Facilitator Guideline - NNA

Clinical Facilitation
Network Nursing Agency
Network Nursing Agency
Clinical Facilitator
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Clinical Facilitation
Network Nursing Agency
Facilitator Guideline
Welcome to Clinical Facilitation with Network Nursing Agency. We are delighted to have you
as part of our team and look forward to working collaboratively to promote quality
education and learning experiences for students.
Content:
Objectives ---------------------------------------------------------------------------------------------------------------3
Placement routine ----------------------------------------------------------------------------------------------------4
Placement of students on allocated wards --------------------------------------------------------------------5
Daily routine -----------------------------------------------------------------------------------------------------------7
Evidence to determine assessments ----------------------------------------------------------------------------8
Debriefing --------------------------------------------------------------------------------------------------------------9
Feedback --------------------------------------------------------------------------------------------------------------10
Conflict resolution --------------------------------------------------------------------------------------------------11
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Clinical Facilitation
Network Nursing Agency
Objective:
As the Clinical Facilitator, you will assist the students by bridging the gap between nursing
theory and practice. You are responsible for nurturing them and helping them develop the
necessary knowledge, skills, and attitude needed as a novice Registered Nurse. You are also a
support person as well as a professional role model for the students under your guidance. In this
role, you are responsible for maintaining a positive professional relationship with the health
care team, which includes NNA, the education provider, the hospital staff and administration,
and the students. You will liaise with the educator and supervising Registered nurse to ensure
that your students are able to maximise their clinical learning experience.
Facilitates optimal ongoing learning opportunities for the student to meet the
theoretical and clinical objectives of the subject in the clinical setting
Demonstrate practice leadership and expertise in application of knowledge and skills
Promote development of enquiring, reflective, critical and innovative approaches to
learning
Facilitate the selection of appropriate learning strategies to integrate learning from
practice and academic experiences
Facilitate students to meet ANMAC Standards of Practice for the Registered Nurse
Maintain and promote the standards and policies of the School of Nursing, and the
health care facility
Provide ongoing and constructive support to facilitate transition from classroom based
learning to a clinical environment
Monitor and evaluate student performance throughout the clinical placement, using
clinical performance assessment tools and stated learning objectives
Provide prompt and constructive feedback about student performance to the student
and Clinical Placement Team
Develop collaborative relationships with health care facilities through pre-clinical visits,
participation in facility based orientation and other activities as required
Co-ordinate learning within an inter-professional learning and working environment
Respond promptly and professionally to the concerns and needs of students and staff in
the health care facility and refer to appropriate Faculty staff members when required
Ensure students demonstrate safe and professional practice, able to make decisions and
take actions in line with their theoretical preparation and scope of practice
Ensure documentation of student clinical performance is completed accurately on the
required forms and returned to the Faculty promptly
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Clinical Facilitation
Network Nursing Agency
Placement Routine:
On the first day of each placement, students are to present at the specified time and meeting
place. Students are informed that they are not to make their way to a ward/unit without
undergoing required pre-placement checks and facilitator orientation. Facilitators should
undertake an initial briefing with the students prior to escorting them to their wards. This will
allow facilitators to set the standards and expectations for the placement, highlighting the scope
of practice required for each individual clinical placement and review the clinical objectives. This
process will ideally take 30-45 minutes depending on the year of the students you are
facilitating and the dynamics of your group. The following are suggestions for inclusion:
Introduction of yourself and students to one another, exchange contact details and
explain the process of how and when students should contact you
Describe the allocated wards and expectations, if details are known
Reinforce the uniform requirements, as required
Understanding of shift times, meal break, and attendance requirements
An orientation checklist may be completed
Time, place and frequency for debriefings. Facilitators will have different styles in their
approach to this and it will be determined also by the location(s) of students and
dynamics/needs of the group. (Ideally 3-4 times/week for first year students, 2-3
times/weeks for second year students, and 1-2 times/week for third year students.
Debriefs should take no longer than 30 minutes and not occur during handover times.)
Clarify students scope of practice according to their year of study and setting boundaries
Procedures to undertake in the event of sickness, being late or misadventure
Your expectations of the student and the students’ expectations of you. Encourage
discussion around this subject. Include such things as professional conduct, use of
mobile phones, punctuality, communication with staff and facilitation, what to do when
the student is asked to do something that they (student) are either not comfortable with
or know is outside their scope of practice
General discussion as to what is involved in the assessment process, discussing specific
clinical learning objectives
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Clinical Facilitation
Network Nursing Agency
Placement of Students on to Allocated Wards:
Escort the students to their allocated ward and introduce them to the NUM/CNE and staff as
appropriate. Typically, facilitators will have students allocated to numerous wards within one
facility; it is ideal to place the students onto the ward with someone to orientate them and then
go back to check they have been allocated to a staff member or ‘buddied’ up satisfactorily.
Allocation of students to staff will be largely dependent on the skill mix of ward staff, staffing
numbers, whether or not the ward has an available CNE and managers present for the shift.
Students should be allocated to a registered nurse for each shift, however, in some cases it may
be appropriate for students to be allocated to staff other than a Registered Nurse.
The allocation of students to new graduate registered nurses should occur with caution, as new
graduates are novice practitioners and still seeking/requiring supervision themselves. They can
also at times feel overwhelmed having the extra workload that comes with supervising student
nurses. This said, new graduate nurses can provide encouragement and insight to students
about their newly chosen career which is often beneficial to students. If allocation does occur
where students are ‘buddied’ with new graduates, more complex tasks for example, medication
administration should be done with either a more senior nurse or the ward CNE.
Dependant on the year of study, it may also be necessary and appropriate for students to be
‘buddied’ to enrolled nurses. Students should ideally not be ‘buddied’ with assistants in nursing
(AINs). There may be exceptions to this, for instance, in Aged Care facilities where most of the
staff are AINs supervised by only 1 or 2 RNs.
Ensure that:
Either yourself or ward staff have orientated the students’ to the ward
Students each have a ward handover for the day, and have an understanding of
abbreviations used in handover to a level expected for their year of study
Each student understands the diagnosis of each patient they are allocated to care for
each day
You have discussed the students objectives and goals with the supervising RN/CNE
Ensure students and supervising staff have a clear understanding of their scope of
practice and that students know what to do if they are unsure
Students know who they are ‘buddied’ with for each shift and have a clear
understanding of that staff member’s level of experience (i.e. AIN, new graduate, RN,
CNS and CNE).
Ensure both students and supervising staff, CNEs, NUMS have your contact details and
obtain for yourself the contact numbers for the ward/unit and any key contacts
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Clinical Facilitation
Network Nursing Agency
At times, as the facilitator you will be required to negotiate the most appropriate allocation for
students, however, ultimately the decision rests with the supervisor/NUM in each placement.
Whilst facilitators are in a great position to be advocates for students, which does occur, it
needs to be kept in mind that students are visitors in an often complex health care delivery
system. Address any issues with diplomacy and good negotiation skills to achieve the best
outcome possible for the student, the ward and the relationship the Education Provider has
with the facility. Regular two way communication with supervisors is essential so that issues
that may arise with allocation can be dealt with in a timely manner.
N.B. For some students, commencing a new placement is a very stressful experience and this
may manifest in various ways. Please be mindful of this and support students at the
commencement of each placement and allow them time to settle into the placement and
routine.
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Clinical Facilitation
Network Nursing Agency
Daily Routine:
There will be individual variation as to how facilitators plan their days and weeks of placement.
This may be dependent on the number of facilities being covered, student’s stage in the
program, etc. However, some key activities need to be considered in the daily routine, as
applicable to the placement setting, including:
Monitor student attendance, punctuality, etc. A placement summary sheet is prepared
for each placement and is to be completed by the facilitator and returned on completion
of the placement
Where appropriate, attend handover on ward(s)/unit, varying the venue each day
Monitor student allocations each day to ascertain that they are working with an
appropriate caseload and with an appropriate supervising nurse
Visit and where applicable, work alongside students within facility guidelines, taking into
consideration the needs of each student and the ward on each particular day
Monitor that students are working towards meeting their learning objectives
Endeavour to review students written reports and verbal handovers
Obtain regular feedback from NUM/CNE/ and ward/unit staff on student performance
Keep a high profile so that students and ward staff are aware of your presence
Ensure that you can be contacted at all times whilst the students are on the wards
Identify learning opportunities and support students in accessing/utilising these
Keep a diary of events, issues and pertinent discussions with staff and students relating
to student performance or critical events
Organise debriefing sessions with students
Ensuring each student understands the diagnosis of each patient they are allocated to
Ensure students and supervising staff have a clear understanding of their scope of
practice and that students know what to do if they are unsure
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Clinical Facilitation
Network Nursing Agency
Evidence to Determine Assessment:
The gathering of evidence on all students’ performance in an impartial and transparent manner
informs the decision as to whether to award a satisfactory or unsatisfactory grade to the
student for the placement. Students are assessed as to whether they are achieving their
learning objectives for the subject. This is a criterion-referenced basis for the assessment. In
criterion referenced assessment, the outcome is based on the student performance in achieving
their objective and not how they compare to other students at the same stage in the program.
Evidence relating to a students’ performance can be gathered from a number of sources
including, direct observation by the facilitator, feedback from the supervising nurses on a daily
basis, as well as feedback from the Clinical Nurse Educator or Nursing Unit Manager. The
information should be objective and form part of discussions when giving feedback to the
student. When the facilitator receives information from sources other than their own
observation they should endeavour to validate the information by their own observation or
questioning and discussions with the student.
A useful approach is for facilitators to make regular diary notes on all students throughout the
placement, including strengths and areas for development, issues/concerns, as this will enable
the facilitator to:
Provide ongoing objective and constructive feedback to each student
Ascertain how the student is developing in their clinical practice and if they have
incorporated feedback already given during the placement
This can also be used as a basis of further written documentation, if required, such as in
the event of an unsafe accident or unsatisfactory result
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Clinical Facilitation
Network Nursing Agency
Debriefing:
Debriefing is a valuable tool to help students explore their experiences and frame their learning
during their placements. Debriefing should have a direction and purpose and suggestions
include but are not limited to:
An exploration of patient cases that the students have care for
Practicing verbal or written handover
Consideration of professional conduct and professional boundaries
How to seek out and maximise opportunities for self-directed adult learning
What would be the expected role of students in the event of medical emergencies,
management of patient/clinical issues afterhours
Gaining insight to facility organisation, structure of healthcare, management, senior and
junior staff roles
Scope of practice, what to do when they (student) are asked to do something that they
are either not comfortable with or feel is outside their scope of practice
The different models of ward nursing (i.e. ‘team nursing ’and ‘allocated nursing’ and
how as nursing students they ‘fit’ into these models)
To encourage conversation and interaction – have student discuss a topic in pairs and
then feed back to the larger group. This may be particular useful for students initially
reluctant to speak in the large group including students from non-English speaking
backgrounds
Make these sessions interesting and enjoyable. Encourage students to employ problem solving
skills, to explore their experience, knowledge and attitudes, and ask their facilitator and each
other questions.
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Clinical Facilitation
Network Nursing Agency
Feedback:
Effective and appropriate constructive feedback is an essential component of all clinical
placements as it allows students to know how they are progressing, both areas of strength or
areas for further development, and what they may need to do to progress with their clinical
practice.
The general principles for providing feedback include:
Create the atmosphere – feedback sessions need to be done in a private and reassuring
environment
Be specific – identify specific performance/behaviours that you are addressing
Do it in a timely manner – the feedback should be given at an appropriate time for the
student and as soon as possible after the behaviour/incident is observed
Be constructive – if providing negative feedback, focus on the desired outcome and
explore strategies for improvement with the student
Encourage dialogue – get a reaction for every feedback session and talk about how the
students feel about the feedback
Motivate – acknowledge progress the student has made/is making towards achieving
learning goals
Be consistent – provide progressive formal/informal positive/negative feedback
throughout the placement
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Clinical Facilitation
Network Nursing Agency
Conflict Resolution:
As a Clinical Facilitator, you may be faced with a conflict situation between yourself and a
student, the student and the facility, or between two students. Interpersonal conflict occurs
whenever an action by one person prevents, obstructs or interferes with the action of another
person. People often mistakenly believe that a good relationship is one where there is no
conflict. However, skilfully managed conflict can facilitate change and improvement, and
therefore should not be avoided. Below are some conflict resolution strategies you might find
useful when facing a conflict solution. Please note there is an abundance of further reading
about this topic.
Approach the other person
Make sure you gather information about the conflict situation from all parties involves
Address the issues with the people involved when you have the time and appropriate
venue
Communicate openly – express your perceptions in a non-threatening way
Comprehend fully – utilise your listening skills, be objective, avoid emotional responses
Do not demand change – suggest and negotiate changes in behaviour
Communication styles:
Describe the person’s actions – don’t label
Define the conflict as a mutual problem to be resolved
Clarify the issues (i.e. what action do you find unacceptable and what outcome is
sought)
Listen to, and try to take the other person’s perspective
Document and address sequence of events as soon as possible
What to do when the resolution strategies are not working:
Recognise that you have a responsibility to all students – if you find one student is
monopolising all your time due to conflict issues, contact the Nurse Educator/Clinical
Placement Team for assistance
If a student is verbally abusive or physically threatening towards you, and you feel the
situation could escalate out of control, the student should be asked to leave
Inform the education provider of the situation
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