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CLINICAL nursing courses has been prepared to confirm the accuracy of the practice, help students find their way through the varies clinical courses and attempt to clarify students responsibilities in clinical practice. This handbook provides students with rules and regulations, and professional standards that guide and direct their practice in clinical settings, in order to promote efficient and safe practice.
1. NURSING ETHICS
Ethics are the principles of conduct governing the student as a member of a nursing group. It is a code of behavior. In addition to the nurse's responsibility for learning about nursing theory and practice, the Code of Nursing Ethics requires that the student nurse shall:
Accept the responsibility of providing care to any individual.
- Keep all information confidence about the patient, family, co-workers, and agency.
- Follow rules and routines of the agencies in which he/she is associated.
- Perform only functions for which he/she is prepared.
- Keep relationships with patient on a professional basis.
2. CODE FOR NURSES
Jordanian Code for Nurses, first published in 1996, describes the primary goals, obligations, duties, and values of nursing profession. It shapes and defines the commitments that nurses make to patients and the public. The following are major principles:
- The nurse provides services with respect for human dignity and the uniqueness of the client, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.
- The nurse safeguards the client's right to privacy by judiciously protecting information of a confidential nature.
The nurse acts to safeguard the client and the public when health care and safety are affected by the incompetent, unethical, or illegal practice of any person.
- The nurse assumes responsibility and accountability for individual nursing judgements and actions.
- The nurse maintains competence in nursing.
- The nurse exercises informed judgment, uses individual competence and qualifications as criteria in seeking consultation, accepting responsibilities, and delegating nursing activities to others.
- The nurse participates in activities that contribute to the ongoing professional knowledge development.
- The nurse participates in the profession's efforts to implement and improve standards of nursing.
- The nurse participates in the profession's efforts to establish and maintain conditions of
- employment conducive to high quality nursing care.
- The nurse participates in the profession's efforts to protect the public from misinformation and misrepresentation and to maintain the integrity of nursing.
- The nurse collaborate with members of the health professions and other citizens in promoting community and national efforts to meet the health needs of the public.
3. STANDARD PRECAUTIONS AND STUDENT RESPONSIBILITY
- Nursing students must have a proof of receiving three doses of Hepatitis B. Vaccination. This proof should be submitted to course instructor before starting nursing 216 course.
- Students are responsible for expenses incurred for Hepatitis vaccine, each dose of hepatitis vaccine cost the student 10 JD.
- All students must adhere to Standard Precautions –which is an approach to infection control- and comply with standards on "Occupational Exposure to Bloodborne Pathogens." According to Occupational Exposure to Bloodborne Pathogens all human blood and body fluids are considered to be potentially infectious materials. Body fluids include: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, peritoneal fluid, amniotic fluid, saliva any body fluid that is visibly contaminated with blood. As well all body fluids in situations where it is difficult or impossible to differentiate between body fluids.
- Students in the clinical settings or campus laboratory must use protective equipment such as gloves, masks, and/or gowns, that depend upon the task and degree of exposure anticipated.
- Contaminated needles and other contaminated sharps shall not be recapped or removed unless no alternate is feasible. Recapping or needle removal must be accomplished through the use of a mechanical device or a one-handed technique.
4. COMMUNICATION IN HEALTH CARE FACILITIES
Although students assume responsibility for their assigned patient while in clinical lab, the agency does not relinquish patient responsibility. Patient safety is the students' responsibility. Students who are overtired may compromise safety; therefore, working a shift immediately prior to clinical is not adviced.
The student is required to obtain information from the instructor or staff regarding a patient before giving care. Before leaving the clinical setting, the student is required to report or explain the care given to patients to:
- The staff member who is assigned to that patient.
- Registered Nurse who is responsible for the coordination of care.
- Clinical instructor.
5. ATTENDANCE AND ABSENCE
Attendance is required for all clinical conferences, seminars and practice. Students are responsible for their own transportation and costs incurred during their clinical experiences, But some time nursing school offers transportation according to the availbility of transportation from the university. The faculty of nursing protects clients and students, therefore, faculty members' may exclude any student from the clinical area due to illness, lack of preparation, inappropriate clothing or any other situations deemed unsafe for both the student or/and the client. Student's absences are subjected to the university rules and regulations.
Excused or unexcused absence should not exceed 10% of the clinical hours. However, unexcused absence will affect student's grade.
Acceptable excuse for their an absent:
Illness, that must be supported with medical report from the health center. All medical excuses must be singed and stamped from the university health center shortly after the absence day.
Death of a close family member or crisis in the family.
Any other situations will be within the faculty member's prerogative to determine the acceptability of the abscences.
Unexcused absence and late, will be evaluated in the clinical courses as following:
One day abscent will be considered zero evaluation for that clinical day.
Late should be less than 15 minutes. A late that exceeded 15 minutes will be reported as an abscent day.
Three lates will be consider as one day abscent.
Unexcused absence over than 10% of the clinical hours for a course, the student will be given 35% of grade or will be asked to withdraw from the course.
6. APPEARANCE AND HYGIENE
Comfort, security, and well being of the patient is dependent upon the nurse's level of knowledge and competence, however, in addition to this, it is influenced by the nurse's personal hygiene, appearance, and behavior. Poor grooming and inappropriate behavior may convey to the client and family a feeling of carelessness. Students who are working with clients and health professionals as a part of their learning practice are expected to dress in a professional manner, clean and neat. The students' appearance and dress must be consistent with the faculty policy. All faculty members will closely uphold the following guidelines:
The uniform will be white for female students and white tope with navey blue trouser for male students. Uniform could be in of any style that provides a professional appearance, allows comfort and freedom of movement. White washable (with white buttons) sweaters may be worn with the uniform. The student is presponsible of purchases uniform. Uniform is to be worn in the clinical setting only.
b) Name Tag
The student name, student academic year and the institution "University of Science and Technology" imprinted on the name tage and should be worn at all times. Name tag is the student responsibility to buy.
c) Jewelry and Scents
Watches, nametags, medical alert identification, plain wedding ring, and small stud earrings may be worn. Jewellery should not be worn, perfume and scented after-shave should be avoided.
All shoes must be clean and in good repair. White shoes for female student and black shoes for males student. Shoes must cover the entire foot and have a close toe and heel. The heel will be no higher than 3 cm.
e) Hair and Nails
Hair must be worn off the collar and away from the face. Men must keep facial hair trimmed or closely shaven. No nail polish may be worn, and nails must not extend beyond the end of the finger.
7. CLINICAL SETTINGS NOT REQUIRING UNIFORM
In settings not requiring uniforms, students should dress lab coat, and is clean, neat and reflects a
professional manner. Dressing in a professional manner means that students have a clean lab coat, well-groomed appearance, wear appropriate clothes under the lab coat, no excess jewellery and wear a clean shoes. These settings may include home visits, psychiatric units, public health department, and nurseries.
8. CAMPUS LAB PRACTICE
Students are given time practice for in campus lab during scheduled courses. Any students requiring additional practice should contact the clinical instructor, lab supervisor and the course coordinator. to arrange the appropriate time according to lab schedule.
9. LAB PRACTICE RULES AND REGULATIONS
Foods, drinks, smoking and gum are not allowed at any time in the labs.
All students are obliged to observe the appropriate clinical practice guidelines and policies.
Students must not disturb or distract others by conduction others by conducting themselves in properly in an inadmissible manner.
All equipment assigned to the lab should remain in the lab or be repleced (retained) by the end of the day.
All students items such as; bags, jackets must be left at the assigned places and student will be responsible for their belongings.
Students are strictly forbidden from taking out any items belonged to the labs without authorization from lab supervisor.
It is student's responsibility to consult with the lab supervisor on how to operate the lab equipment.
10. BRROWING LAB EQUIPMENTS
Equipment may be borrowed from the lab on the following basis:
Equipment can only be borrowed for legitimate educational purposes.
The student must fill in a correct form to borrow any item from the lab.
Borrowed equipment must be returned by the specified retune date, if not returned in specified date the student will be subjected to the disciplinary committee.
The student is responsible for any missing or malfunction of the borrowed equipment.
11. PROFESSIONAL VS. NON-PROFESSIONAL BEHAVIOR
Nurse students must convey a professional behaviors and avoid the offenses behaviors. The following guidelines are reflecting the professional behaviors and outline the offensive non professional:
Students are required to attend classes/clinical labs/campus labs.
Students are to be primarily focused on course/program objectives.
Students must notify faculty prior to scheduled clinical and class if an absence must occur, unless it is an emergency.
Students are expected to maintain high standards of academic honesty and integrity in accordance with the Academic Code of the College.
Students are expected to conduct themselves as mature, honest, ethically sensitive, and responsible persons.
Offensive Non-Professional Behaviours:
Disregard of proper dress and/or personal hygiene.
Use of profane or offensive language.
Inconsiderate treatment of patients, classmates, and faculty members.
Intoxication and/or use of intoxicants.
Substance Abuse or Misuse.
Unexcused absences from clinical and conferences.
Unethical conduct as defined by the Jordanian "Code of Ethics"
12. UNSAFE CLINICAL BEHAVIOR
Nursing faculty have the responsibility to protect the public. Thus any student happened to be engaged in any situation that may have potential outcomes for violation of safety standards will be subjected to immediate dismissal from the clinical area and / or a failing grade in the clinical course. Further more, the clinical agencies reserve the right to terminate use of its facilities by a particular student, when necessary to maintain its operation free from disruption and to ensure quality of client care. Unsafe clinical behavior is demonstrated when the student:
Violates or threatens the physical safety of the client, e.g.: neglegant use of side rails, restraints; comes unprepared to clinical; leaves bed in high position.
Violates or threatens the psychological safety of the client, e.g.: uses cliches repeatedly, does not encourage verbalization, is not aware of difference in ability to communicate, failure to document or act on changes in behavior.
Violates or threatens the microbiological safety of the client, self, or others e.g.: unrecognized violation of aseptic technique and universal precautions; comes with communicable disease to clinical experience; unrecognized violation of isolation procedure.
Violates or threatens the chemical safety of the client, e.g.: violates the "5 Rights of Administering Medications"; fails to monitor IV infusions safely; fails to identify and follow through on significant nursing implications related to medications.
Violates or threatens the thermal safety of the client, e.g.: fails to observe safety precautions during O2 therapy, heat/cold applications; leaves unreliable patient alone while he/she smokes.
Inadequately and/or inaccurately utilizes the nursing process, e.g.: fails to observe and/or report critical assessment regarding patients.
Violates previously mastered principles/learnings/objectives in carrying out nursing care skills.
Assumes inappropriate independence in actions or decisions, e.g.: fails to seek supervision when situation is questionable.
Any other facts or circumstances potential for violation of safety standards.
13. POLICY ON STUDENT SUBSTANCE ABUSE/MISUSE
All students are expected to perform their clinical activities efficiently and safely, without the influence of drugs or alcohol. All students have a responsibility to notify their instructor (s) if they are taking any medications, which may impact students' ability to provide safe and competent care. The purpose of this policy is to protect the clients, students and instructors. The following actions / conditions are prohibited:
Deficient clinical performance due to use of drugs and/or alcohol.
Reporting for a clinical session with the odor of alcohol or illegal chemicals on the breath.
Possessing any illegal narcotic, hallucinogen, stimulant, sedative or similar drug while on clinical time.
Using any intoxicating liquor or illegal substances prior to or while on clinical time, on the premises or away from the premises when required to return to the clinical facility.
Removing any drug from the institution or patient supply for any reason.
All students have a responsibility to notify their instructor(s) if they are taking any medications which may impact student's ability to provide safe, competent care. The purpose of this policy is to protect the clients, students and instructors.
Honesty: Honesty is required in both written and oral communications within classroom and clinical settings. Sanctions that may be imposed include, but are not limited to, expulsion, academic probation, suspension, and failure in the course. The student dismissed for dishonesty will not be eligible for readmission ot the nursing program.
Confidentiality: Confidentiality is required concerning client information including, but not limited to, written, printed, verbal or observed information and status. Breach of confidentiality is grounds for dismissal from the nursing program.
Safe Practice: Safe Practice in the clinical setting is required. Students are expected to demonstrate behavior leading to safe practice. Failure to demonstrate those behaviors can result in sanctions determined by the faculty and/or dismissal from the program. The behaviors expected are identified in the clinical evaluation tool for each course.
15. POLICY REGARDING REPORTING OF INCIDENTS IN THE CLINICAL AREA
An incident is defined as any happening which is not in accord with the routine operation of the institution or the routine care of a particular patient/client. It may involve a patient/client, staff member, student, visitor or all four. It could involve as well supplies, equipment, procedures, or particular services or programs.
To document the type and frequency of incidents that occur during student clinical experiences in order to identify, analyse and take action to eliminate such incidents.
To provide documentation for potential litigation.
To serve as an educational tool to assist faculty to detect gaps in understanding and direct changes in the educational program.
The following guidelines are to be followed when completing incident reports:
All incidents shoul be reported on incident form provided by faculty of nursing.
Documentation about the incident should be objective and contain factual information only.
Normally, reports are to be completed by the person directly involved in or present at the time of the incident, i.e., student or faculty supervisor. When a student is under the supervision of a preceptor, the faculty supervisor is to be notified of the incident. The incident report is to be completed by the person who was directly involved.
Reports are to be handled as CONFIDENTIAL and are not to be copied or circulated.