Attendance in Clinical Residency

Attendance in Clinical Residency

The goal of this program is to develop competent clinical practitioners. To attain that goal, extensive clinical experience in anesthesia administration is required. Clinical rotations are arranged to maximize student experience.

The clinical residencies are structured to give students anesthesia experience five days per week for 18 months. 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. If the student experiences numerous days longer than 10 hours in duration, the student has been instructed to make the clinical coordinator aware of this so their schedule can be adjusted. Logging clinical time as accurately as possible on the Typhon system will help program administrators and clinical coordinators assure that individual or aggregate student time commitment is not excessive.

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 should not exceed 64 hours per week. This time commitment includes the sum of the hours spent in class and all clinical hours averaged over four weeks. Students must have a 10 hour rest period between scheduled clinical duty periods (i.e. assigned continuous clinical hours). At no time may a student provide direct patient care for a period longer than 16 continuous hours… Clinical Hours is defined to include time spent in the actual administration of anesthesia (i.e., anesthesia time) and other time spent in the clinical area. Examples of other clinical time would include in-house call, preanesthesia assessment, postanesthetic assessment, patient preparation, OR preparation, and time spent participating in clinical rounds.”

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. Students are not to utilize anesthesia technicians to prepare their equipment or drugs.

Students should arrive in the clinical area before 6:30 am prepared to start the first case of the day, regardless if the assigned case(s) start later in the day. Surgical schedules are subject to change. After being relieved from the operating room, students must obtain their clinical assignments for the next day (if available) and make pre and postanesthesia 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.

Students are discouraged, although not prevented, from working as nurses during their clinical residency phase. However, they are not permitted to work during the 8 hours prior to the start of their clinical training day. If the coordinator suspects that a student is working prior to anesthesia training, which poses a threat to vigilance and patient safety, the coordinator should discuss it with the student AND report it to the program administrators immediately.

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.

Unexcused Absences (Illnesses) or Tardiness

Students who become ill during their clinical training residencies must notify the clinical site coordinator or his/her designee as soon as possible. Email communication is NOT acceptable. The student is expected to verbally communicate the 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. Leaving messages with ancillary operating room personnel or general nursing supervisors is NOT considered adequate notification and may result in disciplinary action.

If the student expects to be absent for greater than two days due to illness, that student must notify the faculty at RFU 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.

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 will not be tolerated. Clinical coordinators should report tardiness concerns directly to the Anesthesia Department at RFU.