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2514 RNSG Care of the Client with Complex Health Needs SYLLABUS Revised for Fall 2008 Page 1 of 11 RNSG 2514 Theory Care of the Client with Complex Needs COURSE DESCRIPTION: Application of a systematic problem-solving process and critical thinking skills to provide comprehensive nursing care to diverse clients/families across the life span with complex health care needs including, but not limited to, complex childhood/adolescent diseases, complicated perinatal care, acute mental illness, complex peri-operative care, serious adult health problems and health issues related to aging. Emphasis on tertiary disease prevention, health maintenance/restoration and collaboration with members of the multidisciplinary health care team. Topics include the role of the nurse as client advocate and coordinator of care and applicable competencies in knowledge, judgment, skills, and professional values within a legal/ethical framework. Nursing Process is the systematic problem-solving process utilized in this course. Prerequisites: ENGL 1301 with a grade of C or better. All first year prerequisites must be completed or admission to the program through Advanced Placement and credit for RNSG 1327. Co-requisite: RNSG 2462; BIOL 2420 and a college level 3 semester hour speech course academics. SEMESTER HOURS: 5 (4 LEC/2 LAB) Subject to change disclaimer The policies, regulations, procedures, and fees associated with this program are subject to change without prior notice, if necessary, to keep College and program policies in compliance with State and Federal laws and/or with rules related to the program s accrediting agency. The College and the program reserve the right to change curricula, rules, fees, and other requirements, of whatever kind, affecting students in any way. The provisions of this document do not constitute a contract, express or implied, between any applicant, student, faculty or staff member and McLennan Community College or this program. WECM COURSE OBJECTIVES: The student will: Develop and implement a teaching plan for a client/family to promote health maintenance/health restoration based on assessment data C7, C10, C11, F5, F6, F13. Demonstrate the ability to utilize critical thinking skills to make safe and ethical clinical decisions C5, C6, C16, F7, F9, F11, F12, F13, F16. Use a systematic problem-solving process C5, C6, C7, C11, C15, F7, F8, F9, F12. Develop and implement a plan of care for the diverse client/family across the life span with complex health care needs in a variety of health care settings C5, C6, C7, C11, C15, F7, F8, F9, F12. Demonstrate a working knowledge of the implications of the Nurse Practice Act C5, C6, C7, F1, F13. Apply therapeutic communication skills with diverse clients and families C5, C6, C7, F5, F9, F10. Recognize opportunities for client advocacy and professional development activities C11, C16, C17, F5, F6, F13, F17. Collaborate in multidisciplinary planning to provide care for clients/families with complex health care needs C3, C4, C7, C9, C14, F5, F6, F15. COURSE OBJECTIVES: Provider of Care 1. Determine the health status and health needs of clients based upon interpretation of health data and preventive health practices in collaboration with families, and interdisciplinary health care team members. F7-12, C1-8 a. Applies the components of a holistic health history and assessment to the development of care for a complex client/family b. Applies the principles of anatomy, physiology and complex pathophysiology to the development of care. c. Develops primary and secondary diagnoses for clients/families. Page 2 of 11 2. Formulate goals/outcomes and plan of care based on nursing diagnoses in collaboration with clients, their families and interdisciplinary health care team members. F7-12, C1-9 a. Utilize complex therapeutic communication techniques within the nurse-client relationship. b. Participate in the development of the plan of care within the context of the interdisciplinary team. c. Collaborates with faculty, client/family, and interdisciplinary team in setting care related priorities. 3. Implement plan of care within legal and ethical parameters, including scope of practice, in collaboration with the client and interdisciplinary health care team to assist client in meeting health care needs. F7-12, C5-8, C14 a. Applies holistic plan of care with emphasis on tertiary prevention/health maintenance and restoration. b. Provides safe, efficient, and effective care to multiple clients/families with complex problems. c. Incorporates legal and ethical parameters of nursing practice and respects and client s rights. 4. Develop and implement teaching plans for clients concerning promotion, maintenance, and restoration of health. F1-8, F15, -17, C1, C3-7, C10-14, C18 a. Teaches client/family regarding therapeutic regimen and discharge planning. b. Utilizes complex theoretical concepts to individualize teaching plan for diverse clients/families. c. Utilizes the presence of self in therapeutic relationships. 5. Evaluate client s responses and outcomes to therapeutic interventions. F1-6, F8-10, F12, F13, F16, F17, C1, C58, C11, C12, C14, C18, C19 a. Evaluates the outcomes of nursing interventions and interventions of the interdisciplinary team. b. Utilizes evaluation tools to evaluate outcomes. c. Reports and documents responses to all interventions to appropriate health team members. 6. Provide for the care of multiple clients either through direct care or assignment and/or delegation of care to other members of the health care team. F1-7, C1, C3-9, C11-13, C15 a. Provides care for multiple complex patients/families during the clinical period. b. Incorporates understanding of the complexity of the health care delivery system into the development of care. c. Incorporates the Associate Degree Nursing Handbook, Texas Nurse Practice Act, institutional policies and procedures into delivery of care. 7. Use a critical thinking approach to analyze clinical data and current literature as a basis for decision making in nursing practice. F7-12, C5-7 a. Demonstrates evidence of critical thinking when making clinical judgments for clients/families with complex, acute and complicated health care problems. b. Makes clinical judgments and utilizes faculty to confirm them. c. Functions as a contributing member of the interdisciplinary health care team. Coordinator of Care: 1. Coordinate human and material resources for the provision of care for clients and families. F7, F8, F121, C1-4, C9 a. Makes clients/families aware of community resources. to accomplish effective care. b. Utilizes time management skills in order to provide care to multiple complex clients/families. c. Utilizes the interdisciplinary health care team to enhance the care of multiple diverse clients/families. 2. Collaborate with clients, families and the interdisciplinary team for the planning and delivery of care. F5, F8, F9, C9-14 a. Functions efficiently and effectively within the structure of the health care delivery system in a variety of settings. b. Functions as an advocate for clients rights. c. Includes clients/families and interdisciplinary health care team in the implementation of care. 3. Refer clients and families to resources that facilitate continuity of care. F5-9, C11-15 a. Assess the adequacy of the support system of the client. b. Identify providers and resources to meet the needs of clients/families. c. Communicate clients/families needs to interdisciplinary health care team. 4. Function within the organizational framework of various health care settings. F1, F2, F5, F11, F12, F15, C1-4, C15-20 Page 3 of 11 a. Uses agency orientation to enhance delivery of care. b. Functions within the appropriate lines of authority and accountability of the agency to identify needed change. c. Incorporates cost-effective measures into development of care for multiple clients/families. Member of a Profession: 1. Assume accountability and responsibility for the quality of nursing care provided to clients and families. F11, F13-17, C11, C13-20 a. Promotes care within the institution that incorporates legal and ethical standards, institutional policies and procedures, and ADN Student Handbook. b. Uses critical-thinking to address issues affecting the RN role and delivery of nursing care. c. Engages in self-evaluation processes 2. Act as an advocate to promote the provision of quality health care for clients. F11, F13-17, C11, C13-20 a. Promotes caring, nonjudgmental, nondiscriminatory nursing care using established policies and procedures. b. Uses critical-thinking to address issues of responsibility and accountability regarding nursing actions. c. Promotes appropriate peer/staff/faculty/client boundaries. 3. Participate in activities that promote the development and practice of professional nursing. F1, F2, F6-9, F1317, C1-4, C9-13 a. Addresses issues affecting the development and practice of associate degree nursing. b. Participates in activities that promote the image of the associate degree nurse. c. Promotes a collegial relationship with faculty, peers, and members of the interdisciplinary health care team. COURSE CONTENT: CNS: HRM: NBC: CV: CVC: ABB: MH: SKILLS Nursing the Client with Alterations of Central Nervous System Function Nursing the High-Risk Childbearing Family Nursing Management of the Newborn with Complications Nursing the Client with Alterations of Cardiovascular Function Nursing Management of the Child with Alterations in Cardiovascular Function Nursing the Client with Alterations in Acid/Base Balance Nursing the Client with Alterations in Mental Health Complex Nursing Skills STUDENT INFORMATION: The information contained here will be of value to you now and as you continue in this course. The syllabus concerns various learning experiences in which you will participate in order to meet the objectives outlined for this course. The student is responsible for being familiar with and abiding by all the policies of the Associate Degree Nursing Department as identified in the ADN Student Policy Handbook and the course syllabus. Page 4 of 11 SCHEDULE OF CLASSES: Classroom (Theory) Theory is scheduled for Monday and Wednesday 10:20 A.M.-12:30 P.M. The content is divided into the following sections: Neurology, cardiology, high risk maternity, newborn and pediatric complications, and mental health. See calendar and unit guide for specific topics. Explanation or clarification of material contained in this syllabus should be sought from faculty currently teaching the course. CELLULAR PHONES and PAGERS must be silenced during class, skills lab and clinical, and may not be brought into testing areas. Ringing or answering cell phones during theory disrupts and disturbs others trying to learn. Faculty may ask you to leave class if you do not adhere to this request. Pre-class preparation and active involvement in classroom/lab activities are necessary for comprehension, integration, and implementation of course concepts. Students are expected to come to class/lab having read/prepared all assigned activities. Pre-class preparation and active involvement enhances mastery of course content. Skills Lab Skills lab meets once a week for 2 hours; Wednesdays from 08:00 A.M-09:55 A.M. OR 12:50 P.M.-14:45 P.M. Attendance is required. During this time, the student will learn complex nursing skills. The class consists of approximately one-half hour of teaching/demonstration and one-hour of practice and/or evaluation. The student needs to come to lab prepared for the lab experience. There is insufficient time in skills lab for students to develop competency in skills performance. Students are expected to practice skills on their own outside of the class/skills time. Sue Graham, RN, MS, Skills/Clinical Lab Specialist HC 208 299-8351 is available by appointment to assist students with: a) skills enhancement, practice and prescription needs as well as assisting the teaching team with skills checkoffs. b) clinical remediation needs. Please note that the Health Careers Lab Assistant, Catherine Fleming HC 201 299-8341 will also be available by appointment to assist students with skills practice. The student is required to bring the Critical Skills sheet, the Skills Competency and packet practice equipment to each class. All skills must be completed by a specific date in the skills lab. All skills will be taught and evaluated in skills lab before the student performs a skill in the clinical setting. CRITICAL SKILLS TO BE COMPLETED IN LAB: 1. 2. 3. 4. 5. EKG strip interpretation Arterial blood gases puncture and analysis Neurological and Glasgow Coma Scale assessments Central Line Dressing Change/TPN Process Recording Page 5 of 11 MEDS Publishing System The Meds Publishing Learning System will be used for learning support for students throughout the curriculum and is considered a part of the critical skills to be completed. The Learning System is a mentoring and retention tool that supports the curriculum from the first day of the program to graduation. The system is designed to increase critical thinking skills, improve reading comprehension, decrease attrition and increase NCLEX-RN test success. The program provides test question logic to help students build critical thinking and reasoning skills and interpret and analyze test questions. Tests can be set to be a practice mode to allow students to work at their own pace with interactive audio and visual clues. The tests can also be in assessment mode, which mimics a real testing environment. The program also has a "talking" glossary that defines and pronounces terms. STUDENT HANDBOOK The student is responsible for the information in the A.D.N. student policy handbook. In particular, review the following in the handbook: 1. 2. Attendance policy Grading 3. Testing policy 4. Scans information ATTENDANCE POLICY Regular and punctual attendance is expected of all students, and each instructor will maintain a complete record of attendance for the entire length of each course, including online and hybrid courses. Students are expected to be on time as tardiness is disruptive to others trying to learn. Students will be counted absent from class meetings missed, beginning with the first official day of classes. Students, whether present or absent, are responsible for all material presented or assigned for a course and will be held accountable for such materials in the determination of course grades. In the case of online and hybrid courses, attendance will be determined in terms of participation, as described in the course syllabus. Absence from 20 percent of scheduled lecture and/or laboratory meetings will be taken as evidence that a student does not intend to complete the course, and the student will be withdrawn from the course with a grade of W. The instructor may reinstate the student if satisfied that the student will resume regular attendance and complete the course. If the student s 20 percent absences are reached after the official drop date, the instructor may assign W, if the student is passing and requests to be withdrawn. However, if a student who is not passing reaches the 20 percent point after the official drop date, the student will receive an F. In extenuating circumstances, the instructor may assign a W to a student who is not passing. FACULTY ADVISORS Each student will be assigned a faculty advisor who will assist them as needed. It is suggested that each student visit their advisor weekly. See blackboard for the advisor list. Any student having less than a 75% test average must meet with their advisor weekly until their test average becomes 75%. All leveling and transfer students must meet with their advisor weekly. Page 6 of 11 RETENTION SPECIALIST The purpose of the MCC Nursing Student Retention Specialist is to increase the numbers of students that successfully complete the Associate Degree Nursing Program at MCC and become Registered Nurses. To achieve this outcome the Retention Specialist provides several different services for nursing students at MCC. The Retention Specialist can be reached at (254) 299 8308. The following services are offered through the Retention Specialist: 1:1 Educational Guidance: Students meeting the following criteria will be referred by faculty for individual test analysis and 1:1 educational guidance: students who have failed previous nursing course (s) and have been readmitted to the nursing program students who fail an exam in any nursing course. A student must schedule an appointment with the Retention Specialist within 5 business days after being notified that he/she meets one or more of these criteria. Appointments must be scheduled by calling the Retention Specialist. The student will be notified by the school email that he/she must make an appointment with the Retention Specialist. If the student does not comply with the above, the student will not be allowed to take the next scheduled exam, and will be required to take a make-up exam when scheduled. Continued meetings between the student and the Retention Specialist will be determined by student progression toward academic success. Counseling and referral services: any student may self refer to the Retention Specialist for: 1:1 guidance to improve course grades, assistance with financial aid, child care, transportation, textbook loan, referral for personal counseling issues. TEST DATES: See the course calendar for the specific test dates. The student must pass both RNSG 2514 and RNSG 2462 and complete BIOL 2420 and SPEECH (College level) with a grade of C, to progress in the Associate Degree Nursing Program. GRADE DETERMINATION: A grade of C or above in theory is required to pass RNSG 2514. The grade scale for this course is: A B C D F = = = = = 89 - 100 80 -88 75 -79 65 -74 below 65 Only the Final theory grade determination will be rounded to a whole number and based on: 4 Exams 1 Final exam Meds Pub Project/Presentation 17.5% each 25.0% 2.0% 3.0% Evaluation Four unit examinations and one comprehensive final exam are given in the course. These examinations provide primary evidence of student s mastery or non-mastery of the course and lecture objectives. The majority of exam questions are in a multiple choice format. Remaining exam questions employ alternative testing formats used in the NCLEX-RN such as, Page 7 of 11 but not limited to, fill in the blank, multiple multiples, and calculations. Material for testing may come from previous course content, assigned lecture/skills readings, assignments, computer programs, and/or other media, guest speakers, lecture, handouts. Examinations may be given by paper and pencil format using student-supplied Scantrons. An examination blueprint will be available on Blackboard for each examination. An explanation of the blueprint is also available on Blackboard. The blueprint mirrors the NCLEX-RN blueprint. Students unable to sit for a scheduled examination must notify course faculty prior to the administration time of that examination. Failure to notify faculty will result in a lowering the exam grade by ten (10) points. Make-up examinations are written in the Testing Center according to the RNSG 2514 calendar. Make-up examinations will cover content as presented in theory and assigned in other course-related activities but the format for the examination may not be multiple choice and may include, but is not limited to, formats such as fill in the blank, case study, short answer, essay, and/or matching. In cases where the format is multiple choice, questions will differ from questions on the original examination. Faculty advisors will conduct exam reviews for their advisees after examination grades have been posted on Blackboard. All students are strongly encouraged to review their examinations. Students failing an exam are required to meet with their faculty advisor. Examinations may be reviewed for a two-week period following administration of the exam. A thirty-minute period is allotted for exam review. No review of the examination will occur with the faculty advisor after this period. Students desiring additional information or rationales regarding an examination item must submit their concerns to their advisor on the Student s Test Item Comments form (available on Blackboard) within 24 hours of the established review time of the student s advisor. This information will addressed at Faculty Team Meeting. Students will be notified of the Team s decision. Only complete, legible forms will be accepted/considered. Students making below 75% on any examination are required to complete the Student Test Analysis form. Students are responsible for scheduling an appointment with their advisor to complete this form. Students failing to complete the Student Test Analysis activity may not be allowed to sit for the next examination. ADA STATEMENT "In accordance with the requirements of the Americans with Disabilities Act (ADA), and the regulations published by the United States Department of Justice 28 C.F.R. 35.107(a), MCC s designated ADA co-coordinators, Dr. Johnette McKown, Executive Vice President and Dr. Lynn Abernathy, Vice President, Student Services shall be responsible for coordinating the College s efforts to comply with and carry out its responsibilities under ADA. Students with disabilities requiring physical, classroom, or testing accommodations should contact Marc Sweatt, Disability Specialist, at 299-8122 or msweatt@mclennan.edu. Required Textbooks: Page 8 of 11 Varcarolis: Foundations of Psychatric Mental Health Nursing (with VCE) 5th ed., Saunders-Elsevier HESI : HESI NCLEX-RN Review w/Studyware CD. Elsevier Science Wong, Perry, Hockenberry: Maternal Child Nursing Care (with VCE) 3rd. ed. Saunders-Elsevier Potter & Perry: Fundamentals in Nursing (with VCE), 6th ed., Saunders-Elsevier Potter & Perry: Fundamentals in Nursing Workbook, 6th ed., Saunders-Elsevier ( Kee, Hayes, & McCuistian; Pharmacology: A Nursing Process Approach (with VCE) 5th ed., Saunders-Elsevier Kee, Hayes & McCuistian, Pharmacology: A Nursing Process Approach Study Guide, 5th ed., Saunders-Elsevier . Lewis: Medical Surgical Nursing (with VCE) 6th ed., Saunders-Elsevier Optional Textbooks: Board of Nurse Examiners: Nursing Practice Act (Latest Edition) LaCharity: Prioritization, Delegation & Assignment 1st ed., Saunders-Elsevier CHOOSE ONE: Deglin: Davis Drug Guide for Nurses, Mosby s Nursing Drug Reference Skidmore: Mosby s Drug Guide for Nurses. Elsevier Science. CHOOSE ONE: Silvestri: Strategies for Alternate Item Formats on the NCLEX-RN Exam. Saunders-Elsevier. Zerwekh. Illustrated Study Guide for NCLEX-RN Exam w/CD 6th ed., Elsevier Science Supplies: F289-ERI Scantron Parscore (6) Sharp Calculator EL 2435B (optional) NURSING DEPARTMENT PERSONNEL Page 9 of 11 Program Director Mrs. Melesia Henry A D N Administrative Sec. Mrs. Faith Glatter Nursing Counselor Mrs. Becky Griffin Simulation Coordinator Mrs. Susan Olson Retention Specialist Mrs. Sharon Allen Skills/Clinical Lab Specialist Mrs. Sue Graham A D N Administrative Sec. Mrs. Donna Fouts Office HC204 HC 203 HC 205 CSC HC 206 HC 208 HC202 Office Phone 299-8349 299-8367 299-8354 299-8744 E-Mail mhenry@mclennan.edu fglatter@mclennan.eu rgriffin@mclennan.edu solson@mclennan.edu sallen@mclennan.edu mgraham@mclennan.edu dfouts@mclennan.edu 29908308 299-8351 299-8367 RNSG 2514 INSTRUCTORS Instructor Ms. Sharon Hammond Mrs. Miley Pulliam Mrs. Sandi Walter Dr. Sandi Swick Mrs. Dee Mackey HC Office 221 222 122 211 220 Office Phone 299-8314 299-8394 299-8307 299-8359 299-8313 Home Phone 753-5677 799-6963 254-248-1266 776-3284 254-765-3908 Cell Phone 722-1036 717-0725 299-8307 E-Mail shammond@mclennan.edu mpulliam@mclennan.edu awalter@mclennan.edu sswick@mclennan.edu dmackey@mclennan.edu Grievance Policy Page 10 of 11 Step 1 Faculty, administrator Resolution or other individual involved in the grievance No resolution Step 2 Immediate supervisor of individual involved in grievance Resolution Step 3 Appropriate Dean or Vice President No resolution Resolution No resolution Formal Grievance Process Step 1 Request in writing to President of College for Formal Grievance Hearing Accepts Request Rejects Request Step 2 Appointment of Grievance Committee Step 3 Grievance Hearing Accepts Recommendation Recommendation Rejects Recommendation Proposes alternative solution Step 4 President of College Accepts Solution Rejects Solution Step 5 Review of case by Board of Trustees of College Page 11 of 11

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