Practice Expectations

NP Practice Expectations

Seattle Pacific University Nurse Practitioner (NP) Students complete a minimum of 720 hours of clinical practice in practicum sites in the final year of their program. Students are expected to steadily progress in clinical competence and confidence and require less supervision by their preceptor over their time in clinic. *Professional Role performance expectations are 100% at all times.

Summer Quarter

Autumn Quarter

Winter Quarter

Spring Quarter

Advanced Beginner

Competent

Proficient

Transition to practice, Immersion

By the end of the first practicum quarter in Summer, NP students are expected to perform at least 50-65% of the skills listed below at a basic level with close supervision by the preceptor.

By the end of the quarter, the student should be able to complete 4-5 patient visits from start to finish, including documentation in the medical record.

By the end of the second practicum quarter in Autumn, NP students are expected to competently perform at least 66-80% of the skills listed below at an proficient level with some supervision by the preceptor.

By the end of the quarter, the student should be able to complete 6-7 patient visits from start to finish, including documentation in the medical record.

By the end of the third clinical practicum quarter in Winter, NP students are expected to proficiently perform at least 81-90% of the skills below with standby supervision by the preceptor for complex patients and minimal supervision for more straightforward/less complex patients.

By the end of the quarter, the student should be able to complete 8-9 patient visits from start to finish including, documentation in the medical record.

By the end of the final clinical practicum quarter in Spring, NP students are expected to proficiently perform 90% or more of the skills below with standby supervision by the preceptor for complex patients and minimal supervision for more straightforward/less complex patients including a leadership role within an interprofessional team. Safe, entry level to practice.

By the end of the quarter, the student should be able to complete 10-12 patient visits from start to finish including, documentation in the medical record.

Students are to work toward proficiency in the following tasks:

Assessment	Complete an accurate, thorough history and physical exam Establish good rapport with the patient, preceptor and clinic staff Take into account the patient’s personal and cultural beliefs and preferences regarding their care
Diagnosis	Analyze subjective and objective data Develop a leading diagnosis, two possible diagnoses and a “can’t afford to miss” diagnosis using critical thinking, diagnostic reasoning, and the evidence based literature Report these to the preceptor in an organized, concise manner
Management Plan	Develop a plan that addresses the diagnosis which includes prescribed and otc meds if appropriate Self-care strategies for the condition(s) Diagnostic testing or specialty referrals if needed Health promotion/patient education counseling and what to do/when to return to clinic if the condition does not improve Red flag emergency instructions if the condition worsens Communicate the plan to the preceptor and patient in an organized, concise manner
Evaluation	Assess patient response to treatment Develop a follow up plan to monitor compliance Revise the plan or refer the patient back to specialty care if needed Consult the evidence-based literature and guidelines for plan evaluation
*Professional Role	Model the NP role by communicating and behaving in a professional and ethical manner Develop positive relationships with the preceptor, other providers, staff and patients Display a strong work ethic and willingness to openly engage in all learning opportunities made available in practicum

Management of Patient Health and Illness

Status and Demonstration of the Student Nurse Practitioner Role

Differentiate between normal, variations of normal and abnormal clinical findings.
Devise treatment plans collaboratively for common episodic conditions of clients, with consideration of evidence-based therapeutic options.
Devise treatment plans collaboratively for stable chronic health conditions of clients, with consideration of evidence-based therapeutic options.
Conduct a complete health assessment including a complete history and physical exam, incorporating health promotion, health protection, mental health and disease prevention strategies.
Formulate differential diagnoses utilizing critical thinking and diagnostic reasoning.
Order and interpret appropriate diagnostic tests, with consultation and with consideration of safety, efficacy, cost, invasiveness, and acceptability of tests.
Prescribe medications, with consultation, within scope of practice and legal authorization.
Identify and utilize interdisciplinary, community resources.
Demonstrate appropriate utilization and referral to specialists.
Develop plans to evaluate clinical care outcomes.
Model exemplary professional and academic behaviors:
Document accurately, concisely, and legibly using a problem-oriented format.
Communicate respectfully with patients and families, peers, preceptors, faculty, and allied health workers, preserving patients’ control over decision making.
Demonstrate teamwork and an interdisciplinary approach to patient care.
Establish a therapeutic relationship with patients and families, reflective of patients’ inherent worth and dignity.
Present clinical cases to preceptor and site visitor in a logical, concise fashion.
Make decisions collaboratively, as appropriate, with recognition of student’s abilities and scope of practice.
Implement research and evidence-based guidelines in the management of patient care.
Identify individual learning objectives and goals with development, implementation, and communication regarding student’s learning plan, while being constructive in response to feedback.
Demonstrate responsibility and accountability in all aspects of clinical practice including attendance, punctuality, and maintenance of confidentiality and privacy.
Assist patients and families to meet their spiritual needs and incorporate patients’ spiritual beliefs in care.