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DEU Guidance for NMs / Charge Nurses Making Assignments

How should we schedule our Clinical Instructor (CI)?

CIs should be scheduled for a regular shift when their students are here. 

A regular semester will be 13–14 weeks, one shift per week.

If a CI is planning a vacation or knows in advance that they will not be available on a certain date, they should notify Amy Parks ASAP. We will try to schedule a makeup or alternative experience for the student.

What if a CI calls in sick when they're supposed to have a student?

The CI should also be directed to call off to Amy Parks, the Clinical Faculty Coordinator (c) 463-8110; (b) 654-8342.

Be on the lookout for the student in case they still report to the unit. If they do, let them know their CI is out and direct them to stay on the unit and contact Amy Parks for directions.

Where will our CI teach their student?

The CI works on their home unit and takes a regular assignment for the most part. 

Who pays CI salary when they teach?

The home unit pays for salary when the CI is there with their student; it is treated as a regular work day for the CI. (Palmetto Health has committed student clinical training as an in-kind contribution towards the grant project.) 

The Nursing Duke Endowment pays for CI orientation (ie. class and clinical day). 

Do CIs get preceptor hours? Who pays for this?

Yes, CIs with regular FT or PT status at Palmetto Health are eligible for preceptor hours. Preceptor hours are part of each unit's budget. 

**The Nursing VPs have agreed to an additional incentive that applies to the DEU only. If a CI is teaching more than one student, the CI becomes eligible for double preceptor hours. (ie. CI has 2 students for a 7 hour shift. She can log 14 preceptor hours). 

CIs should use Palmetto Health RN Preceptor Pay Request form to keep up with their hours. Approval is done by area DON (same as if precepting new hires, leadership students).

How do we make assignments when our CI has a student?

This varies, depending on the unit. Some units staff up to protect their CIs while the student is present. Others do usual staffing, but with some support for the CI.

On the first day, students do not take an assignment. They follow their preceptors on a regular assignment to orient for a half day. From then on, the CI will be assigning someone from their regular assignment for the student to follow / care for.

Depending on your area (ie nurse:patient ratio >1:4), you may have to scale back on your CI's assignment for the first 1–2 actual clinical days so that your CI can get a feel for what level their student is at. If your CI has 2 students, you may need to scale back on the 3rd clinical day as well. These circumstances are justified variances.

After that, for the most part, CIs have felt comfortable going back to their normal assignment.

How can Charge Nurses help the CIs when a student is scheduled?

There are a number of creative ways to support your CIs when they have a student.

CIs are made aware of what their students are covering in class each week and try to incorporate this into the SN assignment. Some CIs like to call the person making shift assignments to request the patient or type of patient needed for the student.

If there is another group of students due on the unit (ie. MTC or another USC traditional group), you can assign some of the patients that they are covering to your CI. This frees up some of the CI's time for teaching.

If there are clusters of 4 versus 5 patients or 3 versus 4 patients, assign the CI the smaller cluster if possible when the student is scheduled.

Some of the units hold off on giving CIs admissions until after the students leave (1330–1400).

In order to insure the best experiences for SNs and have the CIs feel supported in their roles, the Nursing VPs have agreed to "protect" the DEU CIs on the shifts that their SNs are with them. Ideally, CIs:

• should not be excused for low census
• should not be floated
• should not be in charge

How can the rest of the staff support the CIs when a DEU student is scheduled?

The DEU student experience really belongs to the whole unit. We would like for units to view themselves as "teaching communities" when the DEU students are present. You are investing in creating the strongest graduate nurse that you can (and maybe she'll end up working on your unit in the future). 

It's important for nights to be aware of what a CI would like left to meet their SN's needs (ie. skills that SNs can practice early in the day shift: injections, foley dc's, baths...).

It is equally important for nurses to keep the CIs aware of unique diagnoses / procedures / learning opportunities that she may want to expose her student to. If everyone could think of things they wish they would have experienced in nursing school and keep their eyes out for them, it will really add to your student's repertoire.

We teach the CIs to "think out loud" when their students are present. This helps students to see and understand how nurses prioritize, organize, etc. If a student asks you a question or is following you, you should take the same approach.

Be aware that students watch everything that goes on around them...communication, teamwork, unit culture, etc.

What are the DEU students supposed to do when they have a patient assignment?

CIs have been oriented as to USC CON expectations. Student capabilities will depend on their level in the program and their previous clinical experiences.  For the most part, students are responsible for patient assessment, safety, med administration, and nursing procedures (under the guidance of their CIs). Students are also responsible for assuring that basic patient needs are met (feeding, toileting, hygiene, positioning, ambulation, etc.). Depending on acuity, CIs usually allow students more independence as they validate their competencies over time. 

Although the student will concentrate on one patient for written assignment purposes, they do follow their CI with their entire assignments to experience "real nursing."

Who should we call with DEU questions / suggestions?

Ros Squirewell
(o) 296-5089 

Amy Parks
(c) 463-8110; (b) 654-8342

Courtney Hillen
(c) 206-7213