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NCLIN 411: Transition to Professional Practice

NCLIN 411 allows you to immerse yourself into the role of the Registered Nurse and begins the transition into the professional role. BSN students take NCLIN 411 during spring quarter of their senior year. ABSN students take NCLIN 411 during summer quarter, their final quarter.

NCLIN 411 Course Structure

NCLIN 411 is a 9-credit C/NC course. It is a combination of a weekly two-hour clinical seminar plus approximately 240 hours of preparation, clinical practice, and laboratory experiences. Students have a School of Nursing clinical instructor as well as nurse preceptors at their NCLIN 411 site. The School of Nursing clinical instructor leads the clinical seminars and does site visits with individual students and preceptors. Students work side-by-side with their preceptor(s) during their shift. Depending on the site, these shifts may range from 8 to 12 hours and occur during days/evenings/nights/weekends/holidays. Students must be prepared to be available any combination of days and shifts.

NCLIN 411 Clinical Match Process

Goal

Open, transparent standardized process for students to sign up for an available clinical slot for NCLIN 411 with computerized random ordering of students for sign-up, along with a standardized process for a voluntary, one-time only trade.

Meeting Values/Expectations

  1. Teamwork and collaboration among students, faculty, and staff is highly valued.
  2. School meeting ground rules will be in effect for the meeting.
  3. All students are and will be expected to conform to the Essential Qualifications for BSN/ABSN Admissions, Continuance, and Graduate that are found here: http://nursing.uw.edu/node/897  Please note that the UW Student Conduct Code is embedded in and an expectation for the BSN/ABSN Essential Qualifications. Conformance to Essential Qualifications is one of the three requirements for students to make “satisfactory progress” in the degree program: http://nursing.uw.edu/academic-services/degree-programs/bsn/satisfactory-progress.html

Procedure Details

Giant Post-It Notes will be on the wall with a line for each available slot in five categories: Medical-Surgical; Pediatrics; Maternity; Psychiatric/Mental Health; Community Health.  During Summer Quarter, some of these categories may be combined, such as Pediatrics/Maternity.

Procedure

  1. Review and agree on meeting ground rules. Special attention will be focused on respect for all in the room and on no side conversations during the entire process. Please bring something to work on if you’d like and/or bring your lunch, but we will need relative quiet and calm in the room to move through the process as accurately and efficiently as possible.
  2. We will:
    1. Take attendance to reconcile the names of all expected students for NCLIN 411;
    2. Project an Excel spreadsheet that contains the names of all students planning to take NCLIN 411;
    3. Use an Excel function to generate random numbers in a column next to the name of each student;
    4. Call student names in order; students will go up and place their name on an open slot.
  3. The process will continue until all students have signed a slot.
  4. The Post-It notes will be photographed before any students exit the room; photos will be sent by email immediately to the cohort.
  5. Information on the Post-It Notes will be transcribed by an Academic Services staffer and sent out to students in DRAFT form.
  6. Students have the opportunity to trade clinical section choices once by finding a partner for the trade.  Both students must appear in Academic Services during the published “trade” meeting and by presenting a signed trade agreement form. The Director of Academic Services will approve the trade by signing the form.
  7. After the “trade” deadline, a FINAL list of students/slots will be sent to the cohort and to department chairs.
  8. After the final arrangements are sent out, clinical instructors for each section will contact their students for site/unit/preceptor matches. Please wait until you hear from your clinical section instructor.

Nursing student clinical matches are complex given the number of nursing schools (all levels of education) and number of nursing students in the Puget Sound area. In addition, the education of nursing students is very prescriptive both from a national accreditation standpoint and from Washington State rules. In recent years, issues around clinical matches became so complex and inefficient that the North Puget Sound Clinical Placement Consortium was formed. The mission of the Consortium is to deal with these complexities and balance the needs and interests of the clinical agencies with the needs of the Schools and their students and faculty while maintaining compliance with state laws and national standards for accredited schools, as well as any regulations healthcare agencies must adhere to.

In thinking about clinical matches, considerations that must be accounted for and balanced are:

  1. Schools of Nursing (in general)
    1. All schools in the North Puget Sound (and some schools straddle the South Puget Sound) placement needs.
    2. This year, consortium member schools are requesting to place 1,200 undergraduate students in 3,500 placements.
  2. UW School of Nursing
    1. Student progression, student learning needs
    2. Compliance with State of WA rules that dictate that we may not place more than 10 undergraduate students in a section. This has real-world implications for the number of slots we offer by section, given the need to balance teaching loads with FTEs while we make sure that available faculty has the required and appropriate expertise to teach students in certain settings with certain populations.
    3. Instructor expertise
    4. Instructor availability
  3. Healthcare agencies/care settings
    1. Agency staffing levels – enough qualified staff to precept students
    2. Patient/client type and number must be sufficient to allow for learning opportunities for nursing students
    3. Healthcare system prioritization of its own “new” nurses for precepting. (i.e., agencies may prioritize use of experienced staff nurses to precept/orient their own new employees versus student nurses.)
    4. Healthcare system capacity to precept students given internal and external pressures they may be facing as an organization, such as implementing a new Electronic Health Record system and the need to train their own staff during a particular time period or preparing for accreditation.
    5. Constraints and restrictions placed on accommodating students across health sciences and related disciplines, such as legal restrictions as set out in agency-specific Affiliation Agreements with the School of Nursing and the response of our Attorneys General to such negotiated agreements.
  4. North Puget Sound Clinical Placement Consortium
    1. The School of Nursing is, by necessity, a member of and must work with the North Puget Sound Clinical Placement Consortium (the “Consortium) for “gridded” Consortium slots. Agencies make known potentially-available slots, and Schools of Nursing must submit reservations 12-15 months in advance for “gridded” consortium slots. (“Gridded” slots are most likely, but not exclusively, inpatient slots.) To add to the complexity, Consortium-member agencies also have what they call Consortium-Non-gridded slots; i.e., agencies want control over these slots through the consortium, but do not put them in the “grid.” Finally, there are agencies that do not belong to the NPSCPC (e.g., Seattle Children’s Hospital (SCH), others). That creates a delay in us knowing how many slots we have for certain sections. So, for example, every year we reserve NPSCPC slots for pediatrics, but we do not get as many as we would like from NPSCPC. So, we wait to see what Consortium-gridded peds reservations we will “get” and, when confirmed, we approach SCH and other agencies to get the Consortium-non-gridded slots and the Non-Consortium slots for additional pediatrics slots for students. Any delays on the part of NPSCPC or its member schools delays the systematic response to all.


      CategoryType "Lead" time for reservations
      Consortium
      Gridded
      12-15 months in advance
      Consortium Non-gridded
      12-15 months in advance
      Non-Consortium N/A
      Varies; 9-12 months in advance is typical


Frequently Asked Questions

The NCLIN 411 placement process was changed in 2013. What were the reasons?

The process was changed in 2013 as part of quality improvement. The previous placement process was not transparent and there were perceptions that the process was biased.

To  eliminate or decrease to the greatest extent possible any possibility for bias in the process, the Associate Dean for Academic Affairs worked with attorneys and other experts to develop a random, transparent, and public process that allows students to express preferences by signing up for available slots after their name is randomly selected through a “random order” function in Excel.

Can students know more about types of clinical opportunities in advance of the match process meeting? What types of experiences are available to help inform choices?

The School of Nursing will make every effort to provide details in advance of the match meeting. Academic Services will query clinical section faculty about site details in the future to help students make informed decisions. The goal is to ask maternal/child, community health, psychiatric/mental health faculty to provide descriptions about the types of choices that may be available as part of their clinical sections. For example, psychiatric/mental health encompasses inpatient/outpatient options across the greater Seattle area, including hospice, public schools, nurse-family partnership, and inpatient oncology/radiation. We hope that descriptions will help students understand the wide variety of opportunities, but there is no guarantee that all options described will be available.

After the match meeting, students will know which a clinical section category they are in (e.g., pediatrics, medical-surgical). The clinical instructor for each section will work out individual sites with each student. This may take approximately 3-4 weeks from the time of the match meeting until all decisions have been made.

Please explain the difference between sites and units.

For medical-surgical and pediatric opportunities, we reserve blocks in specific clinical agencies. As an example, 12-15 months in advance, we may reserve 10 slots at UWMC, 10 slots at Harborview, 10 at Virginia Mason, and 10 at Children's Hospital. Where blocks are reserved, one instructor is assigned to work with all students who are slotted for an agency. This instructor will have different units, shifts, and preceptors to choose from at one clinical agency. Maternity, community health and psychiatric/mental health match students with different agencies across the greater Puget Sound area. Community Health, for example, may have learning opportunities through Public Health, Seattle Public schools, hospitals, or non-profit agencies. Therefore, students will be matched with a site and a preceptor.

Will we be able to choose our site and unit during the "match" meeting?

No. You will sign up for a section during the match meeting. Once the sections have been sent to you in “draft” form, you have a chance to trade sections once with another student. After the final arrangements are made, your clinical section instructor will contact you either individually or as a group to discuss site/unit/preceptor matches. That is the time to discuss your learning objectives, talk about your professional experience in health care and other areas, your career goals, and your preferences for specific opportunities in your clinical section. The final decision for your site/unit/preceptor is with the clinical instructor and the clinical agency.

Can students switch between sites within the same category?

We want to ensure that the entire process is open and transparent. Switching between sites may be allowed during the open “trade” period, approximately 1-10 days between the match meeting and the end of the “trade” period, but only if we have a final decision about which agencies are hosting students.  Both students trading between sections must come together to Academic Services and sign a “trade agreement form” in front of the Director of Academic Services. This is to ensure that both parties voluntarily agree to switch without undue influence of one student over another. Once the “trade” period is over, decisions are final. The only adjustments to sections will be due to changes in clinical slots offered by an agency. 

Why do you offer more psychiatric/mental health and community slots than student interest indicates?

When planning NCLIN 411 opportunities, the School has three departments that must each hire, pay, and supervise instructors to teach NCLIN 411. Ideally, department chairs are interested in splitting resources equally. We already maximize placements in medical-surgical nursing to meet student demand. Thus, opportunities are not equally split among departments.  Community Health and psychiatric/mental health opportunities account for approximately 20% of NCLIN 411 placements, while medical-surgical placements usually account for 40-45% of placements.

SoN plans to offer opportunities for students to learn about the possibilities for psychiatric/mental health and community health opportunities beyond the current assumption of what a community health or psychiatric/mental health placement in NCLIN 411 may be.

Why aren’t personal factors (e.g., work schedule, child care, commute time) considered in the choices I have?

Please see the clinical placement agreement form that you signed during your initial orientation.

If I would like to get a NICU site, which category should I choose: maternity or pediatrics?

NICU options are usually part of the maternity section throughout the greater Puget Sound area. Availability is based on staffing and site availability.

Is there a possibility to be placed in the Emergency Department (ED) as part of medical-surgical and pediatrics?

We usually have some options in the ED through medical-surgical sections and sometimes in the pediatric section. ED availability is not guaranteed. It is based on site and staffing availability. Also, EDs are sometimes not good NCLIN 411 learning experiences for NCLIN 411 students since there are fewer hands-on and patient management opportunities than on other units.

Are there any NCLIN 411 sites outside of the Puget Sound area, across the state, across the US, or abroad?

No. All NCLIN 411 placements are within the greater Puget Sound area. We use agencies in Seattle, the eastside, north of Seattle (including Everett), and south of Seattle (including Tacoma).

Will we be able to carpool to our NCLIN 411 sites?

Generally no, since you will be working according to your preceptor's schedules and are not on the same units/shifts.

What are the objectives for NCLIN 411?

Each student must demonstrate the following abilities:

  1. Synthesize knowledge in using the nursing process to provide care for a community, group of clients, or a single client with complex health problems.
  2. Organize nursing care effectively, set appropriate priorities for nursing actions, and develop competency as coordinator of care who manages care transitions and is an active participant on the inter-professional team.
  3. Learn new technical skills or protocols relevant to the care of clients and communities.
  4. Communicate effectively with clients and families in a manner sensitive to condition, age, gender, and social and cultural status.
  5. Collaborate with other health care providers in planning, implementing, and evaluating care.
  6. Evaluate one's own practice.
  7. Be self-directed in the use of appropriate resources, including research findings, to solve nursing care problems.
  8. Implement, monitor, and evaluate holistic, patient centered care that reflects an understanding of human growth and development, pharmacology, medical management, and nursing management across the health-illness continuum and across the lifespan.