data from a variety of resources in order to apply the

information to the clinical setting.

• Apply skills of memorization, comprehension, and application.

REASONING:

• Address current issues in health care, generate new ideas, and make decisions based on the understanding of

information gathered throughout the semester.

• Generate solutions and/or alternatives to problems based on understanding the issues addressed.

CRITICAL THINKING:

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• With data available, cluster related information while applying it to the client’s situation therefore, determining

inferences and decisions.

• Think beyond the usual limits and make decisions based on new ideas and solutions.

PERSONAL QUALITIES RESPONSIBILITY:

• Attend all classroom, laboratory and clinical activities.

• Complete written assignments, participate in group collaborative activities / discussions, and present effective

oral presentations.

• Monitor your performance based on exam results, verbal and written feedback from instructors related to

mastery of objectives, and self evaluation of progress.

• Complete written, oral, and clinical assignments in a timely manner.

SOCIAL SKILLS:

• Collaborate with groups on assignments, requiring understanding, cooperation, and adaptability.

• Work responsibly and collegially as members of the health care team.

SELF-MANAGEMENT:

• Demonstrate self-control, mature behavior, and a positive manner in regards to group assignments.

• Manage responsibilities within your personal life as well as those related to school and work.

• Utilize college resources for stress reduction, such as counseling to manage personal crises or difficulties.

INTEGRITY/HONESTY:

• Exhibit ethical conduct by not plagiarizing the work of others, presents accurate information, and work

collaboratively with others.

• Develop a foundation of integrity and honesty in one’s personal life and student activities.

WORKPLACE COMPETENCIES MANAGING RESOURCES:

• Effectively manage your time outside the classroom, enabling you to meet the requirements of the course,

complete assignments, and participate in assigned activities.

• Complete assignments within a timely manner, including management of nursing care within the time allowed

for clinical activities.

• Organize own material resources in meeting the demands of home, work and school.

• Identify resources available to the health care team in meeting client needs.

• Delegate to other health care workers and recognize your responsibility in determining if the care is provided

adequately.

• Manage resources so that care is provided safely and cost efficiently.

PARTICIPATING AS A MEMBER OF A TEAM:

• Participate as members of a team within the program and then as members of the health care team.

• Demonstrate the ability to work collegially and responsibly to accomplish assigned tasks.

TEACHING OTHERS NEW SKILLS:

• Implement established teaching plans with clients who have identified health problems and learning needs.

• Present client situations in post conferences.

EXERCISING LEADERSHIP:

• Take a leadership role in presenting information gathered.

• Take a leadership role when delegating to others in the clinical setting.

WORKING WITH CULTURAL DIVERSITY:

• Apply concepts from previous courses about different cultural groups.

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• Administer nursing care to clients with varying cultural and ethnic backgrounds.

• Demonstrate respect for all co-workers, clients and their families.

• Recognize cultural diversity, bridging any barriers that exist in providing care and in working together.

UNDERSTANDING SYSTEMS:

• Understand systems of human information processing, biological systems as they relate to the health of the

individual, and systems related to health care delivery.

• Working in a variety of health care facilities to observe the interactions and relationships between the systems.

TECHNOLOGY WORKING WITH A VARIETY OF TECHNOLOGIES:

• Word processing and accessing databases.

• Attend open computer labs to work with computer programs related to information being studied, to review

software designated for each unit, to practice computerized test banks, and to tutor self in different areas.

• Select and utilizing appropriate technologies available in the clinical setting, such as the IV pumps, the vital

sign equipment, and computerized charting and data systems.

• Access web based classrooms to complete assignments and supplements to traditional classroom presentation.

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COMPETENCIES OF NEW GRADUATES Provider of Care 1. Determine the health status and health needs of clients* based upon interpretation of health data & preventive health practices in collaboration with clients*, their families, and interdisciplinary health care team members.

A.) Five steps of a systematic process, which includes assessment, analysis, planning, implementation and evaluation.

B.) Classification system for nursing diagnoses (e.g.) North American Nursing Diagnoses Association).

C.) Structured and unstructured data collection tools and techniques for assessment of clients* reasoning; and cultural and spiritual beliefs and practices related to health, illness, birth, death, and dying.

D.) Characteristics, concepts, and processes related to clients*, including anatomy and physiology; physical and psychosocial growth and development; pathophysiology and psychopathology; ethical reasoning; and cultural and spiritual beliefs and practices related to health, illness, birth, death and dying.

E.) Characteristics, concepts, and processes related to disease transmission, risk factors, preventive health practices and their implications for selected populations and community resources.

F.) Medical diagnoses, pharmacotherapeutics and other therapies and treatments.

G.) Introduction to established theories, models and approaches that guide nursing practice.

H.) Characteristics, concepts and processes related to families, including family development, structure and function; family communication patterns; and decision-making structures.

I.) Technologic applications.

J.) Introduction to complex and multi-system healthcare problems.

K.) Political, economic and societal forces affecting the health of individuals and families.

2. Formulate goals / outcomes and plan of care based on nursing diagnoses in collaboration with clients*, their families and interdisciplinary health care team members.

A.) Principles of establishing a nurse-client relationship

B.) Techniques of written, verbal, and nonverbal communication including information technologies.

C.) Principles of disease prevention, health promotion, education and rehabilitation for clients.

D.) Clinical practice guidelines as a basis of interventions to support client* throughout their life span including end-of-life care

E.) Collaborative aspects of the relationship between the nursing plan of care, the therapeutic regimen, the plan of interdisciplinary health care team members, and cost factors.

F.) A systematic approach for setting priorities and strategies for coordinating plan of care

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G.) Strategies for collaborative discharge planning.

H.) Principles of humanities & natural, social, and behavioral sciences applied to the care planning of clients

3. Implement plan of care within legal and ethical parameters, including scope of practice, in collaboration with the client and interdisciplinary health care team to assist client* in meeting health care needs.

A.) Health practices and behaviors of clients* related to developmental level, gender, cultures, belief systems, and the environment.

B.) Modes of therapeutic communication.

C.) Rights and responsibilities of clients* related to health care.

D.) Physiological and psychosocial (spiritual, cultural, gender, developmental level, financial) aspects of nursing interventions.

E.) Principles and factors that contribute to the maintenance or restoration of health.

F.) Principles and rationale underlying the use, administration, and interaction of pharmacotherapeutic agents, including intravenous medications.

G.) Management of the client’s* environment.

H.) Principles and strategies of stress management and crisis intervention.

I.) Code of ethics and framework for ethical decision-making.

J.) Legal parameters of professional nursing practice and health care.

K.) Interdisciplinary resources and organizational relationships.

L.) Issues and factors impacting confidentiality.

M.) Nursing procedures and skills to implement plan of care.

N.) Decision-making, problem solving and critical thinking processes.

4. Develop and implement teaching plans for clients concerning promotion, maintenance, and restoration of health.

A.) Developmental stages and socio/cultural variables affecting the teaching/learning process.

B.) Principles, methods, strategies and out-comes of learning and teaching.

C.) Knowledge of community resources related to teaching/learning.

5. Evaluate clients’* responses and outcomes to therapeutic interventions. A.) Methods for evaluating clients* responses to interventions and client* outcomes.

B.) Common methods to evaluate health care processes.

C.) Performance improvement concepts

6. Provide for the care of multiple clients* either through direct care or assignment and/or delegation of care or assignment and/or delegation of care to other members of the health care

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team. A.) Standards of Care; Standards of Practice.

B.) Characteristics, trends and issues of health care delivery.

C.) Principles for determining priorities and organization of nursing care.

D.) Principles of delegation, supervision, collaboration including delegation rules from Texas Nursing Practice Act.

E.) Principles of decision making.

7. Use a critical thinking approach to analyze clinical data and current literature as a basis for decision-making in nursing practice

A.) A conceptual framework of nursing practice as a means of planning care and solving clinical problems.

B.) Critical thinking and decision-making processes.

C.) Application of current literature and/or interpreted research findings in improving client* care.

Coordinator of Care 1. Coordinate human and material resources for the provision of care for clients* and families.

A.) Principles of organizing and managing resources.

B.) Principles of management, decision making, assertiveness, communication, motivation, time management, delegation, and change theory.

C.) Group process as a means of achieving and evaluating goals.

D.) Cultural differences and major needs of vulnerable clients*.

E.) Major current issues affecting public / government / private health care services, programs, and costs.

F.) Local human and material resources.

G.) Current systems for managing client* information.

2. Collaborate with clients, families and the interdisciplinary health care team for the planning and delivery of care.

A) Structure, function, and interdisciplinary relationships within the health care system

B) Patterns and modes of effective communication and collaboration including conflict resolution and negotiation

C) Principles of team management & leadership

D) Legal/ethical processes related to healthcare.

3. Refer clients* and families to resources that facilitate continuity of care.

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A.) Institutional and community resources including agencies/services and health care providers.

B.) Roles of family and significant others in response to alteration in health status.

C.) Referral processes.

D.) Issues and trends in health care delivery.

Member of the Profession 1. Function within the organizational framework of various health care settings.

A.) Methods for promoting safety in the work environment consistent with current Federal/State/local regulations and guidelines.

B.) RN’s role in risk management.

C.) Basic principles of management and communication within an organization.

D.) Relationships among members of the interdisciplinary health care team.

2. Assume accountability and responsibility for the quality of nursing care provided to clients* and families.

A.) Code of ethics for nurses.

B.) Standards of nursing practice and care.

C.) Legal parameters of nursing practice including the Texas Nursing Practice Act.

D.) Issues affecting the RN role and the delivery of client* care.

E.) Self-evaluation, staff evaluation and peer evaluation processes.

F.) Methods for the development of policies / procedures.

G.) Communication techniques and management skills to maintain professional boundaries.

3. Act as an advocate to promote the provision of quality health care for clients. A.) Current issues and legal principles relating to safeguarding client* rights.

B.) Roles of the nurse as client* advocate.

C.) Role/Responsibility For Public Safety And Welfare.

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STUDENT ACCOUNTABILITY FOR MEETING REQUIREMENTS

OF THE DEGREE PLAN

The NHMCCD Associate Degree Nursing Program requires 72 semester hours completed in order to receive the

Associate of Applied Science Degree. Thirty-four hours of general academics and related courses are required

and 38 hours of nursing courses in the integrated basic nursing program. In the block program, 28 hours are of

general academics and related courses with 44 hours of nursing courses. It is the responsibility of the student to

be certain that prerequisite and co-requisite courses are completed as prescribed in the degree plan. Nursing

faculty/Advisor and the program director are available throughout the semester and during every registration

period to advise students on required course work. It is the responsibility of the student to review the individual

degree plan/advising profile with a nursing faculty member or Advisor EACH SEMESTER. Failure to review

the degree plan on a regular basis could jeopardize progression to the next nursing course or delay the granting of

the AAS degree. The student cannot sit for the state licensing exam or receive a permit for work until all

required courses for the degree are completed and grades are officially processed by the College District.

ELECTIVE COURSE REQUIREMENT

A three hour elective in the area of fine arts or the humanities is required to complete the degree plan. The

student should validate the choice of an elective with a nursing faculty advisor before enrolling in the course.

Refer to the college catalog under Degree Plan and refer to progression requirements.

BOARD OF NURSE EXAMINERS DECLARATORY ORDERS

The Board of Nurse Examiners (BNE) may refuse to admit persons to its licensure examination, may refuse to

issue a license or certificate of registration, or may refuse to issue a temporary permit to any individual with lack

of fitness to practice by reason of mental or physical health or intemperate use of alcohol or drugs that could

result in injury to clients or the public. The Board may also refuse to grant licensure to any individual with a

history of a conviction. An individual enrolled or planning to enroll in a basic nursing program who has reason

to believe that he/she is ineligible may petition the Board of Nurse Examiners for a declaratory order as to

eligibility. Failure to request a declaratory order at least 12 months prior to graduation could result in a delay in

taking the NCLEX. This delay will adversely affect your ability to gain employment.

If you have a situation that may require declaratory orders, please refer to the Texas Nursing Practice Act and/or

contact the Texas Board of Nurse Examiners, www.bne.state.tx.us.

Student may be required to submit to random selection for drug-screening test, fees will be at student’s expense.

ADN and VN students will be held accountable to the Unprofessional Conduct Rule 217.12 of the Texas Nursing

Practice Act.

Background Checks are required for clinical experience. Fees will be at student’s expense.

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BOARD OF NURSE EXAMINERS REQUIREMENTS FOR LVN LICENSURE

Students who complete the summer electives and the academic courses in the ADN degree plan will have an

opportunity to apply to the Board of Nurse Examiners to take the NCLEX-PN licensing examination and obtain a

license to practice as an LVN. Please refer to the “Annotated Guide for LVN’s to the Texas Nursing Practice

Act”, 2003, Subchapter F, License Requirements.

In addition, applicants who have been convicted of a felony, a misdemeanor, have intemperate use of drugs or

alcohol, or have been treated for a psychiatric occurrence will need to contact the Board in advance to determine

if they will be eligible to take the exam. Please see the following pages of instructions to applicants for

information relating to licensure eligibility. For further clarification, please contact the Board at (512) 305-7400.

ELIGIBILITY FOR NCLEX-PN AND LVN LICENSURE

The Board of Nurse Examiners for the State of Texas has a content/clinical/contact hour requirement which must

be met prior to application for licensure in Texas as an LVN and for taking the NCLEX-PN. In 1996, the

Associate Degree Nursing program at North Harris Montgomery Community College District received approval

to offer a vocational nursing elective exit option. This is called a MEEP Program, a Multiple Entry Exit

Program. Students who successfully complete the ADN degree plan through Nursing II and the two summer

electives are eligible to apply for LVN licensure and take the NCLEX-PN.

Students are also eligible to take the NCLEX-PN and apply for LVN licensure in two other ways. One is to

transfer into a vocational nursing program and successfully complete it, making it possible to apply. Another

option is available for ADN or BSN graduates who have not successfully passed the NCLEX-RN after the first

attempt and who meet the clinical/didactic content hours. These graduate nurses would then be able to take the

NCLEX-PN, and if successful apply for LVN licensure. The graduate has only one year, after the first NCLEX-

RN failure, in which to apply for and pass the NCLEX-PN.

Please consult with the director of the Associate Degree Nursing program for advising related to LVN licensure

and the NCLEX-PN. Additional eligibility requirements for becoming an LVN are listed in information provided

by the Board of Nurse Examiners.

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DEPARTMENTAL POLICIES

ATTENDANCE POLICY:

• Classroom/seminar Students must attend class in order to have a solid knowledge base for practice.

Students must be present for both hours of lecture in order to be counted as present. Students in Nursing

IV who miss a seminar will be required to submit a typewritten summary of the topic covered in the

missed seminar as identified in the syllabus.

• Campus Laboratory: Laboratory attendance is mandatory for all students. If a student is absent from

lab, the lab activity must be made up within one week in order to be able to perform the skill in the

clinical setting. Paperwork requirements will be the student’s responsibility and will be done on the

student’s own time. Students cannot have more than two make up labs.

• Clinical Setting: The nursing faculty believes that experiences in the clinical setting cannot be

adequately duplicated if a student is absent excessively. Absence of more that 10% of the clinical course

contact hours is considered excessive (example, 10% of 144 contact hour clinical course is 14.4 contact

hours rounded to the nearest whole number). Students with excessive absences will automatically be

dropped from nursing and receive a grade of “W” if prior to semester withdrawal date. The student will

have the right to appeal to the nursing department faculty.

APPEALS POLICY:

A student may request initiation of the appeal process by the Nursing Student Appeals Committee for an

unresolved problem involving a departmental rule. A departmental rule is defined as one made by the

entire ADN faculty, which affects more than one individual nursing course, e.g. clinical attendance or

readmission policy. The appeals procedure is found in Appendix B of this handbook.

CLINICAL ASSIGNMENTS:

Due to State Board of Nurse Examiners mandates for student/teacher ratios, nursing students will not

always be able to receive the clinical assignment of their choice. In addition there is no guarantee that a

student will remain assigned to the same campus at which they originally enrolled. If a clinical group is

closed, students will have to move to another section and perhaps to another campus. In addition, students

may be assigned to an evening shift one or more semesters.

CONFIDENTIALITY STATEMENT:

As a student in the NHMCCD nursing program, you will have access to confidential information during

your clinical experiences. Confidential information includes client information, employee information,

financial information, other information relating to your duty as a student and information proprietary to

other companies or persons. You may have access to some or all of this confidential information through

the computer systems of the clinical facilities or through your student activities.

Confidential information is protected by strict policies of the clinical facilities and by federal and state

laws particularly the Health Insurance Portability and Accountability Act. The intent of these laws and

policies is to assure that confidential information, that is, Patient’s Protected Health Information or

Individually Identifiable Information provided to students orally or contained in client medical records or

maintained on the facility’s electronic information system will remain confidential.

As a student, you are required to comply with the applicable policies and laws governing confidential

information. Any violation of these laws will subject the student to discipline, which might include, but

is not limited to, dismissal as a student and to legal liability.

34

In addition to this statement, each clinical facility will require you to sign an additional statement as you

begin your clinical rotation. A sample of the required form is provided in Appendix B.

CODE OF CONDUCT

One goal of the Associate Degree Nursing program is to assist the student in becoming a safe practitioner of

professional nursing. The primary mission of the Texas Board of Nursing Examiners is to protect and promote

the welfare of the people of Texas by assuring that professional nurses are competent and safe practitioners.

The Associate Degree Nursing Program’s fulfill this goal by holding the student accountable for safe mature

behavior and by establishing a code of ethics and conduct along with professional standards of behavior which

will help the student in meeting the Texas Board’s expectation. The following code of conduct has been

established to make the student aware of guidelines regarding the department’s expectations, which are in

keeping with the general rules pertaining to disciplinary process and procedure found in the College Catalog and

ADN Student Handbook.

Infraction of the code of conduct, whether it occurs in the classroom or any of the NHMCCD campuses including

the clinical sites, will result in disciplinary action. Discipline can range from a written Critical Incident to

removal from the program depending on the seriousness of the incident. Students should follow the chain of

command: Instructor, Team Leader, Program Director, Dean, and Vice President of Instruction. Reasons for

disciplinary action may include but are NOT LIMITED TO:

1. Use of alcohol or drugs before or during class or a clinical work shift.

Examples are not all inclusive:

a. Alcohol on a student’s person or detected on her/his breath.

b. Slurred speech, glassy red eyes.

c. Difficulty in maintaining his/her balance.

d. Belligerent, combative, irrational behavior.

e. Illogical or inappropriate decision-making that could endanger clients or others.

f. Possessing articles usually associated with drug use.

Refer to Appendix B for Student Conduct: Chemical Dependency

2. Impairment by reason of mental or physical health, alcohol, or other mind altering drugs

which could expose clients, the public, students, and faculty unnecessarily to risk of harm.

Examples:

a. Demonstration of hallucination, delusion or combative behavior.

b. Physically or verbally attacking or threatening to attack clients, family, or other students or

faculty.

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

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

public, school personnel, other students, and faculty.

Examples may include but are not limited to:

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

or that could frighten others.

b. Informing the charge nurse or faculty member that a treatment, medicine or procedure has been

done when in fact it has been omitted.

c. Possessing medications including narcotics which need to be credited to the client or returned to

the narcotic locker or the pharmacy.

d. Omitting the administration of medications, treatments or other necessary activities which could

endanger the client’s life.

e. Failing to follow instructional directives.

f. Falsifying of records.

g. Stealing.

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

practice under the supervision of the faculty or the designee of the facility.


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

activities.

b. Failure to administer medications in a responsible manner.

c. Failure to follow the physician’s prescribed orders which have been held to be prudent by other

nursing personnel.

d. Failure to follow the instructional directives of the faculty member.

e. Failure to wait for instructor supervision when directed to do so by faculty or student policy.

f. Disclosing confidential information/knowledge concerning clients except where required by law.

g. Performing any act which is beyond the scope of her/his approved level of practice.

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

care plan grade, or grade on any required paper.


a. Cheating on an exam or allowing another student to copy answers.

b. Plagiarizing data for any reason.

c. Submitting late papers and then informing the instructor that the paper was previously submitted.

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

another student.

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

f. Utilizing advanced technology for sharing of information via text messaging, internet, etc.

g. Accessing on-line testing material before or after designated time frame.

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

equipment from campus or a clinical site.

Examples may include but not limited to:

a. Removing limbs, eyes or other body parts from the teaching mannequins or torsos.

b. Destroying computers, printers, CAI programs, library magazine/journal articles.

c. Taking CAI programs without permission.

d. Removing equipment from the lab without permission.

7. Using profane language or gestures.


a. Using inappropriate four letter words, profane or obscene language or obscenities, or words and

phrases that are derogatory or demeaning. Using language or engaging in conduct that could be

construed as sexual harassment under NHMCCD policy on sexual harassment.

b. Demonstrating obscene gesture.

c. Making derogatory statements regarding a specific cultural or ethnic group.

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


a. Arguing with an instructor over an assignment, examination, or other academic/ clinical issue.

The college recognizes the value of class discussion and debate. However, the College will not

tolerate students who are knowingly confrontational or who knowingly attempt to embarrass or

intimidate, making gestures, slamming down books, or talking loudly when someone else has the

attention of the group.

b. Monopolizing class time to share personal family problems, or medical experience.

c. Habitually arriving to class late and disrupting instruction that is in progress.

d. Missing more than allowed hours of clinical time or excessive class absence.

e. Failing to call the instructor when an absence from clinical occurs.

f. Having pager or cell phones not on silent, vibrate, or off mode, text-messaging during

36

class or clinical hours, contacting other nursing students via pager or cell phones is prohibited.

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

confrontational during the instructional process.

Examples can include:

a. Grabbing, hitting or assaulting a student, client, faculty or other persons affiliated with the

college or clinical site.

b. Using menacing, aggressive verbal or physical behavior.

c. Shouting obscene or abusive words.

d. Being argumentative and menacing.

e. Threatening others with physical or personal injury.

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


a. Dressing in a garment that is not the designated uniform.

b. Refusing to follow the guidelines for hair length.

c. Smoking or chewing gum while in uniform.

d. Coming to clinical in a dirty or wrinkled uniform without proper grooming.

11. Demonstrating behaviors that could be categorized as harassment.


a. Following or stalking a faculty member. Except in an emergency or under conditions previously

approved by the faculty member, a student needing to speak to a faculty member after classroom

hours, should schedule an appointment during the faculty’s scheduled office hours.

b. Calling faculty/administrators at home without specific permission.

c. Making repeated phone calls to the faculty member’s office or home to challenge grade or

assignment.

d. Making obscene calls to the faculty member’s office or home.

e. Harassing another student or faculty member in violation of the colleges’ policy on sexual

harassment.

CRIMINAL BACKGROUND CHECKS:

As a part of the admissions process, all nursing students will undergo a criminal background check. Students will

be conditionally admitted to the ADN and VN programs until the criminal background check is deemed

“negative” and all immunizations are complete, including the Hepatitis B series and a PPD tuberculin skin test.

The Texas Board of Nurse Examiners required an additional criminal background check as part of the licensure

process. The cost of all criminal background checks are the responsibility of the student

PROFESSIONAL LIABILITY INSURANCE:

All nursing students are required to carry professional liability insurance. Laboratory fees collected at the time of

registration cover the cost of the college student blanket policy with a major insurance carrier.

PROGRESSION REQUIREMENTS:

To remain in good standing and progress within the ADN curriculum, a student must attain a “C” or higher for

each course in the nursing degree plan and maintain an overall grade point average of 2.0 in the college. A

student must pass all concurrent nursing courses in a single semester to progress to the next semester. A student

who fails or withdraws from one or more concurrent courses must repeat all concurrent nursing courses in the

readmitted semester. In the Integrated Nursing Programs, a Mid-Curricular exam is given near the completion of

the second semester to evaluate the student's readiness for Nursing III. Remediation will be given to assist the

student to be successful in the following semester. In the Block Program, please see course syllabus for end of

course standardized testing.

A standardized exit exam will be given in the last semester of the program to determine readiness for the

licensure examination. Students must achieve an acceptable exit exam score in RNSG 2230 in order to graduate

37

from the nursing program. The student will receive an “Incomplete” in RNSG 2230 until the exit exam is

passed. See “NHMCCD Nursing Program HESI Exit Exam Options”, Appendix B, for details of this process.

All costs for the exams and remediation are the student’s responsibility.

READMISSION POLICY:

A student who withdraws from the Associate Degree Nursing Program is eligible for readmission only one time.

Readmission is not automatic. It is based on remediation of a problem area and space available. Students who

wish to be readmitted must interview with the program’s Readmission Committee. At this interview the student

will be asked to describe what steps have been taken in the intervening months to improve the chance of success

and an action plan for improvement of academic and/ or clinical performance. The committee will then decide if

readmission is advisable.

This policy does not apply to students who are unable to successfully complete the Nursing I courses. These

students must reapply to the program and comply with current admission criteria. The policy also does not apply

to students in the LVN or Paramedic Transition tracks who are unsuccessful in RNSG 1260 or RNSG 1417.

These students must reapply to the basic program.

Readmission into the nursing program must occur within two years of non-completion. After that time,

previously completed work will have to be repeated. Exceptions to the above readmission policy may be made

by the ADN Readmission Committee. Readmission is on a space-available basis.

REFUSAL TO PROVIDE CARE:

Students in the NHMCCD nursing program are expected to provide care to assigned clients. If refusal to care for

a particular client occurs, faculty will provide a review of the Nursing Code of Ethics and counsel the student. A

student who indicates persistent refusal to care for a particular type of client will receive further counseling

regarding the appropriateness of his/her career choice.

STUDENT REPRESENTATIVES:

At the beginning of the semester, each class will have an opportunity to elect class

representatives. These individuals will act as liaisons between the faculty team and the students.

TRANSFER OF NURSING CREDITS:

Students wishing to transfer from another nursing program must meet all ADN admission requirements. In

addition, the applicant must submit to the Nursing Department, the following documents:

1. Syllabi for nursing courses completed with a minimum grade of “C”.

2. A letter from the director of the former nursing program indicating the reason for the withdrawal and

if the student is in good standing. Transfer students must take Nursing III & IV in order to graduate

from the ADN program. Nursing courses must be no more than three years old. Qualified students

are admitted on a space available basis.

GRADING AND EVALUATION POLICY: The scale for determining a letter grade in Nursing is:

A 90 – 100

B 80 - 89

C 70 – 79

D 60 – 69

F Below 60

Students who miss an exam will be allowed ONE make up exam per course per semester within one week of the

missed exam. If more than one exam is missed, students will receive a zero for each additional missed exam.

See course syllabi for grading and evaluation criteria. Revised: May 2006

38


NURSING PROGRAMS

EXAMINATION REVIEW POLICY

The nursing faculty believes that the purpose of examinations is to :

• evaluate student knowledge of content, a minimal level being required for safe practice

• evaluate decision-making

• prepare students for the NCLEX-RN exam

• serve as a learning tool

• evaluate critical thinking

1. Students may request individual conference times with faculty members to review exams and receive

feedback and referrals. Conferences should be scheduled within two weeks of the exam. All

conferences must be scheduled prior to the final exam.

2. Students will be expected to adhere to the high ethical standards of the nursing profession, as well as

college standards for academic integrity. Cheating on exams, misrepresenting information and disclosing

exam questions to fellow students will be considered unethical behavior and grounds for dismissal from

the nursing program. See Student Handbook and Nursing Practice Act for further details.

ACADEMIC SUPPORT, STUDENT SERVICES

Several modalities are available to assist students with academic challenges. The college campus student

learning centers provide math, reading, and biology support. Nursing tutors are available thought the learning

resource center. Please refer to the www.nhmccd.edu\studentservices for further initiatives.

NHMCCD NURSING STUDENTS TRANSFERRING TO ANOTHER NHMCCD CAMPUS

NHMCCD nursing students who transfer to another NHMCCD nursing program (VN to VN; ADN to ADN),

will have access to textbooks used in the nursing program

CHILDREN IN THE NURSING CLASSROOM

The nursing faculty strongly recommends that children not be brought into the nursing classrooms while class is

in session. Children will not be allowed in the clinical or campus lab, for safety reasons. There are occasional

personal emergencies when a student has no alternative but to bring a child to class, or miss that class. In that

situation, it is the responsibility of the student to inform the faculty member in advance, and to seek approval for

that class. It is then up to the discretion of the individual faculty member to decide on the appropriateness of

having a child in the classroom, depending on the availability of space, the age of the child, the possibility of

distraction, and the appropriateness of language and/or content for the children. If the child becomes noisy or

distracting, it is up to the student to leave the classroom or the instructor will ask them to leave. Every effort will

be made to prevent distractions in the classroom, and to prevent the embarrassment of the student involved.

Faculty also recommend that students work on developing a list of alternative childcare options that might be

used when a personal emergency arises. There are currently two facilities, which are open 24 hours, a day and

take children on a drop in basis. One is located near Houston Northwest Hospital; the other is by Northeast

Medical Center Hospital. In addition, North Harris College has a child care center available to students. Please

call 281/765-7731 or 281/765-7730 for information.

39


HEALTH OCCUPATIONS PROGRAMS

STUDENT HEALTH PROCEDURES

(Source: Texas Dept of Health and NHMCCD Risk Management)

Introduction:

North Harris Montgomery Community College District recognizes its responsibility to protect the rights and

privileges of students, employees, patients, and the general public against the contact and spread of infectious

diseases. NHMCCD is also sensitive to the needs and rights of any of its employees or students who have

contracted diseases that might be infectious. In recognition of Human Immune deficiency Virus (HIV),

Tuberculosis (TB), and Hepatitis B Virus (HBV) as serious public health threats, NHMCCD has adopted the

following procedures.

The faculty of the Health Occupations Programs also believes that with proper education, skills, and

immunizations, students in health careers can be reasonably protected from risks of infection while performing

clinical activities.

The following procedures relate to:

1. admission of students who have infectious diseases

2. student immunization

3. tuberculosis policies and procedures

4. prevention of exposure to blood and body fluids

5. exposure to blood or body fluids

6. pregnancy/temporary disability/mobility assisted devices

7. impaired students in clinical practice, and

8. invasive campus laboratory activities for EMS students

Revised: May 2006

ADMISSION OF STUDENTS WITH HIV AND OTHER INFECTIOUS DISEASES

Purpose:

Preventing discrimination against students with HIV or other infectious diseases.

No prospective student will be refused admission based solely on a positive diagnosis of an infectious disease.

Further, NHMCCD will not require preadmission screening for infectious diseases as a condition of admission.

Once admitted, students with infectious diseases, including HIV positive will not be denied access to usual and

normal student activities.

Procedure:

Students will not be required to give information regarding having infectious diseases including HIV or HBV

prior to admission into the health occupations programs.

STUDENT IMMUNIZATIONS

Purpose:

To meet the requirements of the Texas Department of Health, and to protect the student and others from the

spread of infectious diseases.

Upon admission to the Health Occupations Program, students will be required to have current immunizations as

required by the Texas Department of Health. In addition, the hepatitis vaccine series is required to be completed

40

prior to the start of direct patient care. A PPD skin test for tuberculosis is required upon admission to the Health

Occupations Program and yearly thereafter (see tuberculosis policy).

Procedure:

Students enrolled in health career courses that have or will have direct patient contact must show proof of

immunizations using the attached form, or they may submit copies of the original immunization record. Students

who show serological documentation that they are immune to the Hepatitis B virus are not required to be

immunized upon the submission of appropriate medical documentation. These records may be submitted to the

division secretary, the clinical instructor, and/or the clinical facility, as requested. Students will be responsible

for keeping their own records and maintaining currency of immunization status.

Students who are not current on immunizations may not be allowed to attend clinical, depending on the discretion

of the clinical instructor and/or clinical facility. Without valid documentation, students will receive an absence

for each day excluded from clinical due to immunization status.

TUBERCULOSIS POLICIES AND PROCEDURES

Purpose:

1. To document status regarding tuberculosis exposure, both prior to attending clinical activities and following

exposure to tuberculosis.

2. How to prevent spread of tuberculosis.

TUBERCULIN TESTING

Policy:

All students, including those with a history of Bacillus of Calmette and Guerin (BCG) vaccination, must receive a

PPD tuberculin skin test (a tine test is NOT acceptable) prior to their first day of clinical, unless a previously

positive reaction can be documented, or completion of adequate preventive therapy or adequate therapy for active

disease can be documented.

Initial and follow-up tuberculin skin tests should be obtained and interpreted according to current guidelines.

Students with a documented history of a positive tuberculin test or adequate treatment for disease or preventive

therapy for infection should obtain a chest x-ray and review the symptoms of TB. They should be exempt from

future screening unless they develop symptoms suggestive of tuberculosis.

PPD negative students must have PPD’s done according to CDC guidelines. Currently, students must have yearly

PPD’s, however, CDC guidelines may change. Students, whose TB status is not current, as evidenced by

documentation will not be allowed in the clinical agency for the clinical experience of the class.

Procedures:

Students are responsible for maintaining current status. It is their responsibility to show documentation to the

clinical instructor as well as turn it in to the designated division secretary, and/or clinical facility. Students who

are unable to attend clinical due to incomplete immunizations will receive a clinical absence and no alternative

clinical will be provided for make-up.

EVALUATION OF STUDENTS AFTER UNPROTECTED EXPOSURE TO TUBERCULOSIS.

41

Purpose:

Students should be evaluated if they have been exposed to a potentially infectious tuberculosis patient for whom

infection control procedures have not been taken.

Persons with previously known positive skin test reactions who have been exposed to an infectious client do not

require a repeat skin test or a chest radiograph unless they have symptoms suggestive of tuberculosis.

Procedure:

Unless a negative skin test has been documented within the preceding 3 months, each exposed individual (except

those already known to be positive reactors) should receive a PPD tuberculin skin test as soon as possible after

exposure and should be managed in the same way as their contacts. If the initial skin test is negative, the test

should be repeated 12 weeks after the exposure ended. Exposed persons with skin test reactions of 5mm or with

symptoms suggestive of tuberculosis should receive chest radiographs. All diagnostic and treatment related

expenses are the sole responsibility of the student.

EVALUATION AND MANAGEMENT OF STUDENTS WITH POSITIVE SKIN TESTS OR

SYMPTOMS THAT MAY BE DUE TO TUBERCULOSIS

Students who have positive tuberculin skin tests or skin test conversions but do not have clinical tuberculosis

should be evaluated for preventive therapy according to published guidelines. Those with positive skin tests

should be evaluated for risk of HIV infection. If HIV infection is considered a possibility, counseling and HIV

antibody testing should be strongly encouraged.

All persons with a history of tuberculosis or positive tuberculin tests are at risk for contracting tuberculosis in the

future, and must be evaluated further.

Procedure:

These persons should be reminded periodically that they should promptly report any pulmonary symptoms. If

symptoms of tuberculosis should develop, the person should be evaluated immediately.

Students who test positive or convert to positive must obtain a letter from their physician stating it is safe for

them to return to class and the hospital setting.

ROUTINE AND FOLLOW UP CHEST RADIOGRAPHS

Routine chest films are not required for asymptomatic, tuberculin negative individuals. After the initial chest

radiograph is taken, those with positive skin test reactions do not need repeat chest radiographs unless symptoms

develop that may be due to tuberculosis.

Procedure:

Students with a positive skin test reaction will be required to submit evidence of a clear chest film prior to being

admitted into the clinical area. A repeat chest film will be required if symptoms develop.

RESTRICTIONS FOR STUDENTS WITH

CURRENT PULMONARY OR LARYNGEAL TUBERCULOSIS

Students with current pulmonary or laryngeal tuberculosis pose a risk to patients, other students, and staff while

they are infectious; therefore, restrictions for these persons are necessary.

Procedure:

Students with current pulmonary or laryngeal tuberculosis should be excluded from the classroom until adequate

treatment is instituted, cough is resolved, and sputum is free of bacilli on three consecutive smears. Individuals

who discontinue treatment before the recommended course of therapy has been completed should not be allowed

to attend class until treatment is resumed, an adequate response to therapy is documented, and they have negative

sputum spears on three consecutive days.

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RESTRICTION FOR OTHERWISE HEALTHY STUDENTS

WHO ARE RECEIVING TREATMENT FOR TUBERCULOSIS

Students who are otherwise healthy and receiving preventive treatment for tuberculosis infection should be

allowed to continue usual class activities.

Procedure:

Individuals who cannot take or do not accept or complete a full course of preventive therapy should have their

attendance in the classroom/clinical setting evaluated. Restrictions may not be necessary for otherwise healthy

persons who do not accept or complete preventive therapy. These persons should be counseled about the risk of

contracting disease and should be instructed to seek evaluation promptly if symptoms develop that may be due to

tuberculosis, especially if they have contact with high risk patients (i.e., patients at high risk for severe

consequences if they become infected).

CONSULTATION

Consultation on tuberculosis surveillance, screening, and other methods to reduce tuberculosis transmission

should be available from state health department tuberculosis control programs and infection control employee

health affiliates of clinical facilities.

Procedure:

Faculty and students will consult the policies and procedures at the clinical facilities where they have clinical

activities. Policies and procedures will be followed for both the facility and the college whichever is more

restrictive.

PREVENTION OF EXPOSURE TO BLOOD OR BODY FLUIDS

Purpose:

To minimize risk of exposure to blood borne pathogens.

Students must follow standard precautions when coming into contact with blood or body fluids.

Procedure:

1. Prior to practice in the clinical area, student must be given instructions by the clinical instructor in the

following areas:

a. the most current information on modes of acquiring and transmitting infectious diseases.

b. thorough instructions in standard precautions.

c. supervised practice in a skills lab.

2. Prior to practice in the clinical area, the student must demonstrate competency in standard precautions. Also,

students will be required to sign a communicable disease statement and waiver of liability form (see

attached).

EXPOSURE TO BLOOD OR BODY FLUIDS:

Purpose:

To protect the student’s health in the event of an exposure to blood and body fluids.

In the event that a student becomes exposed to blood or body fluids, the student must follow the procedures

outlined by the college. All expenses incurred are the sole responsibility of the student.

Procedure:

1. Current CDC guidelines for exposure to blood and body fluids must be consulted at www.cdc.gov.

2. Student must report exposure to clinical instructor, authorities in health care agency and his/her program

director at North Harris Montgomery Community College District.

3. The student, instructor and facility representative will collaborate to assess the clinical status of the

source client who exposed the student.

43

4. The faculty and faculty representatives will seek out the health care institution’s related policies for

additional information and guidance.

5. The student must be re-tested if negative following current CDC guidelines.

6. The student must seek counseling, or be referred to the college counseling service throughout the

experience.

7. In order to ensure the confidentiality of student and patient medical records, information is shared only

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

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

department.

STUDENTS WITH TEMPORARY DISABILITY:

Any students who request an accommodation in order to permit them to participate in some or all of the

health professions programs because of a disability that is not temporary must contact the Student Disabilities

office and initiate a request for accommodation.

PREGNANCY OR REQUIRING MOBILITY ASSISTIVE DEVICES:

Purpose:

To establish guidance on a student’s continued performance of published clinical objectives during pregnancy or

during any other period when a student is temporarily disabled.

Students who are temporarily disabled shall be entitled to the same rights given other students until such time as

their performance is documented to be impeded.

Procedure:

1. A student is not required to disclose the fact of pregnancy. For safety for the student and her fetus, it is

recommended that the student inform the clinical instructor.

2. A student shall be allowed to continue to perform all program objectives during pregnancy until the

student or her doctor communicate that it is no longer safe to do so, or when the student’s performance is

documented to be substandard, as described below.

“Other Temporary Disabilities”

1. A temporarily disabled student shall be allowed to continue to perform the published clinical objectives

until the student’s performance is documented to be substandard. Some conditions may preclude the

student’s ability to perform in the clinical setting. (For example mobility assistive devices such as

casts/crutches/canes.)

2. A student who has expressed or has been documented as having difficulty performing the published

clinical objectives because of a temporary disability shall be requested to consult with their physician to

determine whether the student may safely continue to perform the published clinical objectives.

3. After consultation with their physician, the student shall present to the division a signed statement from

the physician indicating whether the student can perform all of the tasks required. If the student’s

physician does not give the student an unrestricted release, the faculty member will review the

restrictions with the student and determine if the student is able to still meet the clinical objectives of the

program. If the necessary accommodations will compromise patient or student safety, the student shall

be required to withdraw from the program, but shall be entitled to readmission. Reimbursement for fees

and tuition will be in accordance with general policy for reimbursements.

IMPAIRED STUDENTS IN CLINICAL PRACTICE

Purpose:

44

To protect patient health and safety from students whose performance is impaired by suspected chemical

dependency and/or mental illness.

Students whose performance is impaired by mental illness and/or chemical dependency will not be allowed to

participate in clinical settings. Students in recovery may participate in all aspects of clinical experience and

nursing students will be advised to contact the Board of Nurse Examiners to facilitate eventual licensure and

compliance with proposed restrictions, such as TPAPN (Texas Peer Assistance Program for Nurses)

participation.

Procedure:

The student whose performance is impaired by suspected chemical dependency and/or mental illness and would

therefore endanger patient health and safety will be prohibited by the instructor from participating in the clinical

experience.

1. The on-site instructor will determine whether in his/her judgment, student performance presents a danger

to the patient’s health and safety.

2. The student restricted from practice will be required to call a support person/friend to accompany

him/her to home or to a treatment provider.

3. The student will be advised to seek treatment and referred to counseling services at the college.

4. The instructor will document the specific behavioral observations that required removing the student

from the clinical area.

5. Impaired behavior negatively affecting performance will result in dismissal from the course and failure.

6. Student confidentiality will be maintained at all times, with the exception of informing those who need to

know.

7. Faculty will comply with Sec.301.404 of the Nursing Practice Act which states “ A professional nursing

education program that has reasonable cause to suspect that the ability of a professional nursing student

to perform the services of the nursing profession would be, or would reasonably be expected to be,

impaired by chemical dependency shall file with the Board a written, signed report that includes the

identity of the student and any additional information the Board requires.”

Refer to Chemical Abuse Policy for further information.

Drug and Alcohol Abuse Policy and Procedure

NHMCCD Health Occupation programs must maintain a safe and efficient academic environment for students

and must provide for the safe and effective care of patients while students are in a clinical setting. The use of

substances, lawful or otherwise, which interferes with the judgment, ability or execution of skills while in the

clinical setting, poses an unacceptable risk for patients, colleagues, the college and the health care agency.

Therefore, the unlawful use, manufacture, possession, distribution or dispensing of alcohol or illegal drugs, the

misuse of legally prescribed or over the counter drugs, or being under the influence of such substances while

engaged in any portion of the clinical education experience poses an unacceptable risk for patients, colleagues,

the college and the health care agency and is strictly prohibited.

Drug and Alcohol Testing

1. Testing prior to the Clinical Experience

Students should be aware that clinical agencies with which NHMCCD contracts may require successful

completion of a drug/alcohol testing prior to commencement of the clinical experience.

Students receiving negative drug screens or positive drug screens due to permissible prescription drugs

will be permitted to begin/continue clinical class experiences unless specifically prohibited by the

clinical agency. In the latter case, medical review and documentation will be required.

45

Students testing positive for illegal substances or for non-prescribed legal substances will be dismissed

from the nursing program.

2. Reasonable Suspicion Testing

Students engaged in clinical activity may be requested to undergo a blood or urine screen for drugs and

alcohol if reasonable suspicion exists to believe the student is using or is under the influence of drugs or

alcohol such as to interfere with the safe performance of duties. Reasonable suspicion requires some

specific basis which indicates the student is using or is under the influence of drugs or alcohol prior to

requiring testing. Reasonable suspicion may include but is not limited to:

a. observable phenomena, such as direct observation of drug/alcohol use or the physical symptoms

or manifestations of being under the influence of such; or

b. abnormal conduct or erratic behavior.

In situations in which an instructor has basis to believe that reasonable suspicion exists or that the student

may endanger the safety of patients, employees or self, the instructor will immediately remove the

student from the clinical situation before taking further action.

The instructor will provide detailed documentation of the basis for reasonable suspicion and the

subsequent steps taken immediately following the clinical event. Documentation should include date,

time, behavior, observations and persons involved. A copy should be provided to the Program director.

The student will be presented with the basis for reasonable suspicion and requested to undergo a

blood/urine drug screen within 24 hours. The costs of all testing done on a reasonable suspicion basis

shall be incurred by the student. The nursing director may require a specific test panel and/or vendor for

testing. The student will have to give consent for such testing, and authorization for results to be made

available to the Director of the program. A student who refuses to undergo testing or release of

information may be subject to dismissal from the program.

If it is determined that the student cannot safely continue with assigned tasks, the student will not be

allowed to return to the clinical setting that day regardless of whether reasonable suspicion is

corroborated or if the student is tested or not. Students dismissed from clinical for reasons above must

contact another person to take them home. Students are not to drive and must leave the facility

immediately upon instructor’s request.

The student who is requested to undergo drug testing must provide results from the drug test to the

Program Director within seven days from the incident. Students who are drug tested may not return to

the clinical setting until results from drug screen are provided.

Negative Screening Test

If the results of the test indicate a negative test for alcohol or drugs, the student shall meet with the

program Director to discuss the circumstances surrounding the impaired clinical behavior. Based on the

information presented during this meeting, the Program Director or designee will make a decision

regarding student’s return to the clinical setting.

If returned to clinical setting, the student must make-up any clinical absences incurred.

Positive Screening Test

If the results of the drug screening test are positive and the student provides documentation of a

prescription for the substance, the Program Director and/or designee will consider the case in

46

collaboration with the student and his/her health care provider. Each student will be asked to disclose

prescription and over-the-counter medications he/she is taking at the time of testing.

If the test is positive for alcohol, illegal substances, or medications not prescribed for that individual, the

student will be dismissed from program. If dismissed, student will be notified within seven days from

Director’s receipt of drug screen. After dismissal, the student may appeal the decision within seven days

with the Campus Chief Student Affairs Officer (CSAO). The CSAO will review the case and respond

according to college policy.

If no written notice of appeal is filed by student within given timeframe, the decision stands. If

extenuating circumstances exist which prohibit the student from responding within seven days, the

student has three additional days to appeal. Extenuating circumstances are:

1. Student is hospitalized. (Must show written proof).

2. Death of family member (Must submit death certificate).

3. Other emergencies and circumstances beyond the students’ control, i.e., hospitalization,

severe injury or illness to immediate family member. (Must show proof in form of verifiable

doctor’s release.)

The student may appeal the College CSAO decision according to existing College policy.

Should the student wish to appeal the decision of the Disciplinary Committee, he/she may do so

according to existing campus policy.

In addition, the student is subject to requirements of appropriate licensing, regulatory or certifying

agencies. Graduation from the program of study does not guarantee certification or licensing from

licensing, regulatory or certifying agency. Students are encouraged to review standards set forth by

licensing or regulatory agencies regarding limitations for practice. These standards may not be inclusive

of standards outlined above and there may be additional requirements outlined by their licensing agency.

COMPLIANCE WITH AMERICANS WITH DISABILITIES ACT

The NHMCCD faculty subscribes to the Core Performance Standards recommended by the Southern Council on

Collegiate Education for Nursing. Nursing students who qualify under the Americans with Disabilities Act are

expected to review these core performance standards. If a student believes he or she cannot meet one or more of

the standards without accommodations, it is the responsibility of the student to inform nursing faculty of the need

for a reasonable accommodation at the BEGINNING of the nursing program or if status changes. Every effort

will be made to provide the appropriate assistance and guidance to students who identify potential difficulties

meeting these standards. The standards with examples and signature acceptance page are provided in Appendix B.

STATEMENT OF ACADEMIC INTEGRITY

NHMCCD is committed to a high standard of academic integrity among its faculty and students. In becoming a

part of the NHMCCD academic community, students are responsible for honesty and independent effort. Failure

to uphold these standards includes, but is not limited to, the following: plagiarizing written work or projects,

cheating on exams or assignments, collusion among students on an exam or project without specific permission

from the instructor, or misrepresentation of credentials or prerequisites when registering for a course. Cheating

includes looking at or copying from another student's exam, communicating or receiving answers during an exam,

having another person take an exam or complete a project or assignment for you, using unauthorized notes, texts,

or other materials into class with you for an exam, or obtaining or distributing an unauthorized copy of an exam

or any part of an exam. Plagiarism means the unauthorized use of another's writings without proper

documentation and includes copying material from another source without clear documentation of the source or

47

submitting a paper, report, project, or care plan that someone else has prepared. Collusion is inappropriately

collaborating on assignments designed to be completed independently. These definitions are not exhaustive.

When there is clear evidence of cheating, plagiarism, collusion, or misrepresentation, disciplinary action may be

taken, including but not limited to: the student's presenting an oral defense, resubmitting the assignment in

question, receiving a zero or an F on the assignment, or being withdrawn from the course or expelled.



STUDENT POLICIES FOR CLINICAL AREA

In order to provide for optimal client safety as well as consistency in student learning, the Associate Degree

48

Nursing faculty developed the following guidelines for the clinical experience for students. The guidelines have

been developed in conjunction with hospital personnel and current agency policies. Should a situation arise

where an agency's policy is more restrictive than these guidelines, the agency policy will be followed.

1. Students will report on the status of assigned clients to the designated licensed nurse prior to leaving the unit.

In the acute care setting he/she will also document the client’s status and the name and title of the person to

whom the report was given in the nurse's notes.

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

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

designated nurse.

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

waste forms.

4. Students who work must have adequate sleep to safely care for assigned clients and be able to remain awake

and alert during pre conference, clinical, and post conference.

5. NHMCCD forbids the use of, or appearance of, the influence of narcotics (opium and derivatives),

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

College Catalog under Student Conduct.

See Code of Conduct in the Student Handbook for further standards.

Any behavior in the clinical area which exposes a client to physical or emotional harm may cause a student

to be dropped from the nursing program.

Revised August 2004

MEDICATION POLICY

1. Students are to identify clients for medication administration by following facility policy and cross

checking client name and identification with name band.

2. In alternate clinical settings, students are required to follow facility policy when identifying clients

for medication administration.

3. The ability of students to administer medications in the clinical setting depends on the course in

which they are enrolled. Students in Nursing I may administer oral, topical, rectal, and feeding

tube medications. In addition, students in Nursing II, III, IV and VN elective may:

A. Administer subcutaneous, intradermal, and intramuscular medications.

B. Administer pre-mixed continuous intravenous solutions. *See below for additional restrictions.

In situations where a physician’s order is questioned (i.e., automatic stop date, legibility, etc.) and

cannot be verified with the physician or by agency policy, the student may not carry out the order.

4. Students may not accept verbal or phone orders with the exception of Nursing IV students. In Nursing

IV, they may accept verbal phone orders if the instructor or primary nurse is able to listen to the phone

conversation or is present to hear the verbal order.

49

5. Students may not administer medication to a client in a psychiatric hospital. This directive includes the

psychiatric units that are located in acute care settings.

6. Students needing to give a medication to a client in an area other than his/her assigned faculty room, i.e.,

radiology, etc., must have the nursing instructor present when giving the medication. Students with

preceptors must have the preceptor present in this situation.

7. Students may NOT administer:

a. IV anti-neoplastic agents

b. Intrathecal medications

c. Porta-cath meds into ports not previously accessed

8. Students are NOT to administer blood components that must be typed and/or cross-matched, i.e., RBCs,

whole blood, platelets, fresh frozen plasma, cryoprecipitate, and plasma products used for coagulation

factor deficiencies. Students may assist in monitoring client responses to such therapies.

NOTE THAT THE FOLLOWING POLICIES REFER TO CERTAIN MEDICATIONS THAT

HAVE RESTRICTIONS OR ARE NEVER GIVEN INDEPENDENTLY BY THE STUDENT

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

case” basis. In all cases, the nursing instructor reserves the right to require additional restrictions based

on the learning level of the individual student and/or specific client situation.

10. THE STUDENT SHOULD VERIFY THE ORIGINAL PHYSICIAN’S ORDER before

administering the following:

Insulin Any intravenous push medication

Lanoxin Any primary IV with additives

Anticoagulants Any one time dose or stat medication order

Pediatric medications Mixed medications (i.e. narcotic and anti-

Controlled substances emetic in a syringe)

Oral anti-neoplastic agents

If the original orders cannot be located, the instructor/student will use good judgment based on the

individual situation. If in a non-hospital agency, agency policy must be followed.

11. Nursing III and IV students may:

A. Mix and/or administer continuous IV solutions with additives (i.e. K+ or MVI) under the direct

supervision of the instructor or “instructor designated” nurse.

B. Administer IVPB medications with instructor or “instructor designated” nurse.

12. The following must be given under the direct supervision of the nursing instructor or “instructor

designated” nurse. The instructor must be notified for approval and reserves the right to be present for

certain drugs. He/She will verify client, dosage, lab values etc. or will designate a staff nurse to do so.

Lanoxin (Nursing I and II) IVPB medications

TPN solutions

Narcotics

50

Albumin

13. In addition to the requirements above, the following medications are to be verified each time by the

nursing instructor (per phone or in person) and additionally by the nurse assigned to the client.

The student will show the MAR and actual medication to two licensed nurses prior to administration.

The nursing instructor may designate a separate nurse plus the nurse assigned to the client.

Insulin IV of NaCl solution above 0.9%

RhoGam Any med requiring calculation of dosage

IV with K+ Anticoagulants (heparin, Coumadin, Lovenox)

Pediatric meds Mixed meds (i.e. narcotic and anti-emetic in a syringe)

Oral anti-neoplastic agents

CLINICAL DRESS GUIDELINES

To maintain a professional appearance and infection control, the following guidelines have been established.

• White scrub top and scrub jacket with teal scrub pants are the official uniform.

• Uniforms and shoes neat and clean. If pants are worn, they must be loose fitting. No contrasting color or

pattern should be worn under whites.

• White nurses shoes are recommended. All white leather athletic shoes are also acceptable.

• A patch identifying the nursing program is required and worn on the left shoulder of the scrub top and jacket.

The jacket must be clean and neat.

• Hair secured up and off the collar to prevent falling into client wounds and sterile fields.

• Fingernails short (career length), neat and clean. Long unkempt nails can tear skin and introduce pathogens.

• Neutral or clear nail polish is acceptable. Remember pathogens can harbor in cracks of chipped nails.

• No artificial nails.

• Plain wedding bands may be worn. Rings can harbor microorganisms and can tear skin.

• Earrings should be small (studs), not dangling. Pediatric and confused clients can tear off earrings. Hoop

earrings can be caught by stethoscope and tear the ear lobe. No rings will be worn in other conspicuous

areas of the body (i.e., nose, lip, tongue, eyebrow, etc).

• Cosmetics should be applied conservatively to present a professional appearance.

• Eating, drinking, or chewing gum in client care areas is not acceptable.

• Avoid perfumes or after-shave lotions.

• Hair should be a natural color. Any unnatural colors such as pink, green, blue-etc., are not acceptable.

• Tattoos that are visible outside uniform must be covered while in clinical, either with makeup or a scrub

jacket, depending on location of tattoo.

51



GUIDELINES FOR THE EMPLOYMENT OF NURSING STUDENTS

The faculty of the Associate Degree Nursing Program supports the mandatory Nursing Practice Act of the State of

Texas requiring that persons be licensed to perform specific nursing tasks. Therefore the faculty's position

regarding employment of unlicensed undergraduate nursing students is as follows:

• Students who accept positions in which they receive compensation for client care, do so as unlicensed

individuals and may not wear the Associate Degree Nursing program uniform, name pin or other insignia of

their student status.

• Students are advised to familiarize themselves with the State of Texas Nursing Practice Act so that they will

recognize the full scope and responsibility of nursing practice. Students must realize that they may be held

legally liable for their actions, and therefore, should not accept responsibilities nor perform nursing actions

beyond their knowledge and skills, nor within the responsibilities of the licensed professional nurse.

• The performance of students when working for compensation is the legal responsibility of the individual

student and the employing agency.

• Students are responsible for preparation for classroom and clinical experiences and for maintaining the

required grade point average in the nursing program. The demands of part-time employment upon the student's

time and energies should be carefully considered.

• Night shift employment and employment beyond twenty hours per week is discouraged.

The Rules and Regulations Relating to Professional Nurse Education, Licensure, and Practice state:

"Certain nursing tasks may be delegated to professional nursing students working as unlicensed personnel

in agencies, facilities, or institutions provided the students are currently enrolled in accredited professional

nursing programs or are on semester breaks from such programs, and their course of study has included

appropriate instruction to prepare them to perform the tasks which will be delegated."

Reviewed May 2006

52

GLOSSARY OF TERMS USED IN CURRICULUM


Source of selected terms below is DELC for Texas Nursing Graduates, Sept. 2002

Accountability:

State of being answerable for one's actions -- the registered nurse answers to self, the individual, the profession, the

employing institution, and society for the effectiveness of nursing care performed. (Potter)

Adaptation:

The ability of the individual to maintain the physiological and psychological balance needed for a state of well being;

the process by which change occurs in any of a person's dimensions in response to stress. (Potter)

Advocate:

Being the client's "agent," looking out for his or her rights. (Rubenfeld, 1995)

Alterations in Cellular Metabolism:

Disruptions in cell growth, reproduction, and repair - effects on the individual's ability to meet basic needs.

Alterations in Fluid and Electrolyte Balance:

Disruptions in the levels of water and the elements it contains, and the effect this has on the individual's ability to meet

basic needs.

Alterations in Perception:

Disruptions in the way an individual senses, interprets and understands his environment and the effect this has on the

individual's ability to meet basic needs.

Alterations in Transport:

Disruptions in motor sensory function or in the movement of oxygen, nutrients, and wastes and the effect this has on

the individual's ability to meet basic needs.

Articulation:

The processes through which nursing programs cooperate to facilitate educational progress of students with minimum

repetition; a seamless curriculum.

Assessment:

The first step in the problem solving and/or nursing process; involves gathering, verifying, and communicating data

about a client so that a database is established.

Associate Degree Nurse: A graduate of an associate degree nursing program who is eligible for licensure as a

registered nurse or is currently licensed in the state in which he or she practices. (NLN)

Assistive Personnel:

Employees who give and/or support client care as delegated by the registered nurse.

Basic needs:

The requirements which are necessary for the individual survival and health according to Maslow. They are: nutrition,

digestion and elimination, maintaining body temperature, rest and comfort, oxygenation and circulation, mobility,

sexuality, safety and security, love and belonging and self-esteem.

Caring:

Conveying, through verbal and nonverbal behaviors, nurturing, supportive feelings for clients and significant others.

(Rubenfeld, 1995)

Client:

53

Persons who engage the professional advice or services of healthcare professionals; persons who are served by or

utilize the services provided by a healthcare agency. The client may be an individual, a family or a group of persons in

the community who share a common need and are members of the healthcare team.

Collaborating:

Working with other health care professionals and significant others to provide care. (Rubenfeld, 1995) A relationship

beyond cooperation which uses negotiation to achieve desired outcomes, and creates partnerships. (NLN Vision

Project)

Communication:

Verbal and nonverbal behavior within a social context. Includes all symbols and clues used by persons in giving and

receiving messages. (Potter)

Common health problem:

Health problems about which an essential core of knowledge exists and for which standardized diagnostic evaluative

and treatment regimes are in most instances used. (NLN)

Community:

A group of people who reside in a specific locality, share government, and often have a common cultural and historical

heritage; a social, religious, occupational, or other group sharing common interests or a common heritage; the public;

society.

Community-based nursing:

Nursing activities in a variety of facilities located within the community of service.

Competency:

The knowledge, attitudes, skills and behaviors that establish acceptable performance in a particular situation.

Conceptual framework:

The conceptual construct, which is the guide for curriculum building; provides the foundation and materials from

which the total curriculum structure is devised.

Consumers:

Individuals or groups who access or have the potential to access nursing to meet identified or perceived health care

needs. (NLN Vision Project)

Coordinator of care:

One who organizes and facilitates the delivery of comprehensive services to clients using other provider's services,

human and material resources, and collaboration with clients, their support services, and an interdisciplinary health care

team.

Critical thinking:

Skills in reasoning, analysis and decision making relevant to the discipline of nursing.

Culture:

A set of learned values, beliefs, customs, and behaviors that are shared by a group of interacting individuals.

Homogenous learned patterns of behavior, values, and attitudes shared by a group of people and passed from one

generation to another. (Potter)

Curriculum:

The totality of learning activities that are designed to achieve specific educational goals.

Developmental level:

54

The observable aspects of an individual’s behavior and appearance that indicates his/her cognitive, psychosocial and

physiological stage of functioning.

Direct supervision:

Actual observation of individuals providing nursing care.

Discharge planning:

Set of decisions and activities involved in providing continuity and coordination of nursing care when a client is

discharged from a health care agency. (Potter)

Educational outcomes:

The knowledge, skills, and attitudes demonstrated by the associate degree nurse as the result of associate degree

nursing education. Educational outcomes encompass those competencies expected at the time of graduation as well as

those anticipated after six months of practice as a registered nurse. (BNE, DELC, 2002; NLNAC 2003)

Empowerment:

Providing consumers with tools and/or support to act on their own behalf. (NLN Vision Project)

Environment:

All conditions, which make up the internal and external surroundings for the individual.

Ethics:

Principles or standards that govern proper conduct as they apply to professional issues or problems.

Evaluation:

The step of the nursing process, which involves determining the extent to which the established client goals have been

achieved and the effectiveness of nursing interventions.

Evidence-based Practice:

Client care determined by data gathered from assessment, clinical expert opinion, research findings, scientific

information, practice guidelines, standards of care and evaluation.

Experienced registered nurse:

A nurse who has demonstrated expertise in her or his area of practice. Further, the experienced registered nurse is able

to supervise and teach the new associate degree graduate in such a way to promote the graduate's growth.

Facilitate:

To guide without directing; bringing about change without disruption, helping people self discover new approaches and

solutions to problems; knocking down walls which have been built between people while preserving structure of value;

and above all, appreciating people as people. All of this must be done without leaving fingerprints. (Bob Keisch,

Xerox)

Family:

Two or more people who may share a residence, who possess common emotional bond and perform/engage in

interrelated social positions, roles and tasks.

Goal:

Expected outcome or changes in the status of the individual after receiving nursing care; written in terms of what the

individual is expected to do, is measurable, attainable and includes a time frame.

a. Short-term goals are achieved over a relatively short period of time usually less than a week.

b. Long term goals are achieved over a longer period of time, usually weeks or months.

Health:

55

Dynamic state in which an individual adapts to his internal and external environments so that there is a state of

physical, emotional, intellectual, social, and spiritual well-being. (Potter)

Health care consumer: see client.

Health promotion:

Health education programs or activities directed toward maintaining or enhancing the health and well-being of

individuals. (Potter)

Homeostasis:

The body's tendency to maintain itself in a state of relative constancy and adapt to changes in the internal and external

environment; basic needs are met by minimal output of energy.

Implementation:

The step of the nursing process which involves initiating and carrying out the nursing interventions that foster

achievement of identified goals and that restore, maintain and promote the individual's health.

Knowledge:

An idea or a phenomenon to which a nurse has been exposed and which she or he can remember either by recall or

recognition; frequently manifested by the capacity to name, describe, list, state, explain, etc. (NLN)

Knowledge deficit:

Absence or deficiency of cognitive information related to a specific topic. (Ackley, 6th

ed.).

Learning:

The acquisition of knowledge, skills, and abilities that results in a change in behavior in the learner. (NLN)

Member of profession:

Someone who accepts responsibility for the quality of nursing care for clients; applies research findings and

identification of further research; is aware of legislative, regulatory, ethical and professional standards; aspires to

improve the discipline of nursing and its contribution to society; and values the need for life-long learning.

Multidisciplinary health care team:

A group of individuals with varying skills whose cooperative efforts are designed to assist individuals to attain and

maintain an optimal level of wellness.

Multiple Entry-Exit Program:

A nursing program which grants students credit for specific competencies already achieved and allows them to exit

with skills as a Certified Nursing Assistant, Licensed Vocational Nurse, or Registered Nurse with an associate degree.

Need:

A fundamental physiological or psychosocial requirement for the well being of an individual. (NLN, 1990)

Novice:

Beginners who have had no experience of the situations in which they are expected to perform. (Benner)

Nursing diagnosis:

The step of the nursing process, which involves identifying actual or potential problems in the individual's health status

that the nurse is competent and licensed to treat. A statement of a nursing diagnosis includes:

a. A problem (according to NANDA)

b. A description of the etiology or probable cause of the problem

c. A list of the cluster of subjective and objective data that lead the nurse to pinpoint the problem

Nursing process:

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A problem-solving approach to the identification of a client's needs and the utilization of nursing interventions

designed to maintain, restore, or support health status. The major components of the process are assessment, diagnosis,

planning, implementation, and evaluation. (NLN, 1990)

Outcome: The result of performance.

Clinical Outcome:

The measurable expectation established by the client in collaboration with other members of the healthcare team; the

degree to which client care benchmarks are met.

Positive Client Outcome:

The result of accomplishing the desired performance and meeting the identified benchmark.

Optimal health/optimal wellness:

An individual's perception of the highest level of functioning or well being achievable based on values and capabilities.

(NLN Vision Project)

Philosophy:

Devised narrative statement on the philosophy of the agency and agreements of the faculty.

Planning:

The step of the nursing process which involves identifying individual goals, determining priorities of care and

designing nursing strategies which are based on the identified nursing diagnosis and established goals.

Preceptor:

A registered nurse who directly supervises a student clinical experience, meets or exceeds the performance standards of

the institution and demonstrates an interest and ability to work effectively with students.

Predictable outcome:

Results that can generally be anticipated in advance

Prevention of illness or injury:

Nursing care preceding disease or dysfunction applied to clients considered physically and emotionally healthy

(primary); focusing on individuals who are experiencing health problems or illnesses and who are at risk for developing

complications or worsening conditions (secondary); occurring when a defect or disability is permanent or irreversible,

and involves minimizing the effects of the disease or disability by interventions directed at preventing complication and

deterioration (tertiary). (Potter)

Prioritizing:

The process of ranking nursing care in order of importance; identifying the order in which nursing interventions will be

provided when an individual has multiple problems or alterations, or when there are multiple clients with multiple

problems. (Potter)

Provider of care:

One who provides nursing care to individual clients using a systematic process of assessment, analysis, planning,

intervention, and evaluation.

Rationale:

statement of the scientific principles that provide the nurse with. a reason for selecting or performing a certain nursing

intervention.

Rehabilitation:

57

Restoring an individual to normal or near normal function following a physical or mental illness, injury, or chemical

addiction. (Potter)

Response:

Physiological and psychological adaptations that occur with changes in man's environment and grouped in the

following four areas: perception, cellular metabolism, transport and fluid/electrolyte balance.

Scientific principles:

Comprehensive and fundamental laws, truths, or sets of facts derived from the biological, behavioral and social

sciences that form the basis for nursing interventions.

Seamless curriculum:

A nursing curriculum which facilitates movement from one nursing educational level to another with minimum

repetition.

Significant other:

A person or group of people likely to have influence on or a close relationship with the client. (NLN)

Significant Support Person(s):

An individual or group considered to be special and have an effect on the client. Support person(s) may include family

members, friends, and colleagues.

Society:

Community, nation, or broad grouping of people having common traditions, institutions, collective activities, and

interests, and organized patterns or relationship through interacting with one another.

Setting :

The organizational and physical environment in which nursing care is delivered. (NLN, 1990)

Skill:

A mode of operation or a generalized technique for dealing with a problem. (NLN)

Structured setting:

Geographical and/or situational environment where the policies, procedures, and protocols for provision of health care

are established and in which there is recourse to assistance and support from the full scope of nursing expertise.

Teaching-learning process:

Interaction between the teacher and learner in which specific learning objectives are presented and met. (Potter)

Therapeutic communication:

Planned, deliberate, purposeful communication to form a working relationship with clients to fulfill the purposes of the

nursing process. (Potter)

Unpredictable outcome:

Results that generally cannot be anticipated in advance.

Unstructured setting:

Geographical and/or situational environment, which may not have structured policies, procedures, and protocols and

have the potential for variations requiring independent nursing decisions.

Wellness-illness continuum:

One dimension of human life, which ranges from extreme illness to peak or high level wellness; an individual can be

located at any point on the continuum at any time.

58

APPENDIX - A



NURSING HONORS CONTRACTS

The ADN Program consists of twelve smaller courses, divided between lecture, lab and clinical courses. The nursing faculty

recommend that the lecture courses become the designated honors courses. Each lecture course is five credits. The student

would receive five honors credits at the completion of an honors contract. To be designated an Honors Graduate, a student

must complete fifteen hours of honors contracts, which would be three nursing honors contracts. To be designated an Honors

Scholar, a student must complete at least ten hours of honors contracts with at least a 3.5 GPA and twenty-five hours of

community service. An Honors Scholar with Distinction must complete fifteen hours of honors contracts and twenty-five

hours of community service. Please see Honors Handbook for further details.

Over the four semesters, the ADN program focuses on developing three roles for the professional nurse: provider of care,

coordinator of care, and member of the profession. These roles are delineated for each nursing level (CNA, ADN, BSN) by

the National League for Nursing and by Texas Differentiated Entry Level Competencies (DELC) Competencies. In the

courses offered through NHMCCD, these roles are developed progressively as the student prepares for entry into practice as a

graduate nurse. Honors contracts allow students to pursue additional experiences and interests in each of these roles and/or in

specialty areas of their choice. Students in Nursing 1 develop projects using the Internet and the computer which would

supplement their learning. Students in Nursing 2 pursue activities related to the provider of care role. In Nursing 3, students

select either of the above or develop the role of coordinator of care. In the final semester, students select any of these options,

with an opportunity to develop further as a member of the profession of nursing.

In the four semesters, students are expected to learn about the decision-making process in nursing, different health care needs,

and nursing care to address the needs of diverse clients across the age continuum. Students work in small teams to develop

and implement care, including developing skills in assessment, communication and teaching. In a variety of clinical settings,

students learn to independently care for groups of clients and their family members with many different types of disease

processes.

With an honors contract, students have an opportunity to develop skills in critical thinking, specialty areas such as pediatrics,

obstetrics, and emergency care, and leadership skills for the workplace. Faculty who teach the different courses are able to

work with students on honors contracts.

Several ideas have been recommended as possible honors contract activities:

1. Work with a nurse in a specialty area for a minimum of ten hours to apply skills and knowledge to this clinical

area. These could include a pediatric clinic, a prenatal clinic, a labor and delivery unit, an emergency room or

clinic, an intensive care unit, hospice, or other specialty area. At the end of this experience, the student would

write a paper on the application of the course objectives in the specialty area.

2. Develop an advocacy relationship with a client and/or acquaintance with health care needs that will continue

throughout the semester. In this relationship, the student would be an advocate for the client when going to a

doctor’s office or clinic, when filing insurance claims, when having treatments, and when following the

treatment plan at home or work. The student would research the health care problem and serve as a resource to

the client and the family. Some types of health care problems would be diabetes, cancer, congestive heart

failure, recent heart attack or stroke, pregnancy, new baby in the family, etc. This advocacy role would provide

an avenue for understanding problems from the client’s point of view as well as offering assistance to a person

in need.

3. Develop teaching skills through a planned activity with clients and their families, such as working with a

diabetic educator, a childbirth educator, or a mental health educator. The student would attend classes offered

by a nurse educator, and then assist with portions of the classes as appropriate.

59

4. Develop skills in management of nursing care through working with a charge nurse, nurse manager or case

manager for a minimum of ten hours. The student would be expected to identify the type of leadership activities

in this position, areas of problem solving and crisis management, and how the nurse manager motivates

members of the staff or team.

5. Develop a role in nursing education by working with a nurse educator for a minimum of ten hours in the

classroom and the clinical setting. The student would assist the instructor with students and with

teaching/learning activities. This is one way to stimulate interest in a possible role as a nurse educator.

6. An independent learning contract could be developed to stimulate the student’s interest in a professional

organization, an ethical situation, an expanded role, or other similar type of activity.

7. A literature search and topic exploration of a health care topic of interest to the student and relevant to the

course content. This option is available only to Nursing I students.


HONORS PROGRAM

Associate Degree Nursing courses: See college catalog for listings

Prerequisite: Acceptance into ADN Program Fall/spring semesters

Course Description

See college catalog for individual course descriptions. Each course in the nursing program builds on prior

courses, with a focus on each role of the nurse as outlined by the National League for Nursing. Therefore,

honors candidates may select a topic of interest in any role of the nurse addressed in the currently enrolled

course or prior courses.

Honors Contract

Honors candidates will complete a comprehensive exploration of a topic which will be selected by the student

in collaboration with the faculty. This activity is designed to enhance the learning experience through pursuit

of an area of interest beyond the expectations of the course. This gives the student an opportunity to:

• Develop critical thinking skills in applying theory to practice issues.

• Integrate practice, theory, and research into a synthesized report.

• Identify community resources in relation to practice area.

• Pursue an area of interest in nursing to determine individual goals.

Upon completion of the project, candidates are expected to write a formal report summarizing the work

accomplished, and to provide an oral presentation during the honors review program. A “B” average must be

maintained in the course to receive honors credit.

Intended Audience

Students enrolled in the nursing program that have a strong interest in practice issues, specialty areas, and a

curiosity to learn more about the nursing roles in practice. The projects require much extra time, study and

effort to complete the project. However, the benefit to the student is immeasurable. All candidates must

receive approval from the program director and have a 3.0 grade point average in nursing courses.

Instructors

Nursing faculty members are committed to supporting students in their pursuit of honors contracts. The

program director will serve as honors mentor, with individual course instructors serving on the honors faculty

team. Seminars will be held throughout the semester with honors students in each nursing course participating

together in discussion of issues. A faculty honors mentor from each course represented will participate in these

seminars.

60

APPENDIX B

Compliance With Americans With Disabilities Act

The NHMCCD faculty subscribes to the Core Performance Standards recommended by the Southern Council on

Collegiate Education for Nursing. Nursing students who qualify under the Americans with Disabilities Act are

expected to review these core performance standards. If a student believes he or she cannot meet one or more of the

standards without accommodations, it is the responsibility of the student to inform nursing faculty of the need for a

reasonable accommodation at the BEGINNING of the nursing program or if status changes. Every effort will be

made to provide the appropriate assistance and guidance to students who identify potential difficulties meeting these

standards. The standards with some specific examples follow:

Issue Standards Examples

Critical

Thinking

Cognitive

Ability

Critical thinking sufficient for

clinical judgment.

Identify cause and effect relationships in clinical

situations, develop a plan of care.

Interpersonal Interpersonal abilities sufficient to

interact with individuals, families,

and groups from a variety of social,

cultural, and intellectual

backgrounds.

Establish rapport with patients/clients and colleagues.

Communication Communication abilities sufficient

for interaction with others in verbal

and written form. Communication is

understandable to others.

Explain treatment procedures, initiate health teaching,

document and interpret nursing actions and

patient/client responses.

Mobility Physical abilities sufficient to move

from room to room and maneuver in

small spaces.

Moves around in client's rooms, workspaces, and

treatment areas and can administer cardiopulmonary

procedures. Able to coordinate eyes , hands or fingers

rapidly and accurately in making precise movements

with speed when providing client care.

Motor Skills Gross and fine motor abilities

sufficient to provide safe and

effective nursing care.

Motor skills of lifting, carrying, pushing, and pulling

are required. Physical ability to lift and transfer 50

pounds and carrying of objects up to 25 pounds.

Physical ability of bending or stooping 1 inch from

the floor and of reaching overhead to retrieve or place

items on client/unit shelves; to intermittently push

objects over 100 pounds; stand/walk for 8 -12 hours.

Hearing Auditory ability sufficient to provide

safe and effective nursing care.

Hears, with and without background noises, monitor

alarms, emergency signals, ausculatory sounds, and

cries for help.

Visual Visual ability sufficient for Assess and observe patient/client responses; able to

61

observation and assessment

necessary in nursing care.

identify and distinguish colors and shades of the same

color.

Tactile Tactile ability sufficient for physical

assessment.

Finger dexterity to perform palpation and percussion

functions of physical examination and/or those related

to therapeutic intervention, e.g., insertion of a

catheter. Perceives attributes of object such as size,

shape, temperature, or texture.

I have reviewed the core performance standards and the examples of activities associated with them.

I DO / DO NOT (circle one) need any accommodation to carry out these activities.

Print Name_______________________________ Signature___________________________ Date________________


62


APPEALS PROCEDURE

A student may request initiation of the appeal process for an unresolved problem involving a departmental rule. A

departmental rule is defined as one made by the entire ADN faculty, which affects more than one individual nursing

course, e.g. clinical attendance or readmission policy.

INITIATION OF AN APPEALS HEARING

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

2. If the problem is not resolved, the student initiates the appeal process by submitting a letter to the Chair of

the Appeals Committee of that campus. The intent to appeal and the nature of the problem and the

requested outcome should be clearly stated in the letter.

3. The letter must be received within one week from the time of the problem occurrence.

4. The student will be allowed to continue to go to class/clinical until the Appeals Committee meets and

formulates a decision concerning the appeal.

5. The Chair of the Appeals Committee will call an ad hoc meeting within ten days of the appeals request.

MEMBERSHIP

1. The chair of the committee will be selected from a member of the full time teaching faculty.

2. Each time the Appeals Committee convenes, the chair will appoint three faculty members and two student

representatives. Because the number of ADN faculty may be limited, the chair may need to request

membership from another healthcare program. The student representative/s may come from the nursing

department or another health related program.

3. The Nursing Director may serve as an ad hoc nonvoting member of the Appeals Committee.

4. A faculty member directly involved in any given appeal may not be a voting member of the ad hoc

Appeals Committee. In the event that the Chair of the committee is “an involved faculty member,” the

Director will be asked to appoint a temporary Chair for that single appeal.

PROCEDURES FOR THE COMMITTEE

1. Chair duties:

a. appoint secretary

b. convene the meeting

c. state purpose of meeting

d. introduce committee members

e. direct the appeal hearing

f. call for a vote

g. inform Nursing Director/Coordinator and student of the committee findings

h. maintain minutes of the appeal in a secure file in the nursing department

2. The student should be prepared to discuss the problem situation and defend his/her position.

3. The instructor/s directly involved should be prepared to present data related to his/her position concerning

the appeal problem.

4. The Appeals Committee decision will be a private vote. A majority vote will be required in order to make

an exception to departmental policy.

5. The Chair will inform the student of the committee’s decision. Any special conditions developed by the

committee will be communicated to the student in writing.

ADDITIONAL RECOMMENDATIONS

1. Appeal Committee meeting takes priority over any other meeting.

2. Unresolved issues may be taken to the college’s chief academic officer as outlined in the college catalog.

3. Refer to Nursing Program Appeal Procedure Flowchart in Appendix B.

Revised: May 2006

63

Nursing Program Appeal Procedure Flowchart

Problem

resolved

by meeting

with Faculty - No further action

Appeal resolved.

Student accepts

appeals decision.

No further action

Resolved -

no further

action.

Unresolved.

Student may take the matter

to the college's chief academic

officer as outlined in catalog

The Dean will review the matter and

recommend action.

Appeal unresolved.

Student has 10 days to request

in writing that the appeal be

referred to the division Dean

The Committee

reviews the matter and makes

a decision on the

appeal

The Chair of the Appeals Committee

calls for a formal review within

ten (10) days of the student's request

Student submits written

request to the Chair of Appeals Committee

for a formal appeal procedure

within one week of appeals issue.

Problem is

NOT resolved

by meeting

with Faculty

Student meets

with

Faculty Member

.

Revised: May 2006

64

Student Handbook Copy

CONFIDENTIALITY STATEMENT

As a student in an NHMCCD health occupation program, you will have access to confidential information during your

clinical experiences. Confidential information includes client information, employee information, financial

information, other information relating to your duty as a student and information proprietary to other companies or

persons. You may have access to some or all of this confidential information through the computer systems of the

clinical facilities or through your student activities.

Confidential information is protected by strict policies of the clinical facilities and by federal and state laws

particularly the Health Insurance Portability and Accountability Act. The intent of these laws and policies is to assure

that Confidential Information, that is, Patient’s Protected Health Information or Individually Identifiable Information

provided to students orally or contained in patient medical records or maintained on the facility’s electronic

information system will remain confidential.

As a student, you are required to comply with the applicable policies and laws governing confidential information.

Any violation of these laws will subject the student to discipline, which might include, but is not limited to, dismissal

as a student and to legal liability.

In addition to this statement, each clinical facility may require you to sign an additional statement as you begin your

clinical rotation.

Confidentiality Agreement

As a student in an NHMCCD nursing program, I understand that I will have access to confidential

information.

I promise that:

1. I will use confidential information only as needed to perform my legitimate duties as a student.

2. I will not discuss client information outside of the clinical area and will confine any discussions to the

educational conference.

3. I have participated in training regarding the privacy and security provisions of HIPAA.

4. I will safeguard and not disclose any access codes or authorizations that allows me to access

confidential information.

5. I will make every effort to de-identify client information so that it cannot be connected back to the

client

to whom it relates.

6. I will not remove from the facility any facility generated client protected health information or

individually identifiable information.

7. I will be responsible for my misuse or wrongful disclosure of confidential information and for my

failure to safeguard any authorization to access confidential information. I understand that my failure

to comply with

this agreement may also result in my termination as a student.

___________________________________ ________________________________ Student’s signature Date

___________________________________ ________________________________ Print Name NHMCCD Nursing Program

65

File Copy – Complete, sign and submit to nursing instructor


CONFIDENTIALITY STATEMENT

As a student in an NHMCCD health occupation program, you will have access to confidential information during your

clinical experiences. Confidential information includes client information, employee information, financial

information, other information relating to your duty as a student and information proprietary to other companies or

persons. You may have access to some or all of this confidential information through the computer systems of the

clinical facilities or through your student activities.

Confidential information is protected by strict policies of the clinical facilities and by federal and state laws

particularly the Health Insurance Portability and Accountability Act. The intent of these laws and policies is to assure

that Confidential Information, that is, Patient’s Protected Health Information or Individually Identifiable Information

provided to students orally or contained in patient medical records or maintained on the facility’s electronic

information system will remain confidential.

As a student, you are required to comply with the applicable policies and laws governing confidential information.

Any violation of these laws will subject the student to discipline, which might include, but is not limited to, dismissal

as a student and to legal liability.

In addition to this statement, each clinical facility may require you to sign an additional statement as you begin your

clinical rotation.

Confidentiality Agreement

As a student in an NHMCCD nursing program, I understand that I will have access to confidential

information.

I promise that:

1. I will use confidential information only as needed to perform my legitimate duties as a student.

2. I will not discuss client information outside of the clinical area and will confine any discussions to the

educational conference.

3. I have participated in training regarding the privacy and security provisions of HIPAA.

4. I will safeguard and not disclose any access codes or authorizations that allows me to access

confidential information.

5. I will make every effort to de-identify client information so that it cannot be connected back to the

client

to whom it relates.

6. I will not remove from the facility any facility generated client protected health information or

individually identifiable information.

7. I will be responsible for my misuse or wrongful disclosure of confidential information and for my

failure to safeguard any authorization to access confidential information. I understand that my failure

to comply with

this agreement may also result in my termination as a student.

____________________________________ _____________________________ Student’s signature Date

66

_____________________________________ _____________________________ Print Name NHMCCD Nursing Program

STUDENT CONDUCT: CHEMICAL DEPENDENCY POLICY FOR CAUSE

NURSING AND ALLIED HEALTH PROFESSIONS STUDENTS: (LOCAL)

PURPOSE

The purpose of this policy is to:

1. To promote and protect patient/client safety.

2. To comply with the reporting requirements of the Nursing Practice Act and allied

health professions accrediting agencies.

3. To provide a program for educating students and faculty regarding professional and

personal problems associated with chemical abuse or dependency.

4. To encourage a nursing or allied health professions student who abuses or becomes

dependent upon chemicals to contact the college counseling department for

evaluation, advice, and referral to a qualified counseling or rehabilitation service, if

appropriate.

5. To support and encourage a student who has successfully completed a

recommended counseling or rehabilitation program to return to a nursing or other

allied health program and complete academic work.

6. To establish standardized procedures to be used with students that have shown

cause for drug and/or alcohol screening based on impaired behavior in clinical or

classroom.

REPORTING REQUIREMENTS

NURSING PROGRAM: Any registered nurse employed in or any student enrolled in

any of the NHMCCD nursing programs who has reason to suspect a professional

nursing student may be impaired by chemical abuse or dependency must take one of the

following actions:

1. Submit a signed, written report to the Texas Board of Nurse Examiners (BNE)

identifying the student and provide any additional information required by the

Board; or

2. Report the student to the professional nursing educational program in which the

student is enrolled.

If the director of the nursing program has reasonable cause to suspect a nursing student

is impaired by chemical abuse or dependency, the director of nursing program must

submit a signed, written report to the BNE identifying the student and providing any

additional information required by the BNE.

REPORTING REQUIREMENTS

ALLIED HEALTH: Directors or others regardless of title responsible to provide

program direction in other allied health programs (referred to in this policy only as

“directors of allied health professions programs”) who have reasonable cause to suspect

an allied health student is impaired by chemical abuse or dependency must follow their

accrediting agencies regulations in identifying such student and provide such

information as requested by accrediting agency. REASONABLE CAUSE

The director of the nursing program or allied health program will be considered to have

reasonable cause to suspect the ability of a nursing or allied health student to perform

the services of the nursing or allied health profession as a result of chemical abuse or

dependency if:

67

1. The student acknowledges that he/she is under the influence of drugs or alcohol

while involved in program activities;

2. The student is observed to be taking drugs or consuming alcohol while involved in

program activities;

3. The student’s behavior or appearance indicates that he/she may be under the

influence of drugs, alcohol, or otherwise impaired while involved in program

activities.

LAB TESTING

The director of nursing or allied health program may require a student to submit to

alcohol or drug testing at the student’s own cost if the director determines that

reasonable cause exists to suspect the ability of the student to perform the services of

the nursing or allied health professions as a result of chemical abuse of dependency.

DRUG SCREEN PANEL WITH RANGES

I. Pre-Assignment Drug Screen Panel with Ranges

Integrity Checks Acceptable Range

CREATININE >20 mg/dL

PH 4.5-9.0

Substance Abuse Panel Initial Test Level GC/MS Confirm

Test Level

AMPHETAMINES 1000 ng/mL 500 ng/mL

BARBITURATES 300 ng/mL 200 ng/mL

BENZODIAZEPINES 300 ng/mL 200 ng/mL

COCAINE METABOLITES 300 ng/mL 150 ng/mL

MARIJUANA METABOLITES 50 ng/mL 15 ng/mL

METHADONE 300 ng/mL 200 ng/mL

METHAQUALONE 300 ng/mL 200 ng/mL

OPIATES 2000 ng/mL 2000 ng/mL

PHENCYCLIDINE 25 ng/mL 25 ng/mL

PROPOXYPHENE 300 ng/mL 200 ng/mL

ALCOHOL SCREEN Per LabCorp of America Standards

ALCOHOL

BLOOD URINE

10 dl/ml 20 dl/ml

INDIVIDUAL’S REFUSAL TO SUBMIT TO TESTING

Individual’s refusal to submit to lab testing will be treated as a “POSITIVE” resulting

in immediate expulsion from the clinical agency and referral to the College Committee

on Chemical Abuse and Dependency for appropriate action.

COMMITTEE ON CHEMICAL ABUSE AND DEPENDENCY

The college’s Vice President of Student Services or his / her designee will appoint three

(3) persons with the following experience to form a College Committee on Chemical

Abuse and Dependency:

1. Training and experience in evaluation and treatment of chemical dependency;

2. Faculty member in the nursing program or allied health program with knowledge of

the professional requirements of the program; and

Knowledge of the resources available for treatment of chemical dependency.

68

READMISSION AFTER PARTICIPATION IN CHEMICAL ABUSE OR DEPENDENCY

A student who enters a counseling or rehabilitation program for chemical abuse or

dependency must inform the college director of the nursing or appropriate allied health

program and authorize the professional responsible for the student's counseling or

rehabilitation program to provide the College Committee on Chemical Abuse and

Dependency with the following information:

1. The nature, severity, and prognosis of the student's problem,

2. Periodic reports concerning the student's progress, and

3. A final report indicating whether the student successfully completed the

program and assessing the student's ability to avoid future abuse of chemicals.

Upon receipt of the final report, the Committee will recommend to the college Vice

President of Student Services whether the student should continue in the nursing or other

allied health program curriculum while participating in a counseling or rehabilitation

program or should be withdrawn from the program.

A student who is withdrawn from the nursing or allied health program pending

successful completion of a counseling or rehabilitation program must apply for

readmission. The Committee will review the final report from the professional who was

responsible for the student's program and recommend to the appropriate dean whether

the student should be readmitted.

If the Committee recommends that a student should continue in the nursing or other

allied health programs while participating in a counseling or rehabilitation program or

that a student who has been withdrawn should be readmitted after successful completion

of such program-- the Committee will include in its recommendation any restrictions or

conditions that will apply to the student's future participation in the nursing or other

allied health curriculum. The student’s ongoing participation in the nursing or other

allied health curriculum will be conditioned upon the written agreement of the student to

willingly comply with such restrictions or conditions.

The Committee will be responsible for determining whether a student act in accordance

with the restrictions or conditions established for participation in the nursing or other

allied health curriculum. The Committee will inform a student of any allegations that he

or she has failed to comply with such terms and conditions and will meet with the

student and hear his or her response. If the Committee determines that the allegations are

true, the Committee may impose additional restrictions or conditions or recommend to

the director of nursing or other allied health professions that the student be withdrawn.

READMISSION AFTER PARTICIPATION IN CHEMICAL ABUSE OR DEPENDENCY- CON’T

The decision of the Vice President of Student Services regarding all recommendations of

the Committee is final. Readmission is subject to review and recommendation of the

Nursing or appropriate allied health Readmission Committee.

Participation in a counseling or rehabilitation program for chemical or alcohol abuse or

dependency will not be considered as the sole mitigating factor in determining whether a

student meets the performance standards for the program curriculum and/or readmission. BNE DECLARATORY ORDER

Prior to applying for state licensure, any nursing student with a history of drug or

alcohol abuse must apply to BNE for a Declaratory Order and is not guaranteed approval

by the BNE for licensure even if student has been readmitted to or graduated from the

NHMCCD nursing program.

\\ADMIN\GROUPS\LEGAL\POLICYRE\nursing.doc

Revised May 2006

69

HESI EXIT EXAM OPTIONS

Revised August 2007

Student Attempts

HESI Exit Exam #1

Mid-Semester – Nursing IV

Enrolled in RNSG 2230

1. Does Not Achieve Satisfactory Score 2.

Completes RNSG 2230 –

Required to take

HESI Exit Exam #2

Remediate between HESI 1 & 2 testing

Achieves Satisfactory Score–

Successfully Completes RNSG

2230

GRADUATES

1. Does not Achieve Satisfactory

Score 2. Completes Required

Remediation 3.Takes

HESI Exit Exam #3

Achieves Satisfactory Score

Receives Grade in

RNSG 2230

GRADUATES

1. Does Not Achieve Satisfactory

Score 2.Fails RNSG 2230.

Students who fail HESI Exit

Exam #3 are dismissed from ADN

program.

*See Readmission policy.

Achieves Satisfactory Score--

Receives Grade in RNSG 2230

GRADUATES

70

Appendix C

NHMCCD NURSING PROGRAM

STUDENT HANDBOOK

STUDENT ACKNOWLEDGMENT

I have read and understand the Associate Degree Nursing Program’s policies related to:

• Degree Plan and Graduation

• Requirement for State Board Licensure

• Academic Integrity

• Americans with Disabilities Act and Core Requirements for Program

• Attendance

• Appeals Procedure

• Clinical Assignments

• Ethical Behavior

• HESI Exit Examination

• Extra Credit

• Health and Immunization

• Professional Liability Insurance

• Progression Requirements

• Readmission

• Refusal to Provide Care

• Evaluation

• Code of Conduct

• Grading Policy

• Confidentiality/HIPAA

Name: Date:

(Print)

Signature:

Instructor : _________________________________________ Section: _____________________

71

Top Section: Student Handbook Copy

Signature of Receipt and Acknowledgement of Understanding

By signing below: My signature below indicates I have received, read and understanding the Drug

and Alcohol Abuse Policy and Procedure as outlines in the Nursing Student

Handbook.

My signature below also indicates my willingness to comply with the NHMCCD

Health Occupation programs Drug and Alcohol Abuse Policy.

_____________________________________ _______________________________ Student Signature Date

Lower Section – Student File Copy

Your signature will be retained in your Student File

___________________________________________________________________________________________

Tear along this line, complete and return to your Nursing Instructor

Signature of Receipt and

Acknowledgement of Understanding By signing below: My signature below indicates I have received, read and understanding the Drug

and Alcohol Abuse Policy and Procedure as outlines in the Nursing Student

Handbook.

My signature below also indicates my willingness to comply with the NHMCCD

Health Occupation programs Drug and Alcohol Abuse Policy.

_____________________________________ _______________________________ Student Signature Date

72

NORTH HARRIS MONTGOMERY COMMUNITY COLLEGE DISTRICT ASSOCIATE DEGREE NURSING PROGRAM

DOCUMENTATION OF REQUIRED IMMUNIZATIONS Please Print Name:______________________________________________________________________________ (Last) (First) (MI)

Date of Birth__________________ SS# ___________________ Enrollment Date __________________ All students enrolled in health related courses that have or will have any direct client contact must show proof of the following immunizations prior to starting the clinical component of their course.

MMR (Measles/Mumps/Rubella): Health Care Provider signature verifying record of date of illness or two (2) DOSES on or after first birthday, and at least 30 days apart or a laboratory report of immune serum antibody TITER. (Attach). If given separately,

attach all appropriate paperwork.

Vaccine

Date of

Illness Date of 1st and 2nd

Immunization

Date of TITER

Immune/not immune

Health Care Provider

Signature

Y N

Chicken pox: Health Care Provider signature verifying record of date of illness or varicella vaccine or a laboratory report of immune serum antibody TITER. (Attach)

Vaccine

Date of

Illness

Date of

Immunization

Date TITER

Immune/not immune


Signature

Y N

TB (PPD): PPD Skin Test is required upon admission and yearly thereafter. Students with a history of a positive PPD test should

obtain a chest X-ray. (Attach radiology report)

Date PPD

Skin Test

Date

Test

Read Reaction

Date of

Chest x-ray

X-ray

attached

Other

Treatment


Signature

1st Year

Y N

2nd Year

Y N

DIPHTHERIA-TETANUS: All students must submit proof of a booster shot within the past ten years.

Date of Booster Vaccine Health Care Provider signature

Hepatitis B: Required to begin series before entering. Verification must be submitted when series completed. A Health Care Provider’s

signature is required to verify dates or exemption from series or submit TITER RESULTS.

Date of Immunization Health Care Provider signature

Hepatitis B

Vaccination #1

Hepatitis B

Vaccination #2

Hepatitis B

Vaccination #3

Date of TITER

Immune/not Immune

________________________________________________ ___________________________ Health Care Provider Signature* Date *Validates all information above**Pregnancy is a contraindication to many vaccines. Seek your physician’s advice if you are pregnant. Women should be counseled not to become pregnant for three months after vaccination or until properly advised by a physician.

73



STATEMENT OF ACADEMIC INTEGRITY

NHMCCD is committed to a high standard of academic integrity among its faculty and students. In becoming a part of

the NHMCCD academic community, students are responsible for honesty and independent effort. Failure to uphold these

standards includes, but is not limited to, the following: plagiarizing written work or projects, cheating on exams or

assignments, collusion among students on an exam or project without specific permission from the instructor, or

misrepresentation of credentials or prerequisites when registering for a course. Cheating includes looking at or copying

from another student's exam, communicating or receiving answers during an exam, having another person take an exam

or complete a project or assignment for you, using unauthorized notes, texts, or other materials for an exam, or obtaining

or distributing an unauthorized copy of an exam or any part of an exam. Plagiarism means the unauthorized use of

another's writings without proper documentation and includes copying material from another source without clear

documentation of the source or submitting a paper, report, project, or care plan that someone else has prepared. Collusion

is inappropriately collaborating on assignments designed to be completed independently. These definitions are not

exhaustive.

When there is clear evidence of cheating, plagiarism, collusion, or misrepresentation, disciplinary action may be taken,

including but not limited to: the student's presenting an oral defense, resubmitting the assignment in question, retaking an

exam, receiving a zero or an F on the exam or assignment, or being withdrawn from the course or expelled.

“I have received, read and understand the NHMCCD-ADN statement of Academic Integrity and Code of Conduct

and agree to adhere to it as stated.”

“I understand the clinical policies and procedures and all other stated policies and procedures outlined in this

handbook and I agree to adhere to these policies and directives.”

Date: ________________________

Name of Instructor:

Your Name Printed:

Your Signature: __________________________________________________

Section Number:

74


STUDENT EMERGENCY PROCEDURE INFORMATION

Name:______________________________________________________________________ Address:___________________________________ Telephone:___________________ ___________________________________ In case of emergency, illness or accident, proceed as indicated: (List order of contact 1, 2, 3, etc.) _____Contact next of kin___________________________ ____________________ Name Telephone Number _____Contact____________________________________ ____________________ Name Telephone Number _____Contact Doctor______________________________ ____________________ Telephone Number _____Take to Hospital Emergency Room____________________________________________ Name of Hospital _____Other Arrangements:________________________________________________________ _____________________________________ ________________________________ Signature of Student Date

75


CLINICAL, COOPERATIVE OR INTERNSHIP PROGRAM

STUDENT RELEASE OF LIABILITY

I, ___________________________, am a participant in the clinical/Cooperative/Internship Please Print Name

Program at _____________________________ and/or its subsidiaries (referred to hereinafter as Name of Company or Facility. “Company”). While engaged in my clinical, cooperative, or internship activities, I am not an employee

of Company for any purpose. However, I agree to adhere to all policies and procedures as set forth by

Company.

I release _______________________________ and/or its subsidiaries of any responsibility for any Name of Company or Facility

Bodily injury or property damage that I incur while participating in the Program, including any injury

while traveling to or from performance of work assignment. I assume full responsibility for my

transportation to and from the Program, no matter how arranged.

_____________________________________ _________________________ Student Signature Date

Printed Name of Student _________________________________________ ________________________________ Witness Date ___________________________________ ________________________________ Printed Name of Witness Date

76

APPENDIX D

www.bne.state.us.tx

DIFFERENTIATED ENTRY LEVEL COMPETENCIES

Of GRADUATE OF TEXAS NURSING PROGRAMS

(DELC’S)

Documents

Montgomery College Associate Degree Nursing Student · Montgomery College Nursing Program To Provide: ... • Development across the Life Span The developmental process is a continuous,