You remember the nurse—perhaps it was many nurses—who guided your learning as a student. Sometimes an instructor, sometimes a preceptor or someone else, they were there, watching over your practice to ensure you provided safe, competent care to your clients.
Supporting and supervising nursing students is a professional responsibility. The supervision process is made up of four interrelated parts. Communication is key to the success of the process.
You need to reasonably know the competence of the student you are working with
before proceeding. This information can come from their education program, a clinical instructor, a skills checklist, an outline of activities taught and observed to date, and by talking directly to the student. The student may have learned a skill but not had enough practice to feel comfortable performing the skill. Or they might not have recent experience with the skill. You can only supervise a student according to your own scope of practice and individual competence. This is important when you are a different nursing designation than the student.
Depending on the student's level of competence, you authorize client care activities you expect the student can safely perform. Talk with the student about what activities they will do, with which clients, and where they need support.
At times you will identify an activity that the student may perform that requires you to be physically present or in frequent contact with the student. Or perhaps the activity would benefit from oversight by another health professional (e.g., another nurse, social worker). This is called "setting a condition" for the activity. This part of the process requires communication between you and the student, and with whoever will oversee the student while they perform the activity.
At all times consider risks to the client and take steps to ensure safe care. This could include checking with the student to see if care went as planned, as well as evaluation of the client's experience.
Karyn is an RN working in Home and Community Care. She is assigned a student, Rick, who is taking his third year community psychiatric nursing course.
Karyn talks to Rick about his knowledge and skills gained in the nursing program so far. She reviews his course outline and the skills checklist signed off by his instructors. Karyn has had students before and knows that this information will help her identify appropriate clients and care activities. She asks Rick about what skills he feels he needs more experience with to assess when it will be important for her to review a procedure with him or to directly observe his performance. There may also be opportunities for Rick to go with another nurse to practice his skills.
Together they work out a plan for the first week together, with Karyn planning for close supervision and observation of Rick's performance of activities. If the week goes well, she will consider sending Rick out with Sara, an LPN, to provide care to the more stable clients. Sara will oversee the care Rick provides and report back to Karyn.
Karyn knows that as the supervising RN, she decides which activities to authorize Rick to perform; and that by asking Sara to oversee a portion of Rick's practice, she is setting a condition for performance of the care. She needs to talk to Sara about what is expected.
At all times Karyn monitors the outcomes of care and is responsible to intervene or to change the plan as needed to ensure client safety.
Regulatory supervision is a process by a BCCNP registrant for a nursing student's clinical rotation
activities; you are not responsible for the student. Regulatory supervision responsibilities include:
Both the supervising nurse and the student are responsible and accountable for their own decisions and actions. Students also practice within the policies and expectations set by their education program and rotation organization.
If a student is an employed student registrant (ESR), only RNs or RPNs can provide regulatory supervision for these student activities. Students in an ESR role must also meet the principles of the Employed Student Registrant practice standard.You'll find more information about your responsibilities in the Regulatory Supervision of Students practice standard.
Along with your teaching responsibilities, you are responsible for regulatory supervision of those students during clinical rotations. Regulatory supervision includes:
You may share this responsibility with other nurses at the clinical location. Discuss the supervision process with the nurses and decide who will be responsible for what and how others might be involved. For instance, you may decide to set a condition that the students check with a nurse before performing an activity. Communicate the supervision process and practice expectations to each student and all staff.
The Regulatory Supervision of Students practice standard can provide more information about your responsibilities.
Your first responsibility is ensuring client safety. Take the necessary actions to manage client outcomes and get assistance as needed.
When providing regulatory supervision, you're responsible and accountable for using your professional judgment when authorizing student activities. This includes minimizing risks to the client by planning for situations you can reasonably expect might occur. You're not responsible or accountable for situations you could not reasonably foresee.
Organizations are responsible for providing workplace resources for nurses to meet standards. You are responsible for following your organization's policies and practicing to
BCCNP Standards of Practice.
You'll find more information about your responsibilities in the Regulatory Supervision of Students practice standard.
If you can reasonably anticipate that an activity could have an impact on a client, the activity is subject to regulatory supervision if performed by a student. The amount and type of supervision needed requires professional judgment and depends on the student, activity and risk to the client.
You'll find more information about regulatory supervision in the Regulatory Supervision of Students practice standard.
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