During enrollment at Lakeview College of Nursing, various clinical opportunities are provided to help students successfully complete course requirements. Lakeview has extensive clinical affiliation agreements, including acute and extended care facilities and community service agencies.

Enrolled students must be able to have independent means to travel to and from clinical assignments. Students traveling in private vehicles to and from clinical assignments assume all related risks and liability. Lakeview College of Nursing is not responsible for injuries or damages that may result.

Clinical opportunities are limited, and students are assigned to a clinical time and sites. Students who cannot attend the assigned clinical time and location can withdraw and re-enroll in the course the next time it is offered.  Clinical reassignments are not considered.
 

Per the Health Insurance Portability and Accountability Act of 1996 (HIPAA), all information regarding patients or former patients is considered confidential and protected health information and will be used solely for clinical purposes as part of the educational curriculum. Students may be required by their assigned clinical placement to complete HIPAA training. Students are responsible for adhering to the requirements of HIPAA and any other federal or state laws regarding confidentiality. Students may not download or store confidential client data on a personal electronic device.

The student nurse will not discriminate while providing nursing services based on age, marital status, sex, sexual preference, race, religion, diagnosis, socioeconomic status, or disability.

A student who is or becomes pregnant is encouraged to notify the Title IX Coordinator as soon as possible. By doing so, the student and the Title IX Coordinator can collaborate and develop an appropriate plan to continue the student's education. Pre-planning can also help with particular challenges the student may face while pregnant or recovering from childbirth (e.g., missed classes/clinicals, make-up work, etc.). The choice to declare a pregnancy is voluntary and a student is not required to disclose this information to the College.  For example, voluntarily disclosing a pregnancy may be particularly beneficial due to the unique nature of the nursing program and its clinical requirements. 

For the safety of the pregnant student, the student should be aware of potential risks related to some learning experiences such as, but not limited to, communicable disease[s], strenuous activity, toxic substances, including radiation, and the potential for bodily harm. The student should consult with her faculty member before the clinical experience to know any clinical agency policies related to pregnant individuals, such as not entering where radiation therapy is being administered. Neither the College nor its affiliating clinical agencies assume responsibility for any harm that might occur to a fetus or a pregnant student. The College advises the student to consult with the student's doctor to discuss potential risks.

Student must:

1. Provide evidence of good physical health (through evidence of a physical from a licensed healthcare provider during enrollment.);
2. Provide evidence of meeting Lakeview’s immunization requirements and keeping them updated as required;
3. Provide proof of certification in The American Heart Association-Basic Life Support (CPR & AED Program) or the American Red Cross – Basic Life Support for Health Care Providers and keep it updated as required;
4. Satisfactorily pass a background check prior to the start of classes; 
5. Provide evidence of a negative drug screen (admissions, suspicion and random testing); and
6. Provide proof of health insurance, as applicable.

Attendance at clinical and lab is required. To meet the clinical objectives and requirements, the student must satisfactorily fulfill all required clinical hours.

See course descriptions for required clinical and lab hours. Failure to satisfactorily fulfill the required clinical or lab hours will lead to failure of the course.

If a student anticipates missing clinical or lab, the student must personally notify the clinical/lab instructor and course coordinator of absence before starting the clinical experience. Depending on the course, students may also be required to notify the agency.

The Clinical/Lab Instructor and Course Coordinator will follow the policy to determine if the absence is excused or unexcused.

Failure to notify the clinical/lab instructor of absence in advance of the clinical/lab experience is an unexcused absence. Failure to arrive on time and be prepared for clinical or leave early is an unexcused absence. An emergency will be taken into consideration when determining excused or unexcused absences.

To maintain patient safety, the clinical instructor may dismiss the student from the clinical area if the student is unprepared for the clinical experience or if the clinical instructor determines that the student is unsafe to provide care.  Such dismissal is an unexcused absence.

Absences, whether excused or unexcused, will impact a student’s success in the course, up to and including failure. Opportunities for making up missed clinical days or laboratory sessions may not be available.

If a student has two [2] unexcused clinical absences, they will fail clinical for that course.

Clinical instructors will follow up with course coordinators to discuss the student’s performance in the clinical setting. Specifically, if the student needs to attend an alternative experience to make up for the experience missed and whether or not the clinical outcomes are still possible to achieve, clinical absences will be documented, and the student will be required to make up the clinical hours per the course coordinator.
If available and necessary by the course coordinator, clinical hours will be made up by simulation or demonstrating skills in the lab. The course coordinator will notify the lab coordinator when a student is required to make up the clinical experience.

First Day of Clinical/Lab Orientation

Students must attend all clinical orientations for their assigned agency. Students who miss the first day of clinical, lab, or clinical orientation, whether their absence is excused or unexcused, may be immediately dropped from the course(s). Students who cannot attend the first day must have prior approval from the Dean of Nursing and Course Coordinator. See General Attendance Policy.

Students should check with their clinical instructor if these symptoms apply: (a doctor’s note may be required)

• Fever > 100.4
• Conjunctivitis (Pink Eye)
• Diarrhea or Vomiting - lasting more than 12 hours
• Group A Strep-culture confirmed or physician-diagnosed
• Jaundice - yellowing of the skin which might suggest viral hepatitis
• Cold sores (herpes)
• Active measles, mumps, pertussis, rubella or chickenpox
• Upper respiratory infection (cold) if accompanied by fever and productive cough
• Tuberculosis and/or positive TB skin test
• Head lice, scabies (mites that burrow under the skin causing a rash)
• Scabies (mites that burrow under the skin causing a rash)
• Any draining wound such as Impetigo, Abscess or Boil must be covered
• Mononucleosis
• COVID-19 Symptoms
  ~Fevers or chills
  ~Cough
  ~Shortness of breath or difficulty breathing
  ~Fatigue
  ~Muscle or body aches
  ~Headache
  ~New loss of taste or smell
  ~Sore throat
  ~Congestion or runny nose
  ~Nausea or vomiting
  ~Diarrhea

Students project an image of the College as they engage in practice settings. Lakeview College of Nursing expects professional dress and appearance.  Students are to purchase a student uniform from the approved vendor designated by the College. 

Dress Regulations/Uniform Requirements:

1. Identification Badge
   Lakeview College of Nursing issued i.d. badge should be attached to the upper right collar area and worn at all times (College, Simulation Lab, and Clinical Sites).
2. Uniform
    

   Pants:	Navy uniform pants. Style and number specified by the college. The waist of the uniform pants should not be rolled down.  The pant cuff may not be slit up the side for a flared look.
   Skirt:	Navy uniform skirt. Style and number specified by the college. This is an option for the student who prefers not to wear pants.
   Shirt:	Burgundy, short-sleeved, scrub top specified by the College with the LCN patch sewn on the left side of the scrub top for the patch to sit just above the heart. Students may wear the pre-approved navy shirt, either long or short sleeve, purchased from the Student Government Association. This is a lightweight shirt with crew neck. The long sleeve shirt has the College name embroidered on the right sleeve. These undershirts are the only accepted top worn under the scrub top. A maternity style specified by the college is available for students who need this option.
   Lab Coat:	White lab coat specified by the college with LCN patch sewn on the left sleeve.
   Jacket (optional)	Burgundy, zip-front scrub jacket specified by the College with the LCN patch sewn on the left arm.
   Socks:	White/neutral stockings or white socks (mid-calf or knee-length). Socks must fully cover ankle. If the skirt option is chosen then the hose must be worn.
   Shoes:	White nurse shoes or white leather tennis shoes must be worn (closed heel and toe, solid construction, no mesh). Shoes worn in clinical areas must cover the entire foot and be clean/polished.

3. Watch with a second hand.
4. Stethoscope with bell and diaphragm.

Additional required supplies:  penlight, bandage scissors, a small notepad, black ball-point pen
Students are expected to dress and present themselves professionally in the clinical area. Whenever students are representing the College, the student should be in uniform. Professional attire and appearance are an expectation, not an option. Clinical Instructors may dismiss students from the clinical setting if they are not properly attired. This dismissal will be counted as a clinical absence.

Additional Requirements:

Nails:  Natural nails may not extend beyond fingertips/nail polish, and artificial nails are prohibited.

Hair:  Hair must be kept off the face and above the collar or pulled back neatly (tight ponytail, braid, or bun). Clinical settings do not permit decorative clips, bows, bun pins, hair extensions, and other ornate hair accessories. Tousled/disheveled hairstyles and hair colors that cannot be grown naturally are prohibited. Mustaches and beards are permitted but must be clean, trimmed, and well-groomed.

Headgear: Religious dress/headwear (free of decorative items – solid white or black) is permitted but must allow the student to use a stethoscope and other medical instruments and must not interfere with patient exams, etc. Other caps, hats, bandanas, and headwear are prohibited in clinical settings.

Cosmetics: Make-up may be worn moderately, applied lightly, and non-threatening. Scented products and products containing glitters should be avoided.

Tattoos: Tattoos must be covered whenever possible and should not be offensive or distracting if visible. Some clinical agencies may require total coverage.

Jewelry/Accessories:  These are the only acceptable accessories;

• One pair of stud earrings in each earlobe.
• One plain ring/ring set on one finger. In some clinical areas, all jewelry must be removed.
• Second-hand watch

Undergarments:  No garments or markings on garments should be visible underneath any part of the uniform.  This includes short-sleeved and long-sleeved T-shirts or camisoles worn under the shirt.

Perfume or Cologne:  No perfume, cologne, or smell of smoking is permitted during clinical time.

Certain clinical agencies may have additional dress regulations and uniform requirements. The policies of an affiliated clinical agency hosting students for rotation may differ and always supersede Lakeview College of Nursing’s dress code. However, if the agency allows staff to wear jeans, shorts, mini-skirts, t-shirts, or sweatshirts, it is never acceptable for BSN students to wear these items during a clinical experience.

Students injured during clinical and need immediate attention should be taken to the Emergency Services for care. Any expense incurred is the student's responsibility. The student should see their physician if the injury does not need immediate attention. Students are responsible for carrying their health insurance. Faculty must complete an Incident Report, https://www.lcn.edu/incident_report/form, for Lakeview and the clinical agency where the accident occurred.

Needlestick Injury
Needlesticks or any other injuries must be reported and investigated by the agency (where the incident occurred). The student should be taken to the nearest emergency room when a needle stick occurs. The emergency room's policy/procedure for needlestick injuries should be followed. Any expense that is incurred is the student's responsibility.
In addition to the clinical site's procedure, Lakeview College of Nursing’s form, http://www.lcn.edu/incident_report/form, must be completed. College community members will be transported by car or ambulance to the nearest appropriate facility in an emergency.

This policy establishes guidelines for the appropriate and professional use of electronic devices (e.g., cell phones, smartphones, tablets, computers) by nursing students during clinical. “Clinical” is the various settings utilized in any clinical nursing course (for example, skills laboratory, acute care facilities, sub-acute and rehabilitation facilities, long-term care facilities, clinics and physician offices, and community settings). Students must adhere to the clinical facility's and the College’s policies regarding using electronic devices in clinical settings.

If electronic devices are approved for use according to clinical facility policy, the following restrictions apply:

• Electronic devices may only be used for clinically-related reasons as approved by each clinical instructor and/or course coordinator.
• All devices must be kept on “silent” or “vibrate” mode in the clinical setting.
• Using electronic devices for personal communication (e.g., email, text, social media) or other personal reasons unrelated to clinical use is strictly prohibited. No earbuds are to be worn on the clinical floor.
• Taking any voice recordings, photographs, or videos during clinical is strictly prohibited.
• Students are responsible for adhering to the federal Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH) regulations regarding protected health information. Students may not download or store any confidential client data on a personal electronic device.

Violations of this policy and/or the policy of the clinical facility may result in clinical remediation or failure.

1. Expectations - It is understood that throughout the courses in the program, nursing care will be given:
   1. Safely - so that the environment does not endanger the patient, treatments, and medications; by lack of knowledge of the student; or by disregard of agency policies.
   2. Honesty - so that in every interaction between student and patient, health care team member, and instructor, the student’s communicates ethically and truthfully.
   3. Professionally so that in all actions, a student follows policies and procedures.  Maintains appropriate boundaries and communicates clearly and effectively.
2. Evaluations
   1. Each student will receive a mid-term and final evaluation of clinical performance.
   2. Each student will have the opportunity to discuss the evaluation with the clinical instructor.
   3. Each student who receives an unsatisfactory final clinical/lab evaluation will fail the clinical portion of the course.
3. Remediation
   1. An Academic Improvement Plan (AIP) will be completed for any student who has unsatisfactory mid-term or final evaluations for future clinical settings.
   2. It is the student’s responsibility to follow through with remediation recommendations on the AIP.

Approved list of the Rights to Medication Administration:

• Right client
• Right medication/drug/reason
• Right dose
• Right route
• Right documentation
• Right client education
• Right to refuse
• Right assessment
• Right evaluation

Right client

• Is this the right client to receive this medication?
• Verify the client's identity using at least two identifiers including name and date of birth (check wrist band and ask the client to state their name).

Right medication/drug/reason

• Does the client's condition, symptoms, and health status warrant receiving this medication?
• Has the client's symptoms and the diagnosis made sense for the client to have this medication?
• Is it the correct time for the medication to be administered?
• Determine if the client has any known allergies or sensitives
• Assess the client’s other medication to detect possible contraindications
• Make sure the right medication, packaging, labeling, and spelling of some drugs look alike-watch for visual clues.
• Have another person double-check medications and mathematical calculations.
• Check when the medication was last administered, and if the drug is new, document when it was first given.

Right dose

• Is the correct dose being administered?
• How is the medication administered?
• Does administration require medication math to calculate the dose?
• Ensure that labeling is legible and clearly understood.
• Follow institution medication protocols as written.

Right route

• Is it appropriate to administer the medication orally, intravenously, by injection, or other routes?
• Check the original orders to verify the route of administration.

Right documentation

• Has the correct documentation been completed according to facility policy?
• Complete documentation according to facility policy immediately after administering any medication.
• Document and communicate any signs and symptoms indicative of adverse effects to the appropriate health care provider.

Right client education

• Is the client familiar with the medication?
• Does the client understand the purpose, dosing, administration information, and other information specific to the medication?
• Assess the client’s level of knowledge. Provide client education as necessary.

Right to refuse

• Has the client verbally agreed to take the medication?
• Has the client expressed any concern with the medication?
• Acknowledge the client’s right to self-determination.
• Provide education, then document, and notify the provider about the refusal.

Right assessment

• Is it appropriate to administer the medication, based on the specific data collected?
• Collect appropriate assessment data related to the mechanism of action and/or therapeutic action.

Right evaluation

• How has the client responded to the medication?
• Monitor the client to determine drug's efficacy, detect and prevent complications, and evaluate and document changes.
• When applicable, assess the client’s laboratory values to detect changes.
• Provide client education, when possible, so the client is alert to adverse effects.

Skill statement

Goal:

1. Define satisfactory vs unsatisfactory
2. Provide examples of satisfactory vs unsatisfactory
3. Set disclaimer of sterile technique and the number of identified breaking of technique that is allowed.
4. Set up remediation guidelines for all faculty related to student failure
5. Provide time frames per skill

Testing (Check-off)

• Students will be provided a review day or study content related to the skills required for the check-off.
• Students must be able to demonstrate proficiency for satisfactory performance.
• Retesting will be required if the skill level is unsatisfactory.
• Retesting will be on the student’s own time and is to be scheduled through the lab coordinator.
• Students will not be able to retest until remediation has occurred.
• Repeat testing cannot occur on the same day as the unsuccessful attempt.
• Skill remediation will be determined by the instructor that evaluated the student.
• Skill remediation may include:
  1. Attendance of open laboratory times with lab coordinator.
  2. Review videos, ATI content, and more

Satisfactory and Unsatisfactory Definition

Satisfactory:

• Performs safely and accurately during the performance.
• Demonstrates coordination and dexterity.
• Generally, appears relaxed and confident most of the time with the occasional display of anxiety.
• Completed the skill within a reasonable time frame.
• Focuses on the client initially, but as the skill progresses, focuses on the task.
• Applies knowledge of the principles of the skill accurately.

Unsatisfactory:

• Requires direction or cues from the instructor.
• Demonstrates partial lack of dexterity; is awkward.
• Takes a longer time to complete the skill.
• Wastes energy due to poor planning/anxiety.
• Focuses primarily on the task, not the client.
• Needs direction in the application of the principles of the task.
• Unable to complete the skill within the allotted time.

Break in Technique

The student is only allowed one student identified and reported by the student break-in technique. Any break in technique needs to be recognized and identified by the student before proceeding to the procedure's next step.

More than one break in technique reported by the student will result in an unsatisfactory check-off regardless of the points awarded.

If a break-in technique occurs and is not identified by the student, this will result in an unsatisfactory check-off.

Any break in technique the instructor identifies will result in an unsatisfactory check-off.