YORK UNIVERSITY SCHOOL OF NURSING

NURS 4120 6.0

Community as Partner
Fall 2008 -Winter 2009 Co-Creating Just and Caring Communities

2008-2009 Preceptor Manual

Table of Contents
Overview of the Nursing Program at York University ................................................................................. 1 Mission Statement ...................................................................................................................................... 2 Philosophical Beliefs................................................................................................................................... 2 Human Beings and their world................................................................................................ 2 Health and Healing.................................................................................................................. 2 Nursing.................................................................................................................................... 3 Teaching-Learning .................................................................................................................. 3 Program Goals............................................................................................................................................ 4 Course Theme for NURS 4120 6.0 Community as Partner ....................................................................... 5 Introduction ............................................................................................................................. 6 Clinical Focus.......................................................................................................................... 6 Clinical Hours .......................................................................................................................... 6 Student Groups ....................................................................................................................... 6 Clinical Course Director .......................................................................................................... 7 Team Learning Plan................................................................................................................ 7 Portfolio ................................................................................................................................... 7 Clinical Evaluation................................................................................................................... 7 Mid-term Evaluation & Final Evaluations............................................................... 7 Required learning outcomes for students ............................................................................... 8 Community Health Nursing Standards of Practice ..................................................................................... 9 The Preceptorship Experience ................................................................................................................. 16 Tips on getting started .......................................................................................................... 16 Teaching-Learning Concepts................................................................................................ 16 Interactive Review Process and Success Plan..................................................................... 16 Assisting the students with critical self-reflection and analysis............................................. 16 Role of the Preceptor ............................................................................................................ 17 Role of Clinical Course Director/Faculty Member................................................................. 17 When to call the Clinical Course Director ............................................................................. 18 Role of the Student Team ..................................................................................................... 18 Role of Individual Students ................................................................................................... 18 Preceptor Support ................................................................................................................. 19 Practicum Policies .................................................................................................................................. 20 Work/Education Placement Agreement ................................................................................ 20 Administrative........................................................................................................................ 20 Health Requirement .............................................................................................................. 20 Immunization ....................................................................................................... 20 Incident/Accident Report Form ............................................................................ 20 Basic Cardiac Life Support Certificate................................................................. 20 Attendance ............................................................................................................................ 21 Expenses .............................................................................................................................. 21 Documentation ...................................................................................................................... 21 Professional Appearance and Dress Code........................................................................... 21 Transportation ....................................................................................................................... 21 Strikes ................................................................................................................................... 22 Harassment........................................................................................................................... 22 Clinical Practice Guidelines ...................................................................................................................... 22 Attendance and Praxis Notes ................................................................................................................... 22 Appendix A: Agency Orientation Checklist............................................................................................... 24 Appendix B: Team Leaning Plan .............................................................................................................. 25 Appendix B(a): SAMPLE of one possible learning goal .......................................................................... 26 Appendix C: Team Evaluation .................................................................................................................. 27

Overview of the Nursing Program at York University

York University is located in the north-western area of Toronto. York University launched its 45th anniversary year on March 26, 2004. Since its inception in 1959, York has grown from a small liberal arts university with 76 students to the third largest university in Canada, with 11 Faculties attracting over 50,000 students in search of top-notch teaching and scholarship. MacLeans magazine lists York among the top five universities in Canada. York Universitys commitment to students and to excellence in teaching and research is clear to see in its continued high ranking in indicators that matter most to students: Bursary and Scholarship Support; Most-Educated Faculty; and Investment in Student Services. Yorks faculty are recognized for excellence and innovation in university teaching and research. Two York faculty members have been named Canadian Professor the Year (1993 and 1995) and more than 50 York faculty have received provincial and national awards for teaching excellence. In 1993, the Department of Nursing was established at Atkinson College, York University. It has now become the School of Nursing in the Faculty of Health (July 2006). Currently, the School of Nursing offers a part-time Post-RN BScN Program, an International Educated Nurses BScN program, a Collaborative BScN program, a 2nd Degree Entry BScN program and a Masters MScN program. The School is also part of a 10-university consortium which offers a Primary Care Nurse Practitioner Certificate (post-BScN). In September 1997, students were admitted to the first Collaborative BScN Degree Program in Ontario when they entered year 1 at either Seneca College or Georgian College. At present, there are approximately 350 full-time Collaborative students beginning their third year of the BScN program and another 350 students continuing into their fourth year. As of September 2001, with new government legislation mandating the baccalaureate degree as entry to practice for 2005, year 1 Collaborative students were admitted jointly to the College partner and to York at the same time so the transition to study at York in years 3 and 4 will be seamless. The nursing faculty at York University has grown from a complement of four full-time members in 1996-97 to over 44 in 2007-08. The current faculty have established national and international reputations in their areas of nursing expertise. Scholarly activities have focused on the human science paradigm of nursing, nursing theory and philosophy, and health promotion. Scholarly activities and research programs, including both quantitative and qualitative approaches, encompass such areas as: persons living with chronic illness and their families uncertainty, hope, and having courage nursing futures womens health trans-cultural health international health soulfulness innovation and change health care informatics caring-healing practices phenomenological and narrative inquiries into the lived experiences of patients and their families, nurses, and nursing students empowerment public health nursing arts-informed praxis client-centred care evaluation teaching-learning child rights nursing covenant and the lived meaning of nursing nursing ethics oncology and palliative care

Mission Statement
Our mission is to create a culture of caring that fosters life-long learning and the development of human science-based nursing knowledge, research and practice. We honour and respect the unique lived experience of all people and their inner wisdom with regard to the processes of health, healing and quality of life. The partnerships seek to offer innovative, open, and flexible programs that are responsive to societal needs in diverse communities and to the current and future directions of the nursing profession. June, 2000

Philosophical Beliefs
The philosophy of the Collaborative and Post-RN Bachelor of Science in Nursing programs is broadly based in human science. It draws upon multiple nursing theoretical perspectives that are consistent with the human sciences, such as Newman, Parse, Paterson & Zderad, Rogers, and Watson. Human science focuses on human experiences and the meanings, patterns, and themes that emerge in human living. Our programs are rooted in Nightingale and builds on the Em Bevis and Jean Watsons Caring Curriculum (2000) which sees Nursing as the knowledge and practice of human caring. Caring praxis is seen as practice that is informed by an ethos of caring. This philosophy is lived within all aspects of the curriculum in terms of both process and content. What emerges is a curriculum that embraces individual uniqueness, multiple ways of knowing, creative expressions of nursing scholarship, and global consciousness. This is a distinct departure from conventional nursing curricula where an emphasis is placed, on the bio-medical model, differential power relationships between nurses and patients (nurses as experts, patients as the receivers of the expertise), and objective measurable forms of knowledge as the exclusive source of knowing. The key aspects of the philosophy are the relationship of human beings and their world, health and healing, nursing as a unique body of knowledge, and the teaching-learning process. These aspects of the philosophy will be discussed in the following sections. Human Beings and Their World Nursing as a discipline is concerned with human beings who live as individuals, families, groups, communities, and organizations in diverse, multicultural societies. Our philosophy focuses on the idea that humans live inter-subjectively in relation with others and the world. Humans are meaning-makers and interpreters of their experiences. All humans have the capacity and right to make choices about their ways of living, their ways of learning, and their health. We believe that it is necessary to understand and critique the social, cultural, and political context of individual, group, community, and global health. This stance is needed to challenge systemic values, assumptions, and structures that limit possibilities for human health and healing. Humans live in and with the world, evolving in continuous mutual process. They experience living and create meaning from those experiences in unique ways. The experience of being human is expressed in holistic ways. Health and Healing Health and healing are constantly changing human expressions of ways of being that are lived and defined by those who are experiencing them. From this perspective, health and healing exists within all phases and circumstances of living, including illness and dying. Health and healing are unique expressions of harmony, balance, and wholeness within and between human beings and the world in which they live. This worldview includes respect for our planet which gives forth and sustains all life. The processes of living health and healing are opportunities for transcendence, transformation, and expanding consciousness of human beings and the world. Human health and healing are co-created through intentional caring-healing relationships between nurses and people.

Nursing Nursings mission is the betterment of human and planetary life, both locally and globally, now and for the future. This mission is based on nursing being a unique body of theoretical, philosophical, and personal knowledge that is expressed through ways of being with humans as they journey through processes of living health and healing. The practice of nursing, based on this philosophy and informed by nursing science, is lived in caring relationships with persons, families, and communities. These relationships support and enhance health, healing, and quality of life. Nursing scholarship focuses on inquiry into the human experiences of health and healing, as well as the creative, integrative, and expressive forms of caring-healing enacted in nursing practice. Nursing knowledge and practice inform and shape each other. It is the synergistic effect that enables nurses to understand and significantly contribute to persons experiences of health. Sources of knowing in nursing are unbounded; that is to say that as unitary beings in relation, nurses draw on multiple sources of knowing including rational, empirical, theoretical, philosophical, personal, moral and ethical, intuitive, and transcendent. Caring nurses utilize these multiple sources of knowing to be with, witness, and co-create quality of life with clients, their families, and the community they serve. Nursing is a self-regulated profession. Nurses are responsible and accountable for providing competent and ethical practice to their clients, the public, their colleagues, and themselves. Nurses have a professional responsibility to continuously seek to improve their practice through critical self-reflection, scholarship, research, and innovation. Nurses have a professional and ethical responsibility to influence, advocate for, and support healthy public policy, institutional practices that promote quality of working life, and legislation that contributes to the health of nurses and humankind. Teaching-Learning Nurses value the limitless possibilities of learning. Learning is a life-long, often mysterious, dynamic process of personal and professional growth. It builds on prior experience, stimulates critical reflection, and fosters the (re)formulation of the meaning of experience through the creativity of imagining. It contributes to self-esteem, self-knowledge and choosing our possibilities. Teachers and learners as colearners become partners in a collaborative learning process. A community of learners brings valuable knowledge and experience that is respected in the learning environment. Adults are capable of and have the right and responsibility to be self-directing learners. Teaching/learning is a dynamic process of discovery through interaction and engagement which occurs in both formal and informal contexts that acknowledge multiple ways of knowing. Authentic caring through transpersonal relationships is vital to teaching/learning. Courageous teachers/learners embody the caring curriculum by supporting, encouraging, and valuing learners by believing in them and being truly present with them, thereby promoting trust, honesty, creativity, innovation, and meaning-making. With this in mind, approaches to teaching/learning include dialogue, modelling, practice, reflective thinking, and experiential group process. Formal learning is based on the principles of cooperative, anticipatoryinnovative learning. These principles are designed to create a learning community that supports the strengths and learning needs of all learners. Teaching and learning processes enhance learners ability to think critically and reflectively while finding pathways to new knowledge, freedom, and connectedness with each other. This may occur from both intended and unintended learning. A shared learning journey enables each person to find his/her own voice, nourish his/her soul, and be committed to life-long learning.

Program Goals
The graduate of the program will: Be accountable to the public and responsible for practicing within the professional and ethical standards of nursing. Seek to understand the health and healing experiences of individuals, families, groups and communities by establishing caring relationships toward enhancing health and quality of life. Incorporate multiple ways of knowing in decision making and problem solving, in partnership with clients. Be able to think critically and reflectively. Be committed to life long learning. Facilitate collaborative relationships in nursing, with the community and the interdisciplinary team. Demonstrate leadership in nursing practice. Advocate and support healthy organizational and public policy that promotes the health of individuals, families, groups and communities. Influence the advancement of the nursing profession through excellence in practice, education and research. Demonstrate global consciousness, both personally and professionally, through actions that support and promote human and planetary health.

Overall, to meet the entry to practice competencies and in this case, those associated with community health nursing associated with Ontarios College of Nurses.

Course Themes for NURS 4120 6.0

COMMUNITY AS PARTNER
Community Community Development Community Health Nursing/Evolving Nursing Roles Caring Competence/Ethics Health Primary Health Care Health Promotion Health Promotion Approaches Partnership Empowerment Strength Seeking/Capacity Building Prerequisites for/Social Determinants ofHealth Social Justice Advocacy Political Activism Upstream/Midstream/DownstreamThinking

NURS 4120 6.0

Community as Partner
Introduction
This practicum component of NURS 4120 6.0 builds upon the theoretical component of the course by providing an opportunity for praxis. Students develop knowledge and skills related to community health nursing and caring for a community. Within the context of a caring relationship and with the guidance of the clinical course director (CCD) and preceptor, the student will apply and critically reflect on theories of community health nursing and people-centred health promotion.

Clinical Focus
Community as Partner is a community health promoting nursing course that enables students to understand the process of partnering with communities in order to enable health and empowerment. Students learn to understand how the strategies associated with the Ottawa Charter for Health Promotion (1986), the CHNAC (2003) Standards of Practice for Community Health Nursing and the principles associated with Primary Health Care interface when nurses partner with communities. Community settings and preceptors are requested to ensure students have the opportunity to consult community members regarding their lives, their definition of health and the barriers to health that they experience. In addition, it is important that students are enabled to understand nursings roles in advocacy, capacity building, healthy public policy development, and empowerment based education and community development. York Nursing students are expected to practice according to the Canadian Nurses Association Code of Ethics.

Clinical Hours
The Community as Partner course consists of a community experience, a weekly class and a praxis seminar facilitated by the CCD and the group of students. Students are expected to work with their community and/or on the associated work related to a related health promotion initiative for a minimum of 12 hours per week. Total clinical time is a minimum of 144 hours over one 12 week term. York nursing students will welcome eclectic experiences, and would benefit from multiple views of community health nursing, aggregates and opportunities to partner with communities. Students are expected to be flexible in meeting their clinical hours. In the fall/winter of 2008/09 students will be primarily be placed in settings for two days each week, thus making it much easier to attain their required hours. We rely on the student, the agency and the preceptor to assist the student group to observe, participate and./or initiate other activities in order to meet their 12 hours a week minimal requirements. Only a small amount of time over the semester will be allotted for aggregate research. We consider this research, class prep, and writing praxis notes to be a part of the homework component of this praxis course. The focus is on hours spent with or in partnership with their community aggregate: the more the better. We hope you can help our students achieve this.

Student Groups
In January 2003 York University launched a new model for community practicum whereby students work in small groups. Students work together to complete one learning plan. The group typically works with one preceptor to implement and enact the learning plan. This model is meant to enable collaborative learning and practice: a model usually found in community health nursing practice.

The Clinical Course Director

The Clinical Course Director (CCD) is the clinical instructor that works with you and your student(s). The CCD works in collaboration with you to evaluate and support student learning. The CCD also has a role in grading, facilitating weekly praxis seminars, and acts as an ongoing resource person for the preceptor and student. The CCD will contact you prior to the beginning of the term to help identify a suitable clinical assignment for the student team.

Team Learning Plan

Each student group develops a 12 week learning plan (see sample in Appendix C), incorporating course competencies and learning objectives that relate to the unique practicum setting they are in. This plan is negotiated with the preceptor and discussed with the clinical course director. The plan is reviewed and updated as necessary. The initial learning plan is to be completed by week 4 of the placement, unless otherwise negotiated with the preceptor and CCD.

Tips on helping team develop a Learning Plan: Translate conceptual definitions into concrete learning activities. Have clear descriptions of how to demonstrate accomplishment. Ensure criteria flow from learning outcomes. Ensure standards are clearly stated for each criterion. Use early formative evaluation to demystify standards and expectations. Ensure means of demonstrating achievement are clear.

Portfolio
Each student develops a portfolio throughout the 12 weeks. The portfolio is evaluated by the CCD and is a key part of the evidence that course goals have been met. Each student portfolio is unique and reflects his or her development of professional interests and competencies. A copy of the team learning plan will be included in each individual portfolio.

The portfolio consists of: evaluations praxis notes assignments community report research articles time log learning plan materials developed by student pamphlets/ handouts

Clinical Evaluation
Building on the assumptions of our caring philosophy, the evaluation process is guided by principles of caring for self and for respectful, authentic communication. This means that each partner will have the courage to address performance issues as they arise. In collaboration with your student and CCD, there will be two team clinical evaluations, one at mid-term and one at the end.

Mid-term Evaluation and Final Evaluations

For the mid-term and final evaluation your students will complete a team evaluation form (see Appendix B), which addresses progress towards achieving learning plan goals, strengths, weaknesses, and areas for future study. Each partner (CCD, preceptor, student team) will bring their own evaluation for discussion at the collaborative evaluation meeting.

A mutually agreeable date for both mid-term and final evaluations needs to be set early in the term. The CCD will arrange a date to meet with you and the student teams to review the evaluation. The evaluations are collaborative processes and allow for each partner to participate equitably. Your primary role in these meetings is to provide feedback (see section on Guidelines for Clinical Evaluation) and provide direction to the students and CCD. Successful completion of the Health and Healing: Community as Partner Course 4120 6.0 requires a passing grade in both the practicum and theoretical components of the course. The final clinical grade (pass/fail), which is assigned by the CCD, will be based upon evidence in the clinical portfolio, including the mid-term and final clinical team evaluations.

Required Learning Outcomes for Students in Community as Partner NURS 4120

Praxis embodies the notion of theory informing practice and practice informing theory. As the preceptor, we rely heavily on your guidance to enable the students to meet the following goals: 1. Demonstrate understanding of the philosophical and historical basis of community health nursing praxis. 2. Demonstrate knowledge in the philosophy and skills in the process of partnering with the community. 3. Integrate knowledge from nursing, health promotion, and other disciplines into practice. 4. Develop community assessment, consultation, and health promotion skills. 5. Analyze ethical/legal issues and professional trends in community health nursing. 6. Exemplify professional responsibility and accountability in classroom and community practice settings. In addition, York BScN students will work with their CCD and yourself to understand and achieve praxis in as many of the core competencies set out by the Community Health Nurses Association of Canadas (2003) Standards of Practice. In this manual, we have provided you with an excerpt from this document, and invite you to download the entire document including definitions and references from our course web site. Please ask your CCD for further details.

Community Health Nurses Association of Canada Standards of Practice (May 2003)

The Community Health Nurses Association of Canada (CHNAC) Standards of Practice draw upon certain values and beliefs concerning community health nursing practice. The principles of Primary health care, a model of partnership (and thus the title for the community health nursing course at York University), and an underlying belief that health promoting nursing practice is best rooted in empowerment and advocacy form the basis for CHNACs five interrelated standards of practice.

The Principles of Primary Health Care

Community health nurses recognize that primary health care is a different way of thinking about health and health care that is fundamental to their practice. Primary health care differs significantly from primary care (first point of access to care) and is an integral part of the Canadian health care system. Community health nurses value the following key principles of primary health care as described by the World Health Organization (1978): 1) universal access to health care services, 2) focus on the determinants of health, 3) active individual and community participation in decisions that affect their health and life, 4) partnership with other disciplines, communities and sectors for health, 5) appropriate use of knowledge, skills, strategies, technology and resources, and 6) focus on health promotion/illness prevention throughout the life experience from birth to death. Community health nurses recognize and incorporate knowledge of the impact of the socio-political-economic environment on the health of individuals and the community, and their own practice.

Individual/Community Partnership
Community health nurses believe that it is paramount to have the individual/community as an active partner in decisions that affect their health and well-being. Participation is essential throughout all components of the nursing process. In partnership, the community/individual takes an active role in defining their own health needs during assessment, sets their own priorities among health goals, controls the choice and use of various actions to improve their health and lives, and evaluates the efforts made. During assessment and throughout the community health nursing process, students identify the health values of the individual/community, including what health means to that particular individual or community. Inherent in the nursing process is working with individuals and communities to build capacity and to participate in making decisions concerning their health. For community health nurses, participation is the basis of therapeutic, professional, caring relationships that promote empowerment. Community health nurses also make their expertise available as a resource to those with whom they are working. Concurrent with capacity building, community health nurses also have a responsibility to advocate.

Empowerment
Community health nurses recognize that empowerment is an active, involved process where people, groups, and communities move towards increased individual and community control, political efficacy, improved quality of community life, and social justice. Empowerment is a community concept because individual empowerment builds from working with others to effect change and includes the desire to increase freedom of choice for others and society. Empowerment is not something that can be done to or for people, but involves people discovering and using their own strengths. Empowering strategies or build capacity by moving individuals, groups and communities towards the discovery of their strengths and their ability to take action to improve quality of life.

Standards of Practice Nursing Standards

Drawing upon the values and beliefs of community health nursing, nursing knowledge, and the partnerships that are established with people in the community, five interrelated standards of practice form the core expectations for community health nursing practice. These standards are: 1. 2. 3. 4. 5. Promoting health Building individual/community capacity Building relationships Facilitating access and equity, and Demonstrating professional responsibility and accountability.

STANDARD 1: PROMOTING HEALTH

Community health nurses view health as a dynamic process of physical, mental, spiritual and social wellbeing. They believe that individuals and/or communities realize aspirations and satisfy needs within their cultural, social, economical and physical environments. Community health nurses consider health as a resource for everyday life that is influenced by circumstances, beliefs and the determinants of health including social, economic and environmental health determinants: a) income and social status, b) social support networks, c) education, d) employment and working conditions, e) social environments, f) physical environments, g) biology and genetic endowment, h) personal health practices and coping skills, i) healthy child development, j) health services, k) gender, and l) culture (Health Canada, 2000). It includes self-determination and a sense of connectedness to the community. Community health nurses promote health using the following strategies: a) health promotion, b) illness and injury prevention and health protection, and c) health maintenance, restoration, and palliation. It is recognized that it may be relevant to use these strategies in concert with each other when providing care and services. This standard incorporates these strategies by drawing upon the frameworks of primary health care (WHO, 1978), the Ottawa Charter for Health Promotion (WHO, 1986), and the Population Health Promotion Model (Health Canada, 2000).

A) HEALTH PROMOTION
Community health nurses focus on health promotion and the health of populations. Health promotion is a mediating strategy between people and their environments a positive, dynamic, empowering, and unifying concept that is based in the socio-environmental approach to health. This broad concept is envisioned as bringing together people who recognize that basic resources and prerequisite conditions for health are critical for achieving health. The populations health is closely linked with the health of its constituent members and is often reflected first in individual and family experiences from birth to death. Healthy communities and systems support increased options for well-being in society. Community health nurses consider socio-political issues that may be underlying individual/community problems.

The community health nurse:

1. Collaborates with individual/community and other stakeholders in conducting a holistic assessment of assets and needs of the individual/community. 2. Uses a variety of information sources to access data and research findings related to health at the national, provincial/territorial, regional, and local levels. 3. Identifies and seeks to address root causes of illness and disease. 4. Facilitates planned change with the individual/community/population through the application of the Population Health Promotion Model. Identifies the level of intervention necessary to promote health Identifies which determinants of health require action/change to promote health Utilizes a comprehensive range of strategies to address health-related issues. 5. Demonstrates knowledge of and effectively implements health promotion strategies based on the Ottawa Charter for Health Promotion. Incorporates multiple strategies addressing: a) healthy public policy; b) strengthening community action; c) creating supportive environments; d) developing personal skills, and e) re-orienting the health system Identifies strategies for change that will make it easier for people to make a healthier choice. 6. Collaborates with the individual/community to assist them in taking responsibility for maintaining or improving their health by increasing their knowledge, influence and control over the determinants of health. 7. Understands and uses social marketing and media advocacy strategies to raise consciousness of health issues, place issues on the public agenda, shift social norms, and change behaviours if other enabling factors are present. 8. Assists the individual/community to identify their strengths and available resources and take action to address their needs. 9. Recognizes the broad impact of specific issues such as political climate and will, values and

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culture, individual/community readiness, and social and systemic structure on health promotion. 10. Evaluates and modifies population health promotion programs in partnership with the individual/community and other stakeholders.

B) PREVENTION AND HEALTH PROTECTION

The community health nurse adopts the principles of prevention and protection and applies a repertoire of activities to minimize the occurrence of diseases or injuries and their consequences to individuals/communities. Health protection strategies often become mandated programs and laws by governments for the larger geo-political entity.

The community health nurse:

1. Recognizes the differences between the levels of prevention (primary, secondary, tertiary). 2. Selects the appropriate level of preventative intervention. 3. Helps individuals/communities make informed choices about protective and preventative health measures such as immunization, birth control, breastfeeding, and palliative care. 4. Assists individuals, groups, families, and communities to identify potential risks to health. 5. Utilizes harm reduction principles to identify, reduce or remove risk factors in a variety of contexts including home, neighbourhood, workplace, school and street. 6. Applies epidemiological principles in using strategies such as screening, surveillance, immunization, communicable disease response and outbreak management and education. 7. Engages collaborative, interdisciplinary and intersectoral partnerships to address risks to the individual, family, community, or population health and to address prevention and protection issues such as communicable disease, injury and chronic disease. 8. Collaborates in developing and using follow-up systems within the practice setting to ensure that the individual/community receives appropriate and effective service. 9. Practices in accordance with legislation relevant to community health practice (e.g. public health legislation, child protection). 10. Evaluates collaborative practice (personal, team, and/or intersectoral) in achieving individual/community outcomes such as reductions in communicable disease, injury and chronic disease or reducing the impacts of a disease process.

C) HEALTH MAINTENANCE, RESTORATION AND PALLIATION

Community health nurses provide clinical nursing care, health teaching and counselling in health centres, homes, schools and other community based settings to individuals, families, groups, and populations whether they are seeking to maintain their health or dealing with acute, chronic or terminal illness. The community health nurse links people to community resources and coordinates/facilitates other care needs and supports. The activities of the community health nurse may range from health screening and care planning at an individual level to the forming of intersectoral collaborations and resource development at the community and population level. The community health nurse: 1. Assesses the individual/family/populations health status and functional competence within the context of their environmental and social supports. 2. Develops a mutually agreed upon plan and priorities for care with the individual/family. 3. Identifies a range of interventions including health promotion, disease prevention and direct clinical care strategies (including those related to palliation), along with short and long term goals and outcomes. 4. Maximizes the ability of an individual/family/community to take responsibility for and manage their health needs according to resources and personal skills available. 5. Supports informed choice and respects the individual/family/communitys specific requests while acknowledging diversity, unique characteristics and abilities. 6. Adapts community health nursing techniques, approaches and procedures as appropriate to the challenges inherent to the particular community situation/setting. 7. Uses knowledge of the community to link with, refer to or develop appropriate community resources. 8. Recognizes patterns and trends in epidemiological data and service delivery and initiates

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improvement strategies. 9. Facilitates maintenance of health and the healing process for individuals/families/communities in response to significant health emergencies or other diverse community situations that negatively impact upon health. 10. Evaluates individual/family/community outcomes systematically and continuously in collaboration with the individuals/families, significant others, other health practitioners and community partners.

STANDARD 2: BUILDING INDIVIDUAL/COMMUNITY CAPACITY

Building capacity is the process of actively involving individuals, groups, organizations and communities in all phases of planned change for the purpose of increasing their skills, knowledge and willingness to take action on their own in the future. The community health nurse works collaboratively both with the individual/community affected by health compromising situations and the people and organizations who control resources. Community health nurses start where the individual/community is at to identify relevant issues and assess resources and strengths. They determine the individuals or communitys stage of readiness for change and priorities for action. They take collaborative action by building on identified strengths and facilitate the involvement of key stakeholders: individuals, organizations, community leaders and opinion leaders. They work with people to improve the determinants of health and make it easier to make the healthier choice. Community health nurses use supportive and empowering strategies to move individuals and communities toward maximum autonomy. The community health nurse: 1. Works collaboratively with the individual/community, other professionals, agencies and sectors to identify needs, strengths and available resources. 2. Facilitates action in support of the five priorities of the Jakarta Declaration to: Promote social responsibility for health Increase investments for health development Expand partnerships for health promotion Increase individual and community capacity Secure an infrastructure for health promotion. 3. Uses community development principles: Engages the individual/community in a consultative process Recognizes and builds on the group/community readiness for participation Uses empowering strategies such as mutual goal setting, visioning and facilitation Understands group dynamics and effectively uses facilitation skills to support group development Enables the individual/community to participate in the resolution of their issues Assists the group/community to marshal available resources to support taking action on their health issues. 4. Utilizes a comprehensive mix of community/population based strategies such as coalition building, intersectoral partnerships and networking to address issues of concern to groups or populations. 5. Supports the individual/family/community/population in developing skills for self-advocacy. 6. Applies principles of social justice and engages in advocacy in support of those who are as yet unable to take action for themselves. 7. Uses a comprehensive mix of interventions and strategies to customize actions to address unique needs and build individual/community capacity. 8. Supports community action to influence policy change in support of health. 9. Actively works to build capacity for health promotion with health professionals and community partners. 10. Evaluates the impact of change on individual/community control and health outcomes.

STANDARD 3: BUILDING RELATIONSHIPS

Building relationships within community health nursing is based upon the principles of connecting and caring. Connecting is the establishment and nurturing of a caring relationship and a supportive environment that promotes the maximum participation of the individual/community, and their own self-

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determination. Caring involves the development of empowering relationships, which preserve, protect, and enhance human dignity. Community health nurses build caring relationships based on mutual respect and on an understanding of the power inherent in their position and its potential impact on relationships and practice. The community health nurses most unique challenge is building a network of relationships and partnerships with a variety of relevant groups, communities, and organizations. These relationships occur within a complex, changing, undefined and often ambiguous environment that may present conflicting and unpredictable circumstances.

The community health nurse:

1. Recognizes her/his personal attitudes, beliefs, assumptions, feelings and values about health and their potential effect on interventions with individuals/communities. 2. Identifies the individual/community beliefs, attitudes, feelings and values about health and their potential effect on the relationship and intervention. 3. Is aware of and utilizes culturally relevant communication in building relationships. Communication may be verbal or non-verbal, written or pictorial. It may involve face-to-face, telephone, group facilitation, print or electronic means. 4. Respects and trusts the familys/communitys ability to know the issue they are addressing and solve their own problems. 5. Involves the individual/community as an active partner in identifying relevant needs, perspectives and expectations. 6. Establishes connections and collaborative relationships with health professionals, community organizations, businesses, faith communities, volunteer service organizations, and other sectors to address health related issues. 7. Maintains awareness of community resources, values and characteristics. 8. Promotes and facilitates linkages with appropriate community resources when the individual/community is ready to receive them (e.g. hospice/palliative care, parenting groups) 9. Maintains professional boundaries within an often long-term relationship in the home or other community setting where professional and social relationships may become blurred. 10. Negotiates an end to the relationship when appropriate, e.g. when the client assumes self-care, or when the goals for the relationship have been achieved.

STANDARD 4: FACILITATING ACCESS AND EQUITY

Community health nurses embrace the philosophy of primary health care and collaboratively identify and facilitate universal and equitable access to available services. Community health nurses engage in advocacy by analyzing the full range of possibilities for action, acting on affected determinants of health, and influencing other sectors to ensure their policies and programs have a positive impact on health. Community health nurses collaborate with colleagues and with other members of the health care team to promote effective working relationships that contribute to comprehensive client care and the achievement of optimal client care outcomes. Community health nurses use advocacy as a key strategy to meet identified needs and enhance individual and/or community capacity for self-advocacy. They are keenly aware of the impact of the determinants of health on individuals, families, groups, communities and populations. The practice of community health nursing occurs with consideration for the financial resources, geography and culture of the individual/ community.

The community health nurse:

1. Assesses and understands individual and community capacities including norms, values, beliefs, knowledge, resources and power structures. 2. Provides culturally sensitive care in diverse communities and settings. 3. Supports individuals/communities in their choice to access alternate health care options. 4. Advocates for appropriate resource allocation for individuals, groups and populations to facilitate access to conditions for health and health services. 5. Refers, co-ordinates or facilitates access to service within health and other sectors. 6. Adapts practice in response to the changing health needs of the individual/community.

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7. Collaborates with individuals and communities to identify and provide programs and delivery methods that are acceptable to them and responsive to their needs across the life span and in different circumstances. 8. Uses strategies such as home visits, outreach and case finding to ensure access to services and health-supporting conditions for potentially vulnerable populations (e.g. persons who are ill, elderly, young, poor, immigrants, isolated, or have communication barriers). 9. Assesses the impact of the determinants of health on the opportunity for health for individuals/families/communities/populations. 10. Advocates for healthy public policy by participating in legislative and policymaking activities that influence health determinants and access to services. 11. Takes action with and for individuals/communities at the organizational, municipal, provincial/territorial and federal levels to address service gaps and accessibility issues. 12. Monitors and evaluates changes/progress in access to the determinants of health and appropriate community services.

STANDARD 5: DEMONSTRATING PROFESSIONAL RESPONSIBILITY AND ACCOUNTABILITY

Community health nurses work with a high degree of autonomy in providing programs and services. They are accountable to strive for excellence, to ensure that their knowledge is evidence-based, current and maintains competence, and for the overall quality of their own practice. Community health nurses are accountable to initiate strategies that will help address the determinants of health and generate a positive impact on people and systems. Within a complex environment, community health nurses are accountable to a variety of authorities and stakeholders as well as to the individual/community they serve. This places them in a variety of situations with unique ethical dilemmas. These include whether responsibility for an issue lies with the individual/family/community/population, or with the nurse or the nurses employer, the priority of one individuals rights over anothers, individual or societal good, allocation of scarce resources and dealing with issues related to quality versus quantity of life.

The community health nurse:

1. Takes preventive and/or corrective action individually or in partnership with others to protect individuals/communities from unsafe or unethical circumstances. 2. Advocates for societal change in support of health for all. 3. Utilizes nursing informatics (information and communication technology) to generate, manage and process relevant data to support nursing practice. 4. Identifies and takes action on factors which impinge on autonomy of practice and quality of care. 5. Participates in the advancement of community health nursing by mentoring students and novice practitioners. 6. Participates in research and professional activities. 7. Makes decisions using ethical standards/principles, taking into consideration the tension between individual versus societal good and the responsibility to uphold the greater good of all people or the population as a whole. 8. Seeks assistance with problem solving as needed to determine the best course of action in response to ethical dilemmas and risks to human rights and freedoms, new situations, and new knowledge. 9. Identifies and works proactively to address nursing issues that will affect the population through personal advocacy and participation in relevant professional associations. 10. Contributes proactively to the quality of the work environment by identifying needs/issues and solutions, mobilizing colleagues, and actively participating in team and organizational structures and mechanisms. 11. Provides constructive feedback to peers as appropriate to enhance community health nursing practice. 12. Documents community health nursing activities in a timely and thorough manner, including telephone advice and work with communities and groups. 13. Advocates for effective and efficient use of community health nurse resources. 14. Utilizes reflective practice as a means of continually assessing and seeking to improve personal community health nursing practice. 15. Seeks professional development experiences that are consistent with current community health

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nursing practice, new and emerging issues, the changing needs of the population, the evolving impact of the determinants of health and emerging research. 16. Acts upon legal obligations to report to appropriate authorities situations of unsafe or unethical care provided by family, friends or other individuals to children or vulnerable adults. 17. Uses available resources to systematically evaluate the availability, acceptability, quality, efficiency and effectiveness of community health nursing practice.

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The Preceptorship Experience

Tips on Getting Started
Review orientation checklist to assist students in getting started in your agency (See Appendix A). Share your clinical expertise, areas of interests, your use of nursing theory. Exchange telephone numbers and email, identify contact person in group, and establish dates for mid-term and final team evaluations. Review practicum dates and hours of practicum. Before starting daily work, have students review expectations of the day, assess preparedness of students, identify what you will do together, and how they will update you. Ask how things are frequently, if any questions or concerns have emerged. Give positive and constructive behavioural feedback as close to the event as possible. If possible debrief from events, meetings and situations regarding the students perception, approaches used and alternatives. Encourage early independence within areas of competence and confidence. Keep brief daily notes to facilitate feedback and the progress review process.

Teaching-Learning Concepts
We believe that teaching and learning within the caring curriculum should be philosophically congruent. This means that our teaching-learning theories and practices: Appreciate and value the meaning of the experiences as expressed by students and teachers; Understand the wholeness, uniqueness and the dynamic process of learning and personal growth; Express caring and caring-health relationships; Foster critical reflection on the context, content, and processes of learning; Focus on the lived experiences of students, preceptors, and students. Within the School of Nursing, we are in a process of achieving our ultimate vision of a caring curriculum. Almost daily, we encounter systems, procedures, processes, and habitual ways of being that cause us to critique, re-think, and re-create. That being said, we believe that even now, in our relative infancy, we are creating a new culture of learning and that the experiences of learners in our program are indicative of our commitment to the caring philosophy.

Our Interactive Review Process, forums for feedback and success planning.
We approach conventional evaluation as an interactive and collaborative process intended to foster success for each student and student group. Yet, for students whose performance foreshadows a "failing" course grade at the end of the term (or any other time throughout the course), an Interactive Review Process will be initiated and a Success Plan will be developed which clearly outlines expectations and strategies for success. It is important that you know that you can contact the CCD at any time to discuss any concerns about a student. Sometimes a preceptor tries to deal with issues on his/her own, without support. It is important for you, your clients and the student to address concerns and work towards success. Early identification and planning can help to deal with issues quickly and effectively.

Assisting the Students with Critical Self-Reflection and Analysis

Reflection is a deliberate and conscious activity that will help students to explore and process the practicum experiences on a variety of levels. It will help students to gain a deeper understanding of the lived experiences and it will help unearth new insights, ideas, and concepts. Reflection allows one to think about experiences in order to understand emotional reactions, thoughts about clients, impressions, and the meaning and significance of the experience. Critical reflection can also help make connections between theory, research, and practice.

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Examples of probing questions for the preceptor to consider when in dialogue with students: What did you learn both in theory and practicum and how will you apply that learning to your practice? Describe a significant situation or event that has occurred. Why was it significant? What significance does this learning have to you as a person, and in your development as a nurse? What did you see, hear, feel? What were your assumptions about an aspect of the situation? Have your assumptions changed? What are your fears? What were some obstacles in this event? Identify some differences in what you learned today from what you learned previously. How will you apply this new knowledge? What implications are there for the client, community, and your profession?

Role of the Preceptor

1. 2. 3. 4. Negotiates the terms of the placement with the student team and faculty. Communicates roles and expectations of practice to student and faculty. Identifies a contact person within student team for phone communication. Facilitates opportunities for student team to find appropriate experiences including interaction with community members and opportunities to enact strategies associated with ethical community health nursing practice. Demonstrates/acts as a role model of a competent practitioner, one who is actively engaged in professional nursing practice. Stimulates the student teams critical thinking and reflection about its own caring-healing practice within the agency. Provides feedback to the student and faculty about the student's success in meeting expectations of the course. Initiates contact with the faculty if a problem or concern arises about the student's practice.

5.

6.

7.

8.

Role of the Clinical Course Director/Faculty Member

1. Negotiates the terms of the placement with the student team and preceptor. 2. Initiates and maintains a mutually satisfying pattern of communication among the preceptor, student team, and faculty. 3. Meets regularly with student teams to discuss practice issues and concerns; provides consultation, advice, and role modelling; facilitates and assesses verbal and written praxis notes; evaluates portfolios and provides feedback to students about their success in meeting course and personal learning outcomes. 4. Stimulates students critical thinking and reflection about their own practice. 5. Consults with the preceptor and the student team to determine if the learning goals are being met.

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6. Assigns a pass/fail for the practicum component of the course. 7. In cases where a student is not meeting the minimum expectations of the practicum, the faculty assumes responsibility for taking appropriate action. 8. Facilitates students' synthesis of the caring philosophy into nursing practice. 9. Facilitates preceptor's knowledge and comprehension of the caring philosophy into practice.

When to call the Clinical Course Director/Faculty Member

Clinical Course Directors are your resource person, and would like feedback based on the students progress within this practicum experience. We invite you to be in contact with the student/student group every week, and touch base with the CCD bi-weekly. We would be most interested in hearing about student success, progress, and activities. As the preceptor, we ask that you work closely with students/student groups and provide them with guidance, support, resources and feedback. If this work with the student/student group does not yield satisfactory results, we request that you contact the CCD immediately for the following reasons: Behaviour that places either clients or agency at risk Repeated tardiness/illnesses/absences/cancelled planned practicum shifts Unsafe patterns of care Lack of follow-through on suggestions Lack of transfer of knowledge from one situation to another Limited knowledge integration, critical thinking skills, reflective practice skills Lack of anticipated progress Professional behaviour/accountability issues Interviews for progress reviews Injuries/accidents/illnesses on site Feedback or support

Role of the Student Team

1. Plan to meet with the preceptor during the first week of class (see orientation schedule for your section). 2. Identify one contact person to facilitate communications with preceptor by phone when necessary. 3. In collaboration with the preceptor/faculty, prepare a Team Learning Plan. 4. Meet with the preceptor weekly to discuss progress and concerns, and to request guidance and resources that best support learning. 5. Actively participate in the activities at the practicum site, and actively research your aggregate and current community health nurse practice as appropriate. 6. Engage in weekly praxis seminar with CCD 7. Enact a community consultation, with the support of your preceptor and CCD and present that to your peers over the semester. 8. Develop a team self-evaluation at the middle and end of each semester and bring to evaluation meetings.

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Role of Individual Students

1. Write and submit weekly praxis notes. 2. Develop a portfolio to provide evidence of meeting learning goals. 3. Practice according to the CHNAC (2003) Standards of Nursing Practice and the CNAs Guidelines for Ethical Practice. 4. Prepare individual clinical self-evaluation (to be brought to individual CCD-student clinical evaluation meeting). 5. Practice in accordance with the clinical agencys regulations, rules, policies, and procedures including appropriate applicable provincial legislation.

Preceptor Support
Always remember that you can contact your CCD at any time to discuss any concerns about a student, seek support and ideas. She/he can link with colleagues to problem-solve or search for new and interesting resources. York University, School of Nursing has a variety of preceptor supports available to you. They can be accessed at any time through our course web site. Below are some examples of how you can become more connected with other preceptors, York University staff, course information, research and more. York On-line Library Presentation requests Course Website

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Practicum Policies
Work/Education Placement Agreement This agreement MUST BE COMPLETED before the beginning of the unpaid placement and signed by: a) the student; b) the work placement employer; and, c) a representative of the university (Clinical Course Director). After all the participants have signed the form, the copies are to be distributed as follows: white copy to the student canary copy to the work placement employer pink copy to the Nursing Practicum Coordination Office (NPCO), room 301E HNES Bldg. Administrative Students must report any injuries promptly, however minor, to: a) The Clinical Course Director by phone or pager; b) The preceptor at the practicum site; c) The Placement Employer; d) The Nursing Practicum Coordination Office, 416-736-2100 x33176, email npco@yorku.ca; and e) York Universitys contact person in the Employee Well-Being Office, Human Resources Donna Ptak and Primrose Lewis, 416-736-5518. A York University, School of Nursing, Incident/Accident Report must be filled out for any incident/accident requiring or resulting in: a) health care by a medical practitioner for which there is a fee for service b) lost time from university beyond the date of accident; and c) exposure to a communicable disease.

Health Requirements
Immunization
All students are required to show proof/evidence of up-to-date immunizations, CPR and valid police checks and have shown this proof to the Nursing Practicum Coordination Office (NPCO). Their CCD will check this passport and will not permit any student to attend clinical without meeting these requirements. Students are advised of these requirements upon arrival to York in year three, and are reminded every six months, plus throughout the semester leading up to this particular learning experience. No signed passport = no admittance to clinical.

York University, School of Nursing, Incident/Accident Report form

Must be filled out by the student and the Clinical Course Director for any: Clinical incident involving a student's client who suffers an incident/fall/injury/error while under the student's care. Occurrence which requires an agency incident form to be completed on any client under the student's care, or one he/she was involved with, at the time it occurred. Medication error of omission or commission (including delayed administration and IV management). Reason that a practicum activity is not completed, such as, student feels unsafe in the area due to potential abuse and/or violence.

Basic Cardiac Life Support Certificate

All students are certified in Basic Cardiac Life Support (BCLS) with a recertification each 2 years.

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Attendance
The student shall inform the practicum centre's preceptor and Clinical Course director of absenteeism and lateness, at least one hour before Practicum starts. A maximum of 8 clinical hours of sick time will be considered with a valid doctor's note. This note must be shown to the Clinical Course Director soon after return to Practicum and kept in the student's records. Time taken for family bereavement will be from this pool of 8 hours of sick time. The 8 hours of sick time (including bereavement) do not have to be made up, but the student, preceptor, and Clinical Course Director will meet to discuss a plan for meeting the learning goals and course outcomes. Any student's missed hours (e.g. ill dependent, snow day), not considered sick time, will have to be made up by the student at the preceptor's and Practicum Centre's convenience.

Expenses
Students are responsible for all expenses related to Practicum e.g., uniforms, travel costs including transit costs, meals, and accommodation. The students are not allowed to accept financial remuneration by the Practicum Centre or the clients. The Practicum Centre is not responsible for any expenses related to the Practicum Agreement that may be incurred by the university or by a student, including, but not limited to, travel costs.

Documentation
Students must sign client/agency documents legibly indicating full name and York Nursing Student (YNS). All documentation is to be checked by their preceptor.

Professional Appearance and Dress Code

All students must maintain a professional appearance when attending any practicum setting. Where there are specific uniform policies within the Practicum Centre, the student is expected to follow those policies. Where there are no policies, then professional dress is required. Unique considerations that are specific to individual community settings can be discussed with the Clinical Course Director. If the student is not appropriately attired or is unkempt, the faculty or the Practicum Centre will refuse admission of the student to the Practicum Centre, and this time must be made up at the convenience of the Practicum Centre and the Clinical Course Director. To assist the student in determining what is considered to be professional appearance/dress the following principles have been identified: adhere to agency policies regarding jewellery ability to maintain safety of self and the client maintenance of professional image cleanliness and neatness avoidance of perfumes/colognes (in consideration of individuals with allergies) comfort and ease of mobility identifiable as a nursing student to patients and colleagues, by wearing York University name tag. This is Non-negotiable.

Transportation
All students are responsible for their own transportation to, at, and from the Practicum Centre. Under no circumstances should students transport clients in their vehicles. York University will not provide insurance coverage for this purpose. Should a student be asked to transport a client(s), please notify the Clinical Course Director or NPCO Manager immediately. In some cases, where there is an Agency policy on transportation, the Agency may permit the preceptor to transport a student. In these cases, the Insurance and Risk Management group recommends that the

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Agency staff carry a minimum of $2,000,000 automobile liability insurance coverage. York University does not accept liability for transportation of students by preceptor. Any student NOT following the above guidelines may be removed from Practicum, with the initiation of an Interactive Review Process.

Strikes
Should a strike or walkout occur at the Practicum site, students must contact the Clinical Course Director or NPCO Manager immediately. A decision must be made about whether the student wishes to remain in the Practicum until the dispute is settled or renegotiate another Practicum. Under no circumstances is a student to cross a picket line or to perform the work of the striking workers.

Harassment
The ethics governing behaviour in a professional relationship between a student and preceptor should be the same as those in a worker-client relationship. Students are especially vulnerable as they are being evaluated. If a student feels uncomfortable in any way, he/she should consult the preceptor and/or Clinical Course Director immediately. In addition, the CNA code of ethics governing nurseclient/community relationships must be adhered to, whereby the client/communitys dignity is of utmost concern. Dealing with prejudice and discrimination It is important to note that issues relating to oppression and marginalization of minority groups with respect to race, class, colour, gender, culture, age, sexual orientation, language, or disability will not be tolerated by the Department of Nursing. Any such transgressions by the Agency will result in the student being removed from the Practicum. If the Agency reports that the student is engaging in this behaviour, the student will be removed from the Practicum and an Interactive Review Process will be initiated. Students in this course are continuously and reflexively invited to explore their biases

Clinical Practice Guidelines

The practice of Nursing students is also guided by the principles of competence and client safety. Regardless of what is authorized through legislation or policies, students must only provide care in circumstances where they have the necessary knowledge, skill, and judgement to perform safely, effectively, and ethically. The nursing student is expected to: Identify situations where he/she requires assistance; and Seek appropriate assistance, direction, and supervision. Be self-directed, look for feedback, act upon such feedback, and set goals

Nursing students may NOT initiate, delegate, or accept delegation of a controlled act. In addition to these guidelines, Clinical Course Directors and students are expected to be familiar with and follow all of the agencys policies and procedures and any additional guidelines established by the individual units of the agency. If a discrepancy should arise between the agencys policies and these guidelines, the Clinical Course Director and student should arrange to meet with the appropriate agency personnel in order to resolve the issue in a manner which will ensure client safety.

Attendance and Praxis Notes

Students must attend practicum every week and must find opportunities that ensure that they are spending time with their aggregate for 12 hours a week. If a student misses practicum (other than the 8 hours allotted for illness), the CCD is to be called immediately and that student will be removed from practicum. No student is permitted to arrive late or leave early for any reason except an emergency of which they must show their CCD and preceptor written documentation.

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Our only window into their practice is through the feedback of their professional preceptor and their praxis notes. These notes are generally shared with their faculty member. If a student is not providing bi weekly praxis notes, again this student will be removed from the setting. These situations are rare, but we wish to make it clear to settings that we value your agency, the time you are spending with our students, and the importance of students developing caring trusting relationships built on dependability, professional accountability and demonstrated understanding or the course materials. The safety of your clientelle is of the utmost importance to us and if a student is experiencing barriers to meeting the course requirements, we will meet with that student immediately and work out a plan. The CCD will be in constant contact with you, and we hope you feel you can do the same. It is, of course, best that any conversation occur with the student, the preceptor and the CCD. Transparency leads to professional behaviour in workplaces and we wish to foster that while students are learning how to be nurses.

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Appendix A
AGENCY ORIENTATION CHECKLIST

Items Orientation to the Agency Philosophy of the Agency Policies and Procedures Emergency (fire, evacuation) Code Review WHMIS Charting, Documentation Medications/IV Controlled Acts Safety (home visits) Transportation of Students Dress Code, if different from York U policy Other Lines of Communication Hours and Days of Placement Learning Plan discussed with Preceptor Procedure when calling in absent/sick Name of Clinical Course Director given to preceptor

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Appendix B TEAM LEARNING Plan: HH/NURS 4120 York University School of Nursing
Student(s): Resources and Supports Preceptor: Team Learning Goals (Identify in parentheses which of the course goals and CHNAC standard(s) will be met by this learning goal.)
Learning goal #1 (CHNAC standard Course Goal(s)#)

Site: Activities to Achieve Goals What will we do to achieve this goal?

*linked to CNO competencies for community health (see appendix IV )

Date: Resources and Supports

Evaluation Criteria (Learning evidences) How will we know that we have met our goal(s)?

Target Date

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Appendix B(a)

SAMPLE of one possible learning goal

HH/NURS 4120 York University School of Nursing
(Developed by: Theresa Moore)

Student(s): Preceptor: Team Learning Goals (Identify in parentheses which of the course goals and CHNAC standards will be met by this learning goal.)
Goal 1. To collaborate with individuals/community and other stakeholders in conducting a holistic assessment of assets and needs of the community. CHNAC standards: 1. Promoting Health A-1, 2, 3, 8 2. Building Capacity 1, 3 3. Building Relationships 2, 3, 5 Course Goal(s) #:

Site: Activities to Achieve Goals

*linked to CNO competencies for community health (see appendix IV )

Resources and Supports

Date: Evaluation Criteria (Learning evidences)

Target Date

1. Use multiple ways of knowing to learn about community strengths/needs: >empirical i.e. >personal: i.e. >aesthetic: i.e. . >sociopolitical: i.e. 2. Identify and consult with key stakeholders: i.e. 3. Ensure no voices are silenced in consultation by:

Readings from course text: Data from agency, other sectors and organizations, and relevant outside literature: Preceptor

Praxis notes and praxis seminar discussions demonstrate theory-guided practice Praxis notes and praxis seminar discussions demonstrate such integration Praxis notes and praxis seminar discussions demonstrate such critical analysis Community assessment/co

Week 3

Weekly

Weeks 5/6

Week 3

CCD

Ongoing

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nsultation report in portfolios and discussed at praxis seminars Confirmation of meeting in portfolio (e.g., flyers, attendance sheets, evaluations, etc.)

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Appendix C Team Evaluation

York University School of Nursing HH/NURS 4120.6 Fall 2008

Student Name(s):
CCD:
1 Students have not yet begun to complete this objective 2 Students have begun to complete this objective

Preceptor Name:
Practicum Site:
3 Students are making good progress towards completing this objective 4 Students have completed this objective with success 5 Students have completed this objective with excellent success N/A Students did not have an opportunity to work on this objective

**These columns should be copied from your final learning plan. Learning Objective** #1 Activities to Achieve Goals** Learning Evidences** Rating Comments

#2

#3

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#4

Strengths/Areas of Accomplishment:

Areas for Further Inquiry and Professional Development

Students Signature: _______________________________

Preceptors Signature: __________________________ CCD Signature: Date: _____________________

Note: Each clinical partner (the student team, preceptor and CCD are asked to each complete a form in preparation for a joint clinical performance review meeting at mid-term and end-of-term. The 3 evaluations will contribute to the clinical evaluation process between individual students and CCDs at end of term. Team evaluations are not filed in student files.

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