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Policies for Clinical Courses

Health Requirement Report Form (Word document)

Attendance
Attendance is required for all clinical conferences, seminars and practice. It is the responsibility of faculty to protect clients and students. Therefore, faculty members may exclude students from the clinical area due to illness, injuries, lack of preparation for practice, inappropriate attire or any situation deemed unsafe. If the student is excluded for a reason other than illness or injury, the faculty member will not be obligated to makeup the absence with the student. The absence may be reflected in the student's grade.

Absences from 10% or less of the clinical hours for a course will be made up at the discretion of the faculty member. Absences for over 10% of the clinical hours for a course shall be made up during the quarter. If this is not feasible, the student will be given an incomplete grade or "I" or withdrawal from the course may be recommended by the faculty or department.

Clinical Absences
Students are responsible for notifying faculty and the clinical agency of absences from required clinical experiences prior to the scheduled time for the experience. Students are expected to follow guidelines provided by individual courses or levels. Discussion with your clinical faculty member should occur prior to any anticipated absence such as illness or crisis in the family or death of a close family member. It is within the faculty member's prerogative to determine the acceptability of absences.

Clinical Code of Conduct
In keeping with section 4723-5-12-J of the Ohio Board of Nursing Rules:

1. A student shall report and document nursing assessments or observations, the care provided by the student for the client, and the client's response to that care;
2. A student shall accurately and timely report to the appropriate practitioner errors in or deviations from the prescribed regimen of care;
3. A student shall not falsify any client record or any other document prepared or utilized in the course of, or in conjunction with, nursing practice;
4. A student shall implement measures to promote a safe environment for each client;
5. A student shall delineate, establish, and maintain professional boundaries with each client;
6. At all times when a student is providing direct nursing care to a client the student shall:
   1. Provide privacy during examination or treatment and in the care of personal or bodily needs; and
   2. Treat each client with courtesy, respect, and with full recognition of dignity and individuality;
7. A student shall not:
   1. Engage in behavior that causes or may cause physical, verbal, mental or emotional abuse to a client; or
   2. Engage in behavior toward client that may reasonably be interpreted as physical, verbal, mental or emotional abuse;
8. A student shall not misappropriate a client's property or:
   1. Engage in behavior to seek or obtain personal gain at the client's expense;
   2. Engage in behavior that may reasonably be interpreted as behavior to seek or obtain personal gain at the client's expense;
   3. Engage in behavior that constitutes inappropriate involvement in the clients personal relationships; or
   4. Engage in behavior that may reasonably be interpreted as inappropriate involvement in the client's personal relationships;
      For the purpose of this paragraph, the client is always presumed incapable of giving free, full, or informed consent to the behaviors by the student set forth in this paragraph.
9. The student shall not:
   1. Engage in sexual conduct with a client;
   2. Engage in conduct that may reasonably interpreted as sexual;
   3. Engage in any verbal behavior that is seductive or sexually demeaning to a client; or
   4. Engage in verbal behavior that may reasonably be interpreted as seductive or sexually demeaning to a client;
      For the purpose of this paragraph, the client is always presumed incapable of giving free, full, or informed consent to sexual activity with the student.

Clinical Section Assignments Policy (UG Students)
Undergraduate students are assigned to clinical sections by the Associate Dean for Administrative and Clinical Affairs. Students with special needs in relation to clinical placement must make those needs known to the Associate Dean through a written clinical petition prior to the beginning of priority registration for a given quarter. Changes in posted clinical assignments will be made only due to unforeseen, extenuating circumstances unless the student is able to find another student willing to switch sections with her or him. If two students are intending to switch clinical sections with each other, they must submit a written request for the change signed by both students. Clinical section assignments are planned so that students have a range of experiences and exposure to a variety of faculty. Therefore, whether or not requests are honored is at the discretion of the Associate Dean. (Clinical petition forms are available in the Office of Student Affairs.

Critical Requirements for Entry into Clinical Courses
All health profession students must present evidence of having met specific health and legal requirements prior to engaging in clinical experiences. The evidence must be submitted by the date published by the Office of Student Affairs. Failure to comply with the requirements by the defined deadline will result in prevention of enrollment or administrative withdrawal from clinical courses. The requirements are mandated by the clinical agencies used by the College for clinical experiences.

Annual requirements are evidence of:

1. Current certification in adult/child Basic Life Support-Cardiac (BLS-C)
2. Tuberculosis (TB) testing:
   Baseline and annual TB testing is required. Those student who have not had testing in the past 12 months will be required to undergo 2-step baseline testing 10 days apart. University Health Service will provide the TB testing if you wish. Chest X-ray documentation is required for PPD positive persons. X-rays are available through University Health Services for a fee.
3. Completition of Blood Borne Pathogens and HIPAA privacy introduction training at http://cpd.uc.edu.
4. A current Ohio Registered Nurse license for RN/BSN and graduate students (unless an Accelerated Pathway student who has not entered a Master's major). A photocopy of current license must be submitted. The State of Ohio requires the nurses to write the word 'copy' boldly across the front side of the photocopy document with a black permanent ink marker and place their initials after the word 'copy'.

Immunization Requirements
All students entering clinical courses must show evidence of:

1. Evidence of Hepatitis-B immunity - Approximately 6 to 7 months are required to complete the three stage Hepatitis-B series and clinical laboratory titer. Students who have not completed the series inoculations may enter clinical courses provided they show evidence of receiving the first inoculation and follow the required immunization process. Students who become delinquent in completing the inoculations and titer will be removed from clinical practica.
   
2. Documentation confirming previous immunization, natural infection, or serologic immunity against measles, rubella, and mumps. Your personal health care provider must sign such documentation.
   
3. Documentation of two live measles (rubeola) containing vaccines (one since) 1980 is required.
   
4. Chickenpox - All students with a negative history of chicken pox will be required to have a VZV titer drawn to determine immunity. Any susceptible students will be required to receive 2 doses of VZV vaccine.
5. Documentation of diphtheria, pertussis, tetanus and polio immunization.

You must submit proof of immunizations to the Office of Associate Dean. You are responsible for the cost of all immunizations and titers. You may obtain required immunizations, titers and TB testing through your private health care provider or from University Health Services.

NOTE: All requirements apply unless medically contraindicated by physician documentation. Additional testing, evaluation, and documentation may be required in individual cases. All records are considered confidential material and will not be released to anyone without your written permission.

Dress Code
Your standards of personal care and dress represent you as an individual, the College of Nursing, and the profession of nursing. Professional persons set examples for others and students are expected to be neat clean, and well-groomed which includes the following:

1. Nails are clean, short and smooth to ensure patient and student safety.
2. Hair is controlled so that asepsis is maintained for both the student and patient/client. Plain barrettes, bobby pins or elastic bands may be used for this purpose.
3. For asepsis and safety, jewelry is limited to only plain wedding bands, watches and pierced earrings (one set) that are not loops and are small.
4. Shoes must provide good support. Clogs, high heels and sandals are not permitted.
   Shoes and shoe strings must be clean and in good repair.
5. Clothing must be loose enough to provide ease of movement in clinical activities.
6. Jeans may not be worn for clinical experiences including times when obtaining information from an agency for clinical assignments.
7. Street clothes worn in some of the clinical agencies shall be neat and in professional taste.

Undergraduate Uniforms
Each student assumes the cost for his/her uniform. Uniforms are worn for the purpose of protecting the patient and the student. Uniforms vary with the clinical setting. Appropriate attire for each level of nursing student is listed below. All uniform items marked with an asterisk (*) must be purchased from the college's official vendor, McGill's Uniform Company. Each year, the Office of Student Affairs distributes order forms to students. Additional order forms may be obtained from the Office of Student Affairs. Students who appear for a clinical experience without the proper uniform will be dismissed from the clinical area with an unsatisfactory clinical grade for the day.

Students' Uniforms - "whites"

Female	Male
*White lab coat with College emblem *White oxford shirt with College emblem (short or long sleeves) White slacks or white skirt Picture ID name badge - must be visible White hose or stockings; knee socks may be worn with slacks White cardigan sweater White leather, low-heeled, closed toe shoes (no clogs)	*White lab coat with College emblem *White oxford shirt with College emblem (short or long sleeves) White slacks Picture ID name badge - must be visible White socks White cardigan sweater White leather, closed toe shoes (no clogs)

Student Uniforms - Community Settings

Female	Male
*White oxford shirt with College emblem (short or long sleeves) Navy blue slacks or skirt (no jeans or cords) Flesh-toned hose; knee socks may be worn with slacks Navy, brown or black leather, closed toe shoes	*White oxford shirt with College emblem (short or long sleeves) Navy blue slacks (no jeans or cords) No blue, black or brown socks Navy, brown or black leather, closed toe shoes

Lab Coats
Students are encouraged to purchase lab coats. These may be worn over street clothes in selected situations. Because sweaters may not be worn when giving patient care, lab coats may be work over the uniform in clinical settings. The College arm patch must be sewn on the left side sleeve of the lab coat.

ID Badges
All students must wear their UC Medical Center identification badge in all clinical agencies. The Medical Center ID Badge is obtained from the Badge Control Office, Room E9 in the Medical Sciences Building. A fee is charged for lost badges. The loss of a badge must be immediately reported to Medical Center Security. Proof of registration is required to obtain a badge. A badge access system is in place at selected Medical Center entrances for building entry after hours.

Protective Eye Gear (Goggles)
All students are recommended to purchase, and have available for each clinical experience, a pair of eye goggles with side panels for performance of Task I activities, e.g., suctioning - activities that may expose the nurse to patients' body fluids, hazardly exposing the nurse's eyes.

OSHA mandates that all hospital personnel, students, and faculty are required to wear protective eye gear. Students must adhere to clinical agency policies.

Liability Insurance
Students are insured by University insurance while they are performing assigned clinical experiences. Students may choose to carry Professional/Student Liability Insurance in addition to that provided by the University. Liability insurance information is available in the Office of Student Affairs.

Student Safety
Faculty consider the students' safety when planning clinical experiences. Students are expected to assume responsibility for their own safety by adhering to the guidelines listed below and discussing with the faculty situations which the student believes to be unsafe prior to exposing him/herself to risk.

1. Student leaving clinical experiences after dark should travel in groups or obtain escort services from security guards in the agency.
2. Students who use cars should lock their doors at all times and park in well lighted areas. Valuables including health-screening equipment, e.g., stethoscopes, should always be secured out of sight.
3. Students should carry a minimum amount of money and valuables. Be sure to have correct change for a phone call and know emergency numbers.
4. Students should be alert and observant for risks so that suspicious situations can be avoided. Do not enter a suspicious area such as where loitering, fighting or drunkenness is occurring or dark hallways or basements. If the student observes a suspicious situation, the student should leave immediately.
5. Students are responsible for keeping faculty apprised of their plans for community visits and any changes that might occur. Someone, such as a faculty member, roommate, spouse or parent, should always be informed of the student's plans and expected time of return.
6. Whenever possible, community visits should take place during daylight hours. Students planning to make visits at other times should discuss their plans with their supervising faculty members.

Transportation
Students are responsible for their own transportation and costs incurred during their clinical experiences, including those off-campus. Students are responsible for appropriate insurance coverage. Students are not required to produce evidence of automobile insurance. However, students are reminded that mandatory auto insurance is a requirement of the State of Ohio.

Transporting/Driving Clients
Students are NOT to transport patients/clients in students' personal motor vehicle. Students must be aware of and adhere to clinical agency policies.

Unsafe/Unprofessional Practice and Weak Practice
A student whose clinical practice is judged to be unsafe and/or unprofessional may be removed from clinical experience. In order to be eligible to resume the clinical experience, the student who has been removed, must comply with stipulations prescribed by the faculty for readmission to the clinical experience.

The faculty responsible for the clinical experience will review the clinical practice of a student who exhibits weaknesses that may lead to unsafe practice and/or unprofessional practice. The faculty, with appropriate input from the student, will develop a set of expectations that the student is to attain to remedy those weaknesses in the current and/or subsequent quarter.

Rationale
Faculty of the College have a legal and professional responsibility to assure for the public, other students, the University, and the nursing profession that students can practice safely and professionally in their various clinical practice. This policy embodies that accountability by defining unsafe practice, unprofessional practice and weak practice; by establishing guidelines for faculty to make a judgment of unsafe practice, unprofessional practice, and weak practice; and by providing procedures to be followed when a judgment of unsafe, unprofessional or weak clinical practice is made.

Definitions

Unsafe Practice
Behavior in providing nursing care to clients that fails to achieve the standard of care, violates the nurse practice act, violate the ANA Standards of Practice, or calls into question the professional accountability of the student. Depending upon the degree of actual or potential harm a client may suffer, a one time deviation from safe practice may be sufficient to judge a student unsafe.

Unprofessional Practice
Behavior in providing nursing care to clients that violates the ANA Code for Nurses.

Weak Practice with Potential for Unsafe and/or Unprofessional Practice
Behavior with potential for unsafe and/or unprofessional practice in providing nursing care to clients that fails to achieve the standard of care, violates the nurse practice act, violate the ANA Code for Nurses and/or Standards of Practice, or calls into question the professional accountability of the student.

Guidelines

Rules, Regulations, and Standards of Practice
The student practices within the boundaries of the state nurse practice act, current professional standards of practice, College of Nursing course objectives, and College, University, and clinical agency policies and procedures.

Under this guideline examples include but are not limited to the following:

1. Failure to notify the agency and/or instructor of clinical absence;
2. Practicing in a clinical practicum under the influence of drugs and/or alcohol that do or may interfere with the ability to practice;
3. Demonstrating behavior that puts a client at risk of harm by violating standards of care; and/or
4. Violating client privacy rights through beach of confidentiality of interactions or records or failure to protect privacy in personal care.

Accountability
The student's practice demonstrates continuity in the responsible preparation, documentation, and promotion of continuity in the care of the clients.

Under this guideline examples include but are not limited to the following:

1. Acting in a manner likely to cause serious harm to self or others; or
2. Acts of omission or commission likely to cause harm to clients including but not limited to: physical abuse, placing in hazardous positions, conditions or circumstances, mental or emotional abuse, and medication errors; or
3. Failure to provide accurate, inclusive, written and verbal communication or falsely documenting in a client record, written assignment or student log; or
4. Attempting activities without adequate orientation, theoretical preparation, assistance or supervision; or
5. Engaging in behavior that is disrespectful of a client's social or economic status, personal attributes, or health problems.

Procedures

When a professor has reason to conclude that a student has practiced unsafely or unprofessionally:

1. With five working days, the student will be notified by the professor in writing of reasons to believe the student has practiced unsafely or unprofessionally
2. At the time of notification the student will be provided with a written description of:
   1. Specific actions necessary to demonstrate safe and/or professional practice including any medical/health evaluations in situations where the physical, mental and/or emotional behavior of the student placed the client at risk.
   2. The time during which the corrective actions must be achieved.
   3. Any modifications in clinical practicum experience pending completion of specific corrective actions necessary to demonstrate safe and/or professional practice including but not limited to:
      1. Restriction in activities and responsibilities 
      2. Supervision of activities/procedures
      3. Removal from clinical experience
      4. Alteration in clinical site

      Students removed from clinical experiences who, in the professor's professional judgment, have taken the specific improvement actions prescribed to remedy the potential for unsafe and/or unprofessional practice will be permitted to resume clinical practicum experience contingent upon the availability of clinical placements and adequate resources.

   4. The action to be taken if the specific corrective actions prescribed are not achieved include:
      1. Failure of the course, or
      2. Failure of the course and recommendation for discipline under the University Student Code of Conduct
   5. The action to be taken if specific corrective actions are achieved include:
      1. Pass the course but continue improvement activities as prescribed by the current and subsequent clinical professor
      2. Pass the course

      Students correcting their practice will receive a passing grade for the clinical portion of the course but a record of the judgment of unsafe and/or unprofessional practice will remain in their student record. If no further instances of unsafe and/or unprofessional practice occur, the record of unsafe and/or unprofessional practice will be removed at the time any potential for litigation expires.

3. At the time of student notification, the faculty member will also provide written notification to the Department Head and Associate Dean for Academic Affairs. The notice will include a copy of the specific actions to be taken by the student.
   
4. Students who fail a clinical experience due to unsafe and/or unprofessional practice may pursue reentry to the course according to the College Progression Policy.
   
5. Students who fail a course because of unsafe and/or unprofessional practice and who disagree with the evaluation that their clinical practice is unsafe may appeal the professor's judgment through the University Grievance Procedure.

When a professor has reason to conclude that a student's clinical practice is weak with potential for unsafe and/or unprofessional practice

1. The student will be promptly notified by the professor in writing of reasons to believe that the student has potential for unsafe and/or unprofessional practice.
   
2. During a current quarter the professor will provide the student with a written description of:
   1. Specific actions to be taken to improve the student's clinical practice including any medical/health evaluations in situations where the physical, mental, and/or emotional behavior of the student places the client at risk.
   2. The time period during which the specific improvement actions must be completed.
   3. Any modifications in clinical practicum experience pending completion of specific improvement actions necessary to demonstrate safe and/or professional practice including but not limited to:
      1. Restriction in activities and responsibilities
      2. Supervision of activities/procedures
      3. Removal from clinical experience
      4. Alteration in clinical site

      Students removed from clinical experiences who, in the professor's professional judgment, have taken the specific improvement actions prescribed to remedy the potential for unsafe and/or unprofessional practice will be permitted to resume clinical practicum experiences, contingent upon the availability of clinical placements and adequate resources.

   4. The action to be taken if the specific improvement actions prescribed are not fully achieved include:
      1. Pass the course because some improvement has been demonstrated but the student needs to continue improvement activities in the clinical portion of the subsequent course (see Procedures B4)
      2. Fail the course because behavior has become unsafe and/or unprofessional
      3. Fail the course under Procedures B3 d2 and be recommended for discipline under the University Student Code of Conduct
         
3. If actions for improvement must bridge the current and subsequent quarter the professor in the current quarter and the professor responsible for the subsequent clinical practicum will mutually agree upon and provide the student with a written description of:
   1. Specific improvement actions to be taken during the subsequent quarter
   2. The time period during which the specific improvement actions must be completed in the subsequent quarter
   3. Any modifications in clinical practicum experience pending completion of specific improvement actions necessary to demonstrate safe and/or professional practice including but not limited to:
      1. Restriction in activities and responsibilities
      2. Supervision of activities/procedures
      3. Removal from clinical experiences
      4. Alteration in clinical site

      Students removed from clinical experiences who, in the professor's professional judgment, have taken the specific improvement actions prescribed to remedy the potential for unsafe and/or unprofessional practice will be permitted to resume clinical practicum experience contingent upon the availability of clinical placements and adequate resources.

   4. The action to be taken if the specific improvement actions prescribed are not fully achieved include:
      1. Pass the clinical portion of the course because some improvement have been demonstrated but the student need to continue improvement activities in the clinical portion of the subsequent course (see Procedures B4)
      2. Fail the course because behavior has become unsafe and/or unprofessional
      3. Fail the course under Procedures B4 d2 and be recommended for discipline under the University Student Code of Conduct.

      Students correcting their practice will receive a passing grade for the clinical portion of the course but a record of the judgment of unsafe and/or unprofessional practice will remain in their student record. If no further instances of unsafe and/or unprofessional practice occur, the record of unsafe and/or unprofessional practice will be removed at the time any potential for litigation expires.

Weather Emergencies
In case of weather conditions that render traveling hazardous, students and faculty members are urged to exercise their best judgment in determining whether to attend clinical assignments. The clinical area must be notified promptly by the appropriate person, if students or faculty members are going to be absent or late. Faculty members will notify students if they are unable to make it to clinical practice areas. Information about changes in University schedules in case of a natural disaster or environmental accident can be obtained by listening to radio and television news reports.