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Law, Regulation and Ethics: Do’s and Don’ts of Clinical Rotations
Charlette Nimmo Ridout, R.N., M.S., CNE Senior Nursing Education Consultant
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Objective Discuss the purpose of the Board of Nursing
Compare law, regulation and ethics Review Board of Nursing website Review regulations directly related to clinical learning experiences Review regulations regarding unprofessional conduct
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The Board of Nursing “Our mission is to ensure safe and competent patient care by licensing health professionals, enforcing standards of practice, and providing information to health care practitioners and the public.” Who makes up the Board of Nursing? What does the Board of Nursing do?
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Laws, Regulations and Ethics
External Rules Consistent Ethics Internal Personal values and beliefs Individualized
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Laws and Regulations
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Regulation Regulations Governing the Practice of Nursing
Regulations For Nursing Education Programs
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18VAC90-27-60 Faculty Licensure requirement, 2 years experience as RN
Provide evidence of education or experience in the specialty area in which faculty supervise students Clinical orientation to the site in which supervision is being provided 1:10 faculty to student ratio; 1:15 faulty to student ratio when students are participating in preceptor experience
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18VAC Curriculum Supervised clinical experiences related to health attainment, maintenance and prevention of illness, throughout the life cycle, in a variety of settings Nursing fundamentals, adult medical surgical, geriatric, maternal/ infant, mental health, pediatric nursing Development of professional socialization and working in interdisciplinary teams
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18VAC Curriculum Use of critical judgment in the implementation of safe client care Care of clients with multiple, chronic conditions Development of management and supervisor skills Medication administration and documentation of client care Participation in quality improvement, systems to measure client outcomes Supervision of certified nurse aides, registered medication aides and unlicensed assistive personnel
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18VAC90-27-100 Curriculum for direct client care
Practical nursing programs must complete 400 hours of direct client care supervised by qualified faculty Observation experiences do not count towards the 400 hours- Refer to Guidance Document 90-21 Simulation for direct client care hours 25% of 400 hours no more than 50% of any one clinical type of experience Nursing fundamentals, adult medical surgical, geriatric, maternal/ infant, mental health, pediatric nursing
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18VAC90-27-110 Clinical practice of students
Students are responsible and accountable Faculty are responsible for ensuring students perform only skills or services for which instruction has occurred and have been found proficient Preceptors can be used to augment and enhance clinical experiences
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Regulations Governing the Practice of Nursing
18VAC Disciplinary provisions Unprofessional conduct Practicing beyond limits, delegating to unlicensed persons in violation of provisions allowed for in regulation Assuming duties and responsibilities without adequate training Employing or assigning unqualified persons to performs functions of licensed nurse Falsifying or otherwise altering patient, employer, student or educational program records including falsely representing facts
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18VAC90-19-230 Disciplinary provisions
Entering into a relationship with a patient or client that constitutes a professional boundaries violation Violating state laws regarding patient information Obtaining supplies, equipment or drugs for personal use Giving to or accepting from a patient or client property or money for any reason other than a nominal token of appreciation Providing false information to staff or board members in course of proceeding or investigation
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Guidance Documents 90-21, Clinical Learning Experience in Nursing Education Programs, revised February 24, 2017 90-24, The Use of Simulation in Nursing Education, Accepted July 21, 2009, Reaffirmed March 19, 2013
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Do…. Know the regulations
Offer clinical learning experiences where students have the opportunity to develop clinical reasoning Give students opportunity to apply theory to practice Ensure that students have clinical learning experiences in a variety of settings across the life span Link the clinical learning experiences to clinical course objectives Ensure each student completes the required hours
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DO…. Ensure that faculty meet qualifications and are experienced in the area where they are teaching clinical Inform students they are responsible for their actions in clinical Offer frequent formative evaluations Talk with your community stakeholders Comply with the required faculty to student ratio Remember clinical learning is more than skills
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DO….. Maintain overall coordination of preceptorships
Maintain current skills checklist Remain current in practice and role as nursing educator Create an environment of respect with student Contact the Board with any questions Maintain professional conduct
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DO NOT….. Accept an assignment you are not comfortable with
Assign faculty to clinical area unless they have the necessary education or experience Have a clinical learning experience just to meet the hours Cross professional boundaries with patients or student Falsify or “stretch the truth”
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DO…… DO NOT…… Be open minded to new ideas and think outside the box. Do it that way because “it is the way we have always done it”.
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