Oregon Health Sciences University School of Nursing La Grande Campus Guidelines for Student Nurse Clinical Practice Last Updated on 9.2023 La Grande Campus Curriculum Committee

Purpose of these guidelines: The Oregon Health & Sciences University (OHSU) School of Nursing (SON) acknowledges the American Association of Colleges of Nursing (AACN) Synergy Model for Patient Care, the core concept of which is that “synergy results when the needs and characteristics of a patient, clinical unit or system are matched with a nurse’s competencies.” Student nurses are gaining knowledge and experience over the course of the baccalaureate nursing school program. The OHSU SON respects and acknowledges that the health care agencies in which OHSU nursing students are engaged in clinical experience may have agency‐specific limitations on what nursing skills and interventions a student may perform. To clarify for our clinical partners the specific nursing skills that have been formally studied in the OHSU SON program; the following information is provided. The student is responsible for educating preceptors when they are allowed to perform the skills and knowing their boundaries in the clinical setting. The students are expected to carry this document with them during their clinical experience for reference.

Sophomore Students -Head to toe assessment I/O, nutrition and elimination procedures, bladder scanner -Body mechanics -Wound care‐basic/suture, staple and clip removal -VS, Sp02, pain assessment -Capillary blood glucose measurement and Diabetic care: skin, foot care, nutrition, illness, eye care -Health hx interview/Documentation -Drain care: JP, Hemovac, Penrose, T‐Tube, PCA pump                                                                                  -Enterostomal care -Handwashing/Infection control and precautions/Isolation techniques/PPE -Oxygen therapy and delivery devices/ Airway and basic suctioning; oral/nasal -Height, weight, BMI -Sterile technique: gloving sterile field. -Insulin preparation & injection -IV initiation, maintenance, discontinuation, drip calculation, secondary infusions via piggyback -Medication administration and calculation: topical, oral, enteral, inhaled, IM, IV, subcutaneous, intradermal (No chemotherapy) -ALL Medication administration must be under the direct supervision of an RN                                                          -Client & environment safety: ADLs, mobility, fall risk, hygiene, position & transfers, ROM, skin care & pressure prevention -NGT and maintenance/ Enteral feedings                                                                                                -Urinary catheter insertion & maintenance, removal                                                                                                                                    -Chronic and acute Pain assessment & management -Specimen collection: urine, blood, sputum, stool, wound -Pre and post operative care Postpartum/newborn assessment Junior Students/ Senior Students (can participate in all of the above skills and those listed below) -All Medication administration must be under the direct supervision of an RN or cosign any medication orders -Blood administration/monitoring (The student may not be a co‐signer for blood initiation) -Cardiac dysrhythmias: recognition of serious dysrhythmias -Central venous access device (CVAD) – access, de‐access, PICC/Midlines & maintenance -Chest tube maintenance &monitoring -Code Blue/Rapid response –BLS only Epidural Assessment and monitoring -Post‐mortem care -TPN administration & maintenance -Tracheostomy care and suctioning Wound care/Ostomy—advanced   Additional Guidelines The OHSU SON student may perform the following only under the direct supervision of an RN who has deemed the student is adequately prepared:  All Medication administration must be under the direct supervision of an RN  Administer medications or treatments prescribed by standing orders (e.g., insulin, fractional doses). The student must consult with the RN responsible for overseeing the client’s care.  Monitor patients during blood administration.  Monitor patients receiving chemotherapeutic drugs.  Monitor patients receiving conscious sedation.  Care for critically ill patients with monitoring devices or patients requiring expert reading and interpretation.  Change tubing on central lines or discontinue central lines.  Set up a PCA syringe. The OHSU SON student may not:  Administer medications via the intrathecal route/epidural catheter.  Discontinue an epidural catheter.  Administer chemotherapy medications without direct supervision from a certified chemotherapy nurse or per hospital policy.  Cosign any document requiring two RNs to sign (e.g., checking blood, checking chemo orders, TPN, insulin, or co‐ signing pediatric medications).  Package or label drug supplies for any individual.  Perform endotracheal intubation.  Recommend over‐the‐counter drugs or treatments not ordered by the prescribing professional.  Take orders (phone or verbal) independently.  Transport clients in his/her car or drive other vehicles to transport clients.  Ride in ambulance, unless assigned through clinical course.  Perform any skill/task that they have not been trained in or checked off as competent unless approved by OHSU faculty and under the direct supervision of a RN Note: The above list provides guidance but is not all‐inclusive of clinical situations/learning opportunities that may arise. If the RN preceptor has any questions about whether student involvement in a procedure is appropriate, please contact the clinical instructor, or the OHSU SON at the EOU campus. Thank you to all our clinical partners who play such an important role in the education of OHSU SON students!