Level IV Orientation - 1st Sem.ppt

WHAT HAVE I LEARNED IN LEVEL
II?
WHAT ARE MY EXPECTATIONS FOR
LEVEL III?
WHAT SHOULD I DO TO MEET
THESE EXPECTATIONS?

CLINICAL PRE AND POST
CONFERENCE MAYBE HELD TO:
review the focus
establish the goals for the day
identify patient needs
discuss nursing care challenges of
interest for the benefits of all
share ideas for meeting these
challenges.

Identify the client.
State client needs.
Describe pertinent
observations in a review of
systems manner.
Report situation and potential
or real problems experienced.

Discuss nursing approach/solution to
these.
List the drugs administered, and state
the action, dose, desired effect, untoward
effects and method of administration for
each.
List treatments, and state the purpose
of, and client’s response to each.
IV solutions.
Labs/pertinent to patient.
Teaching.

Physical Assessment
Nursing History Taking
Intake and Output
Monitoring
Admission Care

Specimen collection
Positioning
Transferring and Lifting of
Patient
Medication Administration
NGT (Lavage & Gavage)
Feeding through NGT, PEG tube,
jejunostomy tube

IVF administration
TPN administration
Comfort measures (Bed Bath &
Bed shampoo, Perineal care)
Offering & assisting of Bedpan
Application of bandage and
binders
Oxygen Therapy (Application of
nasal cannula, face mask, CPAP,
BIPAP, with artificial airways, etc )

Chest Physiotherapy
Use of incentive spirometry
Postural Drainage
Airway Management:
Suctioning using closed line and
open line suction cathether
(oropharyngeal, nasopharyngeal,
endotracheal, tracheostomy)

Paracentesis
Thoracenthesis,
Thoracostomy
 Blood Glucose Level
Monitoring
Wound Care and
Management
ECG taking

Male and Female Urinary
Catheterization, Cystoscopy
(Foley/Indwelling, Straight,
3-way catheter)
Enema Adminstration
Colostomy Care
Post Mortem Care

The student will:
Learn the physical layout of the clinical area/community
setting.
Review and be familiar with guidelines regarding
universal precautions as related to the clinical/community
setting; know where to find protective equipment, sharps
disposal boxes and infection control manuals located on
the unit/area.
Discuss the ethical, legal issues involved in the nursing
care of the members of the Nursing Care Units.
Identify the chain of command as it relates to the clinical
area.

Be familiar with usual routines for the unit:
vital signs
meal time
visiting policies
Be introduced to the charting system for the
clinical facility.
Be introduced to policies related to IV’s and
medication administration.
Discuss nursing responsibilities related to
medication administration.

Review school policies as they relate to clinical
attendance, e.g. absenteeism, tardiness, etc.
Be oriented to clinical assignments, time of
clinical experience, location and time of pre and
post conferences and other scheduled clinical
experiences in this course.
Review the clinical evaluation tool.
Discuss the role of the nurse as provider of care,
manager of care and member of the profession.
Discuss the issues of confidentiality related to
the clinical setting.
Review the requirements for papers related to
this course.

Attend the orientation and familiarize with the
physical set-up, personnel and policies of the
institution and community setting.
Receives ward endorsement and patient
assignment for the day
Identify and provide a sound decision making in
the care of individuals. families/groups considering
their beliefs and values.
State expected outcomes of nursing intervention.
Develop a comprehensive client care plan.

Implement nursing intervention that is safe and
comfortable.
Act according to clients’ health condition and
needs.
Perform nursing activities effectively and in a
timely manner.
Assess the learning needs of the client.
Develop health education plan based on
assessed and anticipated needs.
Monitor effectiveness of nursing interventions
Revise care plan when necessary.

Establish trust and confidence with
assigned client.
Listen attentively to client’s queries and
requests.
Spend time with the client to facilitate
conversation that allows client to express
concerns.
Utilize appropriate patient care records
and reports.
Accomplish accurate documentation in
all matters concerning client care in
accordance to the standards of nursing
practice.

Render nursing care consistent with the patient’s
bill of rights: (i.e. confidentiality of information,
privacy, etc.)
Observe proper disposal of wastes.
Adhere to policies, procedures and protocols on
prevention and control of infection.
Utilize findings in research in the provision of
nursing care to individuals / groups /
communities.
Make use of evidence-based nursing to
ameliorate nursing practice.

Identify own learning needs, i.e., one’s
strengths, weaknesses/limitations
Project a professional image of the nurse
Possess positive attitude towards change
and criticism.
Detect variation in specific parameters,
i.e, vital signs of the client from day to day.
Report significant changes in client’s
condition/environment.

 RLE is an integral part of
the learning process of
Nursing Education.
 Missed hours in RLE are
missed opportunities to
meet student objectives.

 ATTENDANCE : NO CLINICAL ABSENCES
ARE ALLOWED
Tardiness or late: 1 late = 1 day make-up
duty
 30 min. late = 1 day unexcused absence
Unexcused absence:1 day = 3 days make-up
duty
excused absence:1 day = 1 day make-up
duty
Must present a medical certificate from the
College Physician

PROFESSIONAL APPEARANCE
Required uniform is to be worn at all times
when in the clinical area/community
When obtaining patient’s assignment, the blue
smock gown and the student nursing
nameplate and/or ID must be worn over
appropriate street clothes. Access to patient
records will be DENIED if the student is not in
a proper attire.
Maintain proper decorum and provide
appropriate respect to the persons present
in the area when obtaining patient’s data.

 JEWELRY
 jewelries are to be worn with the
uniform even after duty hours
A wristwatch with a second hand in black
and silver colors only are permitted. NO
FASHION WATCHES.
Miraculous medals are allowed and must be
kept under clothing and not visible.

Makeup should be subtle and in
good taste.
The uniform must be neat and
clean.
Chewing gum is unprofessional
while in the clinical setting or in
the nursing laboratory, thus, it is
prohibited.

Students must maintain personal hygiene,
specifically good oral care.
 strong cologne, after-shave,
and/or perfumes are permitted.
Undergarments should not be visible under
the uniform.
Colored undergarments are not allowed
Fingernails must be cut clean and short
with no nail polish.

• The hair which is a
part of the uniform
must be neat and
clean and should
portray subtle,
professional image.

For girls, Hair
must be clean,
worn off collar, and
tied back from face
while in school/gala
uniform (hair dye is
strictly prohibited!)

 Gel-coated hair
in a bun /
chignon with
hair net when
wearing duty
uniform
(community /
hospital
uniform)

For boys, Clean
haircut (crew
cut), with hair not
touching the ears
and the collar

Beards and
moustaches in
males are not
permitted.

 body
piercing jewelry
or tattoos are
allowed in the
area.

Cell phone use
Turn them off. NO CELL PHONES IN YOUR
POCKETS
Response to any call or SMS should be done
ONLY during breaks.
Cell phones for communication of any type or
taking pictures in the classroom, nursing
laboratory, or the clinical unit will face
disciplinary action that may include permanent
dismissal.
Absolutely smoking
The effects of the use of cigarette prior to or
during the period of time when you are
providing patient care can be offensive.

Never leave patients unattended.
Endorse your patient if you plan to be OUT
OF POST
SLEEPING ON DUTY is definitely
prohibited.
Eating breakfast, lunch, snacks, or dinner
outside school premises is not allowed
Never come on duty on an empty
stomach.

Nobody must be seen wearing their
uniforms
in performing tasks outside school
movement except for official school
activities and
in public places such as malls, markets,
movie houses, bars and restaurants,
computer places, beach or “tiangge”
where unacceptable, brazen moves like
gambling, fighting, and drinking alcoholic
beverages could be done

Every one is expected
to act appropriately
putting into action the
values and attitude a
true Vincentian
Anthonian must have.

Violations to the
aforementioned items =
DEFICIENCY
3 deficiencies = 1 makeup duty

Consistent unsatisfactory clinical evaluations.
Failure to immediately report a patient-care
error to the CI and/or nursing personnel.
Lack of adequate theoretical knowledge for
application to patient care.
Violation of principles of CONFIDENTIALITY.
Lack of preparation for clinical practice.
Failing to respect client rights and dignity.
Soliciting, borrowing, or removing
property/money from client or client’s family.

Assuming client care tasks for which the
student nurse lacks the education or
competence to perform.
Removing drugs, supplies, equipments, or
medical records from the clinical setting.
Abandonment: Leaving clinical area or patient
assignment without notification.

 Jeopardize life
Impede recovery
Interfere with the
maintenance of the
client’s current
health status

CI reports an incident
SN writes a narrative
account of the incident
Meeting with Level
Coordinator
Meeting with the Dean
Meeting with Disciplinary
Committee (ad hoc)

will depend on the individual instructor
Notebook (uniform) for sample charting
Digital thermometer
3 pens with blank, blue, red ink
Paper tape
Ruler
Permanent marker
 calculator
 measuring tape
 Vital signs paraphernalia w/ tray
 Penlight, bandage scissors

will depend on the individual instructor
Medication tray w/ green cloth
 4 medication cups
 Index cards (5x8)
Endorsement sheet
Gordon’s Functional Health Pattern Assessment Tool
Clipboard (long and black)
 References (group)
 Drug handbook/MIMS, Nursing Diagnoses handbook,
Lippincott’s Manual of Nursing Procedures, Bate’s Physical
Assessment handbook, Nursing Care Plan, Medical-Surgical
Nursing

Submission will depend on the individual
instructor
1. MEDICATION CARDS
Description: The Medication Card is a 5”x 8”
index card containing information about specific
drugs and the classification of drugs that the
client is receiving.
Content: 1. Medication Cards will be completed daily for
all drugs that the patient is receiving.
2. Medication Cards will be brought to the clinical
area and submitted to the instructor on the first full
clinical day of each week.

3. These cards are updated as necessary.
4. The Medication Card shall contain the following
information:
a. Generic name
b. Trade name
c. Classification of drug
d. Action and Uses
e. Side effect and Adverse Reactions
f. Contraindications
g. Dosage Routes
h. Nursing responsibilities

NAME OF THE MEDICAL DIAGNOSIS (PATHOPHYSIOLOGY)
1. Describe the Pathophysiology
a. Signs and Symptoms
b. Etiology
c. Complications
2. Medical Management
a. Medications and Therapies (e.g. Physical Therapy)
b. Diet
c. Diagnostic Tests
d. Surgery (if appropriate)
3. Nursing Management
a. Specific Nursing Interventions in relation to
pathophysiology.
The student is expected to review normal anatomy and physiology
of the body system involved relevant to the patient’s diagnosis.

2. PATHOPHYSIOLOGY CARDS
Description: The Pathophysiology Card contains a
description of the client’s diagnosis, medical
interventions and nursing management’s. This
information assists the student in planning nursing
care during clinical experience.
Content: The Pathophysiology Card is to be
submitted weekly to the clinical instructor on the first
day of patient care.
3. Gordon’s Functional Assessment
* To be done every change of patient.

 RLE Duty (Hospital-60%
Community Settings-40%)
SKILLS – 40%
 Performance of nursing
procedures in the ward,
Written outputs
KNOWLEDGE – 30%
 Case Presentations,
evaluation exams
ATTITUDE – 30%
 Journal, compliance to
requirements, and
behavior
FINAL GRADE = 100%

Graduation is not a goal. It is
simply the natural consequence
of your actions!
Don’t give up. Failure is
not an option!
Replace your fear, anxiety, and
worry with JOY. Have fun with
what you know. Have fun learning
neat new stuff. You can’t stop bad
things from happening but you can
learn from it. You can enjoy your
new role.

Level IV Orientation - 1st Sem.ppt

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Level IV Orientation - 1st Sem.ppt