DEPARTMENT OF NURSE ANESTHESIA

Clinical Site Coordinator Manual

THANK YOU!

The Department of Nurse Anesthesia at Rosalind Franklin University of Medicine & Science thanks you for serving as the Clinical Coordinator for our students during the clinical phase of the training program. The partnership we have with our clinical sites is an invaluable one. This manual has been developed to assist you in managing the operations of clinical training for our students. It also outlines policies that we have put in place regarding student activities and performance during their clinical rotations. If you have any questions that are not answered in this manual, do not hesitate to contact the Program Director or Coordinator of Clinical Education. We appreciate you sharing your time and expertise to create an exceptional learning environment for the students.

Nurse Anesthesia Mission & Vision

The mission of the Department of Nurse Anesthesia is to prepare and educate diverse nurse anesthetists to provide high-quality care in a competent, equitable, and ethical manner. Our vision: “Together transforming the future of nurse anesthesia, to advance health with individuals, families, and communities”. The Department of Nurse Anesthesia realizes its mission and vision within a value-driven culture. This culture emphasizes critical thinking and analysis of ideas; commitment to life in discovery; confidence grounded in humility; and personal responsibility for developing excellence.

Nurse Anesthesia Program Directory

Main: 847-578-3436

Fax : 224-538-2325

Anesthesia Department Offices: 847-578-extension*

NAME

TITLE

EMAIL ADDRESS

WORK EXT*

MOBILE PHONE

Aries Hernandez

Administrative Director

Aries.hernandez@rosalindfranklin.edu

*8396

Lori Anderson, CRNA, DNP

Chair, Program Director

Lori.anderson@rosalindfranklin.edu

*8385

815-222-7769

Peter Kallio, CRNA, DNP

Associate Program Director

Peter.kallio@rosalindfranklin.edu

*8578

262-510-3816

Franklin McShane, CRNA, DNP

Associate Professor Director of Simulation for Health Professions

Franklin.mcshane@rosalindfranklin.edu

*8397

920-896-2455

Jennifer Greenwood, CRNA, PhD

Associate Professor, Coordinator of Research & Doctoral Scholarship

Jennifer.greenwood@rosalindfranklin.edu

*8386

847-636-7774

Michael Ledvina, CRNA, DNP

Assistant Professor, Director of Simulation

m.Ledvina@rosalindfranklin.edu

262-893-1693

Kristine Tierney, CRNA, DNP

Assistant Professor, Coordinator of Clinical Education

Kristine.tierney@rosalindfranklin.edu

815-768-5529

Role of a Clinical Preceptor

An effective clinical preceptor is essential to the training of the student registered nurse anesthetist (SRNA). The preceptor role is a collaboration between the clinical faculty member and the SRNA. As a preceptor, you serve as a role model for the student, while also guiding and challenging the SRNA to apply their foundational knowledge in the realm of clinical care. After an introduction to the student, you will develop a professional relationship built upon mutual trust and open communication. Effective feedback, open dialogue, setting clear expectations, and providing consistent guidance in patient management will enhance the student’s growth and the preceptor’s satisfaction. The role of the preceptor in assisting the SRNA in understanding the contextual realities of the foundation anesthesia knowledge is invaluable.

Clinical preceptors are expected to maintain a respectful, ethical and competent anesthesia practice. Constant reflection upon actions taken will further facilitate the learning process and provide deeper meaning for the student to incorporate into his / her own practice. Adult learners have unique characteristics, and they are highly invested in their education. They bring a large volume of past experiences as clinicians and also from the didactic phase of the program. The experiences provided in the clinical phase should be arranged by the preceptor to provide meaningful patient exposures that reinforce the application of the SRNAs knowledge. Through this collaboration the preceptor is instrumental in moving the student from novice to competent anesthesia practitioner.

Several instructional support materials for preceptor development are available through online learning portals and through the RFU main webpage at no cost to our clinical partners. A direct link to the Preceptor Enhancement Program has been provided at the end of this manual.

Clinical Coordinator Description of Duties

1. Assist students as needed with credentialing.

2. Orient each new student at the clinical site (use of the RFU Generic Orientation Checklist is encouraged):

a. provide a physical tour of the anesthetizing areas

b. obtain EMR access for the student

c. obtain medication /Pyxis access for the student

d. facilitate access to the facility, and parking permit as required

e. obtain identification badge (if needed)

3. Communicate essential information about the student to your site’s anesthesia department staff in advance of his/her arrival (as provided by RFU in their pre-rotation packet).

4. Promote student success through effective communication, role modeling, case discussion, and debriefing.

5. Plan and coordinate student’s daily clinical assignments, achievement of rotation objectives, and uniquely identified needs.

6. Act as a clinical preceptor in anesthetizing locations.

7. Identify other appropriate clinical preceptors.

8. Provide clinical preceptor mentorship to the anesthesia team.

9. Help ensure that students receive at least 2 formative evaluations (electronic) each week that clearly describe strengths and areas for improvement.

10. Conduct a summative evaluation (PDF form provided by the program) for each student at the end of the rotation and email to Kristine.tierney@rosalindfranklin.edu or fax the document to the Nurse Anesthesia Department on the last day of the student’s rotation @ 224-538-2325.

11. Communicate with RFU all concerns associated with a student’s clinical performance.

Kristine Tierney, DNP, CRNA, Aries Hernandez

Phone: 815-768-5529 Phone: 847-578-8396

Kristine.Tierney@rosalindfranklin.edu Aries.hernandez@rosalindfranklin.edu

12. Communicate with RFU in a timely manner issues such as accidental risk exposure, suspected substance abuse or emotional instability.

13. Communicate with RFU any clinical site credentialing updates and contact information updates so that we may update our records.

14. Assist in providing documentation needed by the Department of Nurse Anesthesia to maintain or exceed Council on Accreditation of Nurse Anesthesia Educational Program (COA) standards.

15. Review and disseminate aggregate and anonymous evaluation feedback provided by students (via program officials).

16. Complete the online Preceptor Enhancement Program provided by RFU.

*Below are policies from the Department of Nurse Anesthesia Program Handbook, that relate to clinical residency training.

Orientation to Clinical Residency Training

In the quarter prior to the start of the first clinical residency, students will be provided an extensive orientation to clinical residency training. The orientation will include: 1) review of key policies and procedures related to clinical residency training, including clinical supervision requirements and student’s reasonable time commitment; 2) detailed review of the COA Guidelines for Counting Clinical Experiences; 3) training on the Typhon system for logging of clinical experiences; 4) clinical residency objectives and expectations of students throughout their clinical residency; and 5) formative and summative evaluation processes, including required documentation. At the completion of the clinical residency orientation, students will be asked to sign an acknowledgment of their understanding of key requirements.

Each clinical site at which a student rotates will provide a site-specific orientation. The clinical site-specific orientation will include: 1) tour of the facility; 2) assistance in obtaining access to the electronic medical record, pharmacy, or medication dispensing systems; 3) details as to any site-specific expectations of students (anesthesia department processes, work flow); and information regarding parking and ID badge. Sample orientation checklist is included in appendix B and can be customized to fit your department specifics.

Anesthesia Care Plans

The anesthesia care plan is a tool that helps students organize their evaluation of the patient and plan the perioperative anesthesia management for their assigned cases. During the didactic phase of training, students create care plans specific for patients with certain pathologies, with considerations for the patient’s diagnosis(es), history and physical assessment, laboratory results and other pertinent data. During the clinical component of the program, it is an expectation that SRNAs develop a plan for anesthesia care that is specific to patient comorbidities, complexity of the surgical procedure, and other relevant factors pertaining to the patient/procedure.

The clinical coordinator or the clinical preceptor should communicate with the SRNA regarding expectations for these care plans. The SRNA should discuss their anesthetic plan of care with the assigned clinical preceptor.

Appropriate Student Identification in the Clinical Area

All Nurse Anesthesia Residents (NAR) are required to properly identify themselves as such. Failure to identify oneself as a trainee, through omission, also qualifies as improper identification. You are required to sign all clinical documents with your first and last names followed by RN, NAR or SRNA. If evidence exists that you improperly identify yourself as a CRNA, function in any capacity as a CRNA, or fail to properly identify yourself as a Nurse Anesthesia Resident while enrolled at RFU, will cause you to be subject to dismissal from the Nurse Anesthesia program. Alternatively, it is acceptable to identify yourself as a registered nurse (RN) in a graduate nurse anesthesia program, as long as you are clear that you are not a CRNA. The title “Student Registered Nurse Anesthetist” (SRNA) is also acceptable.

Introductions to a patient must also include the following. “I will be working with (name), your anesthesiologist and/or (name), your nurse anesthetist”. You may NOT refer to yourself simply as “part of the anesthesia team,” “I’m with anesthesia,” or “I’m helping with anesthesia.” Using the phrases, “I’m your anesthesia provider,” or “anesthesia staff,” are also unacceptable forms of identification.

Facility ID badges must be worn at all times, worn at chest height, and visible to the patient and staff, unless patient care dictates otherwise. If site specific identification is not provided by an affiliate clinical site, the student will wear their RFU identification badges at all clinical sites.

This is a professional expectation which supports fair and ethical care of patients. It is also an accreditation standard that is non-negotiable. Failure to identify yourself to a patient as a nurse anesthesia resident/student/trainee is grounds for dismissal from the program.

Attendance in Clinical Rotations

A typical clinical day may extend well beyond an 8-hour day. SRNAs are not shift workers, and they are encouraged to stay and finish cases. Therefore, the end of the clinical day occurs when the student’s preceptor says it is over. Logging clinical time as accurately as possible will assist the clinical coordinator in ensuring that the aggregate student time commitment is not excessive.

Clinical Preparation

Students are required to arrive at the clinical site in sufficient time to prepare all necessary drugs and equipment for their assigned clinical experiences. This includes preparation of the anesthesia machine, all airway equipment, drugs, and ancillary equipment necessary for the conduct of the surgical procedure and anesthetic. If additional IVs, regional anesthesia trays, fluid warmers, and invasive monitoring lines are required, they should also be set up by the SRNA.

After being relieved from the operating room, students must obtain their clinical assignments for the next day (if available) and make pre and post-anesthesia rounds. Students should check with the clinical coordinator or his/her designee before going home to ensure that they have been released for the day.

In accordance to the Council on Accreditation’s (COA) definition of reasonable time commitment to ensure patient safety and promote effective student learning, student time commitment at the clinical site should not exceed 64 hours per week, as determined by the average clinical hour commitment over a four-week period. Students must have a 10-hour rest period between scheduled clinical duty periods (i.e. assigned continuous clinical hours). And at no time may a student provide direct patient care for a period longer than 16 continuous hours. Clinical hours are defined as time spent in the actual administration of anesthesia (i.e., anesthesia time) and other time spent in the clinical area.

Absences or Tardiness for Assigned Clinical Shifts

Students who become ill, or must be absent during clinical residency training must notify the clinical site coordinator or his/her designee as soon as possible. Email communication is NOT acceptable. You must verbally communicate your absence by 6:00 am on the morning of the absence. The SRNA should make a concerted effort to speak with the clinical coordinator directly. If the clinical coordinator cannot be reached, the SRNA should speak directly with a staff member in the anesthesia department (the on-call anesthesiologist or CRNA), and also leave a message for the clinical coordinator. Not following the clinical site-specific call-in procedure, or leaving messages with ancillary operating room personnel or general nursing supervisors is NOT considered adequate notification and may result in disciplinary action.

Once the site has been notified, the student should also notify the Administrative Assistant in the Nurse Anesthesia Department at RFU by email. If the student expects to be absent for greater than two days due to illness, that student must notify the Department and the clinical site with an expected return date. The Department reserves the right to ask for a physician’s note and documentation of illness and missed time for any absences of 3 consecutive days or more.

Absence during the clinical portion of the program will be counted against your allowable personal days for time off. This is to ensure that students obtain adequate anesthesia experience, anesthesia time, and anesthesia case experiences to achieve successful program completion within the allotted time frame. Absences that exceed allowable personal days off, due to illness or any other reason, must be made up after the scheduled end of clinical residency training.

Habitual tardiness that impacts the student’s ability to adequately prepare for cases, conduct a thorough patient interview, and present the case to their preceptor may be grounds for disciplinary actions up to and including dismissal from the program. Clinical coordinators have been instructed to report tardiness concerns directly to the Department of Nurse Anesthesia.

Clinical Conferences

Students are expected to attend conferences, in-services and meetings at the clinical facility to which they are assigned. If the institution holds an early morning conference, students should allow sufficient time to prepare for the day’s cases prior to the conference.

Daily Clinical Assignments

Daily clinical assignments may be obtained the day before the scheduled clinical experience, when applicable, so that the student will have adequate time to prepare for the cases. Preparation includes the review of any anesthesia-related history, laboratory and other diagnostic findings, and available physical examinations. Access to electronic health records is provided at most of the clinical sites to facilitate this process. Students are expected to prepare care plans specific to their patients and review them with their preceptors prior to the administration of the anesthetic.

Students will be assigned cases of increasing complexity, given their level of training and competence. Students eventually have the opportunity to administer all types of anesthesia to patients across the life span with a wide range of pathophysiology undergoing surgical procedures in all specialties.

Call Experience

Call experiences (experiences outside of the regular operating room schedule) provide rich clinical opportunities to provide emergency airway services, anesthesia services for obstetrical labor analgesia, and anesthesia for emergent surgical cases. Call schedules will vary with clinical sites, and may entail shifts longer than 8 hours, staggered shift hours (e.g., 11 am – 9 pm), overnight in-house or from-home call, including weekends. Regardless, of the call schedule, clinical hours must be consistent with COA rest period guidelines. When the student is on call, the nurse anesthetist or anesthesiologist on call must also be present during the call.

Professionalism in Clinical Residency

Your entry into the ranks of the profession of nurse anesthesia confers many privileges that are accompanied by significant responsibilities. You should project your best image to the clinical partners as well as to the patients. You are entering and representing the oldest and most respected advanced practice nursing specialty, and your goal should be to honor and advance this distinguished profession. The criteria for promoting professionalism include, but are not limited to:

● Appearance and attire that is appropriate for the place and situation as defined by the clinical or didactic faculty

● Appropriate ethical behavior in all situations

● Demonstration of appropriate communication skills, including maintaining comprehensive, timely, accurate, and legible healthcare records

● Completion of assignments and tasks in a timely manner

● Transfer of the responsibility for the care of a patient to another qualified healthcare provider in a manner that assures continuity or care and patient safety

● Overall attitude that demonstrates interest in learning and willingness to actively engage in learning activities

● Evidence of consistent and thorough preparation for clinical responsibilities

● Respectful and appropriate interactions with all lecturers, faculty, staff, clinical preceptors and fellow students

● Physical appearance that conveys a professional demeanor (no facial piercings, no visible tattoos, business casual attire)

● Adherence to rules regarding jewelry, watches, fingernail polish, and other accessories as described by the clinical sites

● Adherence to all institutional policies and procedures, including those associated with performance improvement, risk management, infection control, and the administration of controlled substances (failure to properly adhere to documentation of controlled substances, may result in adverse action including receiving a grade of “F” (failure) for a clinical rotation, and/or other serious adverse action that may be taken by a clinical affiliate institution)

Department of Nurse Anesthesia Code of Conduct

With input from both students and faculty, the following guidelines were established to form a “Code of Conduct” for members of the RFU Nurse Anesthesia community:

· Define how YOU will display professionalism--it must include behaviors in both didactic and the clinical arena

· You never get a second chance to make a great first impression -- be mindful about what you say to students outside of our program because it could set the tone for how they view our profession as nurses and CRNAs in the future.

· Stay positive.

· Be inclusive: Competition between classmates is not acceptable.

· Be open, honest, and considerate when dealing with classmates.

· Do not harass: Harassment includes (but not limited to) mockery or defaming comments to classmates or faculty about another classmate, and/or comments based on religion, race, sex, socioeconomic status, academic status, or disability.

· Competition is only with self--not with your other teammates.

· Be kind to each other. You all will be together for 36 months. Being kind to each other can greatly decrease the stress of the program.

· Be humble. All of you are the best of the best. Understand that anesthesia school is a new journey, requiring a new set of skills.

Confidentiality

Patient information should remain confidential at all times. Patient information should only be discussed in the anesthetizing areas with appropriate members of the anesthesia or surgical team who are responsible for impacting delivery of care to that patient. Only access electronic health information of patients for which you are personally involved in providing care.

NO photos should be taken of the patient, under any circumstances. NO COMMENTS SHOULD BE POSTED ON SOCIAL MEDIA SITES REGARDING YOUR CLINICAL EXPERIENCES. Often innocently intended comments create unforeseen complications that negatively affect the relationship between the clinical site, the university, and our program.

Additionally, students must be in full compliance with the HIPPA policies of the clinical training sites at all times.

Supervision in the Clinical Setting

As required by the Council on Accreditation, standards F-5 and F-7, only CRNAs and/or physician anesthesiologists who are institutionally credentialed to practice by the clinical affiliate site may supervise SRNAs. Physician residents, senior nurse anesthesia students or anesthesiologist assistants (AA) are NOT considered qualified personnel to supervise SRNAs. Appropriate supervising individuals must be immediately available in the clinical area at all times. The intensity of clinical supervision must take into consideration the student’s knowledge, ability, and experience; as well as the physical status of the patient and complexity of the case. The ratio of clinical supervisor (CRNA or MD) to student nurse anesthetist shall not exceed 1:2 at any time. Under no circumstances is a SRNA permitted to initiate any type of anesthetic without the presence of appropriate supervising personnel. This policy applies to all areas in which anesthetic services are rendered by SRNAs. Clinical supervision IN NON-ANESTHETIZING AREAS is restricted to credentialed experts who are authorized to assume responsibility for the SRNA (i.e. hospitalist or intensivist credentialed to perform central line insertion supervises an SRNA placing a central line in the intensive care unit). Failure of students to adhere to this supervision policy may result in failure of the clinical course and dismissal from the program.

Credentialing of SRNAs

SRNAs assume responsibility for credentialing with each clinical site. Specific and detailed information regarding the credentialing process for each site can be found in the D2L course CSC 504 Student Clinical Site Information. Credentialing should be initiated with the clinical site at least 60 days prior to the start of each scheduled clinical rotation. Failure to receive approval to begin a clinical rotation as a result of credentialing delays, due to the actions or inaction of the resident, will result in a possible postponement of that rotation and subsequent extension of the clinical residency.

Students should ensure that their credentialing, licensing, immunization, drug screens and background check materials in the CastleBranch and MedProctor systems are always up to date. It is the responsibility of the student to maintain these records and compliance with state licensing renewals.

Each site will receive relevant student information in the form of a pre-rotation packet. This information includes a student photograph, professional work history, and current stage of nurse anesthesia training. In addition to the credentialing process started 60 days ahead of the rotation, the students must initiate contact with the clinical site coordinator at least one week prior to the start of their clinical rotation via email. Contact information for each clinical site coordinator is posted in course CSC 504.

Clinical Evaluation Process

The nurse anesthesia program has an overall evaluation plan that is essential for assessment of competency and ongoing quality improvement. Elements of this plan include formative clinical evaluations of students by their clinical preceptors; summative evaluations by the clinical coordinator or his/her designee; student evaluations of their clinical preceptors; and student evaluations of the clinical sites. Students are expected to receive 2 formative evaluations per week during their clinical rotations; as soon as they are completed, all formative evaluations are routed (via email) to the assigned faculty mentor. If a student should experience difficulty in obtaining 2 evaluations per week (lack of response from clinical preceptors), they must notify their faculty mentor by email. Student feedback about clinical sites or clinical preceptors will not be shared unless anonymity can be guaranteed.

Between 0-6 months of clinical training, students are expected to receive (for the majority of performance indicators) minimum evaluation ratings of Novice or Advanced Beginner; at 6-13 months minimum expected ratings are Advanced Beginner or Competent; and between months 14-18 of clinical residency, students are expected to receive ratings of Competent or Proficient. Descriptions for these ratings, and the minimum expected evaluation ratings, are included on the summative evaluation tool.

Formative evaluations are summarized at the end of each clinical residency into summative evaluations, which are reviewed with the students by a member of the program faculty. Students will also participate in an advising session with the program faculty at the end of each rotation when the formative tools and summative evaluation are reviewed. The student will be given an opportunity to make comments on the advising form if they disagree with the summative assessment of their performance. Faculty will review and discuss all rating of “Safety Concern” with the involved student (and preceptor as indicated), with any resulting action based on the findings of that review.

It is possible to meet the expectations of the clinical rotation but have identified issues, either professional or knowledge-based, that can jeopardize clinical progression. Consistent concerns related to professionalism or foundational knowledge documented on formative evaluations by multiple preceptors can trigger a meeting to review student performance. These patterns of evidence may trigger a focused clinical evaluation and remediation plan.

Mentoring and Student Advising During Clinical Residency Training

Students are assigned a faculty mentor upon matriculation to the program. Mentor assignments may be modified at the start of clinical residency training (based on Doctoral Project Advisor assignments), but all students will have an assigned faculty mentor during clinical residency training. In addition to ongoing communication with the faculty mentor and project advisor (many times the same faculty member), students will generally meet with a faculty member during the monthly return to campus events (or no less than once per quarter) to discuss clinical performance, clinical case records, formative evaluations, summative evaluations, any concerns of mistreatment, and the status of their doctoral project work. These advising interactions are documented on the Clinical Advising Form.

Exposure Incidents

Students may encounter risk of exposure incidents to potential hazards during didactic and clinical training (including chemical, radiation and infectious hazards). As there is no way to eliminate these risks, students are expected to use standard precautions at all times while in patient care areas and implement all reasonable and expected risk reduction behaviors whenever entering any patient care environment. Students are expected to know, and adhere to, each clinical facility and anesthesiology department’s established processes for infection control and prevention strategies, reporting, communicable disease exposure responses, performance improvement and risk management. If a student is accidentally exposed to a known or potential biohazard via needle stick, punctures, or other routes of exposure, the student should follow the policy defined by the individual facility and by RFU policies and procedures in dealing with this matter. As part of these processes, all such students must complete and submit the “Accidental Exposure Form-Nurse Anesthesia” (located in the D2L repository for CSC 504 Student Clinical Site Information)—and complete related actions including: 1) immediately notify the Clinical Site CRNA Coordinator, or supervising clinical faculty; 2) within 24 hours, notify Student Affairs and the Department of Nurse Anesthesia; and 3) for COVID illness or exposure, follow the established RFU process for reporting/care.

Liability Insurance

RFUMS provides malpractice insurance coverage for trainees’ activities in its education programs at standard industry coverage limits. The RFUMS Office of Insurance Services manages all verifications related to a student’s claims history and proof of group insurance coverage. Proof of coverage is provided to clinical sites on a yearly basis when the policy is renewed.

Critical Clinical Incident Reporting

Nurse Anesthesia Residents participating in the care of patients during clinical residency training, are required to report any adverse patient events using the Department of Nurse Anesthesia “Incident Report Form”. The form can be located in the D2L course repository of CSC 504 Student Clinical Site Information.

Preceptor Resources

Preceptor Enhancement Program

This program has been developed as an interdisciplinary educational tool to help

clinicians become better teachers. Please feel free to share this link with any interested parties.

The content has been approved by the AANA for Class A credit. It has also been approved by

the regulating bodies of the AMA, Podiatry, PA, Pharmacy and PT.

https://www.rosalindfranklin.edu/preceptor-enhancement-program/

Preceptor Resources

https://www.rosalindfranklin.edu/academics/college-of-health-professions/degree-programs/doctor-of-nursing-practice-entry-dnp/preceptor-resources/

Appendix A. Position Descriptions

POSITION DESCRIPTION

CLINICAL COORDINATOR

Position Title: Clinical Faculty- Clinical Coordinator

Description: A Certified Registered Nurse Anesthetist or Physician Anesthesiologist who coordinates the clinical education of RFU Nurse Anesthesia residents.

Qualifications:

1. CRNAs must maintain Registered Nurse and Advanced Practice Nurse Licensure (as required by law) by the state-specific Board of Nursing. Physician Anesthesiologists must maintain medical licensure with the state Medical Board.

2. Currently credentialed with privileges to practice at the facility.

3. Preferred minimum of 1 year of experience as a CRNA or a Physician Anesthesiologist.

4. Currently active in clinical anesthesia practice.

5. Managerial skills and experience necessary to coordinate student clinical activities.

6. Analytical skills necessary to plan, prioritize, and direct appropriate activities within the department.

7. Effective interpersonal and leadership skills necessary to foster productive working relationships.

8. Effective oral and written communication skills.

Position Summary:

1. Assists the nurse anesthesia faculty in the coordination of clinical education of students enrolled in the Nurse Anesthesia Program.

2. Develops and communicates clinical schedules for SRNAs.

3. Directs and participates in the education of SRNAs.

4. Continually maintains communication regarding student education issues with Nurse Anesthesia faculty.

5. Oversees the quality of education SRNAs are receiving in the clinical area.

6. Responsible for communicating student issues with clinical preceptors at site and with nurse anesthesia faculty.

7. Maintains SRNA confidentiality at all times.

Position Responsibilities:

1. Coordination of the anesthesia case assignments of each nurse anesthesia resident in order to:

a. Maximize the student’s clinical experience.

b. Facilitate the student’s learning in a progressive manner.

c. Promote and facilitate participation in cases that will allow the nurse anesthesia resident to obtain the required number of clinical experiences for graduation.

2. Provides (self or designee) each SRNA an orientation to the clinical site either prior to, or upon arrival, that details role expectations and responsibilities and identifies available learning resources.

3. Ensures that each SRNA has an immediately available CRNA or Physician Anesthesiologist supervisor for each of the cases in which they participate.

4. Ensures that SRNAs are ONLY supervised by a CRNA or Physician Anesthesiologist and that supervision never exceeds a ratio of 2:1 student to preceptor.

5. Maintaining the quality and standard of anesthesia care of SRNAs by:

a. Discharging or removing the resident from the clinical area should the student fail to demonstrate patient safety, appropriate care plans, inadequate knowledge, and/or lack of professional behavior.

b. Evaluating the SRNAs clinical performance for competency and reporting to Nurse Anesthesia faculty any patterns of difficulty in the learner’s ability to achieve objectives.

8. Assists and directs the SRNA and/or clinical Preceptor.

9. Promotes and demonstrates skills among the other preceptors that exemplify appropriate feedback and follow up.

10. Ensures that resident time commitment consists of a reasonable number of hours and does not exceed 64 hours per week averaged over a two-week period.

POSITION DESCRIPTION

SRNA ADVOCATE

Position Title: Clinical Faculty- SRNA Advocate

Description: A Certified Registered Nurse Anesthetist or Physician Anesthesiologist who advocates for the fair and equitable treatment and wellbeing of SRNAs enrolled in the Nurse Anesthesia program during their clinical training at a facility. Promotes a positive, inclusive learning environment.

Qualifications:

1. CRNAs must maintain Registered Nurse and Advanced Practice Nurse Licensure (as required by law) by the state-specific Board of Nursing. Physician Anesthesiologists must maintain medical licensure with the state Medical Board.

2. Currently credentialed with privileges to practice at the facility.

3. Preferred minimum of 1 year of experience as a CRNA or Physician Anesthesiologist.

4. Currently active in clinical anesthesia practice and acts as a preceptor.

5. Effective interpersonal and leadership skills necessary to foster positive working relationships.

6. Effective oral and written communication skills.

Position Summary:

1. Possesses an understand of the unique culture of the clinical training site.

2. Has knowledge of the impact of the clinical training environment on a SRNAs ability to thrive and be successful.

3. Aware of the psychological effects of the stress involved as a trainee in anesthesia, and can act as an advocate for SRNAs.

4. Maintains an open line of communication between RFU faculty in regard to student issues or struggles.

5. Always maintains student confidentiality.

POSITION DESCRIPTION

CLINICAL PRECEPTOR

Position Title: Clinical Faculty- Clinical Preceptor

Description: A Certified Registered Nurse Anesthetist or Physician Anesthesiologist who supervises the student nurse anesthetist during the administration of anesthesia.

Qualifications:

1. CRNAs must maintain Registered Nurse and Advanced Practice Nurse Licensure (as required by law) by the state-specific Board of Nursing. Physician anesthesiologists must maintain medical licensure with the state Medical Board.

2. Currently credentialed with privileges to practice at the facility.

3. Participate in continuing education/faculty development activities, which enhance their role as educators.

4. Demonstrate competency in their area of responsibility and be knowledgeable in the teaching / learning process.

Position summary and responsibilities:

1. Supervises the SRNA during the administration of anesthesia.

2. Discusses the patient’s status and rationale for the anesthetic management with the SRNA to facilitate clinical comprehension.

3. Evaluates the student’s clinical performance, and constructively discusses this performance with the student and faculty of the Nurse Anesthesia Program.

4. Teaches by discussion and by demonstration.

5. Informs the Clinical Coordinator and RFU Faculty of pertinent student performance deficiencies through the provided electronic evaluation form utilizing specific objective information.

6. Supervises the SRNA in the immediate post-operative care and evaluation of the patient.

7. Encourages the SRNA to ask questions and think critically.

8. Discharges the resident from the clinical area should the student demonstrate behaviors inconsistent with safe patient care, insufficient preparation for assigned cases, and/or lack of professional behavior.

9. Always maintains student confidentiality. Limited to discussions between the SRNA, the site clinical coordinator, and the program when necessary.

Appendix B. Sample Clinical Site Orientation Checklist

Clinical Site: ____________________________

Clinical Facility:

 Parking

 Locker Rooms

 Scrub Access- badge needed?

 ID Badge

 Medication Access

o Pyxis access or

pharmacy supplied

 Codes to Supply Rooms

Anesthesia Department:

 Introduction to key personnel

 Contact information exchanged (cell phone #s, email, etc.)

 Office

 Process for reconciliation of controlled substances reviewed.

 Requirements for supervision established.

 Departmental polices/procedures reviewed or location where to find

 Expectations or case/OR set-up discussed, what supplies are ok/not ok to open, drugs diluted, etc.

 Schedule: when available how to obtain assignment

 Documentation and record keeping

o Expectations and how to perform pre-anesthetic evaluation documentation.

o How to perform intra-op charting

o Expectations and how to write post-op notes/orders

o Billing procedures discussed

Equipment

 Anesthesia machines

 Monitors, IV pumps, warmers and tubing

 Travel cart/offsite equipment

 OB equipment/carts

 Peds cart/Difficult Airway equipment

 Ultrasound

 Arterial line equipment/central line equipment

 BIS/Cerebral ox/ syringe pumps/ IV infusion pumps

 MH Cart

 Crash Carts

Student:

 Verification of SRNA’s level in the program, typhon numbers, case access

 Process for case discussions with preceptor (evening prior; email, text, or day of discussion)

 Call-in/off procedure reviewed

 Expectations regarding evaluations

 Goals for rotation reviewed

SRNA Signature:

____________________________

Coordinator Signature:

____________________________

Date_____________________