SRJC Course Outlines

5/27/2022 7:51:09 AMNRV 53L Course Outline as of Spring 2004

Changed Course

Discipline and Nbr:  NRV 53LTitle:  ADVANCED CLINICAL  
Full Title:  Advanced Vocational Nursing Clinical
Last Reviewed:10/13/2014

UnitsCourse Hours per Week Nbr of WeeksCourse Hours Total
Maximum6.50Lecture Scheduled017.5 max.Lecture Scheduled0
Minimum6.50Lab Scheduled017.5 min.Lab Scheduled0
 Contact DHR19.50 Contact DHR341.25
 Contact Total19.50 Contact Total341.25
 Non-contact DHR0 Non-contact DHR Total0

 Total Out of Class Hours:  0.00Total Student Learning Hours: 341.25 

Title 5 Category:  AA Degree Applicable
Grading:  P/NP Only
Repeatability:  00 - Two Repeats if Grade was D, F, NC, or NP
Also Listed As: 

Catalog Description:
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This is the advanced level clinical course for the full time vocational nursing program which includes a 120 hour preceptorship component in the final six weeks of the semester. The course prepares students to make the transition from student vocational nurse to entry-level practice. The principles learned in prerequisite and corequisite theory and skills level courses are applied to care of patients in acute, home care and skilled nursing settings with a team leadership component. Students are challenged with more complicated and unstable clients in a variety of settings. There is a community health focus which includes visits and reports on agencies in our community that can be used for referrals from a variety of settings

Course Completion of NRV 52.1L ( or NRV 52AL) and Concurrent Enrollment in NRV 53 and Concurrent Enrollment in NRV 58C

Recommended Preparation:

Limits on Enrollment:

Schedule of Classes Information
Description: Untitled document
Advanced level VN clinical course. Application of principles from the prerequisite and corequisite theory and skills courses. Care of complex and unstable patients. Team leading in skilled nursing component and a community health focus including home care and other agencies. The course ends in a preceptorship component to emphasis entry level expectations.
(P/NP Only)

Prerequisites:Course Completion of NRV 52.1L ( or NRV 52AL) and Concurrent Enrollment in NRV 53 and Concurrent Enrollment in NRV 58C
Limits on Enrollment:
Transfer Credit:CSU;
Repeatability:00 - Two Repeats if Grade was D, F, NC, or NP


Associate Degree:Effective:Inactive:
CSU GE:Transfer Area Effective:Inactive:
IGETC:Transfer Area Effective:Inactive:
CSU Transfer:TransferableEffective:Fall 1981Inactive:Fall 2021
UC Transfer:Effective:Inactive:

Certificate/Major Applicable: Certificate Applicable Course


Outcomes and Objectives:
Upon completion of the course, students will be able to:
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Under the following clinical learning conditions:
a. Students are minimally supervised and perform most tasks independently.
b. Support is provided by instructor and resource nurses (preceptors) but
less than in intermediate courses.
c. Students assume judgments related to care.
d. Principles from prerequisite and corequisite courses are applied.
e. Students practice advanced skills while maintaining fundamental and
intermediate skills previously taught.
Upon completion of this course, students will be able to:
1. Apply theoretical knowledge bases including physiological, pathophysio-
logical, psychological, spiritual and social concepts in providing care.
2. Analyze patient scenarios encompassing a broader view with more
complicated patient assignments.
3. Assess environmental hazards in the home, skilled nursing and acute
care settings and develop prevention strategies.
4. Critique care given relative to cultural sensitivity, therapeutic
communication and appropriateness of spiritual care.
5. Utilize the entire nursing process to implement care in a manner of
efficiency with a high degree of organization and ability to prioritize.
6. Devise teaching strategies for families and patients relative to care.
7. Calculate, administer, and evaluate all types of medications given
within the vocational nurse scope of practice.
8. Relate as a collaborative member of the health care team.
9. Supervise and delegate within the VN scope of practice to unlicensed
10. Manage the role of a vocational nurse in a variety of acute,
sub acute, skilled, and ambulatory care settings.
11. Evaluate both the care given and areas of personal growth/development.

Topics and Scope
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1. Skilled and ambulatory care nursing settings.
2. Community health nursing.
3. Home care nursing.
4. Governmental rules and regulations for varied agencies.
5. Advanced level of practice in acute care assuming care of 4-5 patients.
6. Clinical pathways and discharge teaching protocols.
7. Case management and quality assurance with the role of the vocational
nurse as a multidisciplinary team member.
8. Team leading concepts and delegation of tasks to unlicensed personnel.
9. Spiritual care principles integrated with total patient care.
10. Safety protocols and independent versus dependent role functions.
11. Advanced development of nursing process including assessment, planning
implementation and evaluation of patient outcomes.
12. Coping strategies and adaptation of patients to chronic illnesses.
13. Teaching protocols and leadership skills.
14. Mental health versus illness in the care of all patients.
15. Developmental phases of families in a variety of settings.
16. Gerontological care: sexuality, losses of old age, behavior
management, regulatory guidelines, elder abuse, and physiological changes.
17. Health care goals, priorities and the management of case conferences.

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Acute Setting Rotations:
Students will:
1. Collaborate at the beginning of shifts to determine plans of care.
2. Gather data and implement care plan on an increased patient load to
a normal patient load for entry level graduate nurse.
3. Perform all aspects of care of VN scope of practice  taking into
account multi system effects of serious chronic illnesses.
4. Administer all medications and perform aspects of IV therapy which fall
into basic non-IV certified scope of practice.
5. Monitor all responses to care and collaborate with staff and instructor
alteration and modifications of care required.
6. Analyze and interpret diagnostic tests and lab results pertinent to
medications and adjustments to care at an expanded level.
7. Practice physician phone calls, intrashift/intershift reports, and
transcribing of physician orders under guidance of licensed staff.
8. Present case studies and relate care given to theory objectives.
Skilled Nursing Home: Team leading Rotation
Students will:
1. Analyze care data for a group of 8-12 residents.
2. Create a master worksheet for prioritizing and administering care.
3. Collaborate with staff to identify strategies for surmounting residents
barriers to care (both physical and cognitive).
4. Participate in giving shift reports and delegate responsibilities to
unlicensed staff including ongoing supervision.
5. Administer all medications and treatments to assigned group and monitor
effects of psychotropic and other meds.
6. Analyze and interpret lab and other diagnostic tests of residents and
perform chart review of ADL's for possible new nursing diagnosis.
7. Perform and document weekly summaries of residents in skilled nursing.
8. Report to physicians via Fax and phone and participate in proposing
solutions to resident problems.
9. Implement wound care and wound assessment and prevention of decubiti.
10. Participate in post team conferences and discussion of end of life
Preceptorship Component:
Students will:
1. Collaborate with faculty to select a preceptorship site.
2. Establish an effective teacher-learner relationship with preceptor.
3. Write realistic and attainable weekly objectives.
4. Complete objectives in a timely manner and/or discuss rationales if
objectives unattainable.
5. Consistent with safety, gradually increase patient load, independence,
contributions to plan of care, and problem solving strategies.
6. Increase complexity of skills, prioritizing care, individualization of
client care and assuming of total preceptor assignment by the end of the
7. Participate in a preceptorship preparation class, a mid evaluation of
the preceptorship and a final evaluation of the preceptorship to develop
conflict resolution and all skills necessary for the entry level graduate.
Community Health Rotation:
Student will:
1. Participate in observation and patient teaching in dialysis units with
the focus on facilitating patients acceptance of living with chronic
2. Select and collect data on a community agency for the presentation to
peers. Focus on regulation, referral, and services available for possible
future referral from a variety of  clinical settings.
3. Observe and assist home care nurse in the visitation of home care
clients with a variety of chronic and short term acute needs. Focus is on
comparing and contrasting the criteria for patient's obtaining skilled
nursing referrals in the home setting, VN scope of practice in the home
care setting and participating in the monitoring and teaching of patients
with any number of specific needs.
4. Perform independently under the direction of licensed staff in the
ambulatory care setting in a variety of immunization clinics, health
promotion and disease prevention as well as urgent care needs of clients
not qualifying for acute care.

Methods of Evaluation/Basis of Grade.
Writing: Assessment tools that demonstrate writing skill and/or require students to select, organize and explain ideas in writing.Writing
15 - 45%
Reading reports, Lab reports, Term papers
Problem solving: Assessment tools, other than exams, that demonstrate competence in computational or non-computational problem solving skills.Problem Solving
0 - 0%
Skill Demonstrations: All skill-based and physical demonstrations used for assessment purposes including skill performance exams.Skill Demonstrations
55 - 85%
Class performances, Field work, pass/fail clinical evaluations of each rotation
Exams: All forms of formal testing, other than skill performance exams.Exams
0 - 0%
Other: Includes any assessment tools that do not logically fit into the above categories.Other Category
0 - 0%

Representative Textbooks and Materials:
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Maebius, W.B. Saunders, Philadelphia (2003).
CLINICAL NURSING SKILLS, 5th ed., S.F. Smith & D.J. Duell, Prentice Hall
Saunders NURSING DRUG HANDBOOK, by B.B. Hodgson & R.J Kizior, W.B. Saunder
Mosby, St. Louis (2003).
Anderson & Braun CARING FOR THE ELDERLY, 2nd ed., by K.R. Culliton, F.A.
Davis, Philadelphia (1999).

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