Florida atlantic university christine e. Lynn college of nursing

sthrush@fau.edu

561 434-6645
Rosario Medina-Shepherd, PhD, ARNP, BCRN
rmedina6@fau.edu

561-297-3955

1. 
   Actualize the role of advanced practice nurse grounded in caring in coming to know adolescents/adults/older adults and families with comprehensive health problems in primary care.
   
2. 
   Collaborate with others on the health care team through demonstration of advanced practice nursing grounded in caring in responding to calls for nursing with adolescents/adults/older adults and families with comprehensive health needs.
   
3. 
   Demonstrate advanced practice nursing responses to calls for nursing with older adults and patients/families in end-of-life situations.
   
4. 
   Envision and discuss role of advanced practice nurse grounded in caring after program completion.
   

2. Advance the discipline of nursing through practice and research.

1. 
   Demonstrate comprehensive knowledge of advanced practice nursing responses to calls for nursing with adolescents/adults/older adults and families with comprehensive health problems in primary care with minimal collaboration with preceptor/faculty.
   
2. 
   Demonstrate integration of multiple patterns of knowing such as empiric, personal, ethical, aesthetic and others in creating advanced practice nursing responses for adolescents/adults/older adults and families with complex health problems including: neurological, immunological, musculoskeletal, pulmonary, renal/urological, gastrointestinal, and endocrine, such as pharmacologic, non-pharmacologic and complementary approaches, including community-based approaches based on current research findings.
   
3. 
   Identify and apply standards of care based on current research findings.
   
4. 
   Support advanced practice nursing responses with research both during oral and written presentations.
   

3. Demonstrate synthesis of advanced practice nursing role.

1. 
   Creates a broad-range of advanced practice nursing responses to calls for nursing with adolescents/adults/older adults and families with multi-system health concerns in primary care integrating multiple patterns of knowing.
   
2. 
   Demonstrates critical thinking and diagnostic reasoning skills in clinical decision-making based on standards of care.
   
3. 
   Creates advanced practice nursing responses with minimal preceptor/faculty input.
   
4. 
   Prioritizes health problems and initiates effective emergency measures in complex, urgent situations.
   
5. 
   Demonstrates knowledge of reimbursement, legal issues related to prescribing & other malpractice issues.
   
6. 
   Exhibits ability to negotiate related to employment opportunities & initiates a collaborative protocol.
   

4. Incorporate an understanding of wholeness of person as connected with the others and the environment through caring.

1. 
   Demonstrates an understanding of self as caring person in relation to others within vulnerable populations and communities.
   
2. 
   Demonstrate an appreciation of culturally-diverse, underserved, and vulnerable adolescents/adults/older adults and families in complex health situations as connected wholes within community.
   
3. 
   Explore environmental issues and challenges in providing culturally-diverse primary care, including work-related risks, environmental exposures, & disaster care.
   
4. 
   Demonstrates competence and leadership in various role dimensions such as direct care provider, consultant, collaborator, educator, advocate, researcher
   
5. 
   Understand the relevance of community in the lives of persons and the leadership role of advanced practice nursing in influencing health care environment as well as other environmental issues on the micro and macro level, including developing a global perspective of health.
   

5. Actualize advanced practice nursing as nurturing the wholeness of others through caring.

1. 
   Demonstrates pharmacological, non-pharmacological and complementary responses to adolescents/adults/older adults with comprehensive health problems in primary care including emergency situations.
   
2. 
   Considers cost, access, efficacy and quality when making health care decisions.
   
3. 
   Identify strategies that facilitate collaboration with others in monitoring and ensuring the quality of health care.
   
4. 
   Accepts responsibility for own practice and continued professional development, including monitoring research to improve quality care; strives to attain the highest standards of practice.
   
5. 
   Acts ethically to meet the needs of patients.
   

practice experiences and related issues including modeling, coaching, and confirmation. Clinical conferences with discussion of advanced practice nursing situations in practice and related issues. Reflective journaling, aesthetic projects.

SOAP Notes 25%

Participation in Clinical Conferences 5%

Clinical journal 5%

Completion of clinical paperwork 5%

GRADING SCALE: The following grading scale has been approved 1-2007. You must state here that a grade below B is not passing in the Graduate Program.
93-100 = A

90-92 = A-

87-89 = B+

83-86 = B

80-82 = B-

77-79 = C+

73-76 = C

70-72 = C-

67-69 = D+

63-66 = D

60-62 = D-

0–59 = F
REQUIRED TEXTS:

• 
  Health care of persons across the lifespan, including management of complex health problems in neurological, immunological, musculoskeletal, pulmonary, renal/urological, gastrointestinal and endocrine problems
  
• 
  National guidelines as related to diagnoses and treatment of all of the above
  
• 
  Cultural and ethnic implications of care
  
• 
  Pharmacologic and non-pharmacologic advanced practice nursing responses in nursing situations
  
• 
  Collaboration & referral; community resources
  
• 
  Negotiating a contract, employment opportunities, drafting a protocol, work on resume, professional presentation of self, as well as written and oral communications
  
• 
  Legal and ethical issues, including privacy and confidentiality
  
• 
  Health care policy, finance and leadership are stressed
  

• 
  Weekly Clinical Journal – each student is required to keep a clinical journal during this semester. This journal will be a weekly reflection of the clinical experience. Please remember not to include any identifying information regarding any specific patient. These weekly journals are due each week and should be emailed to your professor or posted on the Blackboard site.
  

• 
  Each student must submit a minimum of three (3) SOAP notes during the course. These must be submitted by e-mail or to the Blackboard site. Do not submit notes written during the clinical day.
  
• 
  Faculty may require rewriting of SOAP notes or additional notes to be written.
  
• 
  It is expected that the quality of the written SOAP note will progress over the semester. Each SOAP note should be clear, concise, complete, and submitted by email.
  

1). Date of visit

2). Biographical Data

a. patient’s initial (no names please)

b. gender, race, age

c. marital status

d. insurance

e. informant and reliability

3). Subjective Data

a. Chief Complaint (“cc”)

b. History of Present Illness (HPI)

c. Past Medical History (PMH)

d. Family Medical History (FMH)

e. Social Health History (SHH)

f. Review of Systems (ROS)

Note: c, d, e, & h are included ONLY as they relate to the “cc” and HPI

4). Objective Date

a. physical findings (vital signs and BMI)

b. confirmed laboratory findings

5). Assessment

a. suspected or confirmed diagnoses. If more than one, number so that the plan can match the diagnoses. Address each diagnosis separately

b. status of the problem (new onset, poorly controlled, resolving, well controlled, chronic)

c. differential diagnoses

d. ICD-9 diagnosis code

a. pharmacologic

b. non-pharmacologic

c. education/teaching

d. diagnostic

e. anticipatory guidance/ counseling

f. return to clinic (RTC) date
Example of Assessment and Plan:
1) HTN (well controlled) ICD-9 743.00

a. Start HCTZ 12.5 mg, advised of side effects

b. Therapeutic lifestyle changes

c. EKG, CMP and lipids

a. Continue present medications

b. Follow up with diabetes educator
7). On occasion, your approach to a problem may be different from the one suggested by your preceptor. Be sure to include any comments regarding this.

8). Document the CPT code (level & type) of visits, such as – 99201, 99213.

9). Cite in APA format, the references used in developing this SOAP note and describe how and where you use it in your SOAP. Include at least 2 professional journal references.
PARTICIPATION IN CLINICAL CONFERENCES

Three clinical conferences will be held during the semester. Attendance is mandatory. Active participation in the clinical conferences constitutes 5% of the clinical grade. Conference dates, times, and locations will be negotiated by the clinical group.

1. 
   Credentials
   
   1. 
      Student credentials must be up to date in order to practice in the clinical setting. The college of nursing now uses the Magnus system to track all background checks and health requirements.  Please see the following link for complete instructions including a flow chart. The instructions are campus specific.  http://nursing.fau.edu/index.php?main=3&nav=713. Students must make a copy of the Magnus face sheet and hand it into the clinical faculty by the second week of clinical.
      
   2. 
      Name tags should be worn
      
      1. 
         Signature: Nancy Nurse, BSN, RN, FAU Graduate Nursing Student
         
2. 
   Clinical Sites
   
   1. 
      Arrange for the preceptorship a full semester in advance.
      
   2. 
      The list of approved clinical sites is on the FAU College of Nursing Web page.
      
   3. 
      Students should present a CV along with the course objectives when looking for a clinical site and preceptor. Think of it as an interview for a job. Students in the FNP track should begin looking for pediatric and OB sites well in advance.
      
   4. 
      Initiating a new site should be done a semester in advance because it may take a full semester to initiate a new site contract.
      
   5. 
      Students should not have more than 2 clinical sites.
      
   6. 
      Preceptor qualifications include NP, PA (Master’s prepared), DO, or MD.
      
   7. 
      Clinical Arrangements Form is required by the first week of class once you know who your clinical faculty is. YOU MUST SUBMIT THE FORM ELECTRONICALLY FROM THE CON WEBSITE. You may not start clinical until your site has been approved by your clinical faculty. You will need to have a form completed for each site.
      
   8. 
      Preceptors receive an elaborate packet of information when the contract is completed and they site will appear on the data base when this is finished.
      
   9. 
      Clinical sites should be family practice or internal medicine for Primary I and II.
      
   10. 
       You may choose to do 40 hours in a specialty area during the last semester of clinical studies.
       
   11. 
       Clinical hours for the semester totals 180 hours or 12 hours per week. Preceptor vacations can influence available hours. Clinical hours are not allowed when the University is closed unless arrangements have been made with your clinical faculty.
       
   12. 
       Plan for hurricanes.
       
   13. 
       Write a thank you note or bring in a small gift of appreciation at the end of the semester.
       
3. 
   Clinical Logs (available on the College of Nursing Web site)
   
   1. 
      Complete the logs and have them signed daily.
      
   2. 
      Academic honesty-falsifying logs is grounds for dismissal.
      
   3. 
      Write legibly in pen.
      
   4. 
      Include doses and mg/kg/day for pediatric patients.
      
   5. 
      Abbreviate treatments and teaching (anti-reflux measures, TLC, DM teaching).
      
   6. 
      You can use more than one row for complex patients. Only use one side of the sheet.
      
   7. 
      Level of responsibility should progress from 1-4.
      
   8. 
      Preceptor must sign logs and verify hours.
      
   9. 
      Hand in original logs to your clinical faculty at the end of the semester and keep a copy for your records. Clinical faculty will check your logs during clinical conference and during the site visits.
      
   10. 
       Some of you may have pediatric and women’s health hours during the first two clinical experiences with the majority of the hours during the last semester. To take credit for these hours, estimate a half of an hour for a WH, OB, or peds visit and subtract that from the total. You must complete the Summary of Clinical Hours each semester.
       
   11. 
       It is expected that in this course students will average a minimum of 1-2 clients per hour. If you are in the site for 8 hours and only see 4 patients, take credit for only 4 hours. During this clinical experience, it is expected that the student will manage the care of many complex patients.  If at any time during the course the average number of clients falls below the minimum, or the complexity of the majority of patients is not reflective of course objectives, it is the student's responsibility to notify the clinical faculty.
       
   12. 
       You may need to look for another site or plan on spending more time in sites with low volumes of patients. The logs should reflect management of each patient with documentation of treatments and teaching. 
       
4. 
   Evaluation Forms (available on the College of Nursing Web site)
   
   1. 
      Preceptor Evaluation of Student is due midterm and end of term. Make sure you remind your preceptor and give them plenty of time to complete the evaluation form.
      
   2. 
      Faculty and Student Self-Evaluation is due midterm and end of term. On your midterm self-evaluation, list your goals or plans to increase your knowledge and management skills by the completion of the course. Keep the original and submit a copy of the midterm evaluations (preceptor and self) to the faculty. Save the original so that it may be used for your final course evaluations. It is important to note, that you will not lose points for self or preceptor evaluations that are below “excellent.” It is rare that a student is excellent in every category. Evaluations provide an opportunity for self-reflection and planning.
      
   3. 
      Student Evaluation of Preceptor is due at the end of the term.
      
   4. 
      Student Evaluation of Site is due at the end of the term.
      
5. 
   End of Term Procedures for Handing in Logs and Evaluation Forms
   
   1. 
      A final evaluation at the end of the term will be scheduled. At this time, the student will bring his/her final logs, and the evaluation forms. Complete the Summary of Clinical Hours and attach the evaluation forms, and original logs (in this order) with a rubber band. Notebooks, envelops and clips will not fit in the file cabinet. You will not receive a grade until the clinical faculty has reviewed the logs and evaluation forms and has signed the Summary of Clinical Hours. Do not hand in your logs to Carol Kruse.
      
6. 
   Role transition from RN to NP student
   
   1. 
      Be assertive.
      
   2. 
      Learn to present a patient to your preceptor. Provide only pertinent information.
      
   3. 
      You should be able to independently interview a patient, do the exam, and suggest a diagnosis and a plan to your preceptor when you present the patient. The assessment and diagnosis is always the most difficult part for the beginning students. You are not there to follow your preceptor around from room to room (except on the first day).
      
   4. 
      Documentation varies. If you are not allowed to document at the site, please use your own form and provide it for your preceptor as notes.
      
   5. 
      Writing prescriptions
      
      1. 
         Florida statute requires that the number of tablets and the month be spelled out in textual as well as numerical form. Do not allow preceptors to sign the Rx and hand it to you to fill out.
         
7. 
   Clinical Site Visits
   
   1. 
      A clinical evaluation site visit will be scheduled before or around midterm.  This visit will be to evaluate the student's management of patients and documentation of the visit in the patient's medical record.  In addition to the student's ability to work with his/her preceptor and the staff will be evaluated.  A second clinical site evaluation may be scheduled based on student's progress in meeting the course objectives.
      
   2. 
      During the clinical evaluation site visit, the student will have all completed logs to date for review, his/her completed Faculty and Student Self-Evaluation, and the midterm Preceptor Evaluation of Student.  The student will retain a copy of  his/her self-evaluation and the preceptors' midterm evaluation.   It is expected that each student will critically evaluate behavior and support their ratings with narratives in selected areas in the self evaluation. 
      
8. 
   Resources
   
   1. 
      PDA or other hand held device with epocrates. www.epocrates.com
      
   2. 
      The Stanford Guide to Antimicrobial Therapy. www.sanfordguide.com
      
   3. 
      Prescribers Letter. www.prescribersletter.com
      
   4. 
      Medical Letter. www.medicalletter.com
      
   5. 
      Fitzgerald Health Education Associates. www.fhea.com
      
   6. 
      Journal of the American Academy of Nurse Practitioners (512) 442-4262
      
   7. 
      Medifile (800) 762-0233 can be ordered for your practice if your provider is an FMA member.
      

a). The Christine E. Lynn College of Nursing Graduate Handbook located at:

b). Florida Atlantic University’s Academic Policies and Regulations

http://www.fau.edu/academic/registrar/catalogRevs/academics.php

and http://www.fau.edu/regulations

The University policy regarding academic integrity is enforced in this course. Students at Florida Atlantic University are expected to maintain the highest ethical standards. Dishonesty is considered a serious breach of these ethical standards, because it interferes with the University mission to provide a high quality education in which no student enjoys an unfair advantage over any other. Dishonesty is also destructive of the University community, which is grounded in a system of mutual trust and places high value on personal integrity and individual responsibility. Harsh penalties are associated with academic dishonesty. For more information, see:

http://www.fau.edu/regulations/chapter4/4.001_Code_of_Academic_Integrity.pdf
The College of Nursing regards adherence to the Code of Academic Integrity as a professional competency and an expectation of all students. ANY act of dishonesty that violates the code of academic integrity and misrepresents your efforts or ability is grounds for immediate failure of the course.
DISABILITY STATEMENT:

In compliance with the Americans with Disabilities Act (ADA), students who require special accommodations due to a disability to properly execute coursework must register with the Office for Students with Disabilities (OSD) located in Boca Raton – SU 133 (561-297-3880), in Davie – MOD 1 (954-236-1222), in Jupiter – SR 117 (561-799-8585) or at the Treasure Coast – CO 128 (772-873-3305), and follow all OSD procedures.

The Incomplete Grade Policy is enforced. A student who registers for a course but fails to complete the course requirements, without dropping the course, will normally receive a grade of “F” from the course instructor. A student who is passing a course but has not completed all the required work because of exceptional circumstances may, with the approval of the instructor, temporarily receive a grade of “I” (incomplete). This must be changed to a grade other than “I” within a specified time frame, not to exceed one calendar year from the end of the semester during which the course was taken.

Students are expected to attend all of their scheduled University classes and to satisfy all academic objectives as outlined by the instructor. The effect of absences upon grades is determined by the instructor, and the University reserves the right to deal at any time with individual cases of nonattendance. Students are responsible for arranging to make up work missed because of legitimate class absence, such as illness, family emergencies, military obligation, court-imposed legal obligations, or participation in University-approved activities. Examples of University approved reasons for absences include participating on an athletic or scholastic team, musical and theatrical performances, and debate activities. It is the student’s responsibility to give the instructor notice prior to any anticipated absence and within a reasonable amount of time after an unanticipated absence, ordinarily by the next scheduled class meeting.

Instructors must allow each student who is absent for a University-approved reason the opportunity to make up work missed without any reduction in the student’s final course grade as a direct result of such absence.
RELIGIOUS ACCOMMODATION

In accordance with rules of the Florida Board of Education and Florida law, students have the right to reasonable accommodations from the University in order to observe religious practices and beliefs with regard to admissions, registration, class attendance, and the scheduling of examinations and work assignments. Students who wish to be excused from coursework, class activities, or examinations must notify the instructor in advance of their intention to participate in religious observation and request an excused absence. The instructor will provide a reasonable opportunity to make up such excused absences. Any student who feels aggrieved regarding religious accommodations may present a grievance to the director of Equal Opportunity Programs. Any such grievances will follow Florida Atlantic University’s established grievance procedure regarding alleged discrimination.

The Christine E. Lynn College of Nursing may use students’ course-related materials for legitimate institutional purposes, such as accreditation, university review process, or state board of nursing review process, etc. In such cases, materials will be used within the college and university.

 

April, 2002.