Clinical Practice 4: Multi-system Care

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FALL/ 2012

COURSE NUMBER NUR 4748L – Section 3414 & 3417

COURSE TITLE Clinical Practice 4: Multi-system Care


PLACEMENT BSN Program: 4th Semester Upper Division

PREREQUISITES NUR 4739 L Clinical Practice 3: Restoration of Wellness

COREQUISITES NUR 4748 Systems of Care 4: Multi-system Care


Laura Sutton, PhD, ACNS, BC HPNP 352-273-6358 Friday 10:30 – 12:30 3228 & By Appointment

Course Coordinator

Hyochol (Brian) Ahn HPNP: 352-273-6385 Friday 9:00 – 11:00

PhD, ARNP, ANP-BC 3218

Carla Anderson, MN, ARNP, CNL H441-1 352 548 6393 Friday 9:00 – 11:00

VANA Faculty VA office

Bonnie Carlin, MSN, RN-BC HPNP 352-273-6322 Wed. 4:00 – 6:00 3215

Justina (Tina) Chappell 2 East H243-1 352-548-6252 Thurs 12:30 – 14:30

DNP, FNP-BC VA office

VANA Faculty

Sheryl Curtis, MSN, ARNP, CPNP HPNP 352-273-6409 Thurs 10:30 – 12:30 2222

Anita Stephen, MSN, RN, CNL HPNP 352-273-6407 Tues 2:00 – 4:00 1203A

Becky Weber, MS, RN HPNP 352 548-6298  Friday 10:30 – 12:30

VANA Faculty 3224 & By Appointment


Joyce Stechmiller PhD HPNP 352-273-6394 By Appointment


Associate Professor

COURSE DESCRIPTION This purpose of course is to provide the student with clinical experiences in the provision of healthcare for diverse clients with multi-system alterations in equilibrium and the application of population focused care principles. Emphasis is on effective decision making with clients with varied potential for restoration to wellness in a variety of settings. Focus is on the delivery of holistic, safe, and evidence based healthcare for clients with multi-system illness.

COURSE OBJECTIVES Upon completion of this course, the student will be able to:

  1. Implement evidence based nursing interventions in the care of clients with multi-system alterations in equilibrium.

  1. Evaluate the effectiveness of plans of care.

  1. Evaluate healthcare technologies and information management systems that support safe nursing practice.

  1. Analyze interprofessional, collaborative strategies in the care of clients with multi-system illnesses.

  1. Utilize principles of population focused care in the healthcare management of individuals and groups.

  1. Evaluate professional behaviors and boundaries in the provision of holistic care of clients.


Monday and Tuesday August 27 – October 15, 2012; No clinical on September 3 (Labor Day). There are a total of 135 clinical hours in this course which includes hours for the Labor Day holiday. Clinical hours are arranged by individual faculty but average 9 hours per clinical day. Post clinical conferences will be arranged by clinical faculty. There are no separate weekly seminars. Students will also attend clinical simulation on one of their assigned clinical days to meet course objectives and required clinical hours. Clinical evaluations and orientation to NUR 4944L – Transitions will be on October 16, 2012.

Orientation for the course and clinical site mandatory requirements are arranged by clinical faculty. Clinical faculty will provide specific details for their clinical students. There will be an average of 18 hours per week of hospital clinical experience including seminar.

E-Learning in Sakai is the course management system that you will use for this course. E-Learning in Sakai is accessed by using your Gatorlink account name and password at There are several tutorials and student help links on the E-Learning login site. If you have technical questions call the UF Computer Help Desk at 352-392-HELP or send email to

It is important that you regularly check your Gatorlink account email for College and University wide information and the course E-Learning site for announcements and notifications.

Course websites are generally made available on the Friday before the first day of classes.


Students are expected to be present for all scheduled clinical practice experiences, simulation laboratories and post-clinical conferences. Students who have extraordinary circumstances preventing attendance should explain these circumstances to the course instructor prior to the scheduled clinical practice experience, simulation laboratory, or post-clinical conference. Instructors will then make an effort to accommodate reasonable requests. A grade penalty may be assigned for unexcused seminar or clinical absences. The faculty member will advise the method of notification for absences to the clinical site e.g. phone, email, and notification of facility.


Each semester, students are responsible for requesting memorandum from the Disability Resource Center to notify faculty of their requested individual accommodations. This should be done at the start of the semester.


Students are to refer to the College of Nursing Student Handbook for information about University & College of Nursing policies, Academic Honesty, and professional behavior.


Supervised clinical practice experience, simulation laboratory, and post-clinical conferences.


Providing and evaluating care for assigned clients in a variety of settings (all multi-system acute adult settings).

Clinical Unit Guidelines

Clinical Practice 4 is not an observational experience. During this time students are to develop critical thinking, apply previously learned concepts to multiple client systems, e.g. individuals, families, groups of individual patients, nursing, interprofessional health care teams. The students are also to work on developing nursing skills (IV medications, insertion of foleys, NG tubes, dressings, etc.), organization and priority setting, identification and implementation of delegation and accountability within the unit, assessment and charting. Students are to progress to providing care for multiple patients. This includes medication administration according to the policy of the facility. There is no clinical pre-planning for this course.

  • All charting by students must be reviewed and co-signed by the faculty member unless faculty specifically gives permission to the staff RN to co-sign

  • All medications administered by students must be checked and co-signed by the faculty member or staff nurse depending on the clinical site policy.

  • Students may NOT administer any IV fluids or medications without direct supervision and observation by the staff nurse or faculty member depending on the clinical site policy.

  • Students cannot take telephone or verbal orders from anyone.

  • Students cannot process or sign-off orders.

  • Students cannot sign as witness on any type of consent form or legal document.

  • Students are not to give blood products or chemotherapy agents.

  • If injured in the clinical area, Instructor must be notified as soon as safely possible.

  • If a student needs to complete an Incident Report for any reason, Instructor must be notified immediately.

Simulation Lab Guidelines:

Simulation lab is considered to be part of your clinical experience and professional behavior should be reflected. Students are to wear their CON scrubs and closed toed shoes. Students are to arrive to the lab on time, tardiness will not be accepted. Use of personal technology not related to participation in the clinical scenarios will not be accepted. If it is determined that a student is not adhering to these guidelines during the simulation experience, that student may be sent home at the discretion of the faculty instructor. Evaluation of a student’s participation in the simulation experience will be a factor in the student’s clinical evaluation for this course.


Clinical experience in both the clinical units and in the simulation laboratory will be evaluated through faculty observation, verbal communication with the student, written work, and agency staff reports using a College of Nursing Clinical Evaluation Form. Faculty reserve the right to alter clinical experiences, including removal from client care areas, of any student to maintain patient safety and to provide instructional experiences to support student learning.

Evaluation of clinical performance on the clinical unit and in the simulation laboratory will be based on achievement of course and program objectives using a College of Nursing Clinical Evaluation Form. All areas are to be rated. A rating of Satisfactory represents satisfactory performance and a rating of Unsatisfactory represents unsatisfactory performance. The student must achieve a rating of Satisfactory in each area by completion of the semester in order to achieve a passing grade for the course. A rating of less than satisfactory in any of the areas at semester end will constitute an Unsatisfactory course grade.

The faculty member will hold evaluation conferences with the student and clinical preceptor, if applicable. The faculty member will document or summarize each conference on the Clinical Evaluation Form or Incidental Advisement Record. This summary will be signed by the faculty member and student. Mid-rotation evaluation conferences will be made available to each student. Final evaluation conferences with faculty members are mandatory and will be held during the last week of each clinical rotation. A student may request additional conferences at any time by contacting the faculty member.


S Satisfactory

U Unsatisfactory

For more information on grades and grading policies, please refer to University’s grading policies:


Berman, A. & Snyder, S. (2012). Kozier & Erb’s Fundamentals of Nursing: Concepts, process, and practice (9th ed.). Boston: Pearson. ISBN: 0323035620

Deglin, J. H., Vallerand, A. H., & Sanoski, C. A. (Eds.). (2011). Davis's drug guide for nurses (13th ed.). Philadelphia, PA: F. A. Davis Co ISBN-13: 978-0-2837-2837-3

Evolve RN Practice Tests:  HESI RN Practice Test, Version 3.0 ISBN # 978-0-3230-6867-3

Giddens, J. F. (2010). The Neighborhood. Boston, MA: Pearson. On-line at ISBN-13: 978-0-13-504998-3

Kee, J. L., Hayes, E. R., & McCuistion, L. E. (Eds.). (2012). Pharmacology: A nursing process approach (7th ed.). St. Louis MO: Saunders Elsevier.

Lewis, S., Dirksen, S., Heitkemper, M., Bucher, L., & Camera, I. (2011).  Medical-surgical nursing: Assessment and Management of Clinical Problems, (8th ed.). Maryland Heights, MO: Mosby. ISBN # 978-0-320-65801

McCance, K.L., & Huether, S. E. (2010). Pathophysiology: The biologic basis for disease in adults and children. (6th ed.). St. Louis: Mosby/Elsevier.

Mosby’s Nursing Video Skills: Student Version DVD (2009). Mosby ISBN# 9780323052924

Perry, S., Hockenberry, M., Lowdermilk, D., & Wilson, D. (2010). Maternal child nursing care (4th ed.). Maryland Heights, MO: Mosby. ISBN – 978-0-323-05720-2

Potter, P. & Perry, A. (2010).  Clinical Nursing Skills and Techniques (7th ed.).  St. Louis, MO: Mosby. ISBN # 978-0-323-05289-4

Townsend, M. C. (2011). Essentials of psychiatric mental health nursing: Concepts of care in evidence-based practice (5th ed.). Philadelphia: FA Davis. ISBN 13: 978-0-8036-2338-5


Evidence-based articles appropriate to the students’ clinical experiences. May be obtained from sources such as CINAHL and Pubmed.

Online sources. The Internet has a wealth of sites that contain evidence-based information. Examples:

The American Heart Association

Center for Disease and Prevention:

Academy of Medical-Surgical Nurses:

Quality and Safety Education for Nurses (QSEN):

Van Leeuwen, A.M. & Poelhuis-Leth, D.J. (2011). Davis’s comprehensive handbook of laboratory and diagnostic tests with nursing implications (4th ed.). Philadelphia: F.A. Davis

While using non-professional search engines and resources such as Google and Wikipedia are permitted, caution must be exercised to ensure material obtained from any source is supported by evidence-based information.


Academic Affairs Committee:

General Faculty:

UF Curriculum Committee:

09/09; 02/12

09/09; 03/12

10/09; 04/12

NUR 4748L – Section #s 3414 & 3417 - Clinical Practice 4 CON Final – Fall 2012


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