CNA Handbook: Clinical Policies

Clinical Assignments/Facilities

Clinical instruction is provided throughout the program in conjunction with classroom theory. This instruction is provided in various locations, such as on campus, at local hospitals, long-term care facilities, and other community facilities.

Because of limited clinical placements, it is not possible to assign a student specific clinical time or locations due to work assignments. Students should therefore not schedule a work assignment on a clinical day.

Students may be assigned to day or evening clinical rotations, both during the week and on weekends.

Clinical Policies

  1. The clinical laboratory session is a learning opportunity where the student is expected to utilize all resources to extend the learning experience.
  2. As opportunity permits, clinical instructors facilitate student responsibility for learning, encouraging, or requiring such activities as student participation in the selection of learning experiences, sharing of personal learning goals, keeping a record of skills and evaluation of one’s own clinical performance.
  3. The instructor’s "anecdotal notes" relating to an individual student are available to that student in the nursing instructor’s office. Each instructor destroys anecdotal notes at the end of each semester after all "clinical evaluation" conferences are completed and grades are posted.
  4. Individual instructors, prior to each clinical rotation, give specific instructions regarding preparation for scheduled clinical lab sessions.
  5. The clinical laboratory experience may begin with a pre-conference. During the pre-conference, general instructions may be given and the student is assisted to plan or meet individual client needs.
  6. Clinical sessions may conclude with a post-conference, during which time is usually spent sharing learning experiences. Such sharing is part of developing professional communication skills.
  7. Students are expected to perform safely in all areas of client care. Any performance, which endangers a client's well being, may result in the student’s removal from the clinical.
  8. Students will be expected to function according to stated hospital policies in relation to parking, use of cafeteria, nursing assistant scope of practice, uniform requirements and routines established for the nursing unit.
  9. Students are evaluated weekly during the clinical rotation. Clinical checklists are utilized to ensure that skills can be demonstrated and then practiced several times. If performance is unsatisfactory, comments will be noted and student will be counseled and contacted and required to sign the performance evaluation. Signing does not imply concurrence with the evaluation. It is the student’s responsibility to be aware of the clinical objectives and behaviors to be evaluated. Students are encouraged to schedule appointments with their instructors, as needed, to discuss their progress in the program. All faculty are available to assist students.
  10. Unsafe behavior: At the discretion of the instructor, any student who does not perform CNA duties safely, in accordance with what may be considered unsafe and excluded from the clinical area. A student permanently excluded from the clinical site because of unsafe behavior shall fail the course, or may withdraw, in accordance with college policy.
  11. Accident or emergency regulations: It is the student’s responsibility to know what the appropriate policies and regulations are regarding each clinical site for handling of accidents, emergency situations, and fire regulations during the period of rotation at each site.
  12. Reporting of incidents and/or injury: If a student is involved in an incident with a resident/patient, the appropriate TMCC Accident/Exposure/Incident/Injury report form(s) must be completed immediately. Incident reports must also be completed according to each agency’s policy. Specific TMCC forms are available on the CNA Program website; forms are also available in the CNA Program office. If the student incurs an injury, the appropriate Accident/Exposure/Incident/Injury report form(s) must be completed immediately with the clinical instructor and agency. Students should be aware that some facilities require immediate drug screening. See medical care per personal insurance coverage.
  13. Phone calls: Students are not to use telephones on the units to make or receive personal phone calls. If a student needs to be located regarding an emergency please call 775-673-7117. The CNA staff will then notify the clinical instructor who will find you. Contact clinical instructor as directed. Individual faculty will provide specific information.
  14. Reporting Suspected Child or Elder Abuse: Nevada Revised Statutes (NRS) 432B.220 and NRS 200.5091 require a student to report suspected child or elder abuse or neglect to the clinical instructor. According to the statute, this includes physical or mental injury of a non-accidental nature, sexual abuse or exploitation, or negligent treatment or maltreatment. Anyone who fails to report these conditions is guilty of a misdemeanor, as indicated in NRS 432B.240 and NRS 200.5099.
  15. Reporting of problems during clinical:
    1. Students noting patient or staff problems during clinical should inform their clinical instructor immediately.
    2. The instructor will evaluate the behavior or problem against the criteria for Unprofessional Behavior before reporting to the Nevada State Board of Nursing (NSBN).
      • Generally the criteria are: gross negligence, abuse or performing duties outside the scope of practice.
      • Each clinical instructor is responsible for reporting unprofessional behavior directly to the CNA Coordinator.
      • If the incident should be reported to the CNA Coordinator, this should be discussed with the CNA Coordinator, who will evaluate it with the facility site representative, and report it if necessary.
    3. If the incident needs to be addressed, the student should:
      • Ask the staff diplomatically OR
      • Question the staff to help understand the behavior or action OR
      • Report the incident to the clinical instructor who will follow up with facility staff if necessary.
      • The student should always be prepared to state or write what they would do differently in the same circumstance and provide a rationale.
    4. The clinical instructor’s role is to manage the event for a good outcome for the student, the facility staff and the facility.
    5. Global or system issues should be discussed with the facility and the CNA Coordinator.