CLINICAL FIELD

STUDENT INTERNSHIP HANDBOOK 2013-2014

EMS PROGRAM OF

TIDEWATER COMMUNITY

COLLEGE

EMT-ENHANCED EMT-INTERMEDIATE

EMT-PARAMEDIC & CRITICAL CARE

revised July 2013

Table of Contents PHILOSOPHY…………………………………………………………………………….……………………………1 A FEW TIPS ON HOW TO BE SUCCESSFUL……………………………………………………………………..1 DISCLAIMER………………………………………………………………………………….………………………..1 A LETTER FROM DR. ARMADA, MEDICAL DIRECTOR…………………………………………….…………..2 YOUR COORDINATORS………………………………………………………………………….………………….3 STUDENT SECTION…………………………………………………………………………………………………..4 PRE-CLINICAL AND FIELD REQUIREMENTS…………………………………………………………………….5 BACKGROUND CHECKS…………………………………………………………………………………………….5 POLICY FOR CRIMINAL BACKGROUND CHECKS THE CITY OF VB STUDENTS…………………………6 HOW TO COMPLETE YOUR BACKGROUND CHECK…………………………………………………………..6 PROFESSIONAL CONDUCT………………………………………………………………………………………...7 YOU SHOULD………………………………………………………………………………………………………….7 YOU SHOULD NOT……………………………………………………………………………………………………7 PROFESSIONAL AND ETHICAL CONDUCT………………………………………………………………………7 CONFLICT OF INTEREST……………………………………………………………………………………………9 CHEATING……………………………………………………………………………………………………………...9 ACADEMIC MISCONDUCT, ACADEMIC DISHONESTY, & HONOR CODE…………………………………..9 PROBATION…………………………………………………………………………………………………………..10 APPEAL PROCESS………………………………………………………………………………………………….10 STUDENT HEALTH CONCERNS………………………………………………………………………………….11 MEDICAL LIABILITY…………………………………………………………………………………………………11 WITHDRAWAL FROM COURSES………….……………………………………………………………………..12 CHANGE OF NAME/ADDRESS……………………………………………………………………………………12 DISABILITY SERVICES……………………………………………………………………………………………..12 VCCS E-MAIL& COMMUNICATION……………………………………………………………………………….12 COMMUNICATION POLICY…………………………………………………………………………………….…..13 CLINICAL/FIELD DRESS CODE……………………………………………………………………………….…..13 UNIFORM REQUIREMENTS……………………………………………………………………………………….14 MEMORANDOM OF AGREEMENT…………………………………………………………………………….….14 HOSPITAL AND AGENCY PARKING……………………………………………………………………………...15 MEALS…………………………………………………………………………………………………………………15 OUTSIDE EMPLOYMENT…………………………………………………………………………………………..15 USE OF BLACKBOARD……………………………………………………………………………………………..15 PLATINUM PLANNER……………………………………………………………………………………………….16 CLINICAL AND FIELD SCHEDULING AND CANCELLATION POLICY……………………………………….17 HOW TO FILL OUT YOUR CLINICAL/FIELD FORM…………………………………………………………….18 EVALUATION OF AFFECTIVE OBJECTIVES FOR CLINICAL AND FIELD PERFORMANCE…………….19 HOW TO TURN IN YOUR CLINICAL/FIELD FORMS……………………………………………………………19 DEFINED AGE GROUPS……………………………………………………………………………………………20 EMT-ENHANCED REQUIREMENTS………………………………………………………………………………20 EMT-I INTERMEDIATE REQUIREMENTS………………………………………………………………………..22 EMT-PARAMEDIC REQUIREMENTS……………………………………………………………………………..23 INCLEMENT WEATHER/COLLEGE CLOSINGS………………………………………………………………...25 CONCEPTS OF CRITICAL CARE REQUIREMENTS……………………………………………………………25 DO YOU HAVE PREVIOUS HOSPITAL EXPERIENCE?.............................................................................25 ENHANCED CREDIT WAIVER……………………………………………………………………………………..26

INTERMEDIATE CREDIT WAIVER………………......……………………………………………………………26 CLINICALSECTION………………………………………………………………………………………………….28 THE CLINICAL EXPERIENCE……………………………………………………………………………………...29 CLINICAL GRADING CRITERIA……………………………………………………………………………………29 THE CLINICAL PATIENT ASSESSMENT REPORT……………………………………………………………..30 GRADING THE CLINICAL PATIENT ASSESSMENT REPORTS………………………………………………30 REQUIREMENTS OF THE STUDENTS………………………………………………………………....………..31 RESPONSIBILITIES OF TCC………………………………………………………………………………….……31 PRECEPTORED VERSUS NON-PRECEPTORED HOSPITALS………………………………………………31 GUIDELINES FOR CLINICAL ROTATIONS EMERGENCY DEPARTMENT…………………………………32 INTENSIVE CARE UNIT/CRITICAL CARE UNIT……………………………………………………………...…32 LABOR AND DELIVERY UNIT……………………………………………………………………………………..33 PEDIATRIC EMERGENCY DEPARTMENT AND ACUTE CLINICAL CARE………………………………....33 MEDICATION AND IV COMPETENCY……………………………………………………………………………34 POLICY FOR DIFFICULT AIRWAY SCENARIOS………………………………………….………………...….34 ANESTHESIA ROTATIONS…………………………………………………………………………………...……35 CLINICAL OBJECTIVES FOR THE EMT-ENHANCED………………………………………………………….36 CLINICAL OBJECTIVES FOR THE EMT-INTERMEDIATE……………………………………………………..38 CLINICAL OBJECTIVES FOR THE EMT-PARAMEDIC…………………………………………………………40 CRITICAL CARE EMT-P AND RN CLINICAL OBJECTIVES……………………………………………………42 CLINICAL SITES AVAILABLE TO EMS STUDENTS………………………………………………………........44 CLINICAL SITES AVAILABLE FOR STUDENTS IN CONCEPTS OF CRITICAL CARE…………………….45 CLINICAL AGENCIES……………………………………………………………………………………………….45 CLINICAL SITE REQUIREMENTS…………………………………………………………………………………46 FIELD SECTION……………………………………………………………………………………………………..50 THE FIELD INTERNSHIP PHILOSOPHY…………………………………………………………………………51 MISSION………………………………………………………………………………………………………………51 RESPONSIBILITIES OF TCC……………………………………………………………………………………….51 FIELD INTERNSHIP………………………………………………………………………………………………….51 FIELD INTERNSHIP OBJECTIVES………………………………………………………………………………..52 REGIONAL SANCTIONING…………………………………………………………………………………………53 FIELD INTERNSHIP POLICY……………………………………………………………………………………….53 FIELD PATIENT CONTECTS……………………………………………………………………………………….54 FIELD GRADING SCHEDULE……………………………………………………………………………………...54 AFFECTIVE SKILLS………………………………………………………………………………………………….55 FIELD GRADING CRITERIA……………………………………………………………………………………......55 FIELD PATIENT ASSESSMENT REPORT GRADING SCALE…………………………………………………56 FIELD INTERNSHIP SCHEDULING……………………………………………………………………………….56 CANCELLATION OF SHIFTS………………………………………………………………………………………56 APPENDIX A………………………………………………………………………………………………………….57 HIPPA………………………………………………………………………………………………………………….58 APPENDIX B………………………………………………………………………………………………………….60 POLICY AND PROCEDURE………………………………………………………………………………………..61 MEDICATION DISCREPANCY REPORTING………………………………………………………………….…61 APPENDIX C………………………………………………………………………………………………………….62 SUMMARY OF UNIVERSAL PRECAUTIONS &BODY SUBSTANCE ISOLATION………………………….63 HANDWASHING………………………………………………………………………………………………….…..63 APPENDIX D -- FORMS…………………………………………………………………………………………….64

THE PHILOSOPHY OF OUR PROGRAM REFLECTS THE PURPOSE, GOALS and objectives of the college, in that we believe the academic climate gives students the opportunity to gain the skills and knowledge necessary for entry into each professional level as a safe and confident practitioner. This environment provides for continuing, in-depth evaluation, and provides opportunities to progress. We believe that Emergency Medical Services is humanistic, health-oriented care that focuses on priority oriented treatment plans based on individual needs. We further believe that the preceptor is responsible for creating an environment that identifies and fulfills individual needs, interests and abilities. We recognize that each student is a product of previously gained values and ethics, influenced by culture and experiences, which in turn influences the results of the teaching-learning process. The faculty believes that EMS education is a process that is flexible and responsive to the current needs of society. The curriculum utilizes multiple instructional methodologies and planned internship experiences in varied hospitals and agencies to supplement the learning process. Graduates of the EMS program are eligible to take specific state or national certification examinations. Graduates of the EMS program may receive an associate in applied science degree with additional courses as outlined in TCC catalog. Graduates will be able to perform at the established competency level for each course level attempted.

A FEW TIPS ON HOW TO BE SUCCESSFUL

Let’s understand what you need to do in order to be successful in this program:

⋅ Read this handbook, first of all. This handy guide should answer just about any question you might have. It is broken down into three sections: Student, Clinical, and Field. The Student section covers anything that you, as a student, are responsible for understanding in the EMS program. From how to schedule your shifts through Platinum Planner to what we and agencies expect from you on your clinical or field rotations, this Handbook lists it all. The Clinical and Field sections respectively detail the specific points about each kind of internship. In other words: Know this information. Live this information. Be this information.

⋅ Turn in your Clinical/Field preclinical requirements – and on time. Understand that you can’t attend any clinical or field rotations until all of the preclinical requirements and forms is turned in, processed, and approved. If your ability to schedule is determined by turning in a packet of signed papers, and your grade depends on what you do during the shifts you were supposed to schedule, why wait? There’s a handy checklist of these requirements in the Welcome Letter, which is available on Blackboard.

⋅ Your Coordinator isn’t like your instructor. Since Clinical and Field internships are virtual classes, you probably won’t see him or her consistently every week – just during posted office hours – and that’s ok. Don’t worry. If you have any questions at all, email your Coordinator and he or she will get right back to you as soon as possible.

⋅ Platinum Planner is your friend. It might seem a little intimidating at first, but this scheduling and tracking program is designed to help you organize your internship experience, from scheduling dates to how many more competencies you need for completion. Let your Coordinator know if you have any questions.

Clinical/Field Handbook Disclaimer This EMS Clinical/Field Handbook is provided to you as a guide and to ensure you understand the academic and conduct expectations that the College has for you during your enrollment in the program. There is mutuality between you and the College concerning it, and thus your reliance upon the information contained within it when making academic decisions does not constitute, and should be construed as, a contract with the College. Furthermore, the College reserves the right to make changes to this Handbook at any time, unilaterally and without notice; however, students will not be held responsible for any associated conduct expectations contained in such changes until notified of them.

DIVISION OF HEALTH PROFESSIONS EMERGENCY MEDICAL SERVICES PROGRAM

VIRGINIA BEACH CAMPUS Dear Student, Congratulations! I would like to take this opportunity to welcome you to the Emergency Medical Services Program of Tidewater Community College. You will find the preparation you receive here to be very positive and rewarding. The academic and clinical preparation you will receive is sufficient for you to be able to practice at each professional level with safe minimum competence. It prepares you to continue learning and to grow professionally. The task of the faculty is to ensure a creative and supportive environment in which you can interact and modify your behavior as you go through the process of learning This Handbook has been prepared to familiarize you with the policies and procedures of the EMS program, and will serve as an adjunct to the College catalog and TCC student handbook. This Clinical/Field Handbook, in addition to the current semester course outline and any addendums provided, constitute the policies and procedures of the program. If the items discussed on the following pages are not clear, please feel free to ask your Coordinator for assistance. Thank you, Manuel Armada, M.D. Program Medical Director

your coordinators! how to reach them | where to find them | who can help you

THE COORDINATORS________________________________________________________________________________________________________________

KATHY MASCIANGELO RICH TRENT office: 757-822-7459 |pager: 677-2009 office: 757- 822-7423 |cell: 757-472-3473 MW307 | kmasciangelo@tcc.edu MW309 | rtrent@tcc.edu ERIC ASHLEY RUSTY HAGERMAN office: 757-822-7423 |cell: 757-544-7224 office:757- 822-7423 |cell: 757-532-8743 MW309 | washley@tcc.edu MW309 | bhagerman@tcc.edu

ADMINISTRATIVE______________________________________________

SHAMERA BOONE BETHANY BUCHANAN office: 757-822-7423 |cell: 757-390-0584 office: 757-822-7488 MW309 | sboone@tcc.edu MW305 | bbuchanan@tcc.edu MARK DECKER AUDREY PINE office: 757-822-7423 |cell: 804-380-5277 office: 757-822-7335 MW309 | mdecker@tcc.edu MW101 | apine@tcc.edu

FACULTY ______________________________________________

PAUL HOUDE LORNA RAMSEY office: 757-822-7423 |cell: 757-333-1165 program director | office: 757-822-7275 MW309 | phoude@tcc.edu MW119 | lramsey@tcc.edu AMBER-LEIGH MITCHELL JASON AMBROSE office: 757- 822-7428 |cell: 757-589-4779 bls program coordinator | office: 757-822-7337 MW104 | almitchell@tcc.edu MW103 | jambrose@tcc.edu JAMIE MORGAN FAX (ADDRESSED PROPERLY)* office: 757-822-7423 | cell: 757-814-7870 757-822-7557 or 757-822-7460 MW104 | jmorgan@tcc.edu *Confirm receipt with an email DIANE PETTWAY office: 757-822-7564 | cell: 757- 641-0353 MW109 | dpettway@tcc.edu NOTE: Communication should be primarily made through the VCCS email system. Phone communication -- calls or texts – is reserved for urgent clinical or field issues.

STUDENT expectations | scheduling | requirements

SECTION

PRE-CLINICAL AND FIELD REQUIREMENTS

In accordance with legal agreements between TCC and our affiliating hospitals and field agencies, there are certain criteria you must

meet before beginning clinical rotations or field internship ride time affiliations. To comply with this agreement, ALL EMS STUDENTS will need to complete the following requirements before the start of clinical and/ or field rotations. Check them off as you go!

Attend Clinical/ Field Orientation Current physical exam (within two years) to include a respiratory fit

test/ respiratory exam. You must also meet the technical standards as indicated on the Physical Examination Form of Tidewater Community College. These include: • Sufficient eyesight to observe patients, read patient

records, manipulate equipment and accessories, visually monitor patients in dimmed light via video monitors, and evaluate radiographs for quality

• Sufficient hearing to communicate with patients and other members of the health care team, monitor patients via audio monitors, and hear background sounds during equipment operations

• Satisfactory speaking, reading, and writing skills to effectively and promptly communicate in English

• Sufficient gross and fine motor coordination to manipulate equipment and accessories, lift a minimum of 35 pounds, and to stoop, bend or promptly assist patients who become unstable

• Satisfactory physical strength and endurance to move immobile patients to or from a stretcher or wheelchair to the x-ray table, work with arms extended overhead, stand in place for long periods of time, and carry 20-25 pounds while walking. You must be able to lift, carry, and balance 125 pounds

• Satisfactory intellectual and emotional functions to ensure patient safety, and exercise independent judgment and discretion in the performance of assigned responsibilities

• Current PPD (tuberculin skin test) that needs to remain current. If student already gets yearly PPDs, then a one-step PPD is acceptable. If you never have had a PPD or it has been greater than two years, then a two-step PPD is required. The initial PPD is administered and read and a second administered one to three weeks after the initial skin test. Positive PPD will require a chest x-ray. During a time of shortage, a T-spot (IGRA) blood draw may be required.

Proof of varicella (chickenpox) immunity by titer results or proof of vaccination. (It is a two-vaccine series)

Proof of MMR immunity (Measles, Mumps, Rubella) by titer results or proof of two vaccinations

Proof of a Tetanus (TDAP) vaccination within 10 years Proof of Hepatitis B vaccination (three vaccine series) or immunity

level by titer results or declination Proof of influenza vaccine Current American Heart Association CPR certification and EMT

certification; current ACLS certification for Intermediate, Paramedic, and Critical Care students. Military Identification, if applicable, should be submitted

OSHA training. It is available on Blackboard and, when you finish it, please print the certificate and hepatitis B declination form and turn it in to your Coordinator.

HIPAA Training. This will be completed during orientation. Drug calculation exam. If you are continuing in the program, but have

sat out one semester or more, or are entering the program at any point, you will need to take the drug calculation exam

IV & med administration test out (given by TCC during class time for new students). Refer to the following pages for more information on “Medication and IV Competency”

Verification of Criminal and Child/Sex Offender Background Check for Enhanced, Intermediate, Paramedic and Critical Care students. Background check remains valid as long as you attend without interruption. Refer to the next page for more information on “Criminal Background Checks”

Completion of all hospital orientation packets and required signature forms submitted

You must complete all pre-clinical/field requirements as outlined in this Handbook. In addition, all Intermediate and Paramedic students must have successfully completed ACLS. Enhanced students must have an agency affiliation letter on file. Local Field Agencies have paperwork/documentation that needs to be completed prior to the student conducting “Ride Time.” The paperwork from these localities will be available on Blackboard or from the field coordinators. Certain forms need to be notarized. It is up to you, not matter your testing level, to read, understand, complete, and submit the documentation in a timely manner. If you don’t, you run the risk of having no “ride time.”

BACKGROUND CHECKS

All Emergency Medical Services Technology students entering the Enhanced, Intermediate, Paramedic, and Critical Care programs will be required to submit to a Criminal Background and Child/Sex Offender Background check at your own expense prior to beginning the clinical portion of the course work.

Tips! Make sure you cross each item off this list

– you can’t go to shifts until you do!

The cost to you is $46. This background check will be valid through completion of the course of study unless you stop attending for a semester. If there is a break in your attendance, the criminal background check will need to be resubmitted. Letters from rescue agencies, federal agencies, and military investigative agencies confirming your completion of a background check will be accepted on letterhead stationery, provided that the background check has been done within six months of entering the program. If your agency completes your background check it must meet the following criteria: •Completed within six months of starting the program •Must include that the background check was a national (NCIS) check to include sexual abuse, offenses against minors and sexual offenses and that it was completed (no results should be listed). •The agency must also state that the applicant meets the standards as set by the State of Virginia Department of EMS.

POLICY FOR CRIMINAL BACKGROUND CHECKS FOR

THE CITY OF VIRGINIA BEACH STUDENTS The following policy outlines the procedure for obtaining criminal background check information for students affiliated with the City of Virginia Beach who are registered for ALS classes in the EMS Program of Tidewater Community College. There are two categories of students: those students who are affiliated and are being sponsored through the City of Virginia Beach and those students who are affiliated with the City of Virginia Beach but are not being sponsored by the City and are paying for and taking classes in TCC’s EMS Program without sponsorship. .City of Virginia Beach sponsored students

1. At the beginning of each semester the City of Virginia Beach will forward a letter to the Clinical Coordinator of TCC’s EMS Program. This letter will reflect the standards of the City in relation to the students, whom are being sponsored, and the policies and procedures for affiliation into their Agency. The letter will describe the level and the means that the background checks are investigated and processed.

2. The Instruction Supervisor will forward a letter to the Clinical Coordinator of TCC’s EMS Program listing the names of those students being sponsored by the City. This will be done each semester. TCC will accept these letters as documentation that any EMS student being sponsored with the City will have met the background check requirements as required by TCC.

3. If a student, who is currently being sponsored by the City of Virginia Beach, loses sponsorship, then the Instruction Supervisor will contact the Clinical Coordinator to inform TCC that the student is no longer being sponsored by the Agency. The student will then need to resubmit their individual background check through www.certifiedbackground.com before continuing in the clinical component of the EMS Program of Tidewater Community College.

4. All students being sponsored will be given a letter from the Agency to present to the Clinical Coordinator at the beginning of each semester. This letter will suffice as proof that the student’s background check has been completed.

5. This policy pertains ONLY to those students who are being sponsored by the Agency.

City of Virginia Beach non-sponsored students 1. Any student who is affiliated with the City of Virginia Beach, who is not being sponsored by the City and who is enrolled in ALS classes in

TCC’s EMS Program will have to obtain their own criminal background check through www.certifiedbackground.com 2. No other background check results will be accepted from these students.

This policy may be reviewed and changed with the agreement of both parties from

Tidewater Community College and the City of Virginia Beach.

HOW TO COMPLETE YOUR BACKGROUND CHECK

(1) First go to the TCC Website at www.tcc.edu or you may go to the www. certifiedbackground.com website directly. (2) Look for Academics on the scroll bar & access the Health Professions Division web page.

Tips! If you’re sponsored, be sure to confirm your background check has been sent and received by your clinical coordinator

(3) There is a direct link on the Health Professions Division web page to www. certifiedbackground.com. (4) Please review the attached CertifiedBackground.com Student Instructions (5) Next, you will click on “Students”. (6) The Service will acknowledge you as a TCC EMS student and will prompt you to enter a package code. (7) In the Package Code box, enter the package code for EMS Students: ID29 (8) It will cost $46. Select a method of payment: Visa, MasterCard or Money Order. If you pay with a Money Order, there is an additional $10 fee and has a longer turn-around time. (9) Once submitted, be sure to print off your receipt and show it into the clinical coordinator. Once your order has been submitted, you will receive a password to view the results of your background check. The results will be available to you in 48-72 hours by going back to the website www.certifiedbackground. com and entering your password. Once the background checks have been processed, Certified Background.com will notify the EMS clinical coordinator via e-mail the names of all EMS students who have used the service and completed the background check. If the results are received as “not complete” then the student will be notified in writing to contact and inform CHKD’s Office of Human Resources. Students must obtain official clearance from CHKD’s Office of Human Resources for permission to attend CHKD for clinical rotations. All students will be held to the standards of the National and State Certification agencies. Any positive findings will be handled accordingly.

PROFESSIONAL CONDUCT

You and your behavior are a reflection of TCC, so it is of the utmost importance that appearance, attitude, and conduct are above reproach while in the clinical setting. You represent the medical profession; the sponsoring institution (TCC), and the hospital affiliates.

Any conduct that tends to discredit or cause injury to the school’s reputation may result in disciplinary probation or dismissal. The clinical facility representative reserves the right to refuse admission or readmission to any TCC EMS student who is involved in any activity not considered professional or conducive to proper patient care, as deemed by the facility.

YOU SHOULD…

1. Report to the hospital or field agency alert and on time wearing the proper and complete TCC uniform. 2. Bring all the necessary equipment (stethoscope, pen, and forms) to all shifts. 3. Wear your TCC picture ID on shirt collars. 4. Conduct yourself in a professional and ethical manner. 5. Eat, take breaks, and smoke only in areas where permitted. You will not chew gum while working in a patient care area. 6. Accept assignments from the clinical or field preceptor, supervisor, or clinical and/or field coordinator, if capable of performing the specific task.

YOU SHOULD NOT…

1. Use or be in the possession of drugs or alcohol while on the agency premises as a student. 2. Not sleep or give the appearance of sleeping on clinical assignment. 3. Exhibit abusive or disrespectful behavior or use inappropriate language while in the clinical or field setting. 4. Not leave the clinical or field agency site for meals or any other reason except with permission of the clinical/field Coordinator only. 5. Not use telephones on the clinical units for personal use. Cell phones are not to be used in the hospital during clinical rotations or while providing

patient care in the field setting. 6. Not leave patients unattended in rooms without proper immobilization or safety devices in place. 7. Not accept any type of gratuity or tip from a patient or a patient's family.

PROFESSIONAL AND ETHICAL CONDUCT

Ethical standards of conduct must always be observed in the agency. At no time should you be impolite in expressing feelings or opinions while in the agencies. It is emphasized that critical thinking and self-direction are necessary and desired of all students.

Tips! To prepare for a shift, make sure you’re wearing the complete and proper TCC uniform and you have your stethoscope, pen and forms. Don’t forget your TCC ID, too!

The cooperating health agencies contribute in large part to the educational process, since the most important "material" for practice is the patient*. You, as well as your instructors, are emissaries responsible for public relations between the TCC EMS program and the agency, and the program and the community. You are responsible to the preceptor and coordinator and should confer with them before consulting agency employees at any time. You do not have the right to refuse any experiences offered to you in your curriculum of study.

*All patients have the right to refuse care by a student. You and your preceptor’s responsibilities to the physician: 1. Accurately carry out the physician's order to the best of your ability. 2. Never indicate a preference for the services of any physician to a patient. 3. Never criticize or discuss a physician and his/her practices with a patient or the patient's family. 4. Interpretation of the patient's condition or diagnosis is the physician's responsibility. You and your preceptor will never assume this responsibility or

express any opinion involving the patient's diagnosis or treatment to the patient or the patient's family. 5. Due to the physician's higher professional position, you should always display the appropriate amount of respect and consideration. Your responsibilities to the patient: 1. Responsibility for a patient is of the utmost importance. You should never be guilty of causing a patient unusual physical or mental discomfort that

could be prevented by technical skill, attentiveness, or sympathetic understanding. 2. It is every patient's right to be treated with humanity and compassion. Although a certain amount of professional firmness is necessary, this should

never be permitted to degenerate into rudeness. Reasonable indulgence should be accorded for the whims of the sick, especially to those whose mental powers have been affected.

3. The patient-student relationship should not develop into an intimate one. Interactions between you and the patient should be held with the highest regard to discretion and respect. You should never divulge any patient’s physical or mental infirmities, character flaw, personal or domestic problems unless a situation occurs and makes this information vital. This obligation confidentiality extends beyond the completion of technical services. Whether within or outside the hospital boundaries, patients’ personal, private and medical information are not to be a subject of conversation between students and their associates.

Remember:

• Providing safe and quality emergency medical care is the goal of individuals who practice emergency medicine. When you enroll in an EMS course, you accept a high degree of responsibility to the patient, preceptors, instructors, fellow students, and members of the health care team. In addition, the qualities of honesty, integrity, dedication and respect for others are essential to emergency medicine.

• Present documentation for the minimum number of skill competencies and hours in the assigned clinical/field agencies. Each course will specify the minimum requirements.

• Clinical/field experiences will be scheduled only at authorized facilities, which currently maintain student agreements with the EMS Program at TCC. • Self-scheduling between you and the facility or agency is not authorized. • Failure to report for a clinical or field shift or attendance of an unscheduled clinical rotation or field internship shift will result in a loss of points and

possible further disciplinary action; hours and skills earned from the unscheduled shift will not be counted. • You should appear for your clinical and field shifts at the designated location, time, and date that you have been assigned, and remain there for the

duration of the shift. You are not permitted to leave a clinical/field assignment before the end of the shift unless given permission by the coordinator. • Students should check in and out with assigned preceptor or charge nurse. All clinical and field documentation must show accurate times of reporting in

and checking out of the unit or agency worked. • Students should refrain from tardiness and absences. Absences due to illness may require a note from a physician excusing your absence before

allowing you to resume clinical and field rotations. If extenuating circumstances exist, an absence may be excused. Unexcused absences will result in loss of points and possible further disciplinary action. Tardiness and absences should be reported to the clinical or field coordinator prior to the beginning of the shift.

• Any necessary cancellations of scheduled assignments should be made in accordance with the cancellation policy in the Handbook and Course Outline.

• Your attendance is essential to the successful completion of this program. Re-scheduling clinical rotations and/or field internships due to illness is the sole responsibility of the student. Repeated absences will be monitored and if necessary will result in academic counseling and possible probationary monitoring. Absence from a clinical or field shift while in a probationary status may result in dismissal from the program.

• If you arrive for a clinical or field rotation and for any reason are not allowed by the facility to remain, you need to notify the appropriate coordinator immediately

• Extension of the clinical experience up to two hours beyond the scheduled time can be authorized with the permission of the charge nurse, provided that there are no other TCC students scheduled. Field internship students may extend their internship time with permission of the agency supervisor.

• You will honor requests for assistance from the hospital staff while on rotation in a clinical area only if you are trained to perform the requested task. The preceptor, charge nurse and clinical coordinator should be notified if any unresolved conflict arises. You shall perform clinical skills only if you have received instruction in the classroom and have successfully performed the skill during skill practice. You may perform skills under direct supervision of the clinical preceptor.

• You shall only administer medications which you are familiar with, or have had time to research. You shall be familiar with the indications, contraindications, actions, side effects, and proper dosages of any medication prior to administration. No medication will be given that you do not have specific knowledge of, are unclear of the dosage, or without a physician’s order and preceptor supervision. You should not administer any drug you have not prepared. Needles, syringes, IV materials or any other medical supplies shall not be removed from the clinical area, field agency areas or any skills laboratories.

• Computer security is strictly adhered to in the hospital. The use of computer systems by students is not permitted. • All contacts with local media shall be directed through the approved public relations officials only. • All students should take the following items to all clinical and field rotations: stethoscope, watch with second hand or digital, Clinical/field

evaluation sheet, black or blue ink pen, and envelope and Clinical/field handbook (recommended)

CONFLICT OF INTEREST

The clinical rotation and field internship are essential components of the EMS training program. Therefore to prevent any potential conflicts of interest, you may participate in clinical rotation or field internship where the preceptor, nurse, employer, or hospital staff member is related to you or by means of definition. The following are examples of conflict of interest: A. Supervisor/Student relationship B. Employee/Employer relationship C. Spouse or significant other relationship D. Relationship that is beyond platonic in nature. Students who are concerned about conflict of interest should consult with the Clinical and/ or Field Coordinator prior to shift to prevent such incidence. Students found to be in violation of this policy may face disciplinary action and may forfeit all clinical or field shift hours and skills

CHEATING

The EMS program adheres to the College policy on cheating which is published in the TCC catalog and Student Handbook. Refer to the most recent publication for this policy. The policy on cheating for the EMS program is outlined in the Academic, Misconduct, Dishonesty and Honor Code Policy.

ACADEMIC MISCONDUCT, ACADEMIC DISHONESTY, & HONOR CODE

The EMS program will not tolerate Academic Misconduct in any form (zero tolerance) and follows the Policy of Tidewater Community College as outlined in the Student Handbook. Academic Misconduct includes but is not limited to the following actions:

Cheating on quizzes and exams Falsifying evaluations (clinical, field, and/or practical) Falsifying documents related to the College, agencies, or hospitals Copying information from another person for graded assignments Plagiarism-the intentional or accidental presentation of someone else’s words or ideas as your own. Submission of work other than your own for written assignments Abuse, theft, or destruction of College, hospital, or agency property Inappropriate language or behavior Any false documentation in Platinum Planner

An Honor Code is based on a student’s personal integrity. There is a responsibility that comes within the EMS profession to monitor yourself and your peers so that a high standard of ethics is maintained. Students should establish and maintain high ethical standards for their behavior and monitor the standards of their peers as well. This integrity includes and is not limited to the following actions:

Following the Academic Misconduct Policy

Reporting any of your peers who are in violation of the Academic Misconduct Policy Reporting of any unethical actions by their peers

It is your responsibility to follow the Honor Code and the Academic Misconduct Policy of the EMS program and that of Tidewater Community College. It is also your responsibility to report violations of the Honor Code and Academic Misconduct Policy among your peers, of which all sources will remain confidential. Cheating in the clinical and field area includes (but is not limited to):

1. Failure to perform a procedure but recording that it was done (i.e.: vital signs, drug therapy, intubations, patient contacts, etc.). 2. Administering a medication that was in error and failure to report it (see Appendix A: “Medication Discrepancy Reporting) 3. Mis-documentation on the patient's chart. 4. Misrepresenting the truth to patients, staff, faculty, or peers. 5. Falsifying documents related to the college, agencies, and hospitals.

The penalty for cheating in the clinical or field area will include receiving a grade of “F” for the involved course (s) and dismissal from the EMS Program for a period of ONE year. The penalty for other forms of Academic Misconduct (other than cheating) may result in counseling, suspension, probation, and/or dismissal from the EMS program for one year.

The outcome of all student disciplinary issues will be determined after consultation with the Program Director AND Medical Director of the Program. These offences are considered to be serious and will be treated as such.

PROBATION

You may be placed on probation if you are not performing satisfactorily in the clinical or field setting. This probationary period will be in effect until the end of the semester. At that time you must be removed from probation in order to continue within the program. The policies and rules of this program have been developed and revised as needed to ensure consistency and efficiency. They apply to all students and are enforced fairly. When policies or rules of conduct are disregarded (including policies and rules set by clinical and/ or field agencies), the following procedure will be followed:

1. Upon first offense you will receive a verbal and/or written warning by your preceptor or coordinator. A counseling form will be completed and a conference may be held with the parties involved.

2. If the same policy or rule is disregarded a second time, further action may be taken. Any student receiving two written warnings within a semester may be placed on probation for the remainder of the semester. If you receive another written warning during the probationary period, dismissal from the clinical component may result and you may receive a failing grade. Any student who is put on probation more than once may be dismissed from the program at the discretion of the coordinator, program director or medical director. Depending on the severity, frequency, and circumstances of the matter, in the opinion of the coordinator, program director, and medical director, you may:

1. Receive a written warning without a verbal warning being issued. 2. Be placed directly on probation without any previous written documentation. 3. In some cases, violations of the policies and procedures can warrant dismissal from the program without probation. 4. Scheduling of clinical and field rotations may be withheld until completion and resolution of any investigation.

Any student dissatisfied with the decision has the right to utilize the appeal procedure. The outcome of all student disciplinary issues will be determined after consultation with the Program Director AND Medical Director of the Program.

APPEAL PROCESS

This policy will be utilized when you are not satisfied with the results of a conference with a preceptor or the coordinator, or you wish to appeal a written warning or probation. The conference between you and your preceptor or coordinator identifying the conflict or policy violation must be documented on the appropriate form. Each party must sign the form to signify knowledge of information contained on it. Please try to resolve the grievance with your coordinator first, before any further steps are taken.

If you do not agree with the contents of the written warning or corrective action, or wish to appeal clinical probation, the proper channels must be observed:

1. Your preceptor or coordinator must be informed of the grievance or appeal within one (1) week of the conference. Otherwise, the decision will be final. 2. Your coordinator will then contact you to set up a meeting to justify his or her actions. At this time the program director and medical director will review the

case. 3. After the initial conference the coordinator may recommend a conference with the involved parties to attempt to resolve the conflict. The program officials

will determine the interpretation of the policy or situation and action taken. A conference with program officials does not assure a reversal of the coordinator's decision.

4. If you are not satisfied with the decision made by the program officials, the division chairman will then be called upon. 5. If conflict cannot be resolved at this level, the division chairman to review the case will contact a college official. At this point you will be contacted to set

up an appointment to see the division chairman or college official. 6. The program official in conjunction with the division chairman and any other designated college official(s) involved will determine the final decision.

STUDENT HEALTH CONCERNS

It is strongly recommended that you carry health insurance. Medical treatment will be available through affiliate hospitals on a cost-for-service basis. The College or agency does not assume any responsibility for students or preceptor's accidents or illness at any time. An insurance plan is available for you to purchase through TCC at a reduced rate for students not already covered by another policy. In the event of illness, you should notify your clinical or field coordinator prior to the start of your shift so that the hospital or field agency can be notified of the cancellation. If you are ill with a fever, cold, cough, runny nose, nausea, vomiting, and diarrhea, or with other symptoms, you should not attend your clinical or field shift.

In the event of illness, injury, or exposure while on a clinical or field shift, you are responsible for notifying your preceptor and your coordinator. If medical attention is necessary, you should report to the Emergency Room for evaluation and treatment. The civilian students’ health insurance will be responsible for any and all costs associated with injury, illness, or exposure sustained during a clinical or field shift. Active duty military students shall follow established work related injury guidelines. A Critical Incident Report form (available in Appendix C) will then need to be completed and submitted to the coordinator for review. In the event of pregnancy, you will need to obtain medical permission from your physician stating that you are able to meet the physical requirements of clinical and field experience. Be sure to call your Coordinator before the shift begins if you are unable to make it!

MEDICAL LIABILITY

All students enrolled in the EMS Program of Tidewater Community College are advised that during their clinical and/or field rotations there may be increased health risks due to exposure of unknown diseases, various bacteria, environmental hazards or radiation. If the student is pregnant or becomes pregnant, be advised that this exposure may be harmful to unborn children. The Office of Nuclear Regulatory Research has taken the position that special protection of the unborn child should be voluntary and should be based on decisions made by workers (students) and employers (program officials) who are well informed about the risks involved. Students must be able to meet the technical standards, the immunization requirements and the immunity levels as required by TCC’s affiliates for continuing with the internship portion of the program. Clinical and field sites may decline from allowing the student to continue doing rotations in their hospitals or field agencies if specified requirements have not been met, regardless of religious or personal beliefs. A student may be asked to obtain a physician’s review of the student’s condition and approval to continue in the program. The student’s Clinical Coordinator, Program Director, Medical Director and Dean may be involved in advising, counseling, and recommending a student’s continuation in the program if requirements have not been met. This will be handled on an individual basis. Should a physician's consultation and written permission to continue in the program be necessary and/or the student has not met all required technical standards of the program (including the immunity/immunization requirements of the affiliates) the student has several options: 1. Withdrawal in good standing with the student returning at the point where the student left off in the program provided that it is within the time frame

as directed by the EMS program requirements. The student may also choose to continue in the classroom portion of the course and postpone the internship portion of the program until a medical clearance is granted by the physician.

2. The student may also be given an “Incomplete” based on the criteria of the EMS program and that of Tidewater Community College. If granted an “Incomplete”, the student would then have to complete course requirements by the end of the following semester.

3. Continuation in the program under the following circumstances:

a. Physician’s approval and meeting the required immunity levels, immunizations, and technical standards of the hospitals and agencies. b. Hospital or Agency approval c. Counseling with the student’s Clinical/Field Coordinator to discuss potential risks d. To ensure consistency in all aspects of clinical education and meeting clinical objectives, all rotations which are missed due to a medical

condition will have to be rescheduled e. A record will be kept to document any missed rotations or incidences while on rotation. f. Depending on the option chosen, it is conceivable that the student's completion date may be delayed until all clinical and field hours and

competencies are completed. g. Neither the college nor any hospital or field affiliate will accept responsibility for alleged exposure damage to the student. h. The student must sign a form releasing the college and its affiliates of any liability associated with medical liability.

WITHDRAWAL FROM COURSES

If you discover a need to withdraw from the internship course you will need to do so within the College’s drop add period. If you fail to do so, you may receive an “F” for your final grade. If you are unable to complete or meet the obligations of the clinical course then you are encouraged to discuss potential options with your coordinator. Students who do not complete pre-clinical/field requirements by the designated due date may be administratively withdrawn from the clinical and/or field course by the course instructor.

CHANGE OF NAME/ADDRESS/PHONE

It is the responsibility of ALL students to inform the admissions office, the EMS office, and the clinical/field coordinators of any change of name, address, phone number, or e-mail address, in writing, within one week following the change to assure accurate records.

DISABILITY SERVICES

A counselor is available on each campus to help students with physical, sensory, and/or learning disabilities, or chronic health problems that require assistance, academic accommodations or program modifications. The Coordinator for Disability Services is based at the Norfolk Campus and maintains office hours at the other campuses. Students needing accommodations for Disability Services may contact a counselor. They are listed in the directory for each campus. All contacts are confidential.

VCCS E-MAIL & COMMUNICATION

All students are assigned a TCC/VCCS email account when officially registered for classes. You are required to use your college-provided email address as your official email address when corresponding via email with TCC faculty and staff.

You are required to email your instructor, clinical coordinator and field coordinator at the beginning of each semester, using this account. This form of communication will be used between you and your instructors for the purposes of class announcements, scheduling requests, and other individual student issues.

You must check your email at least every 48-72 hours.

How to communicate effectively with your coordinator (and vice-versa) EMAIL: --Use your TCC email account, for starters --Have a brief, but direct, subject line --For routine questions, allow about 72 hours for him or her to get back in touch with you; if it requires quick attention, please list a telephone number where you can be reached MOBILE: --If it’s an emergency or especially important, please call or text your coordinator

You may elect to forward mail (at your own risk) from your official VCCS email account to another (student-selected) email system. If you that use this option, you are still required to use your TCC/VCCS email when replying to class emails.

Students are discouraged from forwarding their TCC email to other personal accounts or electronic devices. Messages that are sent or received from the TCC account may get deleted or filtered out as spam.

If you do not have access to the World Wide Web, you may find web access on any TCC Campus, in the open computer labs or campus libraries. You must have a TCC Identification Card for access. You may also find access at your rescue squad or local community library. If you find you are having a problem with web access, you are encouraged to contact your clinical/field coordinator or computer lab staff member as soon as possible to avoid academic penalty.

You are responsible for the information that is disseminated across all channels of communication.

Visit any of the campuses' open computer labs for assistance:

Portsmouth Campus Library-Building A, First Floor Virginia Beach Campus Bayside Building, Second Floor, Room B-200 | Virginia Beach Campus RHPC, Second Floor, in front of elevator Virginia Beach Campus ATC Building, Second Floor Chesapeake Campus Whitehurst Building, Room 2486 Norfolk Campus Roper Building, Room 4101

COMMUNICATION POLICY

Communication is the key to success when taking any college class. With this idea in mind it is imperative that both the instructor and student maintain open channels of communication throughout each semester. Instructors are responsible for providing their students a means to communicate by a combination of the following: office hours, email, and telephone. This information will be updated, and provided via the course outline at the start of each semester, and updates will be provided to the students as needed. Students are responsible for adhering to the communications policy as set forth by your instructor. Students taking EMS classes are in a unique situation that involves many different instructors working together. The instructors include the classroom instructor, practical instructor, clinical coordinator, field internship coordinator, and various hospital and agency preceptors. Although these instructors and preceptors work together, each one specializes in a particular area or discipline. Students desiring information from a particular instructor are encouraged to contact the appropriate instructor to handle area specific questions. Please allow reasonable time for your coordinator to resolve your issue before contacting anyone else. Students must make an effort to handle all problems that arise at the lowest level possible. Going to the Program Director, Dean of Health Professions, or Campus Provost without allowing the issue to be handled at the lowest level possible is inappropriate. Misrepresenting or falsification of facts to the Program Director or Dean of Health Sciences falls under violation of the Honor Code/Academic misconduct, and will be handled as such. Please allow the appropriate coordinator a chance to address an issue prior to involving the EMS Program Director or Higher.

CLINICAL/FIELD DRESS CODE

The following guidelines are used to assist you in the various agencies. TCC expects to have its students represent the college in a manner, which reflects its goal toward high standards of professionalism. The ultimate goal of the dress code is to protect the patient and student from cross-contamination and to reflect confidence and assurance in patient contact and interpersonal relationships.

All students enrolled in EMS programs are required to purchase appropriate uniforms.

You are expected to be well groomed and maintain a professional appearance at all times. The preceptor, coordinator, and charge nurse reserve the right to bring unsatisfactory grooming and improper appearance to your attention and take appropriate disciplinary action.

Tips! You are expected to check your TCC email account at least every 48-72 hours, if not daily. This is one of the main channels of communication between you and your instructor, so you may want to check it a few times a week.

UNIFORM REQUIREMENTS

In order to ensure consistency in the TCC EMS Program, the clinical uniform for all students is specified below. Arrangements have been made with Harbison's Uniform Shop, 479 S. Lynnhaven Road in Virginia Beach, for purchase of uniforms (phone number 757-463-3241). It is your responsibility to order, pay for and pick up the uniform shirts. Please allow 2-3 weeks for your order. Uniforms shirts are also available at the TCC Bookstore on the Virginia Beach Campus. 1. White non-decorated polo shirt without pockets, the embroidered TCC

lettering will be sewn on the left side of the shirt (Blue shirts for Critical Care students).

2. Navy blue, black or khaki long pants (NO JEANS or SHORTS) are to be worn for clinical and field shifts.

3. Uniforms should be clean, unsoiled and freshly pressed so that the student presents in a professional manner. Take pride in good personal hygiene.

4. TCC picture ID (clipped to the shirt collar) 5. Dark, sturdy, closed toe shoes 6. Fingernails are to be sheer clean and well-manicured. Wild nail colors are

unacceptable; false fingernails are strongly discouraged 7. Excessive jewelry should not be worn in the clinical areas. Simple, post type

earrings may be worn. Earring or metal jewelry worn in nose, mouth, eyelids and tongue is unacceptable.

8. Hair should be clean and worn off the collar, arranged to minimize contact with patients and for safety. Beards and mustaches should be short and neatly trimmed.

9. Every effort should be made to cover all visible tattoos. 10. Avoid use of colognes and after-shave lotions. 11. Lab coats or scrubs will only be worn in areas requiring them. 12. For clinical in psychiatry, wear your TCC uniform. Remember to dress

defensively. (No scissors, sharps, etc…) 13. No ball caps / hats are permitted in the clinical or field setting 14. Facilities and/or the preceptor reserve the right to send the student home if a

violation in the dress code occurs. 15. During the winter months field students are permitted to wear a dark color (navy

blue or black) jacket or sweater that is nondescript. You are not permitted to wear any jacket that is from another agency or department.

16. You are responsible for your own safety at all times. While working in a field internship agency, you must familiarize yourself with the safety equipment and procedures for each agency.

17. Be advised, you should not bring anything of value to your shift. 18. Students sponsored agency and completing field shifts may be allowed to wear their agency-appropriate attire, provided TCC has an affiliation letter on

file. 19. If TCC is placing students in agencies for field time the approved TCC uniform is required. If at any time during your field internship you are involved in

a working incident on a street, highway or roadway, traffic vest and safety equipment is required. You must check with your preceptor and crew prior to the start of the shift to ensure the proper amount of safety equipment is available for your use.

MEMORANDUM OF AGREEMENT

Before TCC can utilize a hospital, facility, or agency for their students a current Memorandum of Agreement (MOA) must be in place and be current. If for any reason the MOA is on hold, is awaiting signature, has been cancelled, or is inactive then the student is NOT permitted to do clinical rotations there. Liability is a major focus of the MOA, along with spelling out the requirements, duties and responsibilities of the school and the facility, and requirements and responsibilities of the student. It is very important for TCC to abide by their requirements of these contracts. TCC does hold the liability for our students, provided that we have authorized the students’ attendance at that particular facility; thus the reasoning that “no student may self-schedule between himself/herself and the facility.” The student could face penalties for doing such.

Think you’re ready for your shift?

Do you have your: -- Appropriate uniform

--Dark, closed-toe shoes --TCC ID

Good! What about:

--Your hair. Is it clean? Nicely trimmed? Worn off the collar?

--Sir: Is your facial hair neat, short and maintained?

--Are your fingernails well-manicured?

--Are your tattoos as covered up as possible?

--Are your piercings removed?

All right! And you’re not: --wearing after-shave, cologne or perfume?

--wearing jeans? --wearing a ball cap or hat?

You’re ready for your shift! Good luck!

HOSPITAL AND AGENCY PARKING

You should park in areas designated by the individual agencies and you may be required to remit fees for parking. If you have any questions you should check with the agency or facility staff prior to parking your car for the shift. Tidewater Community College Faculty and Staff assume no responsibility for a student’s vehicle that is parked in any hospital or agency parking lot. If anything happens to your vehicle while parked at a facility contact the facilities security department or police department for further information.

MEALS

Coffee breaks, lunch or dinner schedules will be determined at the discretion of the preceptor, unit supervisor, or coordinator while on clinical or field assignment. As a general guideline, follow the hospital/agency schedule for breaks and meals. You must remain in the clinical/ field agency during meals and breaks.

OUTSIDE EMPLOYMENT

The faculty realizes that it is necessary for students to work while attending school. Work requirements should not conflict with school requirements or obligations. Any student working must arrange his or her work schedule so those work hours do not conflict with scheduled clinical hours. Any problems encountered must be brought to the attention of the clinical and/or field coordinator. Exception is given to field interns working with a 911 agency. Students may receive credit from their employer only if the following criteria are met:

1. Skill competencies shall only be completed when the student is functioning in the presence of an approved preceptor. 2. The student can only receive credit for being the team leader on a call if they are functioning as a third person on the ambulance, under the

supervision of an approved preceptor. This will be discussed in more detail in the Field Section of the Clinical/Field Handbook. If you appear too fatigued or ill to perform SAFELY during your clinical rotation or field internship, the preceptor/instructor reserves the right to dismiss you immediately. Sound physical and mental well-being is important to patient care. Students should not work consecutive shifts (be it work, clinical or field) and should arrange their schedules so they are not fatigued. Disregarding this policy may result in a loss of points accordingly.

USE OF BLACKBOARD

The Student Information System (SIS) automatically assigns an EMPL ID number to each student once the application for admission is processed. This number remains your student identification while you are attending Tidewater Community College. During the semester you will be required to know your EMPL ID. Once registered, you will also be assigned a random clinical/field number referred to as the CFIH. This number will be used to post discrepancy lists, schedules, skill/tracker, and other necessary information. This number can be found under “My Grades” on Blackboard. Blackboard, which is located on the TCC website, is a popular means for faculty to post announcements, assignments, quizzes, additional resources and for communication. You will also be required to communicate with your instructor via the VCCS e-mail system. Your TCC e-mail address and your Blackboard account login can be obtained by going to the www.tcc.edu website and clicking on “My TCC.” Follow the prompts in order to set up your password and pin. Once you have been assigned your password and pin, you will be able to access the Blackboard system (Bb). You can then click the appropriate course listing and check for additional information. Clinical and Field courses will utilize the Blackboard Learning Management System. All students must have access to a working computer and access to the internet. The student may use the computers in the library at any TCC campus, the public library or any computer that will allow access to the internet. Not having a computer, computer crashes, or computer illiteracy are not acceptable excuses for late work or ignorance of announcements, or clinical schedules from the coordinator. Students in need of assistance for technical or general support issues should call the HELP desk at 822-2457. The student is encouraged to insure consistent access to Blackboard within the first two weeks of class. Students are required to check their Blackboard courses every 72 hours, if not daily.

PLATINUM PLANNER Platinum Planner is a multipurpose program that allows the student to schedule both clinical and field shifts through the college, self-schedule if affiliated with an agency, input documentation associated with scheduled shifts, and finally, track your progression throughout your tenure in the program regarding status on competencies. Your instructor will not accept you into class (meaning no access to scheduling) until you meet all pre-clinical requirements. Therefore, if you miss the pre-clinical deadline, you will continue to miss scheduling deadlines until you meet all pre-clinical requirements. How to create your account:

1) Use the link https://platinumplanner.com to access the program. 2) From the “Main Screen” select the “sign up” link in the upper right corner of the screen. This opens the enrollment page. 3) Complete the enrollment page with the required information. Remember, you must use the VCCS email account as your email or the system will

not recognize you. Put your level behind your last name when you sign up (i.e. enhanced, intermediate, or paramedic level.) 4) Complete the information and click “Sign Up.” 5) You will see a slide acknowledging your submission. 6) Check your VCCS email account for the registration email. Click on the link. A window will open in Platinum Planer telling you that you have

“successfully activated your account.” 7) Go to the top of the screen and login with the username and password you just completed. A registration window will open. Select TCC in the

first choice. 8) Your coordinator will tell you specifically which course to enroll in. Then you await approval and acceptance into the program. 9) You will then need to request your class (i.e. EMS 170, 172, so on.) 10) Remember, you won’t be accepted into your class until all pre-clinical and pre-field requirements have been met. 11) Once accepted into the class, you will be able to schedule your shifts – called “opportunities” in Platinum Planner.

Once you schedule shifts, they appear in the Calendar. This is the page the coordinator uses to track your attendance at scheduled shifts. If the shift appears on this screen, you are responsible for attending the shift. Note: if your shift is a pending request, it will not appear on the calendar until approved. How to schedule Clinical shifts

1) Click on the “Find opportunities” button on the top right side of screen. 2) Then, select the specific class you are enrolled in. 3) A window will open showing various opportunity categories. The list of available opportunities will depend upon the class you are enrolled in. 4) Choose the specific type of rotation you wish to schedule. You will see an endless list of opportunities. You may scroll through the opportunities

or you may “Search” for specific opportunities. 5) Here is where we recommend you set down with a calendar for the specific month you are scheduling. Annotate the calendar with work days,

volunteer days, family events, etc. Then, you will have the blank days you are available for scheduling. This is a good opportunity to review the scheduling guidelines in the Handbook. Then you can search based upon the date or specific location for your shift.

6) Select the shift on the right hand side. The shift will then appear in your calendar and on the “My Opportunities” Page. Remember, the approval on the “My Opportunities” page is related to the documentation and not the shift. Note: There are pending clinical opportunities at hospitals like RRMC and Careplex due to additional forms and requirements you must complete before attending those shifts.

7) The process remains the same for every clinical type. Repeat the above process. How to schedule Field shifts

1) The process remains the same as Clinical, at least through step 6. 2) Identify the date you are available for a shift. 3) Choose EMS. 4) Navigate through the available shifts. 5) Select the shift you are available for. 6) This is where the process differs. The shift becomes a “Pending Shift.” The shift is not approved until you are assigned to a specific medic within

a specific agency. 7) The coordinator will approve you and you will receive a message from Platinum Planner indicating which city, station, and times for your field shift.

Be aware of this process. Stay on top of this, or you will miss a shift.

Note: Field scheduling is dynamic and based upon the available shifts provided by the agencies TCC uses for field internship. There is no guarantee for these shifts. It is best to schedule early and schedule more than you need. How to self-schedule If you are sponsored by an EMS Agency, you may affiliate and be sponsored by that agency. This allows you to “self-schedule” with your own agency to conduct Field Shifts. If sponsored, you will also enroll in “Self-Scheduling.” You will submit your schedule to your agency. Once your precepted shifts are approved by your agency, you then select “self-scheduling” as your class and then sign up for shifts on the days provided by your agency. The Coordinator can provide specific guidance for completing this process as needed. However, it remains the same as above. Search to the date, or agency desired, scroll through and select your shift. How to add documentation and clinical/field forms When viewing “My Opportunities” you will see four possible titles; “Begin Documentation, Resume Documentation, View Documentation, Correct Documentation.” Each has a specific meaning. Begin Documentation = enter documentation for the first time Resume Documentation = return to enter incomplete documentation View Documentation = view completed documentation Correct Documentation = correct rejected documentation

1) Select the shift you wish to document, and the documentation window opens. 2) Select Preceptor; a window opens and you select the preceptor from a drop down list. If the preceptor is missing, understand that you will be able

to create your preceptor’s profile – you just need their contact information. 3) Time/Patient Data: a window opens allowing you to input the patient data. Select the “Add Patient” button to begin. 4) The first data input fields are self-explanatory. In the skills drop down menu, a list of skills appears. You will have multiple entries. You will

continue to add skills until you complete all interventions for the specific patient. 5) Correctly identify whether you observe, attempted, or completed the skills. 6) Repeat for each patient. 7) Be sure to include age assessments, categories of assessments and all skills complete. You may get credit for multiple age assessments but not

multiple category assessments. 8) You must complete the documentation of your shift into Platinum Planner within seven days of the shift. The paper copy of your clinical/field form

must be turned in to your coordinator within seven days of completing the shift. How to correct documentation The Coordinator will grade the paper copies of turned-in Clinical (CER) and Field (FER) Evaluation Reports. The graded copy of the CER/FER must be the same as the documentation submitted by the student. If the students’ documentation differs from the graded copy of the CER/FER, the documentation will be rejected and the student will be advised of the necessary corrections. The student will then go into the documentation making the necessary corrections. This process will continue until the documentation is correct or the documentation is rejected by the coordinator for multiple attempts to correct the documentation. Please do not falsify any of the information you enter into Platinum Planner.

CLINICAL AND FIELD SCHEDULING AND CANCELLATION POLICY

1. Students are required to give separate dates of availability to their clinical and field coordinators. Schedule requests for both clinical and field are

due on the 15th of the month for the following month. 2. Schedule requests for clinical and field are submitted through Platinum Planner. 3. Students should submit dates of availability that can be committed to. (No personal appointments should be made until shifts are confirmed).

Students should request only the number of shifts that they can commit to and for which they want to be scheduled. However, due to agency schedule restrictions, it is recommended you give additional dates for field time.

4. Students should not schedule a clinical or field shift immediately following a work, clinical or field shift, especially if the shift ends in the am.

5. Students will be permitted TWO shift cancellations per semester without penalty. This includes cancellations due to illness, change of work schedule, personal appointments, family commitments, or for any reason. Please note Accelerated Intermediate (stand-alone program) and Accelerated Paramedic students are only permitted ONE cancellation per semester without penalty.

6. After the two permitted cancellations, students will lose five (5) points for each cancellation or schedule change thereafter.

7. Any necessary cancellations of scheduled shifts must be made in writing (by TCC e-mail) to the clinical/field coordinator with at least a three (3) business day notice prior to the scheduled shift. Failure to do so may result in a loss of points. Emergency cancellations less than three (3) business days prior to the shift should be made by texting or calling the clinical/ field coordinator. The phone call or text to your coordinator should be followed up with an e-mail.

8. Any extraordinary cases or circumstances must be communicated with the student’s coordinator as soon as possible.

9. If a student feels that they have completed requirements for testing, then a conference must be set up with the coordinator to review his/her status. This must be completed at least three (3) days prior to the scheduled shift. If shifts need to be added or canceled at that time there will be no penalty.

10. In the instance of arriving tardy for a shift, contact your coordinator prior to the beginning of the shift so they can contact the hospital or agency. 11. Understand that you are not allowed to contact the agencies directly to obtain the field ride time schedule.

HOW TO FILL OUT YOUR CLINICAL/FIELD EVALUATION FORM

Top portion Use blue or black ink. Fill in all the information at the top of the first page. Make sure the times you arrived and left are documented and initialed by your preceptor, as well as the checklist on the top of the form. Specific section information: 1. GENDER AND AGE: Must document the exact age and gender of the patient, but name should not be documented! 2. TIME ASSESSED 3. CHIEF COMPLAINT: The presenting problem(s) your patient has. Be sure to document if your patient has multiple complaints. For instance, if your

patient has chest pain AND shortness of breath, you might write “chest pain/SOB”. If you only write “chest pain” we do not assume your patient has shortness of breath and you will not receive credit for such. Another example is a diabetic emergency. If the patient had an altered mental status, it should be documented. We do not assume it, and if you check “Altered LOC” without previous documentation, you will not get credit for the category.

4. ASSESSMENT AND TREATMENT OF: Here, you need to check off in what category or categories your patient fits. If an assessment is NOT performed on a patient, then NO credit will be given for the patient complaint. An assessment includes, but is not limited to obtaining a SAMPLE history, vital signs, focused history, listening to lung sounds, etc.

5. SKILLS PERFORMED:ASSESSMENT: Make sure to give yourself credit for each time you assess your patient. Here, you may get more than one credit if you assessed your patient multiple times, so make sure you use hash marks/ a. Live Intubation: Document if you intubated or tried to intubate a patient. document number of Attempts/Successes. b. Venous Access: Document number of Attempts/Successes. c. Ventilate Patient: Here is where you get credit for ventilating a patient using a BVM on a BLS airway. Document the number of

attempts/Successes. d. EKG Interpretation: Anytime you have a patient on an EKG monitor or 12-lead and you read the strip, give yourself credit. Document number of

Attempts/Successes. e. Medication Administration: Document ALL meds given in the appropriate category. f. Oro/Nasogastric Tube: Document if you performed this skill

6. FIELD USE a BLS Team Leader: All times you were in charge of a BLS call b ALS Team Leader: All times you were in charge of an ALS call c Team leader: All times you were in charge of a call

Tips! Set a reminder on your mobile device for the 14th of each month you’re enrolled. And right when it goes off, sit down right away and hop on Platinum Planner to submit your dates! Don’t hesitate to contact your Coordinator, he or she is here to help you. Should you have to cancel your shift due to a personal emergency, please call or text your coordinator as soon as possible. And follow up with an email, too!

Tips! Review the following areas before leaving the shift: • Preceptors must initial your arrival and departure. Verify

correct time/date. • Preceptors must initial next to each patient in the

preceptor’s initial box. • Preceptors must completely fill-out the behavioral

evaluation. • Preceptors must sign and print their name. Remember a

preceptor must be an RN, PA, or MD, DO, or CRNA. If a tech or paramedic signs, then it MUST be co- signed by an RN. They MUST document their title on the evaluation, e.g. Jane Smith, RN.

7. PRECEPTOR’S INITIALS: Make sure your preceptor initials here on each line you have a patient. If they do not, you will not be given credit for that patient or any skills performed.

8. Behavioral Evaluation (back page): a Your preceptor needs to evaluate you on all 12 areas listed. b Your preceptor MUST sign and print their name and credentials here. If they don’t, you will not get credit for the entire evaluation until it is

signed. Remember, an R.N., P.A. or M.D., D.O., or CRNA must sign for clinical. For field, the preceptor must be at or above the level you hope to test. It is your responsibility to verify preceptors have completed their section appropriately.

c You need to sign. If you don’t, the evaluation will be given back and you won’t be given credit until completed. 9. Student and Preceptor Comments, use as needed. 10. Student Clinical Site Evaluation: You fill out for the agency or hospital. The paper copy of your clinical/field form must be turned in to your coordinator within seven days of completing the shift.

Remember to keep the yellow sheet for your records. Students that have questions or are unsure of the way to fill out a particular section on the Clinical/Field evaluation sheet are encouraged to meet with your coordinator as soon as possible to avoid missing out on receiving the proper credit. Sheets filled out incorrectly and submitted that have been signed by preceptor cannot be modified at a later date.

**NOTE: Any patient for whom you document a presenting problem and you are unsure of the appropriate category, or they have multiple problems, then you need to thoroughly document additional comments in the student comment section at the bottom of the evaluation form. You may attach additional sheets as needed, or continue your documentation on the back of the white copy of the sheet. If you are still unsure of what is required, please contact your clinical coordinator for clarification.

EVALUATION OF AFFECTIVE OBJECTIVES FOR CLINICAL AND FIELD PERFORMANCE

Evaluation of Affective Objectives A. The affective objectives required at the State and national level are:

• Integrity • Empathy • Self-Motivation • Appearance and Personal Hygiene • Self-Confidence • Communications • Time Management • Teamwork and Diplomacy • Delivery of Service • Respect • Patient Advocacy • Team Leadership (Field Only)

B. The affective objectives are currently part of the student clinical/field evaluation (side2-Behavioral Evaluation), and have been evaluated accordingly; Satisfactory, Needs Guidance, Needs Remediation, Not Observed.

C. A numbering system has been assigned to each of the evaluation criteria as listed below: Satisfactory = 3; Needs guidance = 2; Needs remediation = 1; Not observed = 0

D. In order to meet the testing eligibility standards, students must demonstrate a “satisfactory” score in all areas as listed above in order to be eligible to test at the Enhanced, Intermediate, or Paramedic level.

E. Students should maintain “3s” in all areas but must maintain at least a “2” in all areas. F. Students who receive sub-standard scores should receive counseling and/or remediation as appropriate.

HOW TO TURN IN YOUR CLINICAL/FIELD FORMS

• All clinical (hospital) evaluation forms will be completed as instructed and signed by the appropriate individuals (student and RN or

MD or PA or DO or CRNA)

• All field (ambulance) evaluation forms will be completed as instructed and signed by the appropriate individual (preceptor). • These evaluation forms should be folded correctly (folded in three and be placed in an envelope (provided by TCC) and sealed at

the end of the shift. Once sealed, the nurse (for hospital shifts) and preceptor (for field shifts), will be required to sign across the sealed part of the envelope. The signature of the person signing the evaluation form and the signature on the envelope must match.

• Students will then complete the requested information on the front of the envelope to include: name, level, clinical or field shift, name of coordinator, and date submitted.

• All envelopes for completed clinical and field shifts will be turned into the TCC EMS Program office within seven days of the shift.

• Please note: you must enter your shift information into Platinum Planner within seven days of completing the shift.

• There may be off-site drop-off lock boxes for your convenience. The location may change semester to semester. See your coordinator for drop-off box locations for the current semester.

• Clinical and field evaluation forms MAY NOT be accepted after the seven-day drop off period and the hours and competencies may not be counted. If you are unable to submit the paperwork within the seven-day time frame, please contact your coordinator.

DEFINED AGE GROUPS

Peds: Newborn, Infant (0-1), Toddler (2-3), Preschool (4-5), School age (6-12), Adolescent (13-17) Adult: 18-64 years | Geriatrics: 65+ years

EMT-Enhanced Requirements (911 Agency affiliation is required for Enhanced eligibility)

1. All EMT-Enhanced students will be required to do a minimum of forty-eight

(48) hours in a TCC approved clinical/field setting. 2. Additional hours may be required in order for the student to meet the

competency requirements. 3. Once the pre-clinical requirements are met, students will do a minimum of 24

hours in the Emergency Room (only) of one of the TCC approved clinical sites. 4. You will then be required to do field time in order to be eligible for EMT-

Enhanced testing. This is only an option if at the end of EMS-151 you are sponsored by an agency and they have agreed to allow you to do your field hours through them. Agency affiliation is a requirement for Enhanced eligibility. The clinical/field coordinators will need a copy of a letter from the agency for sponsoring the student at the Enhanced level. If you are not affiliated with a 911 agency you will not be able to test at the Enhanced Level.

5. You will be required to complete a minimum of 12 hours of field time and must be in the role of team Leader for a minimum of five calls of which three must be ALS. You may choose to do up to 24 hours in the field if your sponsoring agency is in agreement. If you do less than 24 hours of field time, then you will have to complete additional hours in the Emergency Room so that your hours total 48.

6. Field assignments will be made by the sponsoring agency. Clinical assignments will be made through the clinical coordinator. 7. Clinical/Field rotations will NOT begin until the student has satisfactorily completed all of the initial course requirements (of EMS

151) and pre-clinical requirements of the first session. This includes drug calculation, IV access, and medication administration.

Wait! Before you turn it in, have you… --used black or blue ink to fill in your form? --filled out all the information at the top of the page? --checked if your preceptor initialed the times you arrived and left? --checked if your preceptor signed all skills? --seen where your preceptor filled out and signed the behavioral evaluation? --completed the clinical site evaluation? Students must turn in the original evaluation sheet completely filled out and signed. In the clinical setting, the signature must be that of an RN, PA, MD, DO, or CRNA. In the field setting, the signature must be that of a preceptor who is at the level you are testing or higher. Paramedic students must be precepted by a Paramedic preceptor. It is highly recommended that you keep a copy for your records

48minimum hours

Completion and documentation of all competency requirements and hours is the responsibility of the student. Periodic updates will be available for the student’s review throughout the semester. It is the student’s responsibility to validate or note any discrepancies and report them to the coordinator in a timely fashion. No changes or corrections on clinical and field evaluation forms will be made once the semester has ended.

A total of 48 hours is required to meet the Enhanced eligibility requirement

Enhanced competencies (accumulated between clinical/field times)

EMT-Enhanced Competency Requirements State of Virginia Minimum Requirements

National DOT Recommendation

Cardiac/Chest Pain Assessment 5 ___________

Pediatric Resp./Dyspnea Assessment None ___________

Adult Resp./Dyspnea Assessment 5 ___________

Syncope None ___________

Medical None

Abdominal Complaints Assessment 5 ___________

Altered Mental Status/Neuro Assessment 5 ___________

OB Assessment None ___________

Psychiatric Assessment 2 ___________

Trauma Assessment 5 ___________ Pediatric Assessments Age groups: Infant, Toddler, Preschooler, School age, and Adolescent

5 (one in each age group) ___________

Adult Assessment 12 ___________

Geriatric Assessment 5 ___________

Oral Intubation Mankin only ___________

Venous Access 0-17 years 18-64 years 65+ years

10 Total ________

One One

___________

Ventilate patient Manikin only ___________

Medication Administration 15 ___________

EMT-E Requirements State of Virginia Requirements National DOT Recommendations

Clinical 24 hours minimum Emergency Room; additional hours as needed. ____________

Field 12 hours minimum up to 24 hours; five (5) calls as Team Leader minimum three (3) ALS patients. ____________

EMT-INTERMEDIATE REQUIREMENTS

1. Clinical: All EMT-Intermediate students will be required to complete 48

hours of clinical time each semester; and must have a minimum total of 96 hours upon completion of the Intermediate curriculum in order to be eligible to test at the State EMT-I level. All competencies must be completed in order to be eligible to take the State of Virginia Intermediate (EMT-I) exam. Even though a minimum of 68 hours is required by the state of Virginia, this number is the bare minimum permitted to test provided all competencies are complete. The VCCS system requires each hour of clinical time is equivalent to 48 contact hours. The State of Virginia required hours may not meet reciprocity requirements from state to state.

2. Field: All students wishing to take the Intermediate exam must also meet the field requirements. Each student must complete a minimum of 48 hours of ride time in the second semester. In addition, all students must have 10 calls in which you function as the Team Leader. Five (5) Calls must be as ALS team leader.

3. These hours are only a guideline. Additional hours will may be required in order for the student to meet the clinical/field competency requirements

4. All hours and competencies will be cumulative from the beginning of the Enhanced program through the Paramedic program, provided there has not been more than a year absence in working through the curriculum. They will also be cumulative between clinical and field. If a student is not enrolled – and there’s a break in the program -- steps may have to be repeated.

5. Clinical and field rotations will not begin until the student has satisfactorily completed all of the initial course and pre-clinical requirements of the first semester. This includes drug calculation, IV access, and medication administration.

* Eligibility to begin field time is based on satisfactory completion of semester one and completion of Advanced Cardiac Life Support. Completion and documentation of all competency requirements and hours is the responsibility of the student. It is the student’s responsibility to validate or note any discrepancies and report them to the coordinator in a timely fashion. No changes or corrections on clinical and field evaluation forms will be made once the semester has ended.

96minimum hours

EMT-I Clinical Hour Requirements Tidewater Community College requirements

Semester-1 Semester-2 Emergency Department 40 hours 24 hours

Critical Care (ICU, CCU, MTI, OPSU,PACU) 8 hours

Pediatrics 8 hours Labor & Delivery 8 hours Psychiatry none Outpatient OR (PACU) 8 hours

Total 48 hours 48 hours Grand Total 96 hours (clinical)

EMT-I Field Requirements State of Virginia Requirements

Semester-1

Semester-2 48 hours ride time

Begins in the Second Semester* 10 Team Leader Calls (minimum of 5 ALS calls).

competencies

EMT-I Competency Requirements State of Virginia Minimum Requirements

National DOT Recommendations

Cardiac/Chest Pain Assessment 15 15

Pediatric Respiratory Assessment 4 4

Adult Respiratory Assessment 10 10

Syncope Assessment 5 5

Medical Assessment 5 5

Abdominal Complaint Assessment 10 10

Altered Mental Status Assessment 10 10

Obstetrical Assessment 5 5

Psychiatric Assessment 10 10

Trauma Assessment 20 20

Pediatric Assessment, to include Newborn, Infant, Toddler, Preschool, School age, Adolescent

15 15

Adult Assessment 25 25

Geriatric Assessment 15 15

Live Intubation one live patient* one live patient

Venous Access 0-17 years 18-64 years 65+ years

25 total One One One

25 total One One One

Ventilate patient one 5

Medication Administration 15 15 *If unable to gain competency in the field or clinical, successful completion of the difficult airway scenario may be counted. Completion and documentation of all competency requirements and hours is the responsibility of the student. It is the student’s responsibility to validate or note any discrepancies and report them to the coordinator in a timely fashion. No changes or corrections on clinical and field evaluation forms will be made once the semester has ended.

EMT-PARAMEDIC REQUIREMENTS

1. Clinical: All EMT-Paramedic students will be required to complete 48

hours each semester for a total of 192. 2. These are the state of Virginia hourly requirements. The state of Virginia

and National DOT do not have competency requirements but recommendations for the number of requirements. The National DOT curriculum requires competency completion. The VCCS system requires each hour of clinical time is 48 contact hours. The required hours will not meet reciprocity requirements from state to state. Field: All students wishing to take the EMT-P exam must also meet the field requirements. Each student must complete a minimum of 48 hours of ride time. In addition, the student must have 50

192minimum hours

(all semesters, combined)

patient contacts in which you function as Team Leader. Over one half the calls must be ALS. Paramedic students must complete 25 Team Leader calls in their last semester prior to testing.

3. These hours are only a guideline. Additional hours may be required in order for the student to meet the clinical /field competency requirements.

4. All hours and competencies will be cumulative from the beginning of the Enhanced program through the Paramedic program, provided there has not been more than a year absence in working through the curriculum. They will also be cumulative between clinical and field. If a student is not enrolled – and there’s a break in the program -- steps may have to be repeated.

5. Clinical/Field rotations will not begin until the student has satisfactorily completed all of the initial course requirements and pre-clinical competencies of the first session. This includes drug calculation, IV access, and medication administration.

EMT-P Field Requirements State of Virginia Requirements National DOT Recommendations

50 Patient Contacts as Team Leader (Must have a minimum of 25 as ALS Team Leader.)

50 Patient Contacts as Team Leader (Must have a minimum of 25 as ALS Team Leader.)

Paramedic students must complete 25 Team Leader calls in their last semester prior to testing.

competencies

EMT-P Competency Requirements State of Virginia

Minimum Requirements National DOT Recommendation

Cardiac/Chest Pain Assessment 30 30 Pediatric Respiratory Assessment 8 8 Adult Respiratory Assessment 20 20 Syncope Assessment 10 10 Medical Assessment 10 10 Abdominal Complaints Assessment 20 20 Altered Mental Status Assessment 20 20 Obstetrical Assessment 10 10 Psychiatric Assessment 20 20 Trauma Assessment 40 40 Pediatric Assessment 30 30 Adult Assessment 50 50

EMT-P Clinical Requirements State of Virginia Minimum Requirements

National Recommendations to meet Reciprocity

Emergency Room 120 hours 128 hours

Critical Care (ICU, CCU, OPSU, MTI) 16 hours 40 hours

Pediatrics 8 hours 24 hours Neonatalogy 8 hours

Labor & Delivery 16 hours 24 hours Psychiatry 8 hours 16 hours

OR/Anesthesia/In-Patient OR 16 hours 16 hours Gerontology 0 hours 0 hours Total 192 clinical hours 240 clinical hours

Geriatric Assessment 30 0

Live Intubation 1 1 Venous Access 0-17 years 18-64 years 65 + years

25 total One One One

25 total One One One

Ventilate patient 5 10* Medication Administration 15 15

Completion and documentation of all competency requirements and hours is the responsibility of the student. It is the student’s responsibility to validate or note any discrepancies and report them to the coordinator in a timely fashion. No changes or corrections on clinical and field evaluation forms will be made once the semester has ended.

INCLEMENT WEATHER/COLLEGE CLOSINGS

Information about college closings in the event of inclement weather or other emergencies will be broadcasted on many area TV and radio stations, but is also available from the TCC Information Center at 757-822-1122 and the college’s Web site at http://www.tcc.edu. One of the following notices will be provided:

1. Message: The College is closed. The College is closed day and evening for students and staff

2. Message: The College will open/close at ( ). The College will open/close at designated time for students and staff.

3. Message: Evening classes are cancelled. The College is closed for evening students and staff.

Please do not call the college. Incoming telephone calls tie up lines that need to be used to make decisions and notifications. The radio and television stations will be notified as soon as the administrative decision is made. For additional Weather information, please call the TCC Information Center 757-822-1122.

CONCEPTS OF CRITICAL CARE REQUIREMENTS

A total of forty-eight hours (48) are required for the clinical portion of the course*. These hours will consist of Respiratory Therapy, Medical Transport, Cath Lab, CCU, ICU, and/or C-S ICU experience. Pediatric rotations through CHKD Transport Team are available. The clinical hours may be adjusted or waived by the course instructor.

DO YOU HAVE PREVIOUS HOSPITAL EXPERIENCE?

Credit may be awarded for certification level or past or present medical experience, provided that this experience has been at least six months or greater. This information will be forwarded to the Tidewater Community College – Emergency Medical Services Program Medical Director for review. This review process may take up to 3 - 4 weeks to be completed. All paperwork gathered for this waiver must be submitted together in the specific order listed on the checklist found on the front page of the Clinical and Field Waiver form. Students failing to follow this procedure may delay their paperwork review.

Tips! In the event that the College is CLOSED you will not be able to attend your assigned shift. Please contact your coordinator prior to the shift for agency notification. In the event that the College is OPEN, but classes are cancelled, then you will attend the assigned shift. In the event that circumstances prevent you from attending the shift, please contact your coordinator prior to the shift. The exception: Students ARE permitted to be scheduled and attend clinical and field rotations on holidays which fall within the current semester.

• Typed cover letter from student requesting waiver credit to be granted. • Completed original of the Clinical/Field Documentation List to document all skills performed within the past 12 consecutive months.

This documentation list should be annotated with the number of skills performed and the period in which they were performed. The agency’s medical director or nurse manager’s signature must endorse this checklist. Students must have a supervisor signature in the column beside each number. If a mistake is made in filling out the checklist please strike one line through the mistake and have supervisor initial the item that was lined out.

• Job description of clinical assignment or career. Include employment specifics, any education or training pertinent to medical care in the hospital or pre-hospital environment. (Place employed, length of time employed, number of hours worked per week, and indicate full or part-time.) A resume can be used to satisfy this requirement provided it lists the above information.

• Students must submit a current copy of their certification (Enhanced, Cardiac Technician, Intermediate, and RN) or licensure. • Supporting Military Documentation (Active Duty and Reserve Only). List length of time in service, training, duty stations and any

other specific information regarding education and training that may be beneficial in determining the amount of waiver credit the applicant may be eligible to receive.

• Letter of Endorsement from student’s medical director and/or nurse manager.

ENHANCED CREDIT WAIVER

Please note criteria as listed below:

1. Students who enter the TCC EMS program as a certified Enhanced level provider will be required to submit proof of Enhanced certification, and submit a letter from their affiliating agency which states that the student is affiliated with such agency and has been practicing as an Enhanced-level provider. The date that the student was released to practice as an Enhanced provider should also be included.

2. For Enhanced providers the following applies: a. These students will be eligible for credit in accordance with the minimum Enhanced requirements of the State. b. These students will be granted 24 hours of hospital/clinical time in the Emergency Room and 12 hours of agency/field time. c. Students will be granted the minimum Enhanced competencies and team leader calls (5 TL calls; 3 ALS; 2 BLS) as outlined in the

Students’ Clinical/Field Handbook. d. Upon registering for classes for advanced training toward an Intermediate level, students who are Enhanced providers do not need to

register for EMS 170 (the semester I clinical/field course). These students will be able to submit a WAIVER for EMS 170 and should discuss this with their coordinators.

e. If registered for the clinical component, the student will be required to complete 16 hours of clinical time (8 hours ER and 8 hours Critical Care), along with meeting any other associated clinical requirements for the semester.

3. Students who have completed their Enhanced level of education through TCC’s EMS Program and completion was within thirteen months of re-entering the Program, will have all competencies and hours credited from their previous training.

INTERMEDIATE CREDIT WAIVER

Students entering the EMS Program of Tidewater Community College will be eligible for a credit waiver for past education and experience. This is in accordance with Articulation agreements between TCC and Field Agencies in the Tidewater area, to include: Norfolk, Portsmouth, Chesapeake and the Eastern Shore. Please note criteria as listed below:

1. Students who obtained their Intermediate certification outside of TCC and are released to practice as an Intermediate provider within one year of entering TCC’s EMS Program will be required to submit proof of Intermediate certification, and submit a letter from their affiliating agency which states that the student is affiliated with such agency and has been practicing as a released Intermediate-level provider. The date that the student was released to practice as an Intermediate provider should also be included.

2. For Intermediate providers the following applies: a. Students will be eligible for credit in accordance with the minimum Intermediate requirements of the State. b. Students entering TCC from an articulated program within six months of their program will get the skills, hours, competencies, team

leader calls carried over from the other program. c. Students who are coming into TCC’s EMS Program as an Intermediate provider will be granted credit depending on whether they have

been released as an Intermediate for less than or greater than six months prior to entering the program.

d. If released for less than six months when entering program, they will be granted 48 hours of field time and 10 Team Leader calls (5 ALS and 5 BLS)

e. Students who have been released and practicing for greater than six months prior to entry will be granted 48 hours of field time and 25 Team Leader calls.

f. Students may be granted the minimum Intermediate competencies, clinical hours, and team leader calls as outlined in the Students’ Clinical/Field Handbook.

g. Intermediate level students entering the ALS program may have to enroll in either one or both field sections before meeting Paramedic testing requirements. This will be reviewed on an individual basis to see what credit is warranted.

h. Even though students who are eligible for an Intermediate waiver may be granted the Intermediate competencies, this does NOT include the ‘live intubation’ as a competency for which you will be given credit.

i. All students testing at the paramedic level must complete 25 Team Leader calls in the last semester of instruction. j. All Intermediate students challenging EMS 157 and 159 must pass the final of each class with an 80% or greater.

3. Students who have completed their Enhanced/Intermediate level of education through TCC’s EMS Program and completion was within thirteen-months of re-entering the Program, will have all competencies and hours credited from their previous training.

CLINICAL experience | grading scale | reports |sites | requirements | scheduling

SECTION

THE CLINICAL EXPERIENCE

• The clinical experience is an opportunity for you to become involved in the direct observation and care of the patient. • It affords you with hands-on experience. • Knowledge learned from the classroom and skills acquired in the laboratory are applied to actual patient care. • Begin to develop independent pre-hospital judgment and an interdisciplinary approach to patient care.

The clinical emphasis is two-fold. First, it is the application of psychomotor skills acquired in the classroom. Second, it is the integration of the patient's presentation and chief complaint with the physiological, psychological, and pathological events occurring simultaneously. The assimilation process of theory and practical skills, which occur in the clinical setting, provides an opportunity for the student to grow personally and professionally.

The foundation of competent practice is a firm knowledge base and the ability to transfer that knowledge to a variety of settings. Integration and assimilation will not occur by reading textbooks alone, but will occur in the clinical and field setting by being observant, keeping an open mind, and a compassionate heart. Be mindful that the recipients of your care are people whose medical needs must be met to the best of your ability.

Each and every clinical experience will give the student a fuller understanding of the patient, the patient’s condition, and the proper care of the patient.

CLINICAL GRADING CRITERIA

Grades will be assigned as follows: 1. Student meets or exceeds expectations in the clinical setting. 2. Accurate documentation of clinical hours and competencies. 3. Completion of all course requirements submitted by deadline date. 4. Successful completion of clinical hours in accordance with the curriculum of study. 5. Successful completion of assignments as designated by course outline. 6. Adherence to attendance and cancellation policies. 7. If any of the following occur, the student may lose points, receive counseling, be placed on probation,

and/or be dismissed from the program a) Dismissal from the clinical agency due to inappropriate appearance, attitude, misconduct, failure

to follow clinical directions or documented communication regarding the same. b) Inappropriate clinical performance in areas where the student should possess the basic

knowledge of appropriate performance or where the student is unable to demonstrate improvement according to preceptor evaluation.

c) Inability to adhere to the guidelines and requirements as stated in the Students’ Clinical/Field Internship Handbook.

d) Sub-standard scores received on the behavioral evaluation reflective of the “Affective Objectives.” e) Any violations pertaining to academic misconduct.

8. Retest Policy A drug calculation exam will be administered during class time. All students must successfully pass the drug calculation exam prior to starting any clinical and or field rotations. Retests will be permitted until the student passes.

9. Students may carry one D throughout the clinical internship, provided that the “D” is not received during a testing semester. If two Ds are received, then the student will be required to enroll in an additional clinical course (one credit) for completion and testing eligibility. Students who receive an “F” in a clinical internship will be required to repeat the failed course and complete the hours required for the semester. If an “F” is received for two consecutive semesters, approval from the Program Director and Medical Director will be required in order for the student to continue in the program. Removal from the program may be recommended. If the student receives a third “F” for the clinical grade, approval from the Dean of Health Sciences will be required for continuation in the Program.

10. In order to be eligible for Registry testing the student must receive a “C” or better in all coursework.

Clinical grading scale: A 90-100 B 82-89 C 81-75 D 65-74 F <64 Please refer to the current semester course outline for additional grading criteria

THE CLINICAL PATIENT ASSESSMENT REPORT (This Report must contain a bibliography with at least ONE reference cited.)

The following criteria will be used for evaluation: 1. All student identification information must be completed. The date of the clinical shift should be the date listed on the Patient Assessment Report. 2. The clinical Patient Assessment Report MUST be done on an ALS patient of interest in the clinical setting during the current semester who has had at

least two (2) ALS interventions. An ALS intervention can include: a cardiac monitor, IV, oxygen therapy, medications, or other advanced interventions.

3. Patient information to be completed in full to include a complete set of vital signs and medications. Medications that the patient may have been taking at home may be pertinent to the patient’s medical problem and should be taken into consideration.

4. Presenting problem: The chief complaint, which has resulted in the patient’s visit/admission to the hospital. Remember that some patient’s may have multiple complaints. The chief complaint of the patient may be different from the ultimate diagnosis. Please include both. Students may not report on the same diagnoses or problem more than once.

5. Pertinent Medical History: Any pre-existing conditions or accompanying medical problems/issues, which may impact the presenting problem and/or the care and treatment of the patient.

6. Physical Assessment: The student should perform a complete head to toe assessment on the patient and document all findings whether normal or abnormal. In the hospital setting, the physician’s assessment should be reviewed and included, since the student may not have access to the patient to perform a complete assessment. Be advised not to just write normal, wnl, good, no problem, since these do not explain anything. For example, abdomen/GI: denies nausea/vomiting/diarrhea; abdomen is soft, non-tender and non-distended.

7. Interventions/Treatments: The student will document all treatments (BLS and ALS), medications and diagnostic studies ordered for the patient. If available, document any pre-hospital care provided to the patient that may be pertinent to the patient’s condition. To be included: IV therapy, oxygen therapy, lab studies (specifics), x-rays or other diagnostic studies, medications, and any other treatment rendered.

8. Discussion of Patient’s Problem to include Physiology or Pathophysiology: The student will describe and explain the body’s physiological response to any abnormalities noted in the assessment. Any abnormalities noted in the physical assessment may be part of the response to the patient’s condition or disease, and should be explained. Explain the findings of your physical assessment and how they relate to the presenting problem(s) whether normal or abnormal. Include the Physiology or Pathophysiology of the disease process and the patient’s medical problem/s. What is the difference between the disease process and the patient’s medical problem/s? Research will most likely be needed to complete this section satisfactorily. Any information obtained from outside resources will need to be cited as references. There should be at least one resource used for this portion of the report. TCC policies on plagiarism apply.

9. Discussion of Interventions and Possible Complications: The student will explain the physiology behind each intervention/treatment listed as it relates to this patient. Examples include: the type of oxygen used and how it will help the patient; what information will or did the lab/diagnostic studies provide, and the physiology behind the medications ordered. Also, include in this section possible side-effects of treatments.

10. The Clinical patient Assessment Report MUST be submitted by SAFE-ASSIGN on Blackboard. No reports will be accepted by any other means. The report will be completed using the form which is available on Blackboard. By submitting the report on Blackboard, your report will be date and time stamped and provides you with a receipt of when it was submitted. Grades will be available through Grade Center on Blackboard. It is recommended that you keep a copy of the report for your own record.

11. The Clinical Patient Assessment reports will not be accepted after the due date and time.

GRADING THE CLINICAL PATIENT ASSESSMENT REPORTS

• The student can receive a maximum of ten points for each patient assessment report completed • The student must follow the criteria for the reports as stated in the Clinical/Field Handbook. • Grades of 75 or greater will be considered passing and will earn points. Scores of less than 75 will not warrant any points. • The student will receive the grade in point value. The points will be divided by ten based on the grade received, as long as the grade is 75 or

above. If the grade received is 77 then the student will receive 7.7 added to their grade and if they receive 100 then 10 points will be added to the grade, etc.

Listed below are the point values for each section of the Clinical Patient Assessment Report:

Section 1 (Introductory-Patient History, etc.): correct format, spelling, grammar, patient selection with advanced interventions, inclusive of information requested and bibliography (10 points)

Section 2 (Physical Assessment); thorough assessment as described in the Criteria (20 points)

Section 3 (Interventions): as described in the Criteria (20 points)

Section 4 (Discussion of Patient Problem to include physiology or pathophysiology): as described in Criteria (25 points) (Should include bibliography).

Section 5 (Discussion of Interventions and Possible Complications): as described in the Criteria (25 points)

REQUIREMENTS OF THE STUDENTS

Most of the hospitals share the same language when it comes to the requirements of the student. There may be some variation from site to site but for the most part, they are in agreement. Students must complete all of the pre-clinical/field requirements as outlined in this handbook.

Other additional requirements may include: TCC picture ID worn visibly on the student’s shirt collar IV form/IV card Clinical orientation to the hospital, agency or site Criminal background check for individual hospitals Urine drug screening for individual hospitals Professional attire and attitude among the students

RESPONSIBILITIES OF TCC

It is the responsibility of the clinical coordinators to be sure that all students have met all of the requirements listed above before scheduling students for their hospital rotations. It is also the responsibility of the coordinators to provide the hospital/unit with a schedule of students each month. The hospital does have the right to turn down any of the student assignments due to high student numbers for that particular date. Hospitals need to be contacted if there are schedule changes, cancellations or substitutions. Since the students are guests in the hospitals it is in conjunction with the coordinators’ duties, to monitor the students’ progress regularly and to immediately address any concerns or issues regarding student performance.

PRECEPTORED VERSUS NON-PRECEPTORED HOSPITALS

Preceptored hospitals are the favored clinical sites for all of our students. They provide structure, mentoring, and close supervision for the students, as well as instant communication between the hospital staff and the EMS program. Problems or issues get resolved quickly, and students having difficulty in the clinical setting are easily identified. First semester, Enhanced students should all attend at least on preceptored hospital shift before going to other hospitals. The preceptors assigned to these facilities (Leigh, Norfolk General Hospitals) are TCC practical instructors as well, so they are very familiar with what is being taught and what the expectations are. Whether you are assigned to the Emergency Room or any other unit in the hospital, you will need to check in and out with the preceptor in the Emergency Room. The preceptor will take you to the other units where you are assigned. A minimum of two students is required in the hospital to confirm the shift. The RN/or TCC preceptor should sign the students’ clinical evaluation form. Non-Preceptored hospitals make up the majority for clinical sites available to the students. Students who are more assertive, familiar with the hospital setting or health care, and who are motivated do well at these sites. At all of these hospitals, you should check in and out with the charge nurse or unit manager, be professional and introduce yourself. You will most likely be matched with an RN or an ER tech (paramedic only) for the duration of your shift. Every hospital is different and every staff member who works with the student is different, some being more mentoring and nurturing than others. If there are any concerns regarding a hospital staff member, first direct your issue to the charge nurse, and then to your coordinator. Only the RN, MD, PA, DO, or CRNA can sign the students’ clinical evaluation forms.

GUIDELINES FOR CLINICAL ROTATIONS EMERGENCY DEPARTMENT

Purpose: It is the purpose of this rotation is to assess patients presenting with various medical problems in a medically supervised facility. It is at the preceptor’s discretion which skills and medications the student may perform/administer during their clinical rotations. Remember that these are only guidelines and this is not an all-inclusive list. During the clinical rotations in the ED, the student will:

1. Utilize appropriate universal precautions at all times. 2. Assist in the triage of patients. 3. Perform a patient assessment, including:

a. Vital signs, pulse oximetry and glucose check b. Obtain chief complaint and history of present illness. c. Perform a physical exam. d. Obtain medical history.

2. Demonstrate proper airway management and oxygen therapy. 3. Apply monitoring electrodes and interpret cardiac monitor rhythm. Assist with performing 12-Lead EKG. (Save your

rhythm strips). 4. Discuss and demonstrate proper IV therapy and technique, as well as blood draws. 5. Discuss and demonstrate knowledge of medication prior to administration, including looking up the medication for the

following: indications, contraindications, proper dosage, side effects, calculations of dosage and proper administration technique (SQ, IV, IM, SL, nebulized or ET). Only administer the medication under direct supervision of the RN, MD, or TCC preceptor. Never administer a medication you have not looked up.

6. Assist with the following: hemorrhage control, splinting techniques and cardiac arrest patients (CPR, BVM, medications administration, nasogastric tubes, and orogastric tubes).

NOTE: Remember that you are NOT to answer the radio, but listen to the reports.

INTENSIVE CARE UNIT/CRITICAL CARE UNIT

Purpose: The purpose of this rotation is: 1) Assess patients on various IV medications; 2) Assess the effects of multiple IV medications on Patients; 3) To assess respiratory status of patients on ventilators; 4) To assess patients with acute critical illnesses; and 5) To assess illness pathologies specific to a critical illness. It is at the preceptor’s discretion which skills and medications the student may perform/administer during their clinical rotations. Remember that these are only guidelines and this is not an all-inclusive list. During the clinical rotations in the ICU/CCU, the student will: 1. Utilize appropriate universal precautions at all times. 2. Perform a patient assessment, including:

Vital signs, pulse oximetery and glucose check Obtain chief complaint and history of present illness. Perform a physical exam Obtain a medical history

3. Demonstrate proper airway management and oxygen therapy, including assisting with the care of patients with either mechanical ventilators or trachs (i.e. suctioning, BVM or NGT/OGT).

4. Apply monitoring electrodes and interpret cardiac monitor rhythm. Assist with performing a 12-Lead EKG. 5. Discuss and demonstrate proper IV therapy and technique. 6. Discuss and demonstrate knowledge of medication prior to administrations, including: indications, contraindications, proper

dosage, side effects, calculations of dosage, proper administration technique (SQ, IV, IM, SL, nebulized and ET) under the direct supervision of the RN, MD, or TCC preceptor.

7. Discuss and correlate the injuries sustained by the patient to the mechanism of injury. 8. Discuss and identify the possible complications of the patient’s illness related to the following systems and areas: respiratory,

cardiovascular, musculoskeletal, metabolic, neurological, GI/GU and psychosocial. 9. Take the opportunity to communicate with patients (if possible) and their families to fully comprehend the medical history and

how it relates to the patient’s diagnosis. This will help you gain experience in looking at the “big picture” and better help you understand how your initial care in the field will affect the patient and how their care is continued through admission.

LABOR AND DELIVERY UNIT

Purpose: The purpose of this rotation is: 1) Assess the pregnant patient; 2) Assess the patient in labor; 3) To manage delivery; and 4) Assess for and manage complications of pregnancy, labor, and delivery. It is at the preceptor’s discretion which skill and medications the student may perform/administer during their clinical rotations. Remember that these are only guidelines and this is not an all-inclusive list. During the clinical rotations in the LD, the student will:

1. Utilize appropriate universal precautions as all times 2. Perform a patient assessment, including:

a. Vital signs, pulse oximetry and glucose check. b. Obtain chief complaint and history of present illness. c. Perform a physical exam. d. Obtain a medical history.

3. Demonstrate proper airway management and oxygen therapy 4. Discuss and demonstrate proper IV therapy and technique. 5. Discuss and demonstrate knowledge of medication prior to administration, including: indications, contraindications,

proper dosage, side effects, calculations of dosage, proper administration technique (SQ, IV, IM, SL, nebulized and ET) under the direct supervision of the RN, MD, or TCC preceptor.

6. Discuss the stages of labor and identify the patient’s stage of labor and discuss medications commonly administered to the patient in labor.

7. Assess uterine contractions, including timing, frequency and duration. Observe and assess a pregnant patient during labor, delivery, and post-partum.

8. Discuss and identify the complications of labor and delivery, including: fetal distress, breech birth, prolapsed cord and post-partum hemorrhage.

9. Discuss the management of the pregnant patient with various OB complications, including, but not limited to: bleeding in pregnancy, pre-eclampsia, and eclampsia, gestational diabetes and pregnancy induced hypertension (PIH).

10. Discuss and assist in the care of the newborn including suctioning with bulb syringe and APGAR calculation 11. Discuss and describe newborn resuscitation techniques and assist if needed.

PEDIATRIC EMERGENCY DEPARTMENT

AND ACUTE CARE CLINIC Purpose: The purpose of this rotation is: 1) Assess the pediatric patient, and 2) Perform medical interventions on pediatric patients. It is at the preceptor’s discretion which skills and dedications the student may perform/administer during their clinical rotations. Remember that these are only guidelines and this is not an all-inclusive list. During the clinical rotations the Pediatric ED/Acute Care Clinic, the student will:

1. Utilize appropriate universal precautions at all times 2. Assist in the triage of patients. 3. Discuss and review the difference in assessing a pediatric patient compared to an adult patient. 4. Review/identify the normal vital sign limits for the various pediatric age groups.

5. Perform an age-appropriate patient assessment, including: a. Vital signs, pulse oximetry and glucose check. b. Obtain chief complaint and history of present illness. c. Perform a physical exam. d. Obtain a medical history.

6. Demonstrate proper airway management and oxygen therapy. 7. Apply monitoring electrodes and interpret cardiac monitor rhythm. Assist with performing a 12-Lead EKG. Save your

rhythm strips. 8. Discuss, observe and demonstrate proper blood draw/IV therapy and techniques, along with the modification/differences in

the approach for the pediatric patient. 9. Observe and assist with procedures: lumbar punctures, splinting and suturing.

***NOTE: You are NOT allowed to administer any medications at CHKD***

MEDICATION AND IV COMPETENCY

You are required to prove the following skill competencies through the following procedure before your clinical/field internship can begin:

1. Attend the didactic and lab portion of the med administration workshop. 2. Successfully pass the med administration testing portion of the practical lab. 3. Successfully pass the drug calculation exam.

Upon completion of the above, if you are a first semester student, you will be given an “IV Start Verification” form by your instructor or coordinator (sample form in appendix). This form will be taken to your first clinical shift. You will then be required to successfully complete two observed IV starts with documentation, have the form signed by the RN and return to your clinical coordinator. You will then be given an IV competency card to be worn with your TCC picture ID badge. If you are entering the program at an advanced level (Enhanced or Intermediate), the practical testing portion of the medication administration and IV access exam will be waived. However, you will need to successfully complete the drug calculation exam.

POLICY FOR DIFFICULT AIRWAY SCENARIOS

Upon completion of the second semester of the paramedic program and prior to testing NREMT-Intermediate, all students in the EMS program of Tidewater Community College MUST successfully perform an orotracheal intubation on a live patient. However, if the opportunity does not present itself, the student must successfully complete five (5) special difficult airway scenarios in lieu of the live intubation. Students may be scheduled in the PACU during their Intermediate semesters but may not be schedules in the OR/Anesthesia until the last semester of their paramedic studies.

1. The student MUST inform their clinical coordinator they have not met their intubation requirement at least one month prior to the testing date.

2. Prior to the end of the semester, scenario testing dates will be made available to the student. It is your responsibility to sign up for the testing time, be on time and well-prepared. These dates and times may also coincide with practical station and testing. This information will be sent via VCCS email and Blackboard.

3. The student must complete the required scenarios one week prior to testing. 4. The student will be given a total of five (5) difficult airway scenarios and MUST successfully pass each scenario. 5. The student will be given a maximum of three (3) attempts to successfully pass each scenario. 6. If the student does not successfully pass after three (3) attempts, then remediation by the airway scenario instructor will be

warranted before the student can re-test.

ANESTHESIA ROTATIONS

The following policy and procedure will be followed by all students in the EMS Program of Tidewater Community College prior to any Anesthesia clinical rotations.

1. Students will not begin any clinical rotations in the OR for the purpose of airway management until the last semester of the paramedic program and after they have completed classroom instruction and extensive laboratory ‘hands-on’ experience. All students will receive in depth training during the first semester of the paramedic curriculum which includes didactic classroom instruction, and intensive laboratory “hands on” experience. 2. All students will successfully complete all of the required training and will successfully complete both the classroom and laboratory portion of the curriculum of semesters one, two and three. 3. All students will successfully complete the Advanced Cardiac Life Support course, which includes training and successful testing. 4. The instructor will then sign off on the “Respiratory/Airway/Intubation Classroom Instruction Form” and return the form to the clinical coordinator. 5. The student may then be scheduled for his/her OR/Anesthesia clinical rotation. 6. The clinical coordinator will give the student page one and two of the OR Clinical Rotation packet, which includes the Classroom Instruction Form and the Psychomotor Objectives for OR Rotation Form. 7. The student will take both forms to his/her Anesthesia clinical rotation. 8. The student will arrive at the clinical site dressed in the proper uniform. The student will then be directed to change into the appropriate OR attire. The student should have the TCC Student ID badge clearly visible. 9. The student will introduce herself/himself to the Anesthesia Coordinator or the OR Manager for that day. 10. The student will show the OR Preceptor both pages of this packet prior to beginning any skills or treatments. 11. The student should be sure that page two of this packet is completed and signed ALONG WITH the Clinical Evaluation Form. The forms should be put in the envelope and signed by the OR preceptor for the shift. 12. The student will return the original copy of the signed Clinical Evaluation Form, and pages 1 and 2 of this packet to the clinical coordinator via the blue envelope after the first clinical OR shift. 13. Once reviewed and copied by the clinical coordinator, the student will then be given the OR Clinical Objectives form to take with him/her to the second clinical OR shift. Both the OR Clinical Objectives form and the Clinical Evaluation form should be signed by the OR preceptor and submitted by current policy using the envelope. This form will then be retained in the student’s file.

CLINICAL OBJECTIVES FOR THE EMT-ENHANCED

The following objectives must be successfully accomplished:

A. Psychomotor Skills 1. The student must demonstrate the ability to safely administer medications.

a. The student should safely, while performing all steps of each procedure, properly administer medications at least 15 times to live patients.

2. The student must demonstrate the ability to safely gain venous access in adult and geriatric age groups. a. The student should safely and successfully access venous circulation at least 10 times on live patients of various

age groups. 3. The student must demonstrate the ability to effectively ventilate 1 patient. This is accomplished through manikin

practice. B. Ages

1. The student must demonstrate the ability to perform an advanced assessment on pediatric patients. a. The student should perform an assessment on at least 5 (including newborns, infants, toddlers, preschool, school

age, and adolescent) pediatric patients. 2. The student must demonstrate the ability to perform an advanced assessment on at least 12 adult patients. 3. The student must demonstrate the ability to perform an advanced assessment on at least 5 geriatric patients.

C. Pathologies 1. The student must demonstrate the ability to perform an advanced assessment on at least 5 trauma patients. 2. The student must demonstrate the ability to perform an advanced assessment on at least 2 psychiatric patients.

D. Complaints 1. The student must demonstrate the ability to perform an advanced assessment, formulate and implement a treatment

plan for at least 5 patients with chest pain. 2. The student must demonstrate the ability to perform an advanced assessment, formulate and implement a treatment

plan for at least 5 patients with dyspnea/respiratory distress. 3. The student must demonstrate the ability to perform an advanced assessment, formulate and implement a treatment

plan for at least 5 patients with abdominal complaints. 4. The student must demonstrate the ability to perform an advanced assessment, formulate and implement a treatment

plan for at least 5 patients with altered mental status. E. Affective Skills

1. While in the clinical setting, the student must demonstrate integrity. a. The student must demonstrate honesty and trustworthiness. b. The student must maintain confidentiality. c. The student must accurately complete documentation.

2. While in the clinical setting, the student must demonstrate empathy. a. The student will respond appropriately to the emotional needs of the patients/family members and the health care

team. b. The student will demonstrate respect for others. c. The student will demonstrate a calm, compassionate, and helpful demeanor.

3. While in the clinical setting, the student must demonstrate self-motivation. a. The student will take initiative to complete assignments. b. The student will seek out learning experiences c. The student will take initiative to improve and/or correct behavior d. The student will take on/follow through on tasks with minimal supervision. e. The student will show enthusiasm for learning and improvement. f. The student will strive for excellence in all aspects of patient care and professional activities. g. The student will accept constructive feedback in a positive manner.

4. While in the clinical setting, the student will demonstrate proper appearance and personal hygiene. a. The student will wear neat, clean, well-maintained clothing and/or uniform. b. The student will demonstrate good personal hygiene and grooming.

c. The student will wear proper uniform and identification. 5. While in the clinical setting, the student will demonstrate self-confidence.

a. The student will demonstrate the ability to trust personal judgment. b. The student will demonstrate an awareness of his/her own strengths and limitations. c. The student will exercise good personal judgment.

6. While in the clinical setting, the student will demonstrate adequate communication skills. a. The student will speak clearly, write legibly, and listen actively. b. The student will document a complete and accurate patient care report. c. The student will communicate effectively with Medical Control d. The student will adjust communication strategies as needed.

7. While in the clinical setting, the student will demonstrate effective time management. a. The student will demonstrate consistent punctuality. b. The student will complete tasks and assignments on time.

8. While in the clinical setting, the student will demonstrate teamwork and diplomacy. a. The student will place the success of the team above self-interest. b. The student will help and support other team members. c. The student will show respect for all team members. d. The student will remain flexible and open to change. e. The student will communicate effectively with others to resolve problems.

CLINICAL OBJECTIVES FOR THE EMT-INTERMEDIATE The following objectives must be successfully accomplished: A. Psychomotor Skills

1. The student must demonstrate the ability to safely administer medications. a. The student should safely, and while performing all steps of each procedure, properly administer medications at

least 15 times to live patients. 2. The student must demonstrate the ability to safely gain venous access in all age group patients.

a. The student should safely and successfully access venous circulation at least 25 times on live patients of various age groups.

b. The student must gain venous access on at least one patient aged 0-17 years, one patient aged 18-64 years, and one patient aged 65 and older.

3. The student must demonstrate the ability to effectively ventilate patients of all age groups. a. The student should effectively ventilate at least 1 live patient.

4. The student must demonstrate the ability to safely perform an intubation. a. The student should safely, and while performing all steps of each procedure, successfully intubate at least one (1)

live patient. B. Ages

1. The student must demonstrate the ability to perform an advanced assessment on pediatric patients. a. The student should perform an assessment on at least 15 (including newborns, infants, toddlers, pre-school,

school age, adolescent) pediatric patients. 2. The student must demonstrate the ability to perform an advanced assessment on at least 25 adult patients. 3. The student must demonstrate the ability to perform an advanced assessment on at least 15 geriatric patients.

C. Pathologies 1. The student must demonstrate the ability to perform an advanced assessment on at least 20 trauma patients. 2. The student must demonstrate the ability to perform an advanced assessment on at least 10 psychiatric patients. 3. The student must demonstrate the ability to perform an advanced assessment on at least 5 obstetric patients.

D. Complaints 1. The student must demonstrate the ability to perform an advanced assessment, formulate and implement a treatment

plan for at least 15 patients with chest pain. 2. The student must demonstrate the ability to perform an advanced assessment, formulate and implement a treatment

plan for at least 14 patients with dyspnea/respiratory distress. 3. The student should perform an advanced patient assessment, formulate and implement a treatment plan on at least 10

adult patients and at least 4 pediatric patients (including infants, toddlers, and school age) with dyspnea/respiratory distress.

4. The student must demonstrate the ability to perform an advanced assessment, formulate and implement a treatment plan for at least five patients with syncope.

5. The student must demonstrate the ability to perform an advanced assessment, formulate and implement a treatment plan for at least 10 patients with abdominal complaints.

6. The student must demonstrate the ability to perform an advanced assessment, formulate and implement a treatment plan for at least 10 patients with altered mental status.

7. The student must demonstrate the ability to perform an advanced assessment, formulate and implement a treatment plan for at least 5 patients with medical complaints.

E. Affective Skills 1. While in the clinical setting, the student must demonstrate integrity.

a. The student must demonstrate honesty and trustworthiness. b. The student must maintain confidentiality. c. The student must accurately complete documentation.

2. While in the clinical setting, the student must demonstrate empathy. a. The student will respond appropriately to the emotional needs of the patients/family members and the health care

team. b. The student will demonstrate respect for others.

c. The student will demonstrate a calm, compassionate, and helpful demeanor. 3. While in the clinical setting, the student must demonstrate self-motivation.

a. The student will take initiative to complete assignments. b. The student will seek out learning experiences c. The student will take initiative to improve and/or correct behavior d. The student will take on/follow through on tasks with minimal supervision. e. The student will show enthusiasm for learning and improvement. f. The student will strive for excellence in all aspects of patient care. g. The student will accept constructive feedback in a positive manner.

4. While in the clinical setting, the student will demonstrate proper appearance and personal hygiene. a. The student will wear neat, clean, well-maintained clothing and/or uniform. b. The student will demonstrate good personal hygiene and grooming. c. The student will wear proper uniform and identification.

5. While in the clinical setting, the student will demonstrate self- confidence. a. The student will exercise good personal judgment. b. The student will demonstrate the ability to trust personal judgment. c. The student will demonstrate an awareness of strengths and limitations.

6. While in the clinical setting, the student will demonstrate adequate communication. a. The student will speak clearly, write legibly, and listen actively. b. The student will document a complete and accurate patient care report. c. The student will communicate effectively with Medical Control d. The student will adjust communication strategies as needed.

7. While in the clinical setting, the student will demonstrate effective time management. a. The student will demonstrate consistent punctuality. b. The student will complete tasks and assignments on time.

8. While in the clinical setting, the student will demonstrate teamwork and diplomacy. a. The student will place the success of the team above self-interest. b. The student will help and support other team members. c. The student will show respect for all team members. d. The student will remain flexible and open to change. e. The student will communicate effectively with others to resolve problems.

CLINICAL OBJECTIVES FOR THE EMT-PARAMEDIC

The following objectives must be successfully accomplished: A. Psychomotor Skills

1. The student must demonstrate the ability to safely administer medications. a. The student should safely, and while performing all steps of each procedure, properly administer medications at

least 15 times to live patients. 2. The student must demonstrate the ability to safely gain venous access in all age group patients.

a. The student should safely and successfully access venous circulation at least 25 times on live patients of various age groups.

b. The student must gain venous access on at least one patient aged 0-17 years, one patient aged 18-64 years, and one patient aged 65 and older.

3. The student must demonstrate the ability to effectively ventilate patients of all age groups. a. The student should effectively ventilate at least 5 live patients of various age groups.

4. The student must demonstrate the ability to safely perform a live intubation. a. The student should safely, and while performing all steps of each procedure, successfully intubate at least one live

patient. B. Ages

1. The student must demonstrate the ability to perform a comprehensive assessment on pediatric patients. a. The student should perform an assessment on at least 30 (including newborns, infants, toddlers, preschool, school

age, and adolescent) pediatric patients. 2. The student must demonstrate the ability to perform a comprehensive assessment on at least 50 adult patients. 3. The student must demonstrate the ability to perform a comprehensive assessment on at least 30 geriatric patients.

C. Pathologies 1. The student must demonstrate the ability to perform a comprehensive assessment on at least 40 trauma patients. 2. The student must demonstrate the ability to perform a comprehensive assessment on at least 20 psychiatric patients. 3. The student must demonstrate the ability to perform a comprehensive assessment on at least 10 obstetric patients.

D. Complaints 1. The student must demonstrate the ability to perform a comprehensive assessment, formulate and implement a

treatment plan for at least 30 patients with chest pain. 2. The student must demonstrate the ability to perform a comprehensive assessment, formulate and implement a

treatment plan for at least 28 patients with dyspnea/respiratory distress. a. The student should perform an advanced patient assessment, formulate and implement a treatment plan on at

least 20 adult patients and at least 8 pediatric patients (including infants, toddlers, and school age) with dyspnea/respiratory distress.

3. The student must demonstrate the ability to perform a comprehensive assessment, formulate and implement a treatment plan for at least 10 patients with syncope.

4. The student must demonstrate the ability to perform a comprehensive assessment, formulate and implement a treatment plan for at least 20 patients with abdominal complaints.

5. The student must demonstrate the ability to perform a comprehensive assessment, formulate and implement a treatment plan for at least 20 patients with altered mental status.

E. Affective Skills 1. While in the clinical setting, the student must demonstrate integrity.

a. The student must demonstrate honesty and trustworthiness. b. The student must maintain confidentiality. c. The student must accurately complete documentation.

2. While in the clinical setting, the student must demonstrate empathy. a. The student will respond appropriately to the emotional needs of the patients/family members and the health care

team. b. The student will demonstrate respect for others. c. The student will demonstrate a calm, compassionate, and helpful demeanor.

3. While in the clinical setting, the student must demonstrate self- motivation.

a. The student will take initiative to complete assignments. b. The student will seek out learning experiences c. The student will take initiative to improve and/or correct behavior d. The student will take on/follow through on tasks with minimal supervision. e. The student will show enthusiasm for learning and improvement. f. The student will strive for excellence in all aspects of patient care and professional activities. g. The student will accept constructive feedback in a positive manner.

4. While in the clinical setting, the student will demonstrate proper appearance and personal hygiene. a. The student will wear neat, clean, well-maintained clothing and/or uniform. b. The student will demonstrate good personal hygiene and grooming. c. The student will wear proper uniform and identification.

5. While in the clinical setting, the student will demonstrate self-confidence. a. The student will demonstrate the ability to trust personal judgment. b. The student will demonstrate an awareness of strengths and limitations. c. The student will exercise good personal judgment.

6. While in the clinical setting, the student will demonstrate adequate communication skills. a. The student will speak clearly, write legibly, and listen actively. b. The student will document a complete and accurate patient care report. c. The student will communicate effectively with Medical Control d. The student will adjust communication strategies as needed.

7. While in the clinical setting, the student will demonstrate effective time management. a. The student will demonstrate consistent punctuality. b. The student will complete tasks and assignments on time.

8. While in the clinical setting, the student will demonstrate teamwork and diplomacy. a. The student will place the success of the team above self-interest. b. The student will help and support other team members. c. The student will show respect for all team members. d. The student will remain flexible and open to change. e. The student will communicate effectively with others to resolve problems.

CRITICAL CARE EMT-P and RN CLINICAL OBJECTIVES

In the clinical setting of the critical Care Units (Cath Lab, Cath Holding Area, ICU, CCU, CSICU, CVICU, Neuro ICU, CPCU, Dialysis Unit, MTI STAT 1), the student, in appropriate situations, may: 1. Practice universal precautions following Center for Disease Control guidelines. 2. Perform an advanced patient assessment or focused system review with accurate documentation of findings. 3. Maintain open airway utilizing appropriate airway adjunct. 4. Provide appropriate oxygen therapy and ventilatory assistance in critical patients. 5. Perform mechanical suction of airway in presence of OP and NP airway adjuncts, ET tube, tracheotomy tube, and/ or

mechanical ventilation. 6. Perform focused assessment of respiratory system using inspection, palpation, percussion, and auscultation, identifying

abnormalities. 7. Recognize and identify signs and symptoms indicative of need for endotracheal intubation and mechanical ventilation. 8. Demonstrate knowledge of mechanics of various types of ventilators, including transport ventilator, with ability to identify modes,

settings, alarms, and modifications to system. 9. Troubleshoot problems with mechanical ventilator. 10. Demonstrate ability to assemble, start and adjust PEEP and CPAP when clinically indicated. 11. Recognize and Manage (according to protocols) complications associated with assisted ventilation, including psychosocial

problems. 12. Assess vascular status of patient with documentation of findings. 13. Assess hemodynamic status of patients with various critical conditions with accurate documentation of vital signs, level of

consciousness, intake and output, peripheral pulses, skin color, and cardiac rhythm. 14. Clinically review and correlate lab data, physician orders, and medication regime to patient disease. 15. Perform CPR and ACLS procedures according to AHA guidelines and institution protocol. 16. Obtain pulse oximetry and end-tidal CO2 measurements and intervene when appropriate. 17. Perform precordial thump, vagal maneuvers, defibrillation, synchronized cardio-version, and external pacing when indicated. 18. Identify and interpret ECG rhythm strips. 19. Perform and interpret 12 lead ECG in relation to rate, rhythm, axis, and changes associated with myocardial infarction. 20. Perform focused cardiovascular assessment with recognition of abnormal sounds. 21. Demonstrate ability to set-up, calibrate, and validate pressure-monitoring systems. 22. Identify preferred sites of arterial puncture and perform Allen’s Test for artery puncture. 23. Manage complications of arterial punctures appropriately. 24. Interpret waveforms of various invasive pressure monitors and apply to clinical condition. 25. Observe cardiac catheterization, coronary angioplasty, laser ablation, ICD check, IABP, insertion, and other procedure

performed in cath lab. 26. Demonstrate ability to recognize IABP waveforms, verbalizing triggering and timing. 27. Remove arterial or venous stents when indicated using aseptic technique and providing appropriate post removal care (in

presence of preceptor after having observed procedure). 28. Initiate, maintain, and discontinue peripheral, external jugular, and intraosseous IV lines. 29. Demonstrate proper techniques for administering blood products following institution policy. 30. Prepare and administer medications via oral, IV, IM, SQ, IVP, transtracheal, and feeding tube routes. 31. Perform a complete neurological assessment and document finding. 32. Calculate Cerebral Perfusion Pressure using appropriate formula, relating results to clinical status. 33. Demonstrate ability to provide appropriate care for patient with continuous ICP monitoring, ventriculostomy, and skeletal fixation

of cervical spine. 34. Demonstrate knowledge and clinical skills essential to the care of the patient undergoing various diagnostic testing and

interventional treatments. Aware of patient care standards in the event of the occurrence during transport: Vessel re-bleed, hematoma formation, arterial sheath removal, and chest pain.

35. Demonstrate ability to direct ones-self and other team members to provide optimal care of critical patient in hospital and during transport.

36. Demonstrate ethical and professional standards of conduct. 37. Assess educational needs of the patient and family undergoing diagnostic testing and presents material or alerts team member

to provide material at appropriate instructional level. 38. Identify pharmacological actions, indications, precautions, dosages, contraindications, and side effects for all medications given. 39. Prepare and administer (under direct supervision of preceptor) thrombolytic agents and continually assess patient for

complications and/ or reperfusion. 40. Set-up, activate and troubleshoot infusion pumps. 41. Recognize transfusion reactions and manages appropriately according to institution policy. 42. Demonstrate use of various transfusion devices. 43. Identify various central line catheters (Hickman, Broviac) and PICC lines and demonstrate care of insertion site. 44. Administer external feeding through feeding tube, G or Peg tube, or jejunostomy tube, monitoring for complications. 45. Insert NG tube when appropriate. Assist with insertion of weighted feeding tubes, balloon tubes. 46. Assist with peritoneal dialysis. 47. Recognize and assess AV shunts, AV fistula, and grafts for hemodialysis. 48. Insert appropriate size and type Foley catheter when indicated, accurately measuring output. 49. Demonstrate ability to utilize urine drainage bag and urometer. 50. Observe hemodialysis, hemofiltration. 51. Document completely using appropriate forms. 52. Demonstrate principals of safe practice for self and patient, including proper body mechanics. 53. Ability to interact and communicate effectively with all members of the health care team, understanding the importance of

providing accurate and essential information

CLINICAL SITES AVAILABLE TO EMS STUDENTS EMT-Enhanced, EMT-Intermediate, and EMT-Paramedic Students:

ER and ICU: Albemarle Hospital Chesapeake Regional Medical Center Bon Secours DePaul Medical Center Bon Secours Harborview Medical Center Bon Secours Maryview Medical Center Bon Secours Mary Immaculate Hospital Medical Transport (MTI) (ICU only) Sentara Obici Hospital Portsmouth Naval Hospital (Not available at this time) Riverside Regional Medical Center Riverside Walter Reed Hospital Riverside Shore Memorial Hospital Sentara Careplex Hospital Sentara Leigh Hospital (preceptored) Sentara Norfolk General Hospital (preceptored and unpreceptored) Sentara Princess Anne Hospital Sentara Virginia Beach General Hospital OR (Anesthesia) /PACU: (Anesthesia/PACU rotations are only available Monday – Friday for the day shift. There may be some weekends available, depending on the site. Students should arrive 30 minutes prior to the start of the shift). Students must take their Respiratory/Airway competency forms with them to OR and PACU rotations. Bon Secours DePaul Medical Center (PACU) Bon Secours Maryview Medical Center (PACU) Sentara Obici Hospital (PACU) Riverside Medical Center (OR) Riverside Walter Reed Hospital (OR) Sentara Norfolk General Hospital (OR) Sentara Virginia Beach General Hospital (PACU)Sentara Williamsburg Regional Medical Center Pediatrics: Children Hospital of the King’s Daughters CHKD-Acute Care Clinic (1st floor) Sentara Princess Anne Hospital (Neonatal ICU) RRMC (NICU)

Psych: Sentara Obici Hospital Virginia Beach Recovery Center Riverside Behavior Health Center

*Portsmouth Naval Hospital, although available for all Active Duty, Federal employees, Civil Service and Dependents holding a military ID Card, is unavailable at this time. You must submit a copy of your ID card to the Clinical Coordinator before you are eligible to do clinical shifts there.

CLINICAL SITES AVAILABLE FOR STUDENTS IN CONCEPTS OF CRITICAL CARE

Critical Care Transport: Critical Care: Medical Transport (MTI) Mike Straka (Cardiovascular PA-Pager - 475-0282)

George Markham (Cardiovascular PA-Pager - 475-0766) Respiratory Therapy: Childrens Hospital of the King’s Daughters (Transport Team) Sentara Virginia Beach General Hospital Bon Secours DePaul Medical Center MICU/SICU

Bon Secours Maryview Medical Center critical care/ICU/cath lab. Cath Lab: Sentara Norfolk General Hospital CARE Unit Bon Secours Maryview Medical Center Sentara Virginia Beach General Hospital ICU/ CCU/ C-S ICU/Cath Lab/Resp Riverside Regional Medical Center Therapy Sentara Virginia Beach General Hospital Riverside Regional Medical Center ICU/ CCU/Cath Lab

CLINICAL AGENCIES

FACILITY PHONE

Albemarle Hospital PO Box 1587, Elizabeth City, NC 27906-1587

225-335-0531

Bon Secours DePaul Medical Center 150 Kingsley Lane, Norfolk, VA 23505

757-889-5000

Bon Secours Harborview 5818 Harborview Blvd., Suffolk, VA 23435

757-673-5000

Bon Secours Mary Immaculate Hospital 800 Denbigh Blvd., Newport News, VA 23602

757-886-6000

Bon Secours Maryview Medical Center 3636 High St., Portsmouth, VA 23707

757-398-2200

Chesapeake Regional Hospital 736 Battlefield Blvd., Chesapeake, VA 23320

757-547-8121

Children’s Hospital of the King’s Daughters 800 W. Olney Rd., Norfolk, VA 23507

757-668-7000

Naval Regional Medical Center 620 John Paul Jones Circle, Portsmouth, VA 23508

757-953-5000

Riverside Behavioral Health Center 2244 Executive Drive, Hampton, VA 23666

757-827-1001

Riverside Regional Medical Center 500 J. Clyde Blvd., Newport News, VA 23601

757-594-2000

Riverside Walter Reed Hospital PO Box 1130, Gloucester, VA 23061

804-693-8800

Riverside Shore Memorial Hospital PO Box 17, 9507 Hospital Road, Nassawadox, VA 23413

757-414-8240

Sentara Careplex (Hampton) 3000 Coliseum Drive, Hampton, VA 23669-0640

757-827-2000

Sentara Leigh Hospital (Arrowhead Plaza Shopping Center ) 5622 Princess Ann Rd., Norfolk, VA 23502

757-466-6000

Sentara Medical Transport, Inc. 5792 Arrowhead Dr., Suite 200, Virginia Beach, VA 23462

757-671-8911

Sentara Norfolk General Hospital 600 Gresham Dr., Norfolk, VA 23507

757-668-3000

Sentara Obici Hospital 2800 Godwin Blvd., Suffolk, VA 23434

757-934-4000

Sentara Princess Anne Health Center Princess Anne Road, Virginia Beach, VA 23453

757-507-0026

Sentara Virginia Beach General Hospital 1060 First Colonial Rd., Virginia Beach, VA 23454

757-395-8000

Virginia Beach Recovery Center 409 Birdneck Circle, Virginia Beach, VA 23452

757-385-6952

Sentara Williamsburg Regional Medical Center 100 Sentara Circle, Williamsburg, VA 23188

757-259-6000

CLINICAL SITE REQUIREMENTS

Albemarle Hospital (NC)

For students requesting clinical time at this hospital, please contact the TCC clinical coordinator for further information. Scheduling is done between student and EMS Coordinator of the facility. Students will need to complete a criminal background check and urine drug test (done by the hospital at no additional cost to the student). Units available: ER, ICU, L&D.

Bon Secours DePaul Medical Center Students are permitted at this facility after signing the Bon Secours signature form. Scheduling is allowed for one student per unit per shift. Units: ER, ICU, and PACU.

Bon Secours Mary Immaculate Hospital This site is part of the Bon Secours Health Care System, so the signed Bon Secours signature page is required before the student can be assigned. Unit available: Emergency Room only.

Bon Secours Maryview Medical Center This hospital is part of the Bon Secours Health Care System, so students are required to sign the Bon Secours signature page before doing shifts at this facility. Scheduling is allowed for one student per unit per shift. Units: ER, ICU, L&D, and PACU. The Cath Lab is reserved for Critical Care Program students only.

Note: There is an orientation packet for the Bon Secours that will need to be reviewed and signature form submitted to your coordinator.

Chesapeake Regional Medical Center One student per unit per shift is allowed. Units: ER, ICU (4th floor), L&D.

Note: There is an orientation packet that will need to be reviewed and orientation test completed and submitted to your coordinator.

Children’s Hospital of the Kings Daughters There is an orientation packet for all students with a two-sided profile form, which must be completed. Students can be scheduled at this facility only after we have received the results of their criminal background check and the student profile form is sent to the Affiliation Coordinator. Two units available: Emergency Room and the Pediatric Clinic. No medications will be given at this facility. Proof of influenza vaccine may be required.

Note: There is an orientation packet for all students to review with a two-sided profile form to complete and return to your coordinator.

Naval Regional Medical Center The only students who may attend clinical shifts at this facility are those students who have a base vehicle pass and who have a valid ID card. The card can be for active duty, reserve, civilian (civil service), retiree, dependent, or federal employee. This facility is not available at this time.

The use of cellular phones, portable headphones, earphones or other listening devices while operating a motor vehicle is prohibited. The Traffic Safety policy will be enforced by base security and applies to Navy personnel, civilian employees, family members, contractors, tenants, and visitors to Navy installations. Failure to comply with this policy will include loss of driving privileges on the station and/or removal from the installation and/or denial or re-entry.

Riverside Regional Medical Center (Includes Riverside Walter Reed and Riverside Shore Memorial Hospitals and Riverside Behavioral Center.

This site is available to all students, provided there is one person, per unit, per shift scheduled. This hospital accepts student assignments on a first come first serve basis. Units: ER, ICU, CCU, Cath Lab, L&D, NICU, Psych.

The Psych rotation is through Riverside Behavioral Health. It is not on the Riverside Medical Center hospital site.

Mandatory orientation is required for all students wanting to do shifts at Riverside Regional Medical Center. There are also forms that need to be completed and submitted to your coordinator. The orientation is a computer-based program, and is required prior to scheduling. This program can be accessed through any computer. Please follow instructions listed below prior to completing the Net learning system. Procedure:

a. First, you must e-mail your coordinator to let him/her know that you will be doing shifts at Riverside. The clinical coordinator will email your EMPLID to the Educational Coordinator at Riverside. She will then send your user name and password back to the clinical coordinator. This will then be e-mailed to the student. Please allow 2 weeks for this process.

b. Student should print Riverside Packet from Blackboard and sign the necessary forms. The completed packet must be turned in to your coordinator before you begin the Net Learning program. You will not receive your user name and password from your coordinator until you turn in your completed packet.

c. To access Net Learning, please do the following: 1. Log onto Riverside online-http//www.riversideonline.com 2. Click on “For Employees” (right side of screen) 3. You will be directed to “please sign in” 4. In the password field type: benefits (case sensitive so use all lower case) 5. Click the “submit” button 6. Click on the word Net Learning Student Interface Login Page 7. Enter your User Name: (Case sensitive-must be in all CAPS) 8. Enter your password.

d. If this orientation program is NOT completed as required, you will not be scheduled. e. Once completed with the program, please provide a copy of the transcript for your TCC file.

Sentara Careplex

This site is available to our students with one student being scheduled at any time per unit per shift. There is a Sentara orientation packet and the signature forms must be returned to the clinical coordinator before doing shifts. You will have a checklist to print from Blackboard prior to doing shifts here. While doing clinical rotations at this site, you may be required to wear a Sentara Careplex ID card.

NOTE: There is a Sentara orientation packet and the student must return the signature forms to the coordinator prior to doing shifts. There are online tests which need to be completed. This pertains to all Sentaras.

Sentara Leigh Hospital This is a preceptored site for our students. Availability to the students is made in coordination with TCC’s availability to the site and with the individual preceptors’ scheduled hours. No student may be at this site without the preceptor’s presence. Three (3) students may be assigned in the ER while 1-2 students may be assigned to the ICU. The Labor and Delivery unit

is also available at times. A student may work with an RN, with the preceptor’s recommendation, but the preceptor holds overall responsibility for the student. The student should check in and out of the hospital with the TCC preceptor. A minimum of two students must be scheduled in order to confirm the shift. NOTE: There is a Sentara orientation packet, and the student must return the signature forms to the clinical coordinator prior to doing shifts, in addition to completion of the online tests.

Sentara Medical Transport (MTI)

This agency is available to the student and counts as critical care time. The Critical Care Program also uses this site. There is a Sentara orientation packet and the signature forms must be returned to the clinical coordinator before doing shifts. Report to the Arrowhead Shopping Center on Princess Anne Road. NOTE: There is a Sentara orientation packet, and the student must return the signature forms to the clinical coordinator prior to doing shifts, in addition to completion of the online tests.

Sentara Norfolk General Hospital

This is a preceptored site for our students. Availability to the students is made in coordination with TCC’s availability to the site and with the individual preceptors’ scheduled hours. No student may be at this site without the preceptor’s presence. Four (4) students may be assigned in the ER while one student may be assigned to the Burn-Trauma unit, or Labor and Delivery. A student may work with an RN with the preceptor’s recommendation, but the preceptor holds overall responsibility for the student. The student should check in and out of the hospital with the TCC preceptor. A minimum of two students must be scheduled in order to confirm the shift.

SNGH ER also has a limited number of non-preceptored shifts available for our students on ODD dates between the hours of 7 p.m. to 3 a.m. Students can do either a 4 or 8 hour shift.

Sentara Norfolk General also has OR/Anesthesia shifts available for the paramedic level student.

NOTE: There is a Sentara orientation packet and the signature forms must be returned to the clinical coordinator before doing shifts, in addition to completion of the online tests.

Sentara Obici Hospital Students are permitted to do clinical shifts at this site once all of the pre-clinical requirements are complete; this includes the criminal background check. Scheduling is allowed for one student per unit per shift. Units: ER, ICU, L&D, Behavioral Health (Psych), PACU, OPSU. At the present time students are not permitted into the OR for airway experience.

NOTE: There is a Sentara orientation packet and the signature forms must be returned to the clinical coordinator before doing shifts, in addition to completion of the online tests.

Sentara Virginia Beach General Hospital Even though this is a Sentara facility, it is not a preceptored site. Scheduling can be done with one student per unit per shift being allowed. Units: ER, ICU, CCU, Cath Lab, PACU, Out-Patient Surgery Unit. For Critical Care Program students, the Respiratory Therapy Department and the Open Heart Unit is available for them only.

NOTE: There is a Sentara orientation packet and the signature forms must be returned to the clinical coordinator before doing shifts, in addition to completion of the online tests.

Sentara Princess Anne. Scheduling can be done with one student per unit per shift being allowed. Units: ER, L&D, and Neonatal ICU

NOTE: There is a Sentara orientation packet and the signature forms must be returned to the clinical coordinator before doing shifts, in addition to completion of the online tests.

Sentara Williamsburg Regional Medical Center Scheduling can be done at this facility on an individual basis. Scheduling is set up through the TCC clinical coordinator. Units: ER, ICU, L&D. OR rotations are not permitted for the students at this facility.

NOTE: There is a Sentara orientation packet and the signature forms must be returned to the clinical coordinator before doing shifts.

Virginia Beach Recovery Center This is one of the Psych rotations available to the students. Availability is given to TCC on a monthly basis by the unit coordinator of the Detox facility.

NOTE: Students must arrive 15 minutes ahead of shift time to review this facility’s paperwork and required forms.

FIELD goals | precept policy | patient contacts | grading scale and criteria

SECTION

THE FIELD INTERNSHIP PHILOSOPY The field internship is an opportunity to apply concepts mastered in the didactic, practical, and clinical environments to scene management and patient care in the pre-hospital setting. The field intern, under the guidance of an experienced preceptor, endeavors to develop the critical-thinking skills necessary for successful, independent management of all pre-hospital patients. "The college cannot guarantee ride time within a particular agency at any time. Agencies may restrict ride time availability at any time depending on agency needs and availability of resources."

MISSION

To develop and verify competence required of an individual to operate as an entry-level provider of advanced life support for an applicable level of certification, including the ability to serve as team leader in a variety of pre-hospital emergency medical situations.

RESPONSIBILITIES OF TCC

It is the responsibility of the coordinator to be sure that all students have met all of the pre-clinical/field requirements listed above before scheduling students for their field rotations. It is also the responsibility of the coordinators to provide the agency with a schedule of students each month. Most agencies like a 2-3 week notice of students who will be attending. The agency does have the right to turn down any of the student assignments due to high student numbers for that particular date. Agencies need to be contacted if there are schedule changes, cancellations or substitutions. Since the students are guests in the agencies, it is in conjunction with the coordinators’ duties, to monitor the students’ progress regularly and to immediately address any concerns or issues regarding student performance.

The college cannot guarantee ride time within a particular agency at any time. Agencies may restrict ride time availability at any time depending on agency needs and availability of resources.

The college cannot guarantee students will complete all the competencies requirements during a particular semester.

Students they may need additional semesters of ride time to meet requirements for testing.

FIELD INTERNSHIP

Clinical education represents the most important component of enhanced, intermediate, and paramedic education since this is where you learn to synthesize cognitive and psychomotor skills. To be effective, clinical/field education should integrate and reinforce the didactic and laboratory skill components of the educational program. Clinical/field Instruction should follow sound educational principals, be logically sequenced to proceed from simple to complex tasks, have specific objectives, and be closely supervised and evaluated. During the field internship you should be under the close supervision of a preceptor. Field internship must occur within an emergency medical service that exercises and demonstrates a high level of medical accountability. Medical accountability exists when there is good evidence that the EMS provider is not operating as an independent practitioner, and when field personnel are under direct medical control of an on-line physician or in a system utilizing standing orders where timely medical audit and review provide quality improvement. The ability to serve in the capacity of an entry-level provider (EMT-Enhanced, EMT-Intermediate, or EMT-Paramedic) requires experiences with actual patients. This process enables you to build a database of patient experiences that serves to help in clinical decision making and pattern recognition.

An internship is a period of development for you. It is unreasonable to expect you to derive any benefit from being placed into a field environment and perform independently. Field internship represents the phase of instruction where you learn how to apply cognitive knowledge and skills developed in the skills laboratory and hospital clinical to the field environment. Students are encouraged to have a solid understanding of the specific level of instructional material presented in their didactic class, have practiced required skills in the practical skills lab, worked on honing those skills in the clinical hospital environment, all before starting Field Internship. Field internship is where you the student have the opportunity to put everything you have learned in all of the areas mentioned above together under the direct supervision of a qualified preceptor. The final ability to integrate all of the didactic, psychomotor skills, and clinical instruction into being able to serve as an entry-level provider is conducted during the end of the field internship. The majority of team leader competencies must be met in the final portion of the field internship. It is important to recognize that learning is a complex and dynamic process. Therefore, it is foreseeable there may be some overlap between the initial and final phases. The evaluation of team leadership should occur toward the end of the program, with enough experiences coming after the completion of all other instruction to assure that the student is able to serve as an entry-level provider. For the purposes of this handbook, it is important to define the entry-level technician. This person should be able to handle ALL BLS calls and routine uncomplicated ALS calls as the primary care provider. He/she may require guidance when addressing agency specific issues or handling complicated calls. This curriculum will integrate field activities much sooner into the student’s education. Students will not be permitted to undergo certification testing until they are deemed to be “entry-level” competent. To meet this goal, the field internship is a competency-based program, as opposed to an hour-based program. It is important to note that this “entry-level” technician does not yet possess the needed experiences to be released as a primary ALS provider, thus being responsible for all patient care. Ultimately it is the responsibility of the specific agency and the medical director to assist/facilitate the technician in obtaining additional field experiences needed to function independently on an ALS unit and progress through the regional sanctioning process.

FIELD INTERNSHIP OBJECTIVES

In the field internship setting the student, in accordance with Regional policy, may:

• Practice Universal Precautions, following Center for Disease Control (CDC) guidelines. • Perform an appropriate patient assessment. • Obtain a relevant patient history appropriate to chief complaints. • Assess record and interpret vital and diagnostic signs. • Identify and describe presenting signs and symptoms. • Establish priorities of care and initiate appropriate management. • Maintain an open airway, utilizing appropriate airway adjuncts, including endotracheal intubation and percutaneous

transtracheal catheter ventilation. • Insert NG tubes as indicated • Perform needle decompression if indicated. • Provide appropriate oxygen therapy and ventilatory assistance. • Perform cardiopulmonary resuscitation (CPR) according to American Heart Association (AHA) standards. • Initiate ECG monitoring and perform electrical therapy as indicated. • Identify ECG rhythms and initiate appropriate management. • Initiate vascular access, utilizing peripheral, external jugular, or intraosseous techniques. • Initiate a saline lock using proper technique. • Calculate fluid administration rates for IV fluids. • Obtain blood samples and perform blood glucose evaluation. • Troubleshoot a malfunctioning IV infusion.

• Identify the pharmacology, actions, indications, precautions, dosages, contraindications, and side effects of all drugs administered.

• Calculate drug dosages. • Administer, using proper procedures, subcutaneous, intramuscular, intravenous, rectal and nebulized medications. • Perform, in order of priority, the steps in control of bleeding and shock resuscitation. • Perform correctly bandaging, splinting, and spinal immobilization. • Integrate patient care into the process of patient disentanglement and rescue. • Utilize portable and mobile radios per regional protocols. • Present an organized report via radio to staff in the ED. • Complete accurate written Pre-hospital Patient Run Reports

REGIONAL SANCTIONING

Regional sanctioning is a process by which the regional EMS community verifies competence for its ALS providers. All agency-related field activities will meet the requirement for entry-level providers. In addition, some agencies may choose to integrate additional requirements for regional sanctioning during field activities for its affiliated providers. Ultimately it is the responsibility of the specific agency and the medical director to assist/facilitate the technician in obtaining additional field experience needed to function independently on an ALS unit and progress through the regional sanctioning process. This handbook does not attempt to address all regional sanctioning questions/guidelines. Additional information can be obtained by referencing the Tidewater EMS Council ALS Sanctioning Policies and Procedures. Students from other regional councils and areas may want to contact their local council for specific information pertaining to this process.

FIELD INTERNSHIP PRECEPT POLICY

In order to meet accreditation, and testing requirements for both state and national registry testing, all students registered for field internship must complete all ride time requirements under the direct supervision of a qualified preceptor. A qualified preceptor is regarded as an experienced Enhanced, Intermediate or Paramedic provider who has been recognized by both the agency, and regional council, as one who is released under general supervision, and has the knowledge, skills, and ability to precept student interns. Students submitting paperwork for “team leader” credit must have a qualified preceptor physically observe all patient assessments, skills performed, treatments and interventions from the time the student intern arrives on scene, all the way through hospital Emergency Room staff turnover. Students may not claim “team leader” unless a preceptor was present with the student intern during entire patient transport. Students recording “team leader” on skills sheet must be third on Ambulance. An ambulance crew must have at minimum a driver, qualified preceptor, and student intern. Occasionally, the student intern may be in a position to perform advanced level skills on scene under the direction of a qualified preceptor; however, due to limited availability of on scene personnel they may not be able to transport as the third on the ambulance. In this case the student intern is permitted to have the preceptor sign off on all skills directly observed with the exception of “team leader.” Students completing ride time requirements for Enhanced must be precepted by an Enhanced, Intermediate or Paramedic preceptor. Students completing ride time requirements for Intermediate must be precepted by a qualified Intermediate, or Paramedic. Students completing ride time for Paramedic must have a Paramedic preceptor sign off on all competencies and calls. It is the responsibility of the college to ensure that all students follow State the local Regional Medical Council protocols, Commonwealth of Virginia educational requirements, National Registry competencies, requirements, Accreditation requirements, and assist in providing all students the opportunity to complete ride time under the direction of a qualified preceptor. Students have a responsibility, to become familiar with these requirements and to assist the college in ensuring these policies are followed. Note: If you are “self-scheduling” with your own agency and you are on a piece of fire apparatus (Engine, Ladder, Tower, etc. not Ambulance) and respond to a medical call then the following shall apply: You may complete a Clinical/Field Evaluation Form for that

call(s) while on the fire apparatus. You may receive credit for competencies and team leader only if you have a preceptor with you. All other rules shall apply. You will be granted two (2) hours per call if on the fire apparatus. In the “Hospital/Agency/Unit” section of the Clinical/Field Evaluation form it needs to be written clearly that the student is on such apparatus. Example: Norfolk F.D. Engine-2. If at any time, a student finds one’s self in a situation that violates the above precept policy, they must first seek immediate remedy by notifying their assigned preceptor or EMS agency supervisor at the start of the shift, and request a preceptor change. Contact the TCC Field Internship coordinator. In the event that a remedy is not immediately available the student may not be allowed to continue to ride with an unqualified preceptor and will be asked to leave the agency. Students are not permitted to submit paperwork to the college that is in direct violation of State or National requirements. Students failing to follow TCC, State or National requirements will not be permitted to test. Tidewater Community College – Emergency Medical Science program requires that each Field Internship agency submit a preceptor list to the Field Internship Coordinator at the start of each semester. This list will be used to assist the Field Internship coordinators in determining qualified agency preceptors. This list will be kept in the Clinical – Field Office in the Regional Health Professions Center.

FIELD PATIENT CONTACTS

Although the field internship is competency-based, there are minimum numbers of ALS and BLS patients that must be contacted during your field internship. Completed Field Evaluations must be returned and entered in Platinum Planner within seven (7) days. If you are unable to submit the form within the seven (7) days, you must notify your coordinator as soon as possible. These patient contacts are applicable ONLY when the field intern is operating in the position of ALS/BLS Team Leader. EMT enhanced, and intermediate interns that continue on and take a paramedic course within a year may use their acquired patient contacts for their paramedic course as well. In order to sit for the National Registry of EMT Paramedic or Intermediate exam, the student must meet the following for field internship.

• Student must successfully complete the field internship with a C or better and meet hours competencies for the desired level of testing

• Operational Medical Director of TCC determines intern has successfully met objectives for field internship • Students must also successfully complete all clinical requirements for desired level of testing.

To receive credit for BLS and ALS Team Leader in the Field on the Clincal/Field evaluation form and Platinum Planner you must ensure that the appropriate boxes are checked.

FIELD GRADING SCALE

Please refer to the current semester course outline for the grading scale.

EMT-Enhanced EMT-Intermediate EMT-Paramedic 24Hours ER Contacts 12 Hours Field Contacts 5 Team Leader Contacts 3 ALS Contacts as Team Leader *See competencies required For EMT-Enhanced. Enhanced clinical/field hours Must total at minimum of 48 Hours.

48 Hours Field Contacts

10 Patient Contacts as Team Leader Minimum 5 ALS contacts

*See skill competencies required for EMT-Intermediate.

50 Patient Contacts as Team Leader Minimum 25 ALS Contacts as Team Leader *See skill competencies required for Paramedic Please Note: 25 of the 50 total patient contacts as Team Leader must be completed in your last semester. 25 of the 50 total patient contacts as Team Leader must be ALS.

AFFECTIVE SKILLS We will TEACH you the skills to become competent to practice as an entry-level ALS provider. We will then EVALUATE these skills to verify your competence. Competency will be measured in twelve areas.

1. Integrity 2. Empathy 3. Self-Motivation 4. Appearance 5. Self Confidence 6. Communications 7. Team Leadership 8. Patient Advocacy 9. Respect 10. Delivery of Service 11. Time Management 12. Teamwork and Diplomacy

FIELD GRADING CRITERIA

Please refer to the current semester course outline.

Students registered for field internship and successfully completing requirements will receive a letter GRADE for the one (1) credit hour in which they are registered. In order to receive a letter grade of “A” the student must:

1. Turn in two field patient assessment reports by the due dates listed in the course outline. 2. Comply with the guidelines set forth in the TCC clinical and field handbook. 3. Complete all requirements, submit by posted deadline date. 4. Successful completion of clinical/field competencies and hours in accordance with the curriculum of study. 5. If any of the following occur, the student may lose points and the student will receive counseling, or may be dismissed from

the program. a. Violation of policies and procedures as outlined in the Handbook. b. Dismissal from the field agency due to inappropriate appearance or documented communication regarding the same. c. Dismissal from the field agency due to attitude, misconduct, failure to follow clinical procedures and directions or

documentation regarding the same. d. Inappropriate field performance in areas where the student should possess the basic knowledge of appropriate

performance or where the student is unable to demonstrate improvement according to preceptor evaluation e. Any violations of academic misconduct.

6. Students must have completed all pre-clinical/Field requirements before starting any field time. 7. In order to be eligible to test State or National Registry, a student must maintain a “C” or better in the field sections of the

program. 8. Students are encouraged to either meet in person, over the phone, or virtually via Blackboard with the coordinator two times

during the semester. These meetings can be set up in a small group format and can be completed during practicals. Times for these meeting will be posted and reminders sent via email in advance to allow for student planning and attendance.

FIELD PATIENT ASSESSMENT REPORT GRADING SCALE Students are required to submit two individual patient assessment reports each semester in the following areas: OB, Respiratory, Cardiac, Abdominal, Syncope, ALOC, Psych and Trauma. As stated in the course outline, both of the patient assessment reports are worth a maximum of twenty (20) points each towards the students total overall grade. This adds up to a maximum total of 40 points. Please note: patient assessment forms must be completed on patients actually encountered in the field internship. Students are not permitted to submit field patient assessment reports on patients in their clinical internship. NOTE: All Patient Assessment Reports are to be completed and submitted through Blackboard and Safe Assign.

FIELD INTERNSHIP SCHEDULING

Scheduling your field internship ride time can be accomplished two (2) ways:

1. Field Coordinator Scheduling. - Must submit ride time availabilities through Platinum Planner by the 15th of the month prior. (For example – if you

need ride time for May, then your available ride time must be submitted by April 15th). 2. Employed by a licensed 911 agency.

- Agency must send letter to Field Coordinator authorizing ride time and at which level the student will test. - Students must be the third on the Ambulance crew. - Preceptor must supervise all call from the back of the unit.

Each field agency has its own individual requirements, which will be provided in the information to follow.

CANCELLATION OF SHIFTS

Please refer to the Clinical and Field Scheduling and Cancellation Policy from the Student Section of this handbook. Once a field shift is scheduled, it is important to follow the cancellation policy as outlined in your course outline and this handbook.

1. All cancellation requests must be submitted through e-mail using your TCC/VCCS e-mail address. 2. Students will be permitted TWO shift cancellations per semester without penalty. This includes cancellations due to illness,

change of work schedule, personal appointments, family commitments, or for any reason. 3. After the two permitted cancellations, students will lose five (5) points for each cancellation or schedule change thereafter. 4. Cancellations will be accepted prior to three days of the scheduled shift by sending an email to your field coordinator. A

“missed shift” counseling form must be submitted to the TCC Field Internship lock box within seven (7) days. 5. In the event of an emergency and it is less than three days until the shift, you must contact your coordinator by text or cell

phone call prior to your shift. In addition, a written follow-up via note via e-mail is required to your coordinator Remember to use your TCC email account for all correspondence.

Please note Accelerated Intermediate (stand-alone program) and Accelerated Paramedic students are only permitted ONE cancellation per semester without penalty.

APPENDIX HIPPA

A

HIPAA HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT

The HIPAA Privacy Rule was authorized in 1996, enacted by Congress and took effect April 14, 2003. It ensures that any personal medical information of a patient is protected. It also prohibits disclosure of information without the permission of the patient. Protection of Patient

1. Provide restricted use and disclosure of the patients’ medical records and information. 2. Patients have the right to access their own medical records to a greater extent. 3. Protection of all information contained in the medical record (i.e. social security number, address, etc.) 4. Protected Health Information (PHI) includes all information of the patient, whether it is written on paper, oral, or electronically

recorded. This also includes facsimile, digital or photographic means. HIPAA Rules

1. Patients will receive notices explaining their rights, including the right to examine their medical records and request corrections.

2. Doctors are not permitted to give out patient information to third parties without the patient’s consent. 3. Health care companies may not disclose patient information other than what is minimally necessary to deliver care.

A. Doctors’ offices may continue to have a sign in sheet but only the name would be required and not any other

personal/medical information. B. Large white boards often used in an Emergency Room to list patient names and medical conditions are moved out

of public view or only patient initials are used. C. Patient charts are turned toward the wall or placed face down so that “passersby” cannot read them. D. Computer screens are used to shield the public from viewing any patient information. E. Hospital policies have changed the information that can be given out regarding a patient’s condition. No

information may be released without the patient’s permission, not even to confirm a patient’s stay or condition while in the hospital.

Disclosure of PHI There are certain circumstances in which the PHI can be disclosed. You are permitted to use or disclose PHI for:

• For payment, treatment, and healthcare operations • With consent or authorization from the patient • For disclosure of the patient

You are required to release PHI for use and disclosure under the following conditions:

• When requested or authorized by the individual patient • When required for purposes of investigation for compliance by Health and Human Services

Authorization Patients are required to give their consent and authorization if their PHI is to be used for any other purpose other than treatment, payment, and health care operations. Patient authorization is required for disclosure of psychotherapy notes, purposes of research, or for information that could be disclosed to third parties. Authorization is NOT required by the patient:

• For the facility’s patient directory, • To inform family members/guardians, or other identified persons of patient location, condition, or death, • While informing agencies during the time of disaster relief efforts, • For Public Health efforts in relation to disease prevention/control, • To report victims of abuse, neglect or domestic violence, • During audits, legal investigations, or law enforcement purposes, • For coroners, medical examiners, funeral directors or tissue and organ donations, • Who poses a serious threat to the health and safety of self and others.

Patient Privacy Rights Patients are required to receive notices explaining their rights at the time of the first health care appointment. Patients are also to be informed of their right to examine their medical records and to request corrections. Patients have the right to know if their records have been shared with law enforcement or public health authorities. Parents of minors have the right to access and control the disclosure of the PHI of their minor children except in the following situations:

o HIV testing without parental permission o Abuse cases o If parents have given up their parental right

Penalties Violators of the HIPAA Privacy Rule can face civil and criminal penalties that can mean up to $250,000 in fines and up to ten (10) years in prison. Conclusion Respecting and maintaining patient privacy and confidentiality of all personal and medical information is each and every provider’s responsibility. It is important that you familiarize yourself with each agency/institution’s policy on HIPAA and privacy compliance.

APPENDIX policy and procedure | medication discrepancy reporting

B

POLICY AND PROCEDURE MEDICATION DISCREPANCY REPORTING

PURPOSE: Effectively handle reporting of errors involving medications and IV solutions. OBJECTIVES: Improve patient safety; Identify factors contributing to errors; Improve documentation; Prevent recurrence of errors TYPE OF MEDICATION ERRORS:

1. Incorrect medication, patient, time, dosage, or route. 2. Omission of a medication. 3. Medication administered without an order. 4. Allergy to medication. 5. IV solution errors

a. Incorrect fluid or rate. b. Incorrect dilution.

*Documentation must include rate ordered, amount infused, and use of electronic infusion device. MEDICATION ERROR REPORTING: If a medication error occurs:

1. Report immediately to preceptor, charge nurse, attending physician, OMD and clinical coordinator. 2. In certain instances, the pharmacist must be notified. 3. The individual making the error must complete Hospital and TCC incident reports. 4. The clinical coordinator and the medical director review the incident report, investigate the incident, counsel the

individual(s) making the error and invoke disciplinary actions as appropriate. DOCUMENTATION OF A MEDICATION ERROR: A medication error MUST be documented on the:

1. Incident report immediately upon discovering the error. 2. On nurses’ notes report factual information only. Include the patient’s response to the medication administered. 3. Further documentation as per policies and procedures of the facility.

DISCIPLINARY PROCEDURE:

1. Counseling and/or disciplinary action as a result of a medication error will be handled by the preceptor, clinical coordinator and/or program director.

2. All medication errors will be documented by the clinical and or field coordinator. 3. The judgment resulting in disciplinary action will be based upon the:

a. Severity of the error b. Action and reaction of the individual(s) making the error c. Program medical director

4. The Clinical Coordinator/Field Coordinator reserves the right to institute immediate discipline, including suspension: a. For medication errors, which may cause irreversible damage, or potentially irreversible damage to the patient

APPENDIX universal precautions | hand washing

C

SUMMARY OF UNIVERSAL PRECAUTIONS & BODY SUBSTANCE ISOLATION

Universal precautions are steps that should be taken to reduce the chance of passing on infection from one person to another. It is very important that these steps be carried out within the school to protect children, staff members, vendors, visitors, and others who have contact with the facility. 1. It is recommended that one ears vinyl or latex gloves when one thinks he/she might touch any body fluid.

A body fluid includes the following: Blood Synovial fluid Amniotic fluid Peritoneal fluid Any fluid with gross visible blood

2. Wash hands before and after all procedures. If skin is touched by a body fluid, wash immediately with soap and water. 3. NEVER recap, bend, or break needles. 4. Body wastes (such as those on bed sheets) should be discarded directly in the toilet. Wastes containing blood on disposable pads should be

discarded into a special plastic trash bag before disposal. Make sure that no leaks occur. 5. Spills of blood or body fluids that are visible stained with blood should be treated with chlorine bleach. The bleach should be left on the spill for

several minutes. If spill is on carpet or other material that would be ruined with bleach, use a commercial germicide. Always wear gloves when treating such spills and discard wipes into a plastic bag. The actual language from the standard reads as follows: “Universal precautions shall be observed to prevent contact with blood and certain body fluids. Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infections materials.”

HANDWASHING

Proper hand washing is vital in preventing the spread of bacteria and diseases. It also reduces the risk of illness from skin and wound infections, cold and influenza, pneumonia, diarrhea and food borne illnesses, Hepatitis, Herpes, and other viral infections. The frequency of hand washing is essential in prevention and control of infections. Hand hygiene shall always be performed:

• Before entering and exiting any patient room environment • Immediately before and after any patient contact • Before performing any aseptic technique and after handling any contaminated article(s) • Before eating • After using toilet facilities • Before entering and upon leaving an isolation room • When hands are obviously dirty or accidentally contaminated with blood or body fluids • Between procedures on the same patients (i.e., foley care suctioning) • After removing gloves • Before leaving the hospital

Proper hand washing techniques should be followed: • Wet hands with warm running water • Apply approved hand washing agent and thoroughly distribute over hands • Scrub vigorously for 15 seconds • Rinse thoroughly • Dry with paper towel; turn off faucet with paper towel

All students must familiarize themselves and comply with the hand washing policy of the hospitals and agencies in which they do rotations. Student compliance with established procedures for hand washing is monitored by Infection Control Teams in the hospital and agency setting.

APPENDIX

forms

D

Tidewater Community College Health Sciences Division

Critical Incident Report Date: / / Individual (s) involved: Status: (Circle) Student EMS RT PTA MDA GNA DMS RAD ECHD NUR OTA

Preceptor: ____________

Where incident occurred: Time: Date incident reported:

Activity Involved Possible Causes

Patient Fall Medication / Transfusion Invasive Procedure Hazardous Material Infectious Material Infectious Exposure Complaint Needle / “Sharps” stick Procedure Other Patient Care Other (Explain)

Unclear as to Policy / Procedure Unaware of Safety Hazard Equipment Defect Lifting / Pushing / Pulling Lack of Personal Protective Equipment Type and / or Brand of Device Involved in

the Incident Other (Explain)

Clinical Coordinator/ Supervisor Notified at the Time of Occurrence

Department/ Work Area Where Incident Occurred

Yes

No State Reason:

Witnessed by:

Name: Phone:

Description of Incident Measures Taken to Prevent Incident

Outcome/ Severity Physician Notified

No Injury or Inconsequential Injury Consequential (possible temporary injury

effect) Serious (minor permanent injury of

effect) Severe (major permanent Injury or Effect) Death Not Applicable

No Yes Time Notified:

Name:

Did Physician see patient? (circle) Yes No Was treatment prescribed? Due to incident? Yes No

If Yes, describe

Was patient aware of incident? Yes No If Yes, give patient response to incident:

Student / Preceptor Comments:

Clinical Coordinator / Supervisor / Medical Director Comments:

Reviewed by: Date:

Tidewater Community College Critical Occurrence Report

Date: Individual Involved: Incident Report: Yes No Patient Outcome:

Type of Error Route of Administration Classification of Drug/ IV solution Reporting Time

Wrong Route 1 Wrong Dose 1 Incorrect IV solution rate 1 Fluid overload on a restrictive patient 2 Omission of medication 1 Wrong medication/Solution 3 Wrong Patient 3 Unordered Medication 4 Wrong Technique Non-life threatening 2 Life threatening 4 Note: For medication given to a patient with stated allergy to the particular medication add 4.

IV/ ET 4 IM/ SQ/ SL/ Neb 3 PO 2 Other 1

Specify points according to the list below.

0-30 0 31-60 mins. 1 61 mins. –6 hr. 2 6 hrs. or longer 3

Subtotals

Total Points (ADD ALL OF THE POINTS IN THE FOUR COLUMNS)

CLASSIFICATION OF DRUGS/ IV SOLUTIONS 1 Point 1 Point 2 Points 3 Points 4 Points

Antacids Antidepressants Anti-anxiety agents Anti-diarrheal Anti-emetics Antihistamines/ histamines Anti-inflammatory agents Antipyretics Cathartics/ laxatives

Expectorants Anti-tussives Muscle Relaxants Sedatives/ hypnotics Non-narcotic analgesics Un-medicated IV’s

Antibiotics Anticonvulsants Anti-psychotics Barbiturates Complex IV’s Diuretics Electrolytes Glucose/ Glucagon Narcotic antagonists Oral antidiabetics Steroids

Anti-coagulants Thrombolytics Brochodilators Cardiovascular drugs Anti-arrhythmics Anti-hypertensives Vasoactive drugs Narcotic analgesics

Blood and components Heparin Insulin IV push medication Pediatric Medications Rapid IV Infusions of cardiac Drugs

Error Review:

1. Brief description of error:

2. State immediate corrective action:

3. Does documentation in the patient medical record reflect the incident, patient outcome, and corrective action?

Practice Review:

1. This individual has been practicing: 0-1 1-2 2-5 >5 years 2. This is error # In what period of time? 3. Total number of points from front page:

Disciplinary Guidelines: Total Points Corrective Action

1-15 Counseling with Clinical Coordinator

16-30 Counseling with referral to Instructor for medication review

31-45 Written corrective Action. Individual needs to write analysis of error and action for preventing similar errors.

46-55 All of the above plus counseling with TCC medical Director

>55 Repeat of course, suspension or other action deemed appropriate by Clinical

Coordinator, Medical Director, and Program Director.

Follow – UP Counseling, remediation, and or Discipline: Student Comments: Clinical Instructor Signature: Date: .

Tidewater Community College Emergency Medical Technology Program

Clinical and Field Credit Waiver Student Check List

This checklist is to be used as a guideline when gathering all required items. Please assemble your credit waiver package to reflect the order of this checklist. Students who only qualify for clinical only or field only will only submit the required items listed below. Students who are submitting for both clinical and field must have all items from the checklist completed.

Clinical Documentation - Field Internship Documentation

1. Typed Cover Letter (C/F)

2. Completed Clinical / Field Competency Packet Signed by all Parties (C/F)

3. Job Description and/ or Resume Document. (C/F)

4. Copy of Current ALS Certification (Enhanced, Cardiac Technician, or Intermediate certification. (F)

5. Copy of regional Certificate, agency release letter, or equivalent that states you are released to practice under general supervision. Letter must state that you have been practicing for at least six months at the Enhanced, Cardiac Technician or Intermediate level. Must also include a statement that reflects the student has a minimum of 288 hours released time as an Enhanced, Cardiac Tech or Intermediate. (F)

6. Supporting Military Documentation (Active Duty and Reserve only) (C/F)

7. Letter of endorsement from students agency Medical Director/ or Nurse Manager. (C/F) C = Required for Clinical Credit Waiver Packet F = Required for Field Credit Waiver Packet

Students are only allowed to submit credit waiver one time in a three-year period. Students who qualify for both clinical and field waiver must submit all documentation at the same time. Students who submit both clinical and field documentation will receive competency credit from either clinical or field. Hours may be waived per approval of the medical director. Once you have completed this package, please remove the checklist page and the explanation page before submitting. Students name should be at the top of Competency Documentation List.

Tidewater Community College Emergency Medical Technology Program

Clinical and Field Internship Waiver Packet

This packet is a combined clinical and field competency waver packet and has been designed to streamline the process by which students request competency waiver credit. Students who qualify for both clinical and field competency waiver credit may only submit one complete package that can include both clinical and field internship supporting documentation. Students who are eligible for credit waiver are encouraged to start this process early to ensure enough time is given for review of documentation. Students desiring consideration of past work experience must follow the guidelines of this packet in order to receive full consideration. Incomplete packets will be returned to the student with no credit awarded. Credit may be awarded for past medical experience. This experience must be within the past 12 months prior to entering the Tidewater Community College – Emergency Medical Technology Program, and must be documented in a specific format. This information collected will be forwarded to the Tidewater Community College – Emergency Medical Technology Medical Director for review. This review process may take up to 3- 4 weeks to be completed. All paperwork gathered for this waiver must be submitted together in the specific order listed on the checklist found on front page. Students failing to follow this may delay their paperwork review. • Typed cover letter from student requesting waiver credit to be granted. (Student may request

Clinical and Field consideration in same letter. Please list clinical first.) • Completed original of the Clinical and Field Documentation List (attached) to document all skills

performed within the past 12 consecutive months. This documentation list should be annotated with the number of skills performed and period in which they were performed. The agencies medical director or nurse manager’s signature must endorse this checklist. Student must have supervisor signature in the column beside each number. If a mistake is made in filling out the checklist please strike one line through the mistake and have supervisor initial the item that was lined out.

• Job description of clinical or field assignment or career. Include employment specifics, any

education or training pertinent to medical care in the hospital or pre-hospital environment. (Place employed, length of time employed, number of hours worked per week, please indicate full or part-time.) A resume can be used to satisfy this requirement provided it lists the above information. Student may also include this information in his or her welcome letter.

• Current Copy of ALS Certification. Students must submit a current copy of their certification.

(Enhanced, Cardiac Technician, Intermediate, RN) • Copy of regional release certificate, agency release letter, or equivalent. Certificate or letter must be

submitted on agency letterhead and state that you have been practicing a minimum of six months at the enhanced, cardiac technician, or Intermediate level. Letter must also include a statement that reflects the student has completed a minimum of 288 hours of unsupervised ride time under general supervision at current certified level during the six-month period.

• Supporting Military Documentation. (Active Duty and Reserve Only For active duty and reserve

military personal, please list length of time in service, training, duty stations, and any other specific information regarding education and training that may be beneficial in determining the amount of waiver credit the applicant may be eligible to receive.

• Letter of Endorsement from student’s agency Medical Director and/ or Nurse Manager.

Tidewater Community College Competency Documentation List

Student Name: EMPLID:

Date Range: Skill Tracker: / / (MM/DD/YYYY) – (MM/DD/YYYY) (TCC Coordinator Use) Clinical: Agency: Dept:

Supervisor/ Nurse Manager: Years Worked:

Field: Agency: Dept:

EMS Supervisor/ Director: Years Worked:

Students applying for both clinical and field credit must fill out form in its entirety.

Please do not write in the column marked TCC Credit.

I. Presenting Problems:

Skills / Competency Performed

Number Performed

Supervisor Signature TCC Credit

Cardiac Assessment: Clinical:

Field: Pediatric Respiratory Assessment:

Clinical: Field:

Adult Respiratory Assessment:

Clinical Field

Syncope Assessment: Clinical: Field:

Abdominal Assessment: Clinical: Field:

ALOC/ Neuro Assessment: Clinical: Field:

Obstetrical Assessment: Clinical: Field:

Psychiatric Assessment: Clinical: Field:

Trauma Assessment: Clinical: Field:

II. Assessments: Skills / Competency

Performed Number

Performed Supervisor Signature TCC Credit

Patient Assessment PEDS 0 - 1:

Clinical: Field:

Patient Assessment PEDS 1 - 3:

Clinical: Field

Patient Assessment PEDS 3 - 6:

Clinical Field

Patient Assessment PEDS 7 - 12:

Clinical: Field:

Patient Assessment PEDS 13 - 17:

Clinical: Field:

Patient Assessment Adult 18 – 65:

Clinical: Field:

Patient Assessment Adult 66+:

Clinical: Field:

III. IV/Blood draw Skills / Competency

Performed Number

Performed Supervisor Signature TCC Credit

IV Start (PEDS <17): Clinical: Field:

IV Starts (Adult <65): Clinical: Field

IV Start (Geriatric >65): Clinical Field

Blood Draw (PEDS <17): Clinical: Field:

Blood Draw (Adult <65): Clinical: Field:

Blood Draw (Geriatric >65):

Clinical: Field:

IV. Medication Administration Skills / Competency

Performed Number

Performed Supervisor Signature TCC Credit

Medication Administration – PO:

Clinical: Field:

Medication Administration – SL:

Clinical: Field

Medication Administration – IM:

Clinical Field

Medication Administration – SQ:

Clinical: Field:

Medication Administration – IV:

Clinical: Field:

Medication Administration – HHN:

Clinical: Field:

Medication Administration IV – Piggy Back:

Clinical: Field:

Medication Administration – IO:

Clinical: Field:

V. Cardiology Skills / Competency

Performed Number

Performed Supervisor Signature TCC Credit

12 Lead EKG (Placement): Clinical: Field:

12 Lead EKG Interpretation:

Clinical: Field

Lead 2 Interpretation: Clinical Field

Defibrillation: Clinical: Field:

Cardio-version: Clinical: Field:

External Pacing: Clinical: Field:

VI. Ventilation Skills / Competency

Performed Number

Performed Supervisor Signature TCC Credit

Ventilation (Bag Valve Mask):

Clinical: Field:

Endo-tracheal Tube Placement

Intubations:

Clinical: Field:

C-Pap Ventilation: Clinical Field

Auto-vent Ventilation: Clinical: Field:

Oxcillator Ventilation: Clinical: Field:

Naso/ Orogastric Tube: (Placement)

Clinical: Field:

Naso/ Orogastric Tube: (Suctioning)

Clinical: Field:

Oral Suctioning:

Clinical: Field:

Tracheal Suctioning: Clinical: Field:

VII. Hospital Time Skills / Competency

Performed Number

Performed Supervisor Signature TCC Credit

Emergency Room: Clinical:

Intensive Care Unit: (ICU, CCU, VICU, PICU, etc):

Clinical:

Labor and Delivery: Clinical

Pediatric Emergency Room: (CHKD)

Clinical:

Psychiatric Rotation: Clinical:

Operating Room/ Recovery Room:

Clinical:

VIII. Field Internship Time

Skills / Competency Performed

Number Performed

Supervisor Signature TCC Credit

Hours Since Release Under General Supervision: (must be greater than 288 hours)

Field:

ALS Team Leader: Field:

BLS Team Leader: Field:

Total Calls: Field:

Student Comments:

______________________________

Clinical Supervisor Comments:

Field Supervisor Comments:

Tidewater Community College

Emergency Medical Technology Program

Credit Waiver Signature Page I, , am requesting Clinical and/or Field Internship credit wavier in the Tidewater Community College - Emergency Medical Technology Program. I am including all completed documentation according to the checklist listed on the front page of this packet to support the above competencies and or hours. I understand that all information submitted in this package is complete and true. I also understand that any misinformation or deliberate miss-representation of facts is a direct violation of the Tidewater Community College Honor Code, and is further considered academic misconduct, and will be subject to disciplinary action, and or dismissal from the college. I am aware, by my signature below of the above information and that, the Tidewater Community College Emergency Medical Technology’s Medical Director has the final determination as to how much credit may or may not be granted. Clinical Supervisor Signature: Date:

Clinical Supervisor Name Printed Phone Number:

Field Supervisor Signature: Date:

Field Supervisor Name Printed Phone Number:

Student Signature: Date:

Date Submitted to Coordinator: Coordinator Initials:

Reviewed and approved by: TCC Medical Director: Date:

TCC Clinical Coordinator: Date:

TCC Field Coordinator: Date:

Tidewater Community College

EMS Program D.O.T. Psychomotor Airway Objectives for O.R. Clinical

OBJECTIVE CLINCIAL 1 CLINICAL 2 Perform body substance isolation (BSI) procedures during basic airway management, advanced airway management, and ventilation

Perform pulse oximetry Perform end-tidal CO2 detection Perform peak expiratory flow testing Perform manual airway maneuvers, including: (P-2) on Adult (A) and Pediatric (P) patients

a. Opening the mouth b. Head-tilt/ chin-lift maneuver c. Jaw-thrust without head-tilt maneuver d. Modified jaw-thrust maneuver

Perform the Sellick maneuver (cricoid pressure). Perform use of Magill forceps Demonstrate suctioning the upper airway by selecting a suction device, catheter and technique Perform tracheobronchial suctioning in the intubated patient by selecting a suction device, catheter and technique

Demonstrate insertion of a nasogastric/orogastric tube Perform gastric decompression by selecting a suction device, catheter and technique Demonstrate insertion of an oropharyngeal airway. Demonstrate insertion of a nasopharyngeal airway. Demonstrate ventilating a patient by the following techniques on Adult (A) and Pediatric (P) patient

a. One person bag-valve-mask b. Two person bag-valve-mask

Perform oxygen delivery from a cylinder and regulator with an oxygen delivery device Perform stoma suctioning Perform retrieval of foreign bodies from the upper airway Perform assessment to confirm correct placement of the endotracheal tube Intubate the trachea by the following methods

a. Orotracheal intubation b. Nasotracheal intubation c. Multi-lumen airways

Adequately secure an endotracheal tube Perform endotracheal intubation in the pediatric patient. Perform extubation Perform replacement of a tracheostomy tube through a stoma

Perform patient assessment of adequate perfusion of cardiac and respiratory system

Perform intravenous access Perform medication administration

_______________________________________ _____________________________________ Student Name (Print) Preceptor #1 Clinical (print) _______________________________________ _____________________________________ Student Signature Preceptor # 2 Clinical-Signature _______________________ ____________________ Date Date

Tidewater Community College Emergency Medical Services Program

Academic Misconduct, Academic Dishonesty and Honor Code

The EMS program will not tolerate Academic Misconduct and Dishonesty in any form (ZERO TOLERANCE) and follows the Policy of Tidewater Community College as outlined in the student Handbook. Academic Misconduct includes but is not limited to the following actions:

⋅ Cheating of quizzes and exams ⋅ Falsifying evaluations (clinical, field and/or practical) ⋅ Misdocumentation of any information entered into Platinum Planner ⋅ Falsifying documents related to the College, agencies, or hospitals ⋅ Copying information from another person for graded assignments ⋅ Plagiarism – the intentional or accidental presentation of someone else’s words or ideas as your owns ⋅ Submission of work other than your own for written assignments ⋅ Abuse, theft, or destruction of College, hospital or agency property ⋅ Inappropriate language or behavior ⋅

An Honor Code is based on a student’s personal integrity. There is a responsibility that comes within the EMS profession to monitor yourself and your peers so that a high standard of ethics is maintained. Students should establish and maintain high ethical standards for their behavior and monitor the standards of their peers as well. This integrity includes and is not limited to the following actions:

⋅ Following the Academic Misconduct Policy ⋅ Reporting any of your peers who are in violation of the Academic Misconduct Policy ⋅ Reporting of any unethical actions by their peers

I understand that it is my responsibility to follow the Honor Code and the Academic Misconduct Policy of the EMS program and that of Tidewater Community College. I understand it is my responsibility to report violations of the Honor Code and Academic Misconduct Policy among my peers, and that all sources will remain confidential. ____________________________________________________ ________________ Student’s Printed Name Date ____________________________________________________ Student’s Signature this form will be retained in the student file

Tidewater Community College Emergency Medical Services Program

Please initial at the end of each line in the space provided and sign the bottom of the form in the space provided.

By signing this statement, I acknowledge the receipt of the TCC Emergency Medical Services Clinical and Field Student Handbook, and I agree to observe all policies and procedures as outlined in the Handbook.

_______

I understand that I must comply with the pre-clinical/field requirements as listed in the Handbook. In addition, I will successfully complete a drug calculation exam and attend a clinical/field orientation class before beginning my clinical/field rotations.

_______ I understand that I must submit to a criminal and sex/child offender background check before beginning clinical rotations.

_______ I understand that the College or hospital/agency does not assume any responsibility for student’s accidents or illness at any time. This includes needle sticks and any subsequent testing. Students are encouraged to obtain their own health insurance coverage.

_______ I understand that failure to comply with the established policies may affect my letter grade, or may result in being placed on Clinical Probation, Administrative withdrawal, or being dismissed from the program.

_______ I understand that by participating in the EMS program of Tidewater Community College that I may be exposed to unknown diseases, various bacteria, environmental hazards and radiation. Nonetheless, I wish to continue in the program. I understand that by doing so no one can assure me that I will not be harmed by exposure to one of the mentioned elements.

_______ I give release and hold harmless the Commonwealth of Virginia, State Board for Community Colleges, Tidewater Community College, its faculty, staff, affiliated hospitals and field agencies for any injury or illness to my exposure no matter the cause unless due to the intentional misconduct of any of the said parties.

_______ I give release to the Tidewater Community College EMS program to release copies of certification cards, physical examination forms and other information as required by the clinical/field affiliates and supporting organizations.

_______ I understand I may be photographed or videoed as part of my coursework. I give release to the Tidewater Community College EMS program to use my images on their website and/or any promotional materials.

_______

____________________________________________________ ________________ Student’s Printed Name Date ____________________________________________________ Student’s Signature