Comprehensive Clinical Placement and Orientation Notes for Nursing 3911

Course Overview and Triad Learning Model

• Course Context and Position in Curriculum:

  • Nursing 3911 (N39.11) represents the first acute care clinical placement in the Bachelor of Science in Nursing (BScN) program.
  • Serves as the foundational clinical experience setting up core skills required for subsequent placements:
  • Nursing 3921 (N3921) in the winter term.
  • Fourth-year clinical placement Nursing 4410 (N4410).
  • Final Integrated Practicum (IP).

• Triad Model of Clinical Support:

  • Every student functions within a collaborative clinical triad:
  • Student: Drives the learning experience, identifies personal learning needs, leads evaluations, and takes proactive initiative.
  • Preceptor / Mentor: The assigned bedside nurse working one-on-one with the student. Designated as "Preceptor" across general clinical partners and "Mentor" at London Health Sciences Centre (LHSC).
  • Faculty Advisor: Facilitates synchronous Praxis sessions, provides academic oversight, and supports the student and preceptor throughout the learning experience.

• Course Components and Delivery Structure:

  • Clinical Placement Component: Precepted one-to-one bedside learning totaling 104 to 108 clinical hours (roughly 108 hours total). Shift configurations equal 9 twelve-hour shifts, 13 eight-hour shifts, or equivalent. All clinical shifts must be completed entirely within the designated placement block.
  • Praxis Component: 6 mandatory synchronous virtual sessions conducted via Zoom with assigned Faculty Advisors.

Digital Platforms and Course Operations

• Brightspace OWL:

  • A single unified site houses all N39.11 students and Faculty Advisors across all sections.
  • Student Center enrollment identifies the specific section number and assigned Faculty Advisor.
  • Primary hub for course outlines, announcements, Zoom links, Praxis pre-learning materials, reporting forms, and OWL Q&A discussion forums.
  • Houses the mandatory Knowledge Check quiz, due for all students by September 10 at 8:00 AM under the "Tests & Quizzes" tab.

• HSPNet:

  • Accessible via student account credentials.
  • Used exclusively to retrieve placement assignments, clinical placement dates, unit details, and preceptor/mentor contact details.

• InPlace:

  • Used for entering and updating planned placement schedules and clocking actual completed hours within 24 hours of shift completion.
  • Houses formal clinical evaluation documentation: Clinical Practice Collaborative Evaluation (CPCE), Collaborative Success Plan (CSP), and End of Course Summary.

• Course Rotation and Timeline Logistics:

  • The six-week term is split into two distinct rotation blocks: Weeks 1–6 or Weeks 7–12. Placement shift dates are defined by individual HSPNet schedules.
  • Reading Week Policy: Students are not required to attend clinical placement during Reading Week, but may elect to schedule shifts at their own discretion.
  • Praxis Session Timing: Praxis sessions scheduled outside of the active placement block occur in the morning. Praxis sessions scheduled during the active placement block occur in the afternoon.

Student Accountability and Clinical Initiative

• Driver's Seat Philosophy:

  • Students maintain primary accountability for driving their clinical learning outcomes and seeking active learning opportunities.
  • Early identification of learning needs to preceptors is mandatory, including sharing prior healthcare background (e.g., clinical extern roles, PSW summer employment, past instructor/advisor feedback).

• Progressive Responsibility and Goal Evolution:

  • Learning needs must shift as placement progresses (e.g., shifts 1–3 focus on orientation and baseline care, whereas shifts 4–6 focus on initiating IV medications, analyzing complex patient diagnoses, and managing care plans).
  • Passive learning behaviors—such as waiting for direction, checking personal mobile devices, texting, or browsing social media—are strictly prohibited.
  • Proactive communication phrasing:
  • "Yesterday we covered X, Y, Z, and today I would like to try taking that on myself."
  • "Yesterday I observed you perform a patient transfer, and today I want to lead that transfer."

• Clinical Shift Preparedness:

  • Arrive on the clinical unit early, well ahead of shift start time, accounting for commute, parking, and unit navigation.
  • Contact preceptor in advance (once authorized by Nursing Placement Support) to confirm daily arrival times and routine shift report expectations.
  • Have paper worksheets and writing utensils ready prior to morning/evening shift report.

• Feedback and Downtime Maximization:

  • Solicit feedback continually throughout and at the end of every shift rather than waiting for formal evaluation milestones.
  • During clinical downtime, check on assigned patients, assist other unit patients or peers whose primary nurse is on break, review upcoming medication orders, and research clinical pictures/diagnoses.

Clinical Scope of Practice and Procedural Guidelines

• Assessment and Decision-Making Scope:

  • Focus on conducting thorough physical assessments, recognizing clinical changes, interpreting findings, consolidating the clinical picture, and connecting physical data to medical diagnoses.

• Medication Administration Regulations:

  • Mandatory Direct Supervision: Students are strictly prohibited from administering any medication independently under any circumstances. All medication preparation and administration must occur under direct preceptor/mentor supervision.
  • Controlled Substances: Handling and administration of controlled drugs requires direct oversight in compliance with hospital policy, agency guidelines, and pharmacy legislation.

• Clinical Skills Implementation and Restrictions:

  • Skills may be executed independently or under supervision only when student and preceptor mutually agree that the student possesses requisite knowledge, skill, and judgment.
  • Phrasing for supervised practice:
  • "I have practiced this skill in sim/lab; can we do it together once so I know I am on the right track?"
  • "Could you demonstrate how you do this so I can learn from your practice?"
  • "Could you watch me perform this skill and provide feedback?"
  • Agency Certifications: Students cannot perform skills requiring agency-specific training or certification (e.g., glucometry, venipuncture/blood draws, IV insertion) unless official agency training modules have been completed. These advanced certifications are generally deferred to Fourth-Year Integrated Practicum (IP).

Hours, Scheduling, and Absence Policies

• Clinical Hour Accumulation and Scheduling Rules:

  • Total required hours: 104 to 108 hours (target 108 hours) completed over 9 twelve-hour shifts or 13 eight-hour shifts within the 3-week block.
  • Students must strictly mirror preceptor schedules starting with the first available shift in the block.
  • Working shifts outside the preceptor's schedule is prohibited unless approved by Faculty Advisors or Academic Advisors.
  • The final allowable shift is a night shift starting on the last calendar date of the placement block (extending into the following morning).
  • Floating policy: If a preceptor floats between units (e.g., LHSC medicine floats between nephrology and general medicine, or ENSU floats between Birthing Unit and Antenatal), the student must float alongside the preceptor.

• Absence Policies and Makeup Protocols:

  • Course completion requires meeting both criteria: 1) Successful demonstration of all learning outcomes, and 2) Completion of required clinical hours (104–108 hours).
  • 20% Failure Threshold: Missing 20% or more of total clinical hours results in an automatic unsuccessful grade / course failure.
  • For 12-hour shift schedules: Missing more than 2 shifts equals course failure.
  • For 8-hour shift schedules: Missing more than 3 shifts equals course failure.
  • Clinical Placement Absence Procedure:
  1. Notify preceptor directly or phone the clinical unit prior to shift start.
  2. Submit a formal Student Absence Form.
  3. Arrange makeup clinical shifts with the preceptor within the active 3-week placement block (working alternate preceptor shifts or pairing with an approved alternate nurse).
  4. Update InPlace timesheets accordingly.
  • Preceptor Absence: If preceptor is absent, student must attempt to pair with another unit nurse. If no alternate preceptor is available, student must leave the unit, notify Faculty Advisor / Best in Class educator, and reschedule missed hours.
  • Praxis Absence Procedure:
  1. Notify Faculty Advisor via email prior to Praxis start time.
  2. Submit Student Absence Form.
  3. Complete and submit the mandatory Praxis makeup activity via email to Faculty Advisor within 48 hours of the missed session. Missing more than one Praxis session can result in course failure.

Evaluation Procedures and InPlace Documentation

• InPlace Timesheet Management:

  • Planned shifts must be entered into InPlace immediately upon schedule receipt from preceptor.
  • Actual completed shift hours must be logged in InPlace within 24 hours of shift completion.
  • All timesheet entries must be finalized within 24 hours of the placement block end date.
  • Falsification of timesheets constitutes professional misconduct and triggers direct agency audit.

• Clinical Practice Collaborative Evaluation (CPCE):

  • Format identical to Nursing 2002 and Nursing 2271.
  • Evaluation narrative requires detailed, specific clinical examples illustrating competency achievement.
  • Evaluated at 3 mandatory timepoints across placement:
  • 12-Hour Shift Rotation: Evaluation 1 at Shift 3; Evaluation 2 at Shift 6; Evaluation 3 at Shift 9.
  • 8-Hour Shift Rotation: Evaluation 1 at Shift 4; Evaluation 2 at Shift 8; Evaluation 3 at Shift 13.
  • Student is accountable for tracking evaluation shifts, setting calendar reminders, and ensuring preceptors complete evaluations on time.
  • If preceptor lacks the evaluation link, contact Nursing Placement Support immediately.
  • All CPCE evaluations must be finalized within 24 hours of placement block end date.

• Collaborative Success Plan (CSP):

  • Initiated by preceptor/mentor or Faculty Advisor if a student experiences difficulty demonstrating course learning outcomes.
  • Formulated collaboratively between student, preceptor, and Faculty Advisor, and uploaded directly to InPlace.

Praxis Structure, Course Completion, and Incident Reporting

• Praxis Sessions Workflow:

  • 6 total mandatory synchronous Zoom sessions (~8 students per group).
  • Placement Praxis (Sessions 1, 2, 3): Afternoon sessions attended directly from the clinical placement site.
  • Non-Placement Praxis (Sessions A, B, C): Morning sessions conducted outside the placement block.
  • Execution steps: Complete pre-learning activity on OWL -> Join Zoom via OWL Zoom tab -> Participate in synchronous session.

• End of Course Summary:

  • Mandatory final document submitted via InPlace within 48 hours of the final Praxis session or final clinical placement shift (whichever occurs last).

• Incident and Adverse Event Reporting:

  • Mandatory dual-reporting requirement: All incidents must be logged in BOTH the agency reporting system AND the Western University reporting system.
  • Adverse Events: Client-related incidents or near misses (e.g., patient falls, medication errors).
  • Accidents / Injuries: Student-related health or safety incidents (e.g., fainting, needle-stick injuries, slip and fall).
  • Fainting is explicitly noted as one of the most frequent student clinical incidents and must be formally reported.
  • Just Culture: Reporting is non-punitive and serves to document follow-up care, analyze root causes, and enhance clinical safety systems.
  • Access reporting forms directly on Brightspace OWL.

• Course Support and Q&A Communication:

  • First point of contact for course questions: Anonymous OWL Discussion Forums Q&A.
  • Direct course coordinator contact: Help page messaging system on Brightspace OWL.