Intro to Nursing

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Diversity

is the practice of acknowledging and respecting the multiplicity of personal identities

Social Justice

is treating everyone fairly regardless of economic status, race, ethnicity, age, disability, sexual orientation, gender identity or other characteristics to advance equity.

ExamSoft

is used for all undergraduate nursing courses from sophomore level up. Make-up exams maybe in alternative format.

Inconclusive Drug Screen Tests

A drug screen that comes back neither positive nor negative must be repeated at the student's expense within one week of results. Students may be required to randomly submit to an additional drug screen during the school year as determined by the School of Nursing, once again at the student's expense.

Dismissal from the School of Nursing Program

An undergraduate student is dismissed from the Nursing Program for the following reasons: - Undergraduate students with an unsuccessful second attempt in any NUR or required HLT course. Meaning, if a student fails two (either NUR or required HLT) courses that will be the basis for dismissal. - Students who are determined to be in violation of the Academic Honesty Policy of Mount Saint Mary College. - Students may appeal dismissal from the School of Nursing by following the appeal process through the Academic Issues Committee who then makes a determination. The Dean reviews the Committee decision and makes a decision deemed final and binding. Dismissal Appeal Outcomes are Final and Binding - Students Dismissed from the Nursing Program - May not reapply for reentry into the nursing program. - May meet with Dean, Chair, or another degree advisor to consider another major. - Students Re-Entering the Nursing Program after an Appeal - If a student is permitted to re-enter the nursing program it will be with the understanding that one unsuccessful attempt in a NUR or required HLT course, or withdrawal will result in the final dismissal from the program. - Students re-entering the nursing program are required to participate in the student learning process. See Appendix E.

Study

At Dominican schools, study is directed to the whole of reality, and seeks a greater understanding of God, the human person, and the world. Dominican pedagogy cultivates a contemplative attitude that engenders a deep appreciation for goodness and beauty, and affirms a harmonious relationship between reason and faith.

Ethical Principles and Duties

Enables nurses to follow a code of conduct that respects individuals, families, communities, and populations.

Induction is by Invitation

Have completed ½ of the nursing curriculum; Achieve academic excellence (at schools where a 4.0 grade point average system is used); Rank in the upper 35 percentile of graduating class; Meet the expectation of academic integrity.

Conflicting Policies

If a conflict arises in the interpretation of this policy the School of Nursing will defer to the clinical site fit for duty policy (or similar document) for resolution.

Disability Services

If you need help, you're not alone - 19% of Mount students utilize accommodations through Disability Services. - Whether you have a physical, psychiatric, or learning disability, our office will work with you to ensure you receive the accommodations you need to have a fantastic college experience. Classroom Accomodations- If you have any specific classroom needs, we'll work with our faculty to ensure you have an environment suited to your learning style. Testing Accomodations- We work with students who require testing accommodations for extended time, alternate test space, exam reading/scribes, and more. Advocacy- Students are sometimes hesitant to share their needs with faculty and other campus administration. We are more than happy to advocate for you and work collaboratively to give you the best college experience. Assistive Technology- We work with students in need of assistive technology in the classroom and in their personal work. We frequently utilize Read&Write, an extension of Google Chrome, to assist students with their work. Campus Accessibility- If you have a disability that requires assistance in accessing campus facilities, we will work with our offices of Health Services and Security & Safety to ensure you can access everything you need on campus. If you have a temporary or permanent physical disability, Security & Safety officers are more than happy to drive you wherever you need to go on campus. Learning Specialist- Our learning specialist allows students to grow their study and learning skills through meetings and training. PACT- Persist, Achieve, Connect, and Thrive at the Mount is a small group run through the Office of Disability Services aimed at providing anxious students with skills and connections they need. Learn more about PACT here. Contact: Email- [email protected] Phone- 845-569-3638 Location- Aquinas 100C Hours- Monday - Thursday 8am-5pm Friday 8:00am-4:30pm

Mindfulness: Enhancing physical and mental wellbeing

Mindfulness is considered to have the potential to produce benefits in the treatment of physical and mental illnesses. Sheila Hardy looks at how it could help enhance the well-being of people with diabetes.

Appendix C American Nurses Association (ANA) Code of Ethics

New York State Education Office of the Professions The Office of the Professions refers to the ANA Code of Nurses to guide the practice of nurses throughout their professional practice. They further say: A code of ethics states the primary goals and values of the profession. It indicates a profession's acceptance of the trust and responsibility with which it has been empowered by society. A code of ethics serves to inform both nurses and society of the profession's expectations and requirements in ethical matters. An ethical code provides a framework within which nurses can make ethical decisions and fulfill their responsibilities to the public, to other members of the health team, and to the profession (NYSED.GOV, 2021, para. 2).

New York State Registration and Accreditation

Our nursing programs are registered for professional purposes under Subchapter A of the Regulations of the Commissioner of Education (Chapter II of Title 8 of the Official Compilation of Codes, Rules and Regulations of the State of New York). They are accredited by the New York State Board of Regents Office of the Professions. Since 2020 registration has been extended annually till the next tentative review in spring 2029 Nurse Practice Act: - Defines nursing and legal scope of practice.. - Ethical standards are the basis of the law. - Licensure is granted to students who have completed a program with passage of the National Council Licensing Exam (NCLEX)

Academic Concerns and Grade Appeals

The Grade Appeal process of the School of Nursing differs from the Grade Appeal process of the College due to the nature of the School of Nursing. A student who believes that the grade they have received in any NUR or required HLT course is in error must initiate the procedure outlined below. If the student is dissatisfied with the response at any step, they should proceed to the next step. The Academic Issues Committee does not hear non-NUR or non-HLT courses nor does it change grades. Only faculty or the Dean have the ability to change grades based on the decision being in favor of the student. A grade appeal is intended to allow a student to request a review of how their grade was determined. A student who believes that the grade received in error, should initiate the procedure outlined in this section. Consistent grades lower than 78% in undergraduate work and 83% in graduate work during a course, resulting in a failure for the course, are not grounds for a grade appeal. Step 1: The student must first attempt to resolve any academic concerns with the faculty member of the course by meeting. Step 2: The student must meet with the Chair of the School of Nursing to resolve the issue if not resolved with the faculty member. The student may then submit a written appeal that gives a rationale for a grade change with supporting documentation. Step 3: The student must request a hearing from the Academic Issues Committee. Appeals must be filed no later than two weeks after the course grades are posted. The appeal will proceed as follows: A. The student will submit the written appeal and supporting documentation, including a copy of their transcript, to the designated drop box on the e-Class site by the deadline posted. B. The student must indicate in the written appeal whether they will attend or not attend the hearing with or without a support person. Students may ask one non-faculty college employee such as an academic coach to accompany them to the appeal hearing. No other person may accompany the student. The support person may not speak at the hearing. Their purpose is observing the process and supplying personal support to the student. At the end of the hearing, the support person leaves with the student. C. If the student elects to be present at the hearing, the faculty member must also be present. If the student elects not to be present, the faculty member must supply written documentation of grades and how the students grades were calculated for the course. The Committee may request additional information from the student or faculty member. - When the hearing is in person, the student presents their appeal to the Committee by discussing their rationale and supporting documentation followed by the faculty member. Both have the opportunity to provide additional information at the hearing. D. An appeal hearing maybe recorded by the Chairperson of the hearing. Other recording devices are not permitted. E. The Chair of the Committee is responsible to ensure the procedure is followed, and for communicating the findings to the VPAA, the Dean of the School of Nursing, and the student. F. If the faculty member is no longer employed at MSMC and is unable to be contacted, the Dean will change the course grade if the decision is in favor of the student. G. The decisions of the Academic Issues Committee are by majority vote and provided to the Dean who reviews them. The Dean's decisions are deemed final and binding. H. The student will receive a certified letter with the Committee's decision sent to the student's address of record, as well as an email to the MSMC address, within seven business days of the hearing. A copy of the certified letter, along with all materials presented during the appeal becomes a part of the student's educational record. (This is for FERPA purposes.)

Courses Delivered Online

The majority of the courses are face-to-face but some courses may be delivered hybrid or fully online. As defined in Student Handbook: Online Learning instruction is defined as follows.

§6902. Definition of practice of nursing

The practice of the profession of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual or potential health problems through such services as casefinding, health teaching, health counseling, and provision of care supportive to or restorative of life and well-being, and executing medical regimens prescribed by a licensed physician, dentist or other licensed health care provider legally authorized under this title and in accordance with the commissioner's regulations. A nursing regimen shall be consistent with and shall not vary any existing medical regimen.

Clinical Warning

The purpose of the Clinical Warning is to inform the student that they are not meeting one or more of the clinical objectives and continued failure to do so may result in a course failure. It may be initiated by the course coordinator or the clinical instructor at any time during the semester. Unsafe or negligent behavior will lead to immediate dismissal. The faculty member will meet with the student to discuss the unmet objectives. Both the student and the faculty member will sign the form which will be maintained in the student's file. If the student does not sign the form, the faculty member will send an email with a copy of the form attached documenting the session to the student and the Dean of the School of Nursing. The student may provide a rebuttal that will be maintained with the clinical warning.

We believe the faculty members of the School of Nursing are:

accountable for the quality of the educational programs and for the promotion of safe and effective nursing through teaching, role modeling, scholarship, and collaboration with other professionals and consumers of health care.

Ethics

•Ethics is a standard of right and wrong that prescribe what humans ought to do, usually in terms of rights, obligations, benefits to society, fairness, or specific virtues. Ethics is: • knowing the right thing to do; and • doing "good" and causing no harm.

Creating a Course Binder

- To get organized. - Print out core course documents. - Create course binder. - Create a dedicated file folder in your computer. - Read actively.

Addressing Healthcare Inequities

AACN recognizes the impact of shifting U.S. population demographics, a health system challenged by workforce shortages, and persistent health inequities on academic nursing. Therefore, AACN and its member schools commit to accelerating diversity, inclusion, and equity initiatives to prepare the current and future nursing workforce to be reflective of the society it serves while simultaneously fulfilling societal expectations and needs (Relf, 2016; Danek & Borraya, 2012). Healthcare reform has revitalized efforts to examine how our nation's health system should evolve to meet the needs of all persons while being representative of the population served (Danek & Borrayo, 2012). By 2044, more than half of the United States population will belong to a census grouping other than non-Hispanic White (Colby & Ortman, 2015). By 2060, one in five Americans will be foreign born. Health inequities, including diminished life expectancy and poor health outcomes, vary based on race, ethnicity, culture, sexual orientation, gender identity, age, and socioeconomic status. The social determinants of health - the conditions in which people are born, grow, learn, live, work, play, worship, and age - coupled with the distribution of money, power and resources are primarily responsible for these inequities (World Health Organization, 2016; Healthy People 2020, 2016). Advancing Civic Leadership and Engagement The desired nursing workforce that results from creating more diverse and inclusive nursing schools would be better prepared to advocate with and for others—including engaging with community leaders to work toward achieving equity in health and well-being. The benefits of diversity and inclusivity in education programs also can help prepare health professionals to take action on or address the social determinants of health described above. (National Academies of Sciences, Engineering, and Medicine, 2016, p. 11-20).

American Nurses Association (ANA)

ANA is a National Nursing Organization that plays a predominant role in nursing education of students and in practicing registered nurses. Of importance are their practice standards and their ethical code. ●Nursing: Scope and Standards of Practice (2021) ●Inform and guide registered nurses in the provision of safe, quality, and competent health care. ●The ANAs Code of Ethics

Exam Policies

All NUR and HLT final exams will be comprehensive, which consists of all content taught in that course - No Quiz or Exam grade will be dropped when calculating the Final grade. In all NUR and required HLT courses - All online exams will be forward only progression, meaning that a student may not go back to a previous question - The time limit is one minute 30 seconds per question in an objective exam - Course instructors will not provide a blueprint or study guide for any exams. Students will be advised that all material covered in the class (readings, lectures, etc.) may be on the final exam - Final exams may not be reviewed - Students may review an exam until the date of the next exam in that course. - Students may review exams only once. - Students may only review incorrect answers with faculty. - The format of exams and exam reviews are determined by each professor. Both group and/or individual reviews are acceptable formats. Records should be kept of those who attended - Students struggling in a course should meet with their instructor one-on-one for the reviews

Medication Administration Policy

All medication administration must be directly observed by a faculty member or preceptor. No medication may be given without the clinical instructor or preceptor present. In addition, all patient identification policies of the agency must be followed.

Drug Screening Policies

All students enrolled in clinical courses must submit to and pass a ten (10) panel urine drug screen test as a condition for attendance in clinical courses. - Urine screen tests must be performed by a provider approved by the School of Nursing. - Only results sent directly to MSMC Health Services are acceptable as meeting School of Nursing requirements. - A negative urine drug screen test is required and is usually a one-time requirement. - Students who have taken a leave of absence or readmitted into the nursing program, must repeat the drug screening test. - Students who fail to submit to the drug screen test are ineligible to take a clinical course in graduate program. They must withdraw from course with an opportunity to register for the course the next time it is offered, provided they submit to and pass the drug screen test.

ANA: Code of Ethics for Nurses

Applies to all nurses in all healthcare settings - Sets standards of conduct and behaviors for nurses Includes four fundamental responsibilities of Nurses - Promote health - Prevent illness - Restore health - Alleviate suffering KEY POINTS: - Primary commitment is to persons (individual, family, community, or population). - Demonstrate compassion and respect for all persons regardless of their status - Promote/advocate for the health and welfare of patients, families, communities and populations. - Accountability for individual practice. - Maintain and increase personal knowledge base. - Work to improve healthcare environment for both those receiving care and those providing care.

Appendix D Diversity, Equity, and Inclusion in Academic Nursing AACN Position Statement

As the collective voice for academic nursing, the American Association of Colleges of Nursing (AACN) serves as the catalyst for excellence and innovation in nursing education, research, and practice. The values of diversity, inclusion, and equity are central to advancing AACN's mission. This AACN position statement is intended to articulate the vision and principles of AACN associated with these values, which may be reflected in similar statements by AACN members.

The Nursing Process

Assessment: collecting data from what the patient says (subjective) and from your objective assessments such as blood pressure, pulse, respirations, and temperature. Nursing Diagnosis: Itis, not a medical one. It is an actual one occurring at present or one that could potentially occur. Outcome: Set goals with the patient and these are prioritized using the letters of the alphabet: A = airway B = breathing C = circulation Planning: How the goals are going to be achieved. Implementation: Carry out the plan. Evaluation: Is whether or not the goals were achieved.

Written Assignments

Each assignment should contain the student's name, date, assignment title, course number and title, and instructor's name. The course instructor will indicate to students whether the assignment is required to be typed. All assignments must maintain the confidential nature of patient information. Only initials are to be used in identifying any patient in any written work. Unless otherwise noted in the course syllabus, all formal written assignments are to be completed in the format of the latest edition of the American Psychological Association (APA). Work submitted for one course may not be submitted for any other course, or for the same course if that course is repeated.

Mission of the School of Nursing

Mount Saint Mary College School of Nursing prepares nurses, congruent with the Dominican values of spirituality, study, community, and service. Students engage in service learning to understand the social determinants of health and to promote social justice; use reflective practice and clinical judgement to provide compassionate, skilled, holistic care while respecting diversity, equity, and inclusion of all people; and are prepared to engage in life-long learning and to advance professional nursing practice.

Overcoming Test Anxiety

Most students experience some level of anxiety during an exam. However, when anxiety affects exam performance it has become a problem. General preparation/building confidence: Review your personal situation and skills.Academic coaches can help you in these areas, or refer to our Guides on the topic: - Developing good study habits and strategies. - Managing time (dealing with procrastination, distractions, laziness). - Organizing material to be studied and learned. Take a step by step approach to build a strategy and not get overwhelmed. - Outside pressures, success/failure consequences (grades, graduation), peer pressure, competitiveness, etc. - Reviewing your past performance on tests to improve and learn from experience. Test preparation to reduce anxiety: - Approach the exam with confidence: Use whatever strategies you can to personalize success: visualization, logic, talking to yourself, practice, team work, journaling, etc. View the exam as an opportunity to show how much you've studied and to receive a reward for the studying you've done. - Be prepared! Learn your material thoroughly and organize what materials you will need for the test. Use a checklist. - Choose a comfortable location for taking the test with good lighting and minimal distractions. - Allow yourself plenty of time, especially to do things you need to do before the test and still get there a little early. - Avoid thinking you need to cram just before. - Strive for a relaxed state of concentration. Avoid speaking with any fellow students who have not prepared, who express negativity, who will distract your preparation. - A program of exercise is said to sharpen the mind. - Get a good night's sleep the night before the exam. - Don't go to the exam with an empty stomach. Fresh fruits and vegetables are often recommended to reduce stress.Stressful foods can include processed foods, artificial sweeteners, carbonated soft drinks, chocolate, eggs, fried foods, junk foods, pork, red meat, sugar, white flour products, chips and similar snack foods, foods containing preservatives or heavy spices. - Take a small snack, or some other nourishment to help take your mind off of your anxiety. Avoid high sugar content (candy) which may aggravate your condition. During the test: - Read the directions carefully - Budget your test taking time - Change positions to help you relax - If you go blank, skip the question and go on - If you're taking an essay test and you go blank on the whole test, pick a question and start writing. It may trigger the answer in your mind. - Don't panic when students start handing in their papers. There's no reward for finishing first. o Use relaxation techniques if you find yourself tensing and getting anxious during the test: o Relax; you are in control. Take slow, deep breaths o Don't think about the fear. Pause: think about the next step and keep on task, step by step. o Use positive reinforcement for yourself: Acknowledge that you have done, and are doing, your best. o Expect some anxiety. It's a reminder that you want to do your best and can provide energy, just keep it manageable. o Realize that anxiety can be a "habit" and that it takes practice to use it as a tool to succeed. After the test, review how you did. - List what worked, and hold onto these strategies. It does not matter how small the items are: they are building blocks to success. - List what did not work for improvement. - Celebrate that you are on the road to overcoming this obstacle. Check out local centers and resources in your school for assistance! If you are aware that you have a problem with test anxiety, be sure your teacher or instructor knows before any testing begins (and not the hour before!). There may be other options to evaluate your knowledge or performance within the subject matter.

History of the School of Nursing

Mount Saint Mary College was founded by the Sisters of Saint Dominic of Newburgh in 1930. Initially, the College was a Normal and Teacher Training School for the members of the religious community, awarding Associate degrees. In 1959 the College charter was amended by the New York State Board of Regents to award Baccalaureate degrees and to accept lay students. In the early 1960s, the Dominican Sisters were approached by the Secretary of Education of the Archdiocese of New York to develop an Associate Degree nursing program. The first students entered in 1964 and graduated in 1966 with an Associate Degree, as did the 1967 graduates. In September 1966, the faculty submitted to the College Board of Trustees the recommendation that a professional nursing curriculum leading to the Bachelor of Science degree be incorporated into the offerings of the institution. In 1967, the New York State Board of Regents authorized the College to confer the Bachelor of Science degree to duly qualified students completing the undergraduate nursing program. The first class graduated in 1971. The program received initial accreditation from the National League for Nursing in 1972 and maintained that accreditation through 1998. In 1999, the nursing programs were accredited by the Commission on Collegiate Nursing Education (CCNE). This accreditation has been maintained since that time. In October 1994, the New York State Board of Regents authorized the College to confer the Master of Science degree on qualified students who had successfully completed the clinical nurse specialist program in Adult Health. In 1998, the Adult Nurse Practitioner program was approved. The new Master of Science program in Nursing was fully accredited by the CCNE in 1999. In 2008, the Family Nurse Practitioner track was approved by the New York State Board of Regents. Additionally, the post-master certificates for Family Nurse Practitioner and Adult Nurse Practitioner were approved. In 2015, the Adult Nurse Practitioner track was changed to the Adult-Gerontology Nurse Practitioner track, correlating with the American Nurses Credentialing Center (ANCC) track change. A non-traditional undergraduate track has been in existence for more than 20 years. While the same courses are offered as in the traditional program, classes are primarily held in the evening and many of the clinical experiences are on weekends. Students now matriculate after completing all pre-requisites and college requirements other than those in the nursing major. They begin classes in January and graduate 19 months later with a Bachelor of Science degree. The RN to BS program has existed since 1967. A revised RN to BS program is now a fully online program designed for the Registered Nurse who wishes to obtain a baccalaureate degree with admission to the program occurring each semester. The RN to BS program continuously runs through the fall, spring and summer semesters. Instrumental to the success of all the nursing programs was Sister Leona DeBoer. When Mother Leo Vincent, the first President of Mount Saint Mary College, agreed to open a nursing program, the congregation did not have any nurses. Sister Leona and another sister were sent to nursing school at Catholic University of America to prepare to teach at the Mount. Additional education further qualified them for their new careers. Sister Leona went on to chair the nursing program from 1966 to 1979 and again from 1981 to 1988. From 1995 to 2005 she was the Graduate Program Coordinator. She continued to teach in the nursing program until 2013. The Student Nurses' Association (formerly known as the Nursing Student Union) has provided leadership and service opportunities for nursing students since the beginning of the nursing program. In 1990, the Mu Epsilon Chapter of Sigma Theta Tau International Honor Society of Nursing was chartered. Students and community members meeting the criteria are inducted each year into the Chapter. In 2014, the Division of Nursing became the School of Nursing. This change was brought forth by the nursing faculty and was approved by the Faculty Senate and the College Board of Trustees in recognition of the unique characteristics of professional education and the variety of programs that are offered. Recognizing the complexity of the School of Nursing programs, the faculty requested the School be administered by a Dean. After a nationwide search, the inaugural Dean was appointed in June 2018. To date, approximately 3,000 students have graduated from the nursing programs at Mount Saint Mary College. They continue to provide compassionate, patient-centered care in a variety of settings in New York and beyond. They are researchers, leaders, and teachers who continue to touch many lives and help the nursing profession progress in all aspects of the provision of holistic patient care.

School of Nursing's Philosophy of Nursing

NURSING is a professional practice discipline requiring the acquisition of a well-defined, scientific knowledge base along with the internalization of certain core values such as integrity, respect for human dignity, altruism, social justice, and autonomy. Nursing requires strong critical thinking, communication and assessment skills, and a balance of intelligence, confidence, understanding and compassion. Nurses engage in partnerships with patients and other professionals. Those partnerships facilitate health promotion, risk education, disease prevention, and illness and disease management across diverse environments.

Progression into the Next Courses

Nursing Health Assessment and Foundations will be intensive, busy, and fast paced! Stay on top of readings and assignments. Practice the skills your are learning. Do not procrastinate. Always know that nursing faculty and members of MSMC are here to help you. Do not hesitate to reach out to us.

School of Nursing continued

Professional practitioners of nursing are patient advocates and assume leadership responsibility for planning, executing, and evaluating nursing care given by themselves and others. Additionally, they assume responsibility for management of fiscal resources. Professional nurses utilize technologies and participate in research. They use the findings to continually improve nursing practice, to expand the scope and depth of nursing science, and to perceive trends which have implications for emerging roles within nursing.

Appendix B Drug Screening Procedure and Policies

Procedure Coordination of the urine drug screen test are done through MSMC Health Services and approved providers. Health Services will receive drug screen test results in a confidential manner. Negative results will clear students for clinical. Students must bring their current MSMC Picture ID to an approved provider for the drug screen test. No medical order is required.

Progression Prioritization

Progression into the sophomore year of the traditional nursing program is prioritized as follows: - Direct admits to the nursing program who pass the three required science courses (BIO 1030, BIO 1040 and CHM 1080) on the first attempt; - Direct admits to the nursing program who have to repeat one required science course but successfully do so by July 31.

Social Determinants of Health(Mission Statement and Undergraduate Nursing Student Outcomes)

Social Determinants of Health are defined by the World Health Organization as "the conditions in which people are born, grow, live, work, and age, and the wider set of sources and system shaping the conditions of daily life". World Health Organization. (n.d.). Social determinants of health.

What are social determinants of health?

Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

Transfer between Traditional and Non-Traditional Programs

Students are admitted to a specific program. Transfer between the programs requires written permission from the Dean and may only be done on a space available basis. If approved students must remain in that program.

Audio/ Video Recording for In-Person and Virtual Classes

Students are prohibited from audio or video recording classes and meetings unless they have such a disability accommodation, which is verified by the Office of Disability Services. See the latest version of the MSMC Student Handbook for further information.

Fit for Duty Policy

Students are required to be physically, emotionally, and mentally capable to engage in course work, laboratory sessions, and clinical rotations. See Appendix A for details.

Options for Students who do not Agree to COVID-19 Vaccinations and Boosters

Students who cannot complete this clinical requirement for NUR nursing course(s) may: - withdraw from NUR course(s) which would count as one of the two withdrawals or attempts allowed in the nursing program; - take a leave of absence from the nursing program with the option of full return in fall 2023 if the requirement is met; - decide to pursue degree requirements in another area of study at MSMC. - students prior to taking NUR courses Health Assessment and Fundamentals of Nursing Practice will have the opportunity to change their major in another discipline if they do not agree to COVID vaccinations and boosters - please be aware a MSMC COVID-19 exemption is just for access to the MSMC campus and it does not apply to the School of Nursing requirements.

Positive Drug Screen Results

Students with a positive result are subject to the following: - Students may not repeat the drug screen test during the same semester. - Students must withdraw from the clinical course due to the positive result. - Students must submit to and pass a drug screen test prior to enrolling in a clinical course the next time it is offered.

American Nurses Association (ANA): Code of Ethics for Nurses

The Code of Ethics for Nurses was developed by the ANA and serves as a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession.

Service

The Dominican search for truth is intimately linked to the common good. The great Dominican scholar Saint Thomas Aquinas argued that the fruits of contemplation were meant to be shared with others (contemplare et comtemplata aliis trader). Dominican pedagogy—both within and outside the classroom—seeks to address issues related to the social, economic, and political well-being of the human person and community.

Philosophy of the School of Nursing

The School of Nursing's philosophy portrays the faculty's beliefs about the human person, society, health, nursing, and teaching/learning.

Equity

is affording all people fair and impartial treatment.

Health Literacy

(Center for Disease Control and Prevention, https://www.cdc.gov/healthliteracy/learn/index.html) Personal Health Literacy - "The degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others." - People can "make well-informed" and appropriate" decisions. Organizational Health Literacy - "The degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others." - Connected to Health Equity: 'attainment of the highest level of health"

New York State §6901. Definitions

- "Diagnosing" in the context of nursing practice means that identification of and discrimination between physical and psychosocial signs and symptoms essential to effective execution and management of the nursing regimen. Such diagnostic privilege is distinct from a medical diagnosis. - "Treating" means selection and performance of those therapeutic measures essential to the effective execution and management of the nursing regimen, and execution of any prescribed medical regimen. - "Human Responses" means those signs, symptoms and processes which denote the individual's interaction with an actual or potential health problem.

Healthy People 2030 Leading Health Indicators (LHIs): Children and Adolescents

- 4th grade students whose reading skills are at or above the proficient achievement level for their grade - Adolescents with major depressive episodes (MDEs) who receive treatment - Children and adolescents with obesity - Current use of any tobacco products among adolescents

For students who have not completed all five sciences, acceptance into the program is conditional until the complete admission criteria are met.

- A student who does not obtain a grade of C or better in two of the sciences, or in the same science twice, will not be allowed to matriculate - While other factors may be considered, science grades are a major component of the selection process. - A student is selected for a specific entry date; any student who is ineligible to matriculate by the date or defers their program start will not be given a new start date automatically. The student may reapply for admission to a subsequent cohort. - Prior to matriculation, a student must complete all non-NUR and non-HLT graduation requirements except PHL 3620: Medical Ethics.

A new start after 60: I retrained as a hospice nurse - and lost my fear of death (Article)

- A year after being widowed, Laura Horn began volunteering in a hospice, sitting with people who were about to die. She soon realised she could do more for them ... As well as Margaret, she had outlived her parents, her parents-in-law and her brothers. They both "died of substance abuse, one of a heroin overdose, and the other of long-term substance abuse. That, I'm sure, was part of my motivation," she says. "That kind of pain can also lead to openness and joy, and that's what I've discovered." Volunteering was "a truly transformative" experience for her and Horn realised she wanted more. "I thought, I want to do the nursing part too." As an undergraduate, she had studied biology, and her early work was in public health before she switched to education research. Most of her career was spent "trying to determine what helped students succeed in college and beyond. But I always had the sense that I would circle back to the world of health," she says. At 63, she enrolled at one of the very community colleges whose impact she had been researching, to take the prerequisite courses - anatomy, physiology, microbiology, pharmacology. From there, she applied to nursing school at 65, on an accelerated one-year programme for graduates. The intensity was staggering. "I was devoting every waking hour to studying and my clinical work," she says. The friends who had supported her after Margaret's death, and lived nearby in Berkeley, California, cooked for her three nights a week. Horn would visit for an hour, then leave to study. "We called it 'catch and release'," she says. Her two children with Margaret had left home but were supportive. When she graduated, one of her friends made a little sign out of brightly coloured paper - "It's never too late" - and stuck it to the back of her mortarboard. Now 68, Horn has noticed her own attitude to death evolving. "I think I have relaxed around it," she says. "After seeing all I have about death I'm not so scared of dying. I have a limited amount of time left on this Earth and I will try to make the most of it. And not be too terrified." Most of all, she has realised that palliative nursing care is "a reciprocal relationship with patients and families". She hopes "to find real balance in that, to learn from them as they learn from me. If I've learned nothing else, we can't live a full and meaningful life without deep relationships. And that's what I'm hoping for."

Physical Strength (Gross Motor Control)

- Ability to safely lift 25 pounds unassisted, protecting the patient, those in close proximity, and one's person. - Bend and/or lift to assist patients with activities of daily living and/or move and/or manipulate equipment in close quarters and around obstacles. - With or without assistance be able to lift a patient to safely transfer or position the patient in a variety of situations. - Move, push, or pull equipment, beds, stretchers, wheelchairs, oxygen canisters, or other related equipment in confined spaces with coordination and safe speed. - Ability to raise arms overhead to manipulate equipment. - Kneel and stand independently. - Able to provide care for a full clinical rotation (usually 6 to 14 weeks) and able to stand and/or walk a variety distances for extended time periods ranging from 3 to 12-hour periods.

Olfactory Ability

- Able to detect the smell of smoke. - Identify various physiologic odors emanating from patients.

Manual Dexterity (Fine Motor Movement)

- Accurately manipulate dials, gauges, buttons, and switches to set, monitor, and care for patient care related equipment. - Accurately prepare, measure, and administer sterile and non-sterile solutions without contaminating syringes, needles, solutions, calibrated measuring containers, and all other administrative devices. - Able to grasp small objects, twist, pinch, and pick up said objects; able to write, legibly with pen or pencil. - Able to type and use a computer effectively and efficiently. - Accurately prepare and administer all types of medications (oral, parenteral, topical, transdermal, inhalation). - Perform clean and sterile dressing changes without contaminating the wound, sterile and non-sterile supplies, or the environment. - Efficiently and effectively don, remove, and dispose of personal protective equipment (PPE) to implement standard precautions.

Visual Ability

- Accurately read and visualize all written medical information pertaining to the patient. - Accurately read and visualize all readings and functions of technical equipment pertaining to patient care. - Accurately read and visualize all calibrated containers for accurate measurement of body fluids, specimens, medication administration devices (syringes, pumps, etc.), and intravenous infusion containers.

Healthy People 2030 Leading Health Indicators (LHIs): Adults and Older Adults

- Adults engaging in binge drinking of alcoholic beverages during the past 30 days - Adults who meet current minimum guidelines for aerobic physical activity and muscle-strengthening activity - Adults who receive a colorectal cancer screening based on the most recent guidelines - Adults with hypertension whose blood pressure is under control - Cigarette smoking in adults - Employment among the working-age population - Maternal deaths - New cases of diagnosed diabetes in the population

Determinants of Health

- Age - Gender - Race - Ethnicity - Education - Income - Geographic Location - Early Childhood Development - Education level - Employment and Working Conditions - Food Security - Health Care Services and Access - Housing Security - Neighborhood and Physical Environment - Social Support Networks

To qualify for selection, students must have passed at least four of the following courses with a grade of C or better (or accepted equivalents)

- BIO 1030; Anatomy & Physiology I - BIO 1040: Anatomy & Physiology II - CHEM 1080: Nursing Chemistry Fundamentals - BIO 2020: Microbiology - BIO 3030: Pathophysiology

Healthy People 2030 Leading Health Indicators (LHIs): All Ages

- Children, adolescents, and adults who use the oral health care system (2+ years) - Consumption of calories from added sugars by persons aged 2 years and over (2+ years) - Drug overdose deaths - Exposure to unhealthy air - Homicides - Household food insecurity and hunger - Persons who are vaccinated annually against seasonal influenza - Persons who know their HIV status (13+ years) - Persons with medical insurance (<65 years) - Suicides *Except where otherwise noted

Clinical Warnings

- Clinical Warnings for Late Submission of Requirement Forms - Failure of a student to meet deadlines will result in a clinical warning for unprofessional behavior - A pre-printed form for submitting late requirements are sent to the Clinical Coordinator who will then respond to the student

Communication (Verbal and Non-Verbal)

- Communicate effectively either independently or with corrective devices. - Communicate effectively in English orally and/or the written or read word with instructors, professors, clinical staff, patients, families, and all members of the healthcare team. - Spoken in normal speaking volume, an understanding of oral directions/requests from healthcare workers, patients, voice pages, and telephone messages.

Presentation Overview

- Social Determinants of Health, Health Equality, Health Inclusion, Health Literacy, Health Equity, and Social Justice are distinct but are interrelated with each other. - Professional Nurses have a responsibility for the provision of healthcare to ensure high-quality equitable care to all populations across the lifespan.

Major Trends in Education (Examples)

- Competency-Based Education - Patient-Centered Care (Focus on patient) - Utilization of technology in health care (informatics) - Simulation Experiences - Inter-professional education - Service Learning (translating knowledge being learned to help others) - Reflective Practice (reflecting one's actions for continuous growth and development) - Diversity, Equity, and Inclusion - Shift in U. S. population demographics - Health inequities need nurses prepared to care for underrepresented and underserved populations in rural and urban areas

Social Determinants of Health grouped into 5 domains:

- Economic Stability - Education Access and Quality - Health Care Access and Quality - Neighborhood and Built Environment - Social and Community Context

Course Withdrawals

- For withdrawal from non-NUR or HLT courses, follow the instructions in the latest version of the Undergraduate College Catalog. - A student may withdraw from only one NUR or HLT course throughout the nursing program. A withdrawal is considered an attempt. - Prior to withdrawal from a NUR or HLT course, the student must contact the course faculty and their advisor. A "Withdrawal" form must be filled out and filed with the Registrar's Office. Grad

Behavioral/Mental Performance at all Times and in all Settings

- Function safely, effectively, and calmly in stressful/unexpected situations. - Prioritize and manage tasks simultaneously. - Demonstrate social skills necessary to therapeutically interact with patients, families, other healthcare personnel, and faculty. - Maintain personal hygiene and conform to School of Nursing dress code guidelines. - Display ethical behaviors and actions consistent with professional behavior. - Display the social skills to behave with politeness, tact, and sensitivity to others. - Exercise good/appropriate judgment. - Able to provide care for a full clinical rotation (usually 6 to 14 weeks) and able to stand and/or walk a variety distances for extended time periods ranging from 3 to 12 hour periods. - Able to maintain professional demeanor, communication, and respect for others at all times based on the values and principles of diversity, equity, and inclusiveness. This includes but not limited to age, race, ethnicity, culture, national origin, sexual orientation, gender identification, religion, cognitive and physical abilities, and language.

Exclusion Examples

- Gender - Race/ethnicity - Religion - Culture - Age - Sexual Identification - Disability

Auditory Ability

- Hear all alarms on technical and supportive equipment set at a normal volume. - Listen for and respond to distress sounds from patients. - With a stethoscope accurately detect audibly blood pressure readings and accurately detect audibly breath, heart, bowel, and vascular sounds with a stethoscope.

Examples: Health Inequities

- Higher rates of violence and bullying experienced by gay, lesbian, and bisexual teens than heterosexual teens (Center for Disease Control [CDC], 2019). - Low birth weights and higher infant mortality in Non-Hispanic Blacks/African Americans compared to Non-Hispanic Whites (CDC, 2020).

NUR 1200: Introduction to Professional Nursing

- If a student fails NUR 1200 it does not count as a nursing failure, however the student will have to repeat the course. - Undeclared nursing students will not take NUR 1200 during their first year. If their Major is changed to Nursing at the end of the first year, they will take an online NUR 1200 course in the summer, prior to entering their sophomore year as a Nursing Major - NUR 1200 is a pre-requisite for Health Assessment (NUR 2044). All transfers will have to take NUR 1200 before NUR 2044 (Health Assessment).

Healthy People 2030 Leading Health Indicators (LHIs): Infants

- Infant deaths

Ted Talk: How to make stress your friend by Kelly McGonigal

- Kelly is a Health Psychologist- whose goal is to help people to be happier and healthier. - Kelly fears that what she is teaching for the last 10 years is doing more harm than good- "Stress Makes Your Sick" (increases everything from the common cold to cardiovascular disease). - Kelly turned stress into the "enemy". - Kelly changed her mind about stress. - Study= 30,000 adults in the US for 8 years and asked "How much stress have you experienced in the last year?" + "Do you believe that stress is harmful for your health?" + Used public death records to find out who died. Results: - People who experienced a lot of stress in the previous year had a 43% increased risk of dying, but that was only true for the people who also believed that stress is harmful for your health. - People who experienced a lot of stress but did not view stress as harmful were no more likely to die. They had the lowest risk of dying of anyone in the study including people who had relatively little stress - Researcher Estimate= over the 8 years they were tracking deaths 182,000 Americans died prematurely not from stress, but from the belief that stress is bad for you. That is over 20,000 deaths a year. - Would be the 15th largest death in the US. Killing more people than skin cancer, HIV/AIDS and homocides. - Kelly got wondering can changing how you think about stress make you healthier? - Science says "Yes" - When you change your mind about stress you can change your body's response to stress. - Social Stress Test- Situation designed to stress you out. 1) Presentation-Judges(give discouraging non verbal feedback) 2) Math Test- Experimenter(harassing tester) - See the stress as your body preparing you to meet challenges (study conducted in Harvard) - See stress response as helpful - Heart beating fast- more oxygen to brain - Heart pounding- preparing you for action - Less stressed out, less anxious, more confident - Heart does not construct, more relaxed - Normal stress response- heart rate speed up and vessels constrict (sometimes reason why associated with cardiovascular disease) - Stress Makes you social - Oxytocin- Cuddle hormone(released when you hug someone) - Oxytocin- neuro-hormone, if fine-tunes your brain's social instincts. It primes you to do things that strengthen close relationships. Makes you crave physical contact with friends and family. Enhances empathy. Makes you more willing to help and support the people you care about. - "Snort Oxytocin to become more compassionate and caring." - Oxytocin is a stress hormone! - Pituitary gland pumps this stuff out as part of a stress response. - As much part of your stress as adrenaline that makes your heart pound. - Motivating you to seek support. - Stress response doesn't only have impact in your brain but in your body too (protect cardiovascular system from effects of stress) - Natural anti inflammatory - Helps blood vessels stay relaxed during stress - Heart has receptors for the hormone- Oxytocin helps heart cells regenerate and heal from any stress induced damage - Enhanced by help and social support - Major stress (life, financial, etc.)- 30% increase in death (but not true for everyone caring for others there was 0% in dying)

Essential Core Competencies are based on the following domains

- Knowledge for Nursing Practice - Person-Centered Care - Population Health - Scholarship for Nursing Discipline - Quality and Safety - Interprofessional Partnerships - System-Based Practice - Informatics and Healthcare Technology - Professionalism - Personal, Professional, and Leadership Development

Grade Percentages and Letter Grades

- Letter Grades and Percentages - Letter Grade A is 95% to 100% and Letter Grade A- is 90 to 94% Grades are rounded up from 0.50. - The passing grade for all NUR and HLT courses is 78 percent (C+). - At least Ninety Percent (90%) of the course grade consists of objective testing throughout the undergraduate nursing program. - Extra credit is not allowed in any NUR or HLT course. - A student may not retake any NUR or HLT that they have received a grade of 78% (C+) or higher - If a student fails the same NUR or HLT course twice, they cannot repeat that course. - Students who fail the clinical or college laboratory component of a required NUR course will receive a grade of F for the final course grade. - If a student earns a grade of less than 78 percent in a second required NUR or HLT course, the student will be dismissed from the nursing program.

Health Inequality (Disparities)

- Measurable differences in health between individuals, groups, and communities based on biology, race/ethnicity, language, and culture. - Unmodifiable Example: People in their 20's are more healthier than those in their 60's due to the aging process.

Professional Nursing Practice

- Nursing education is based on standards of care deemed essential for practice established by nurses themselves as a distinct discipline. - Professional nursing practice is guided by a code of ethics. - Legally, professional nursing practice is under the jurisdiction of the NYS Office of the Professions and the Nurse Practice Act. - Education quality is guided by state and national accreditation bodies..

Inclusion as viewed by the American Association of the Colleges of Nursing Position Statement in 2021 (See p. 45 in the Undergraduate Nursing Student Handbook).

- Organizational and environmental cultures intentionally support inclusion - Diverse characteristics are embraced - Experiences and perspectives of others are acknowledged, respected, and welcomed - Nurses and patients have a say in the provision of high quality healthcare.

Traditional Program

- Prospective students being admitted to the nursing program from high school are required to have taken Chemistry, Biology or Living Environment with labs, Mathematics, and have a minimum GPA 3.00. - For the admissions process for undeclared nursing students a 2.75 GPA required

Academic Honesty Policy of Mount Saint Mary College

- Students are responsible for reading and knowing the Academic Honesty Policy of MSMC found in the latest MSMC Student Handbook. - The process for allegations of academic dishonesty and due process are in the MSMC Student Handbook. - Students are responsible for using the latest edition of the American Psychological Manual for all assignments to ensure crediting of author(s) work or ideas to avoid plagiarism. Faculty may require signing a document related to Academic Honesty and may also use a program to ascertain plagiarism such as Turnitin. - Students may not use work submitted previously in a course or from courses they are taking simultaneously. This is self-plagiarism. This includes submitting the same course assignment if the student is repeating the course. - Students are prohibited from recording in any fashion and by any means, including but not limited to taking snapshots, copying questions and answers, and communicating any information about exams or quizzes verbally and/or electronically at any time during or after an exam or quiz.

If there is space available:

- Students who remain on the undeclared list from the previous year - Undeclared students who pass the three sciences on the first attempt (ranked by three science GPA) - Undeclared students who need to repeat one science but do so by July 31 (ranked by three science GPA) - Students who remain on the undeclared list after the selection process will be considered for one more academic year - Internal transfer students who have the required courses (ranked by the three science GPA) - External transfer students who have the required courses (ranked by three science GPA). - Internal transfers into the Nursing program will have priority over external transfers. - If a student failed one science course per semester, they would be allowed to repeat both. However, students would likely be on the 5-year plan unless they can complete their course(s) by July 31st.

Beneficence

- To do good - Actions must aim to 'benefit' peoples health, welfare, comfort, well-being. and by improving their quality of life. - Balance the benefits of an action against risk and harm - Create a safe and supportive environment - Help people in crisis - Act on behalf of vulnerable people to protect their rights Example: Encouraging a patient to quit smoking, start an exercise program,or get immunizations

Social Justice

- Treating everyone fairly regardless of economic status, race/ethnicity, age, disability, sexual orientation, gender identity, or other characteristics (Undergraduate Nursing Student Handbook, p. 3). - Professional nurses have an ethical responsibility to advocate for and for delivering quality equitable healthcare to diverse. vulnerable, marginalized, and medically underserved populations.

Health Inequities

- Unjust differences in health - Disadvantage from reaching health potential. - Differences exist due to resources or knowledge to allow persons to participate in society. - Preventable and avoidable! Examples - Infant Mortality Rates higher in one racial/ethnic group over another due to preventable access to prenatal care and education. - Children living in neighborhoods without recreational areas or access to nutritional food sources are more apt to be overweight.

Student Continued Progression in the Nursing Program. Throughout the program the student:

- may not enroll in any NUR or HLT course until they have successfully completed all pre-requisites; - must take all NUR and HLT courses at MSMC; - may only repeat one required NUR or HLT course during the entire program - may withdraw from only one required NUR or HLT course throughout the entire program unless the withdrawal is for medical reasons. A withdrawal is considered an attempt. - will have a maximum of two attempts for any NUR or HLT course. The first attempt may be a withdrawal OR a failure. The course must be passed on the second attempt. - A second NUR or HLT course withdrawal or failure will result in removal from the nursing program. - A grade of less than 78 percent (C+) in a second NUR or HLT course, the student will be dismissed from the nursing program. - Students who fail the clinical or college laboratory component of a required NUR course will receive a grade of F for the final grade. - One credit nursing elective will not count towards two course failure.

Student Progression to the Sophomore Year Nursing Courses

- must complete BIO 1030, BIO 1040, and CHM 1080 with a grade of C or higher by July 31; 18 - BIO 1030: A&P I, BIO 1040: A&P II; or CHEM 1080: Foundations of Chemistry can be repeated one time - must complete PSY 1010: Introduction to Psychology and SOC 1010: Introduction to Sociology (or equivalent) with a grade of C or higher - must complete PSYCH 3050: PHL 1030 or 1040, MTH 2070, and CIT 1050 with a grade of C or higher

Definitions of misconduct applicable to students include but are not limited to:

- practicing nursing fraudulently, beyond authorized scope, and/or with gross incompetence and/or with negligence; - practicing nursing while the ability to practice is impaired by alcohol and/or drugs; - displaying signs of addiction; (Addiction is a chronic progressive disease which includes physical dependence, tolerance, and preoccupation with obtaining alcohol, prescriptive, and/or illegal drugs); - being convicted of committing an act constituting a crime in any state or federal court in the United States or in other countries; - refusing to provide nursing care or interventions to a person because of an individual's membership in a protected category, including but not limited to race, creed, color, national origin, age, disability, sex, sexual orientation, or gender identity or expression; - failing to comply with established policies, rules, and regulations of the clinical agencies used for fieldwork insofar as they pertain to students while in the clinical agency; A. Confidentiality All medical information both from a student patient or an actual patient, is to be held in confidence and not discussed outside the educational or healthcare environment. There are federal and state guidelines regarding patient healthcare information confidentiality, including but not limited to HIPPA and FERPA. In some instances, violating these guidelines results in substantial fines and actions against a professional license. B. Respect for People and Property Coercion, bullying, verbal threats, physical and/or verbal harassment, unwanted and/or inappropriate physical and/or verbal behavior, or assault directed at other students, faculty, support staff, patients, families, or any other person is not tolerated. These types of behavior are not acceptable and may result in dismissal from the School of Nursing. The Joint Commission on Accreditation of Healthcare Organizations and New York State Department of Health regulations require a patient's personal property be treated with respect and safely managed. The property and facilities of the School of Nursing is also to be treated similarly. C. Professional Appearance The dress code applies to all undergraduate nursing students and includes good personal hygiene, a neat professional appearance, and cleanliness of attire. Hair must be short or styled off the shoulders. Failure to comply with the required dress code will result in dismissal from the laboratory, simulation, or clinical experience and will need to be made-up at the student's expense. Repeated failure to abide by the dress code may result in a failure for the course. Fingernails: No longer than the tip of the finger; no artificial nails, acrylic or gel nail wraps, nail jewelry or nail polish. Body Piercing: No visible body piercing jewelry is permitted except for a single earring in each ear. Earrings should be small and non-dangling. Body piercing other than ears is only permitted if it is a part of the student's religious beliefs and is consistent with safety standards. Tattoos: Any visible tattoo must be covered. Jewelry: Jewelry is limited to wedding bands and small, non-dangling earrings. ID Badge: All students must wear their MSMC photo ID badge in clinical. The School of Nursing has a clip-on plastic holder for your ID badge which is worn on your uniform scrub top. - Hair color is contingent on clinical agencies' policies. Uniform Ordering and Requirements Uniform requirements apply to all clinical, laboratory, and simulation experiences EXCEPT NUR 3051, Mental Health Nursing and NUR 4020, Community Health Nursing. Faculty will advise students of dress requirements for these two courses. See Appendix E for Ordering and Requirements. D. Professional Behavior Failure to comply with professional behavior, as outlined below may result in disciplinary action up to and including dismissal from the School of Nursing. - Students must conduct themselves in accordance with the American Nurses Association Code (ANA) of Ethics. See Appendix C. - Students must conduct themselves in accordance with the American Association of Colleges of Nursing Position Statement on Diversity, Equity, and Inclusion. See Appendix D. - Students are prohibited from giving patients, families, or significant others any contact information such as their telephone numbers, emails, or social media. - Students are prohibited from visiting and socializing with patients, families, or significant others within and outside the clinical site. E. Social Media and Use of Technology: Social media should be maintained separately from your education in the School of Nursing. Future employers may perform background checks that include your social media history. Students who participate in any of the behaviors below will result in disciplinary actions up to and including dismissal from the nursing program and possibly the College. Students who violate these rules may also be subject to applicable legal action. - writing about or using technology such as texting, videoing, taking pictures, or screen shots of patients, families, or significant others and/or posting on social media or transmitting through emails or texting. - writing about or using technology such as texting, videoing, taking pictures, or screen shots within a healthcare facility. - writing about or using technology such as texting, posting, or making videos that portray Mount Saint Mary College, the faculty, staff, and/ or students, in a demeaning, or untruthful manner. - discussing, writing, or using technology to transmit examination questions. F. Breach of the Code of Conduct Expectations for student conduct in clinical situations are derived primarily from Title VIII: the New York State Education Law; Article 130: General Provisions, the Professions; Sub-article 3: Professional Misconduct. Matters pertaining to patient confidentiality must comply with HIPPA regulations. Failure to abide by this Code of Conduct places a student in jeopardy of disciplinary action up to and including dismissal from the undergraduate nursing program. Definitions of misconduct applicable to students include but are not limited to: - Practicing nursing fraudulently, beyond authorized scope, with gross incompetence and/or negligence. - Practicing nursing while the ability to practice is impaired by alcohol and/or drugs or displaying signs of addiction. Addiction is defined as a chronic progressive disease which includes physical dependence, tolerance, and preoccupation with obtaining alcohol and/or prescriptive or illegal drugs. - Being convicted of committing a felonious act constituting a crime in any state or federal court in the United States or other countries. - Refusing to provide nursing care and/or services to a person because of race, color, creed, national origin, or sexual orientation. - Behavior towards patients that would be considered non-therapeutic, harmful, or physically and/or emotionally hurtful. - Failing to comply with established policies, rules, and regulation of the clinical agencies used for fieldwork insofar as they pertain to students while in the clinical agency. - Conducting oneself in an unethical manner. - Breach of confidentiality, lack of respect for people and property, unprofessional behavior, and academic dishonesty.

Student Advisement Responsibilities are as follows:

1. Knowing and monitoring their degree requirements according to their curriculum plan throughout the program; 2. Bringing to advisement their proposed schedule and selecting courses in consultation with their advisor. 3. Completing and submitting an Intent to Graduate Form with the Registrar during the semester prior to the expected date of graduation; 4. Students are to notify their advisor by email of any of the following: - Needing to change their advisement meeting - Dropping scheduled courses - Intent to withdraw from a course - Intent to leave the program and/or MSMC College - Needed alterations in pre-registered schedules previously agreed upon with their advisor - Unsuccessful completion of any pre-requisite or co-requisite courses and - Any extenuating circumstances effecting their academic progression

At the completion of the baccalaureate program in nursing at Mount Saint Mary College, the graduate will be able to:

1. Provide culturally congruent, safe, quality care, based on ethical principles, to diverse population across the lifespan. 2. Synthesize and effectively communicate knowledge from the humanities, biological, social, and nursing sciences to promote health and wellness. 3. Utilize clinical reasoning to provide nursing care for individuals, families, groups and communities applying evidence based research as a foundation for nursing care. 4. Utilize evolving information technologies to enhance professional nursing practice and encourage personal responsibility for life-long learning and professional career development. 5. Demonstrate basic knowledge of healthcare policy, finance, and regulatory environments, including local, state, national, and global healthcare trends. 6. Collaborate and communicate effectively in a variety of modalities with interdisciplinary health care teams, patients, families, and community members to achieve quality outcomes. 7. Integrate health promotion and disease prevention strategies across diverse settings and vulnerable populations to address health disparities and population health.

Program Outcomes for Baccalaureate Graduates

1. Provide culturally congruent, safe, quality care, based on ethical principles, to diverse population across the lifespan. 2. Synthesize and effectively communicate knowledge from the humanities, biological, social, and nursing sciences to promote health and wellness. 3. Utilize clinical reasoning to provide nursing care for individuals, families, groups and communities applying evidence based research as a foundation for nursing care. 4. Utilize evolving information technologies to enhance professional nursing practice and encourage personal responsibility for life-long learning and professional career development. 5. Demonstrate basic knowledge of healthcare policy, finance, and regulatory environments, including local, state, national, and global healthcare trends. 6. Collaborate and communicate effectively in a variety of modalities with interdisciplinary health care teams, patients, families, and community members to achieve quality outcomes. 7. Integrate health promotion and disease prevention strategies across diverse settings and vulnerable populations to address health disparities and population health.

American Nurses Association Code of Ethics

1. The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems. 2. The nurse's primary commitment is to the patient, whether an individual, family, group, or community. 3. The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient. 4. The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse's obligation to provide optimum patient care. 5. The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth. 6. The nurse participates in establishing, maintaining, and improving healthcare environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action. 7. The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development. 8. The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs. 9. The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy. *Reprinted with permission from American Nurses Association, Code of Ethics for Nurses, © American Nurses Publishing, American Nurses Foundation/American Nurses Association, Washington, D.C.

Required Grades in Non-NUR or Non-required HLT Courses

A grade of C or greater is required in the following courses. - BIO 1030 Anatomy and Physiology I (Must pass with a grade of C as pre-requisite for BIO 1040; Fall 2014) - BIO 1040 Anatomy and Physiology II - CHM 1080 Nursing Chemistry Fundamentals - BIO 2020 Microbiology - BIO 3030 Pathophysiology - CIT 1052 Computer Literacy - MTH 2070 Elementary Statistics - PHL 1020 Logic or PHL 1030 Intro PHL - PHL 2100 General Ethics maybe used as a pre-requisite to PHL 3670 Medical Ethics - PHL 1030 or PHL 1040; PHL 3670 Medical Ethics - PSY 1010 General Psychology - PSY 3050 Developmental Psychology - SOC 1010 Introduction to Sociology and SOC 2320 will fulfill the Sociology requirement for the Nursing Major

Pregnancy Policy

A nursing student who is or becomes pregnant must submit in writing, a statement from their healthcare provider indicating that they may continue in the clinical area with no restrictions. This is submitted to Health Services, who then informs the Course Coordinator. After delivery, the student may return to the clinical setting upon presentation to Health Services a letter from their healthcare provider stating that the student may fully participate, with no restrictions, in all clinical activities. This includes the ability to meet the course learning outcomes and no conflict with pregnancy policy at the clinical site. If the student cannot continue with clinical activities with required documentation stating such, this would be considered a medical withdrawal and would count against the student as unsuccessful attempt.

Missed Exams and Quizzes

A student who missed an exam or quiz due to extenuating circumstances may be allowed to take the exam or quiz at a later time. At the professor's discretion, this exam or quiz may be in an alternate format. If the circumstance is not deemed extenuating, a penalty of a set number of points (not to exceed 10% of the points allotted to the exam) may be deducted from the grade (i.e., a 100-point exam may have up to 10 points deducted due to taking the exam at a later time).

Office of Student Success

Academic coaching - Each first year student is assigned an academic coach to meet with throughout their first year and beyond. Our coaches are "transition experts," ready to help you work on skills like time management, test-taking, utilizing campus resources, and more. Undeclared advisement - Our office also acts as academic advisors for undeclared students, helping them explore their options and find a major that fits their interests and goals. Tutoring - The Office of Student Success also oversees free peer tutoring in either one-on-one or small group format for most academic subjects. Student Transition and Engagement Program - STEP offers a specialized transition program for first year students exhibiting non-traditional academic profiles but high potential for success with additional guidance. Students are selected based on their admissions application and invited to campus early for a bridge transition program and additional services throughout their first year. Contact: Email- [email protected] Phone- 845-569-3176 Room- Aquinas 100

Key principles of Bioethics

According to Beauchamp and Childress (2009) there are 4 key principles of bioethics. ◦Autonomy ◦Non-Maleficence ◦Beneficence ◦Justice For health professionals add: ◦Veracity ◦Fidelity ◦Accountability ◦Privacy and Confidentiality

Mission

Advancing World Health and Celebrating Nursing Scholarship, Leadership, and Service.

Student Evaluation Conferences

All students enrolled in clinical nursing courses must have a mid-semester and end-of- semester evaluation conference with a clinical faculty member. Students are encouraged to add their written comments on the evaluation. Students are expected to sign the evaluation, which indicates they are aware of the contents. If a student does not sign the evaluation, the clinical faculty member will send an email to the course coordinator stating this with attachment of the evaluation of the student. The course coordinator will then meet with the student and provide documentation of the outcome of the meeting. Evaluations are kept in the respective nursing student's record, which can be found in the School of Nursing Office.

Clinical Learning Prescription

Clinical learning prescriptions are designed to assist students to improve learning and/or behaviors that may jeopardize the student's academic standing. The faculty member will use the approved form, discuss the area(s) needing improvement with the student, review the recommendations and time frame for improvement, modify if appropriate, and both the student and the faculty member will sign and date the learning prescription. The form will be placed in the student's file in the School of Nursing. If a student is unsuccessful in meeting the objectives in the timeframe developed, the faculty member will counsel the student and make further recommendations to the Dean of the School of Nursing as to the disposition of the student.

Transfer Credits

College-wide policies related to transfer of credit from other colleges and those related to credit by exam apply to all students, including RNs. See Undergraduate Catalog for details. Credit-bearing college level courses in acceptable liberal arts and sciences may be transferred to MSMC from either a two-year or four-year college in accordance with MSMC policy. Non- collegiate liberal arts and science courses from hospital diploma programs are not transferable to MSMC's Baccalaureate Nursing Program. Courses in clinical nursing taken in practical nursing programs, Associate Degree Nursing (ADN) programs, and hospital diploma programs are not transferable to MSMC. Some courses in the traditional nursing curriculum may be waived due to prior RN licensure.

Clinical Compliance

Each clinical site has specific requirements and dates when all clinical documentation must be submitted. Students who do not adhere to the established deadlines as set forth in your "Welcome Letter" for all compliance items, including but not limited to physical exams, AHA BLS certification, drug testing and completion and submission of clinical paperwork are at risk of losing their clinical placement for that semester, resulting in withdrawal from the course. Such a withdrawal contributes to the two withdrawal limits in the nursing program. - Students who have an advisor hold will have to seek advisement from their advisor in order to have the hold released so they may register.

Professional Malpractice/Liability Insurance

Each student must be covered by malpractice insurance prior to participation in any clinical nursing course. The College purchases an insurance policy which covers nursing students only in assigned clinical activities. Students who elect to participate in cooperative education experiences in clinical settings, internships, or independent studies in clinical settings are not covered by this policy. In such cases, students may wish to purchase individual coverage. Registered Nursing students in the RN to BS Program must carry current malpractice/liability insurance with minimum coverage of $1 million/incident and $3 million/aggregate.

Attendance

Education is a cooperative process in which both faculty and students share a responsibility. Students are responsible for meeting the course requirements including attendance as stated in the course syllabus. Faculty will maintain attendance records for each class. It is acknowledged that a student may experience an extenuating circumstance. Extenuating circumstances are unforeseen, unplanned, and/or life altering events which are determined the professor of the course and the Dean. If you experience a verifiable extenuating circumstance, you or your designee must notify the course professor within 24 hours of the event. The ability to make up any missed work will be decided between the course professor and the student. It is the student's responsibility to contact the professor regarding any make up assignments.

Chemical or Alcohol Impairment

Students who exhibit signs and symptoms of chemical or alcohol impairment in class, clinical, or labs on campus or for course activities off campus, will be subjected to the policies in the MSMC Student Handbook, this Undergraduate Student Handbook, and in accordance with New York State Education Department Office of the Profession Education. As defined in Title VIII, Article 130, Sub-article 3 of the New York State Education Department (http://www.op.nysed.gov/title8/subart3.htm) professional misconduct includes the following and subject to disciplinary actions. - Practicing the profession while the ability to practice is impaired by alcohol, drugs, physical disability, or mental disability; - Being habitually drunk or being dependent on, or a habitual user of narcotics, barbiturates, amphetamines, hallucinogens, or other drugs having similar effects.

Community

From its inception, the Dominican tradition recognized the social dimensions inherent in the pursuit of truth. Dominican schools strive to cultivate diverse and inclusive communities founded upon a respect for individual human dignity and the promotion of human equity.

Neighborhood and Built Environment

Goal: Create neighborhoods and environments that promote health and safety. The neighborhoods people live in have a major impact on their health and well-being.1 Healthy People 2030 focuses on improving health and safety in the places where people live, work, learn, and play. Many people in the United States live in neighborhoods with high rates of violence, unsafe air or water, and other health and safety risks. Racial/ethnic minorities and people with low incomes are more likely to live in places with these risks. In addition, some people are exposed to things at work that can harm their health, like secondhand smoke or loud noises. Interventions and policy changes at the local, state, and federal level can help reduce these health and safety risks and promote health. For example, providing opportunities for people to walk and bike in their communities — like by adding sidewalks and bike lanes — can increase safety and help improve health and quality of life.

Economic Stability

Goal: Help people earn steady incomes that allow them to meet their health needs. In the United States, 1 in 10 people live in poverty,1 and many people can't afford things like healthy foods, health care, and housing. Healthy People 2030 focuses on helping more people achieve economic stability. People with steady employment are less likely to live in poverty and more likely to be healthy, but many people have trouble finding and keeping a job. People with disabilities, injuries, or conditions like arthritis may be especially limited in their ability to work. In addition, many people with steady work still don't earn enough to afford the things they need to stay healthy. Employment programs, career counseling, and high-quality child care opportunities can help more people find and keep jobs. In addition, policies to help people pay for food, housing, health care, and education can reduce poverty and improve health and well-being.

Health Care Access and Quality

Goal: Increase access to comprehensive, high-quality health care services. Many people in the United States don't get the health care services they need. Healthy People 2030 focuses on improving health by helping people get timely, high-quality health care services. About 1 in 10 people in the United States don't have health insurance.1 People without insurance are less likely to have a primary care provider, and they may not be able to afford the health care services and medications they need. Strategies to increase insurance coverage rates are critical for making sure more people get important health care services, like preventive care and treatment for chronic illnesses. Sometimes people don't get recommended health care services, like cancer screenings, because they don't have a primary care provider. Other times, it's because they live too far away from health care providers who offer them. Interventions to increase access to health care professionals and improve communication — in person or remotely — can help more people get the care they need.

Non-Traditional Program

The non-traditional program is designed for transfer students, or students who have already completed an associate or baccalaureate degree in a non-nursing field. Selection for this program occurs in May for a January admission date. - Students may transfer up to 60 credits from an Associate Degree and up to 90 credits from a Baccalaureate Degree program. - College level Mathematics, Chemistry, Anatomy and Physiology, Microbiology may be transferred in, or taken at MSMC. - Students are required to have a GPA of 2.75 for entry into the program. They are required to maintain this GPA throughout the program.

Education Access and Quality

Goal: Increase educational opportunities and help children and adolescents do well in school. People with higher levels of education are more likely to be healthier and live longer. Healthy People 2030 focuses on providing high-quality educational opportunities for children and adolescents — and on helping them do well in school. Children from low-income families, children with disabilities, and children who routinely experience forms of social discrimination — like bullying — are more likely to struggle with math and reading. They're also less likely to graduate from high school or go to college. This means they're less likely to get safe, high-paying jobs and more likely to have health problems like heart disease, diabetes, and depression. In addition, some children live in places with poorly performing schools, and many families can't afford to send their children to college. The stress of living in poverty can also affect children's brain development, making it harder for them to do well in school. Interventions to help children and adolescents do well in school and help families pay for college can have long-term health benefits.

Social and Community Context

Goal: Increase social and community support. People's relationships and interactions with family, friends, co-workers, and community members can have a major impact on their health and well-being. Healthy People 2030 focuses on helping people get the social support they need in the places where they live, work, learn, and play. Many people face challenges and dangers they can't control — like unsafe neighborhoods, discrimination, or trouble affording the things they need. This can have a negative impact on health and safety throughout life. Positive relationships at home, at work, and in the community can help reduce these negative impacts. But some people — like children whose parents are in jail and adolescents who are bullied — often don't get support from loved ones or others. Interventions to help people get the social and community support they need are critical for improving health and well-being.

HIPAA

Health Insurance Portability and Accountability Act Protects a patient's right to the confidentiality of their health record. Patients: - can see and copy their medical (health) records whether electronic or paper; - are offered a notice about their rights under this act; - names can not be posted or released; -All health facilities must have specific policies and procedures in place regarding HIPPA Computerized systems- Passwords can not be shared to maintain confidentiality / tracking systems in place

Policy for Missed Clinical, Clinical Laboratory, or Simulation Experiences

Missed experiences may prevent students from meeting the course learning outcomes. In the event a student misses a clinical, laboratory or simulation experience, the student must contact the course coordinator, laboratory instructor and/or simulation coordinator prior to the absence. It will be at the discretion of the instructor as to whether the quality of a single missed experience is such that the student's ability to achieve course outcomes is compromised. In case of multiple absences for serious reasons, the decision relative to clinical makeup activity will be the responsibility of the nursing faculty course coordinator in collaboration with the Dean of the School of Nursing. If permission for clinical makeup is granted, the makeup of missed clinical experiences must be scheduled outside the regular semester or non-traditional session, with a possible added cost to the student for faculty or instructor tutoring. Attendance at any laboratory or simulation experience, make-up or otherwise, requires the student to be in the appropriate MSMC clinical attire for the course, on time, and prepared for the experience. Students must be present for orientation to all clinical agencies. Clinical orientation may not be made-up. Failure to attend clinical orientation will necessitate removal from the course with a "W" on their transcript. Withdrawal is considered an attempt.

The Dominican Values: How it came about?

More than 800 years ago, Saint Dominic de Guzman founded a religious community of men and women dedicated to the pursuit of truth. That mission continues to be lived in Dominican colleges and universities and its distinct character expressed through four values or pillars: spirituality, study, community, and service.

Introduction

Relevant research affirms the core interests of AACN members in advancing diversity, inclusion, and equity in academic nursing. As reflected below, those interests center on many facets of nursing education, central to the success of nursing schools in 21ST Century America. They reflect the need to: 1. Improve the quality of education by enhancing the capacity of academic nursing to maximize learning opportunities and experiences for students and faculty, alike, which depend insignificant ways on learning from individuals with diverse life experiences, perspectives, and backgrounds. 2. Address pervasive inequities in health care by ensuring the preparation of nurses and other healthcare professionals able to meet the needs of all individuals in an increasingly diverse American society. 3. Enhance the civic readiness and engagement potential of nursing students who will be in positions of leadership in health care, as well as in society, more broadly. As used in this position statement, diversity references a broad range of individual, population, and social characteristics, including but not limited to age; sex; race; ethnicity; sexual orientation; gender identity; family structures; geographic locations; national origin; immigrants and refugees; language; physical, functional, and learning abilities; religious beliefs; and socioeconomic status. Inclusion represents environmental and organizational cultures in which faculty, students, staff, and administrators with diverse characteristics thrive. Inclusive environments require intentionality and embrace differences, not merely tolerate them. Everyone works to ensure the perspectives and experiences of others are invited, welcomed, acknowledged, and respected in inclusive environments. More broadly, equity is interrelated with diversity and inclusion. Equity is the ability to recognize the differences in the resources or knowledge needed to allow individuals to fully participate in society, including access to higher education, with the goal of overcoming obstacles to ensure fairness (Kranich, 2001). To have equitable systems, all people should be treated fairly, unhampered by artificial barriers, stereotypes or prejudices (Cooper, 2016).

Licensure Requirement and Renewal of Registration in NYS: Good Moral Character

Required to answer the following questions: - Have you been found guilty after trial, or pleaded guilty, no contest or nolo contendere to a crime (felony or misdemeanor) in any court? - Are criminal charges pending against you in any court? Has any licensing or disciplinary authority refused to issue you a license or ever revoked, annulled, cancelled, accepted surrender of, suspended, placed on probation, refused to renew a professional licensed or certificate held by you now or previously, or ever fined, censured, reprimanded or otherwise disciplined you? - Are charges pending against you in any jurisdiction for any sort of professional misconduct? - Has any hospital, licensed facility or clinical laboratory restricted or terminated your professional training, employment or privileges or have you ever voluntarily or involuntarily resigned or withdrawn from such association to avoid imposition of such measures? - A "yes" answer to one or more of these questions will not necessarily disqualify you from a license or a registration in New York State. The New York State Education Department decides on a case-by-case basis whether prior criminal conviction(s) or other issues will disqualify the applicant from being licensed or registered as an RN in New York State. New York State Department of Education (2021). Moral character requirements. Retrieved from: http://www.op.nysed.gov/prof/nurse/nursingrn.htm

Clinical Requirements

Requirements are on the Undergraduate Nursing Bulletin site. The following must be submitted to the Undergraduate Compliance Officer in the School of Nursing by the deadlines. - CPR Certification with American Heart Association - Health Clearance Form - Criminal Background Check - Fingerprinting - Drug Screen (Please see Policy in Appendix B) - COVID-19 vaccinations and boosters are required for all clinical experiences, laboratory, or simulation components of courses. Students who do not meet this requirement are not permitted to take courses. - Students are to follow MSMC current COVID-19 policies in the academic setting. These maybe different from those required by the School of Nursing and are found in the MSMC Student Handbook, MSMC Portal, and MSMC Announcements via email. - Fit testing of N95 Masks are required. The Compliance Coordinator will provide the procedure to follow.

Computer Requirements

Students are required to own a laptop with the capability to run ExamSoft as described in this link: https://examsoft.force.com/emcommunity/s/article/Examplify-Minimum-System- Requirements. Exams in most, if not all, courses are given using the computer. Computers need to have a webcam and audio capacity. When bringing your laptop to class, it should be fully charged. Exams are graded on that which is uploaded. In the event that nothing uploads, a grade of zero may be given. Therefore, it is imperative that students maintain the functionality of their equipment. The following features will be available for each exam on ExamSoft: 1. Calculator 2. Inclusion of Honor Code The following will not be allowed on ExamSoft: 1. Crossing out 2. Adjusting text size 3. Enabling the warning alarm 4. Highlighting Students who need the ExamSoft features of highlighting, and large print will utilize the Office of Disability Services. - The notes feature of ExamSoft may be enabled at the discretion of the professor. No other note taking device including scrap paper maybe used. - Highlighting is permitted on Notes feature only. - Ear buds and headphones: These devices will not be acceptable in the classroom during exam sessions unless indicated as an accommodation and proctored by the Office of Disability Services. - Students without electronic devices will take their exams in the Office of Disability Services.

Potential Hazardous Exposure during Clinical Rotations

Students are responsible for following all clinical site policies and procedures including those related to exposure to infectious diseases and potentially hazardous substances or events. Students must immediately inform faculty if they have been exposed to any infectious disease, hazardous exposure substance, or any unusual occurrence. The faculty will follow the agency protocol, inform the Course Coordinator, and School of Nursing Chairperson. Students are to go to the nearest emergency room and have follow-up care with their provider. Health Services at MSMC are available to provide guidance.

Transportation to Clinical and Course Related Experiences

Students are responsible for providing their own transportation to all clinical and course related experiences at their own expense. Lack of transportation is not accepted as an excuse for missing required experiences. Under no circumstances will nursing students transport patients and/or patients' family members, or significant others.

Traditional Students and Accelerated Courses

Students enrolled in the traditional program who have 24 or more earned credits may enroll in degree completion face-to-face and evening, weekend, hybrid blended and fully online courses. Transfer students will have the 24-credit policy waived. The requirements for taking fully online courses will be reduced to 24 earned credits.

Nutrition and Pharmacology Proficiency Exam Policies

Students may receive credit for Nutrition and Pharmacology courses by taking the National League for Nursing Proficiency Exams after admission to the College. Information and applications are available from the School of Nursing and Academic Advisors. Applications must be submitted to the School of Nursing at least 30 days prior to the testing date. The fee for the testing is submitted to Student Financial Services.

MSMC Code of Conduct

Students must abide by the current Code of Conduct on campus and off campus. The latest version is in the MSMC Student Handbook. Violations are subject to disciplinary actions. This policy includes violations against the Nursing Code of Conduct.

Observation Skills:

Students must be able to do the following in clinical and laboratory settings which require the use of visual, auditory, olfactory, and tactile senses and cognitive ability to integrate the information to develop and implement a plan of care: - Observe demonstrations of nursing skills and inter-professional procedures; - Implement patient care utilizing models, simulators, medical equipment and supplies, standardized patients, and actual patients - Accurately identify a patient and observe their physical condition and demeanor including non-verbal communication; and - Perform a physical assessment and medical history.

Academic Progression and Grading Polices

Students must complete all requirements for the Bachelor of Science degree in Nursing within seven years from the date of matriculation as a nursing major. They also have to maintain a GPA of 2.75 in the nursing program

Additional Ethical Principles...

Veracity: Obligation to tell the truth Accountability: The nurse is responsible and accountable for their individual nursing practice

Alcohol and Drug Impairment in a Clinical or Laboratory Setting

Students who exhibit signs and symptoms of misuse, dependency, or addiction from alcohol, legal drugs, or illegal drugs are endangering the lives of patients. Clinical faculty have an ethical and legal responsibility to safeguard the well-being of both patients and students. - Students will be removed immediately from the clinical experience. They will be requested to wait in a private and secure area. The clinical faculty will report the situation to the Dean, Chair of the School of Nursing, and the Course Coordinator who will then follow the directions provided. - Report is made to the Dean of Students according MSMC Policy. - An alcohol and/or drug screening test will be required as soon as possible. - Random testing for drugs and/or alcohol may be required to continue in the program. - A second occurrence will result with dismissal from the School of Nursing.

Communication and Keeping Informed

Students, staff, and faculty are required to use MSMC email accounts for all correspondence. - Students are responsible for checking and complying with all requirements conveyed to them on their MSMC email account and/or on the Nursing Undergraduate Bulletin site. - Students are required to check MSMC email at least twice per week throughout the academic year as well as during school breaks, including summer. - All communication with students regarding assignments and clinical requirements are posted on the Nursing Undergraduate Bulletin site, the course e-Class site, and/or sent to the student email account. Failure to read emails may result in missing required deadlines, thus delaying progression in the nursing program. - Faculty and staff in the various institutions are to be addressed by their appropriate credentials. Nursing faculty are to be addressed as Doctor or Professor, as determined by degree, and nursing staff should be addressed according to their preference. First names are not to be used in the educational or healthcare environment.

Spirituality

The Dominican tradition views each human person as made in the image and likeness of God, comprised of a material body and spiritual soul. This holistic understanding of human nature guides Dominican educational practices where the spiritual dimensions of the human experience are nurtured and celebrated.

Appendix A Fit for Duty Policy

The School of Nursing requires students to be physically, emotionally, and mentally capable to engage in course work, laboratory sessions, and clinical rotations. In part, the following information is provided as required by the Federal Government Section 504 of the Rehabilitation Act of 1973 in response to the American with Disabilities Act specifying the fundamental physical and mental requirements of a graduate student in nursing and the expectations of the affiliating healthcare facilities where clinical rotations take place. Students must be able to satisfy the following standards including students with disabilities as defined by the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973 (Section 504). For further information, students may refer to the MSMC Student Handbook and with MSMC Disability Services. The National Council of the States Board of Nursing and the American Association of the Colleges of Nursing have identified the essential functional abilities of nursing students. The following are the core abilities.

Students Nurses Association

The Student Nurses' Association (SNA) plays an essential role in the socialization of future nurses. It is an organization that provides opportunities for nursing students to broaden their network of colleagues across the nation and aids in the development of professional and leadership skills. The SNA not only welcomes all nursing students but also encourages participation in the many activities offered. The members play a vital role in fundraising, event planning, and providing resources to the community they serve. Throughout the academic school year, there are several events that take place on campus and in the community. The SNA has a partnership with the New York Blood Bank and holds biannual blood drives. They participate in student welcoming events and have developed a Narcan training event supported by members of the organization Keep it Moving. Education is provided to students about opioid overdose and how to use Narcan to quickly respond to save lives. In partnership with MSMC Health Services, the SNA provides an affordable and convenient Flu Clinic on campus staffed by senior nursing students with nursing faculty supervision. Undergraduate nursing students are encouraged to participate in the governance and activities of the Student Nurses Association, as it can act as a valuable resource for collegiality among fellow students and professional networking through the academic experience.

School of Nursing Student Code of Conduct

The following provides supplementary policy information governing the conduct of nursing students on campus and in clinical situations. It does not preclude action under the Student Code of Conduct: Student Judicial Code and the Academic Honesty Policy of MSMC. Nursing is a profession that requires ethical behavior. The same ethical behavior is required of nursing students in which they are held accountable for their own actions in all course-related activities and situations. Students enrolled in NUR courses, which include clinical fieldwork, practice nursing under the supervision of nursing faculty licensed in the State of New York. Consequently, review of conduct in clinical practice situations is vested in the faculty of the School of Nursing. Expectations for student conduct in clinical situations are derived primarily from Title VIII: the New York State Education Law; Article 130: General Provisions, the Professions; Sub-article 3: Professional Misconduct. Students must also be compliant with Health Insurance Portability and Accountability Act (HIPPA) of 1996. This federal law protection of sensitive patient health information from disclosure without the patient's consent requires the and/or knowledge. Nursing students are responsible for knowing the expectations for conduct contained herein. Any student found guilty of misconduct as defined in this document shall be subject to penalties up to and including dismissal of the student from a NUR or HLT course and/or the nursing program

Dosage Calculation Proficiency Exam (DCPE)

The purpose of the DCPE is to verify that the student can correctly calculate medication dosages. Students may not administer medications until a score of 100% is achieved in that semester. If a student does not achieve a score of 100% on the third attempt, they will be removed from all clinical courses in that semester. (The only exception is NUR 3051 Mental Health Nursing, because students do not administer medication in that course.) The student will receive a W on their transcript for the courses from which they are removed. All three attempts will occur during the first week of the semester. If a student is removed twice from clinical courses due to not receiving 100% on the third attempt, they will be removed from the nursing program. Testing times may occur outside of the normally scheduled class times. If a student receives less than 100% on the DCPE, the student must perform remediation. Prior to retesting, students must present documentation of remediation. Acceptable forms of remediation include tutoring in the Learning Resource Center (LRC) or the Office for Student Success, using computer assisted instruction (CAI), faculty tutoring, or other means of remediation approved by the course faculty. An unexcused missed exam is equivalent to forfeiture and counts as an attempt with a resulting grade of zero. DCPE will be given during the first week of each semester that students have a clinical that involves medication administration. If a student has more than one clinical experience in a semester involving medication administration, the DCPE only needs to be taken one time per semester, not for each clinical course.

Leave of Absence Policies

There are policies governing leave of absences from MSMC. These include a voluntary leave of absence, voluntary medical leave, voluntary mental health leave, and an involuntary leave of absence. See the current version of the MSMC Student Handbook for further information. Students taking a voluntary leave of absence must file the voluntary leave of absence with the School of Nursing and Registrar's Office. The voluntary leave of absence cannot exceed the time frame of one year. If the time exceeds one year, the student must reapply for admission and if reinstated the student is subjected to the current curriculum plan, grading policies, and requirements. Please note: a voluntary, medical, or mental health leave of absence is not counted as a course withdrawal. Students maintaining matriculation will continue their progression in the program. See the current version of the MSMC Student Handbook for information on an involuntary leave of absence.

The Essentials: Core Competencies for Professional Nursing Education (2021) by the American Association Colleges of Nursing (AACN).

These Essential were voted upon by the American Nurses Association (ANA). - AACN is recognized by the U. S. Secretary of Education as a national accreditation agency. - They provide an outline of the necessary curriculum content and expected competencies to ensure quality and integrity of baccalaureate, graduate, and residency/fellowship programs. - A new competency-based model for education is being used where a major component is competency-level assessments that are observed and measurable. - It is the framework for preparing nursing's future workforce. There is an intentional integration of nursing as a discipline. - Health, healing and well-being, human wholeness, caring and the interrelationship between the environment and health are the five concepts that define nursing as a discipline. - Florence Nightingale is seen as the first nurse responsible for defining nursing as a discipline. She believed that nursing was both a science and an art in which the patient was the focus of nursing. The patient was viewed holistically as mind, body, and spirit. The environment had the ability to impact a person's health and recovery. Health healing and well-being, commitment, and interconnectedness of the environment were evident concepts in caring for patients by her.

Conclusion

To improve the quality of nursing education, ameliorate health inequities, and advance leadership in the profession and society at large, the values and principles of diversity, inclusion, and equity must remain mission central. These values and principles should be a part of the ongoing dialogue of AACN-member nursing schools, which are responsible for defining their particular educational missions and then engaging in the work to make those visions become a reality. Nursing school leaders, administrators, faculty, staff, and students must continue to collaboratively engage in efforts to recruit, retain, and graduate students who will advance institutional missions, which should address issues of diversity, inclusion, and equity. AACN recognizes diversity, inclusion, and equity as critical to nursing education and fundamental to developing a nursing workforce able to provide high quality, culturally appropriate, and congruent health care in partnership with individuals, families, communities, and populations. AACN is committed to preparing a community of scholars, clinicians, educators, and leaders who fully value the importance of diversity, inclusion, and equity to promote the health of the nation and the world. AACN will advocate for advancing diversity.

Improving the Quality of Nursing Education

When diversity is integrated within inclusive educational environments with equitable systems in place, assumptions are challenged, perspectives are broadened, and socialization across a variety of groups occurs, resulting in intellectual and cognitive benefits for all learners (Hurtado, 2005; Chang, Denson, Saenz, & Misa, 2006; Saha, Guiton, Wimmers, & Wilkerson, 2008). In diverse and inclusive environments, students, staff, faculty, and administrators recognize the value of and need for diversity to achieve excellence in teaching, learning, research, scholarship, service, and practice. As academic nursing becomes more inclusive in the recruitment of diverse learners, faculty may need to acquire new knowledge, skills, and attitudes to foster success of the student learner (International Council of Nurses, 2008). Notably, realizing the benefits of diversity in the profession of nursing depends in part on expansion of the traditional pool of nursing school applicants and the employment of faculty and staff by appropriately defining variables reflecting the value and diversity of the human experience. With respect to students, in particular, leadership and faculty should examine how potential student applicants are assessed for meeting qualifications and how merit (or the likelihood of success in nursing) is evaluated. The measures of an applicant's readiness for nursing education and preparedness for practice should extend beyond reliance on specific quantitative data such as standardized test scores and grade point averages, to include other valid and reliable measures of prospective success. Factors such as leadership skills, ability to overcome obstacles, strengths, communication and language skills, ability to gain entrée into underserved communities, other transferable skills and abilities, and prior life experiences of individuals, may be relevant when determining how the applicant might contribute to the profession and/or to the academic environment of a particular institution (Glazer & Bankston, 2014). In addition, academic leadership and faculty should examine any unconscious and conscious biases that may undermine efforts to enhance diversity, inclusion, and equity, including the use of everyday verbal, nonverbal, intentional or non- intentional messages which devalue the perspectives, experiences, and/or feelings of individuals or groups. These biases may restrict academic nursing's ability to attract and retain a more diverse student body and to recruit and promote diverse leaders, faculty, and academic support staff.

Effective Habits for Effective Study

You can prepare yourself to succeed in your studies. Try to develop and appreciate the following habits: - Take responsibility for yourself Recognize that in order to succeed you need to make decisions about your priorities, your time, and your resources - Center yourself around your values and principles Don't let friends and acquaintances dictate what you consider important - Put first things first Follow up on the priorities you have set for yourself, and don't let others, or other interests, distract you from your goals - Discover your key productivity periods and places Morning, afternoon, or evening?Find spaces where you can be the most focused and productive.Prioritize these for your most difficult study challenges - Consider yourself in a win-win situation When you contribute your best to a class, you, your fellow students, and even your teacher will benefit. Your grade can then be one additional check on your performance - First understand others, then attempt to be understood When you have an issue with an instructor (a questionable grade, an assignment deadline, etc.) put yourself in the instructor's place.Now ask yourself how you can best discuss this situation. - Look for better solutions to problems For example, if you don't understand the course material, don't just re-read it. Try something else! Consult with the professor, a tutor, an academic advisor, a classmate, a study group, or the study skills center - Look to continually challenge yourself

Critical Thinking

You do not need to only learn facts and procedures in nursing, but also the ability to evaluate each unique patient care situation.

Social Determinants of Health

as defined by the World Health Organization are "the conditions in which people are born, grow, live, work, and age, and the wider set of sources and systems shaping the conditions of daily life" (World Health Organization, n.d.).

Human Person

has intrinsic value and there is dignity in human life. Human beings are complex, dynamic systems continually interacting with their environment. Environment is conceptualized as anything that has an effect on the person and, in turn, is affected by the person. Individuals are capable of perception, emotion, self-direction, language, and thought and, as such, influence, and are influenced by, the biophysical, psychosocial, and spiritual systems with which they interact. Human beings are in a constant process of change. People are decision makers and participate in decision making in accordance with their respective needs and value systems.

Society

is a complex, dynamic system comprised of institutions in diversified settings, and multicultural groups such as the family, community, and nation. Society has functional characteristics such as values, behavior patterns, prescribed roles, status, and authority. Variables affecting society include technology, politics, economics, knowledge, and resources. In addition, there are human factors such as needs, capabilities, interests, expectations, aspirations, and rights. These functional characteristics and human factors influence behavior, interaction, and perception within the complex system of society. The trends and needs of society are identifiable and provide the impetus for purposeful activities to maintain life and health.

Health

is a dynamic state of well-being characterized by individual and/or group response to the environment, both internal and external. It is a level of wellness that is cyclic, varying according to conditions, circumstances, genetics, and environmental factors. Persons are capable of identifying health needs and maximizing levels of wellness through purposeful activities and interactions with health care systems. Maintenance of health and access to quality health care is a basic right of every individual, family, and community.

Service Learning

is a method of learning that integrates community activities into academic curricula. Service learning enlarges the learning area for students and faculty, providing them the opportunity to reflect on issues in ways that permit use of their academic knowledge to deliver service to the community.

Nursing

is a professional practice discipline requiring the acquisition of a well-defined, scientific knowledge base along with the internalization of certain core values such as integrity, respect for human dignity, altruism, social justice, and autonomy. Nursing requires strong critical thinking, communication and assessment skills, and a balance of intelligence, confidence, understanding and compassion. Nurses engage in partnerships with patients and other professionals. Those partnerships facilitate health promotion, risk education, disease prevention, and illness and disease management across diverse environments.

Clinical Judgment

is acquired knowledge and skills which facilitates the ability to critically analyze and synthesize objective and subjective patient information to improve health outcomes through evidenced-based interventions.

Reflective Practice

is construction and reconstruction of thoughts and feelings prior to, during, and after providing health care that leads to newer understandings and experiences that change future practice.

Inclusion

is organizational practices in which groups or individuals having different backgrounds are culturally and socially welcomed and treated equally. Inclusive environments require intentionality and embrace differences, not merely tolerate them.

Professional practitioners of nursing are:

patient advocates and assume leadership responsibility for planning, executing, and evaluating nursing care given by themselves and others. Additionally, they assume responsibility for management of fiscal resources. Professional nurses utilize technologies and participate in research. They use the findings to continually improve nursing practice, to expand the scope and depth of nursing science, and to perceive trends which have implications for emerging roles within nursing.

Teaching/Learning

promotes the growth of persons toward their full personal and professional potential. Faculty members view education as a continuous, interactive process that best occurs in an organized program which allows for individual differences. Concept presentation progresses from simple to complex, promoting integration, and is achieved through interaction, discussion, and critical evaluation. It is a process through which individuals acquire knowledge and skills that enable them to problem solve through the application of creative and critical thought. Further, learning is a process through which each learner is encouraged and has the opportunity for development of certain core values such as integrity, respect for human dignity, altruism, social justice, and autonomy. These outcomes are best achieved in an academic environment that encourages a community of scholars and that shares resources.

The faculty believes:

that within the field of nursing the scope of nursing practice encompasses technical and professional skills and that preparation for each of these is provided best through appropriately designed programs that are specific in nature and complete in themselves. Baccalaureate education with a valid major in nursing is the minimum preparation for the professional nurse. Liberal arts offerings interwoven with professional nursing courses are essential for baccalaureate education. The integration of humanities, sciences, and professional courses provides individuals with opportunities to develop skills and behaviors appropriate for present emerging roles of the baccalaureate prepared nurse. Baccalaureate education provides the foundation for research, continuing education, and advanced specialized academic study in the profession, thus enabling individuals to further develop as contributing members of the profession and society.

Licensure Requirement Good Moral Character

to be licensed or registered as a Registered (RN). When you apply for a license or to renew your registration, you will be required to answer the following questions: - Have you been found guilty after trial, or pleaded guilty, no contest or nolo contendere to a crime (felony or misdemeanor) in any court? - Are criminal charges pending against you in any court? Has any licensing or disciplinary authority refused to issue you a license or ever revoked, annulled, cancelled, accepted surrender of, suspended, placed on probation, refused to renew a professional licensed or certificate held by you now or previously, or ever fined, censured, reprimanded or otherwise disciplined you? - Are charges pending against you in any jurisdiction for any sort of professional misconduct? - Has any hospital, licensed facility or clinical laboratory restricted or terminated your professional training, employment or privileges or have you ever voluntarily or involuntarily resigned or withdrawn from such association to avoid imposition of such measures? A "yes" answer to one or more of these questions will not necessarily disqualify you from a license or a registration in New York State.

School of Nursing Program Outcomes are derived from The Essentials

´1. Provide culturally congruent, safe, quality care, based on ethical principles, to diverse populations across the lifespan. ´2. Synthesize and effectively communicate knowledge from the humanities, biological, social, and nursing sciences to promote health and wellness. ´3. Utilize clinical reasoning to provide nursing care for individuals, families, groups and communities applying evidence based research as a foundation for nursing care. ´4. Utilize evolving information technologies to enhance professional nursing practice and encourage personal responsibility for life-long learning and professional career development. ´5. Demonstrate basic knowledge of healthcare policy, finance, and regulatory environments, including local, state, national, and global healthcare trends. ´6. Collaborate and communicate effectively in a variety of modalities with interdisciplinary health care teams, patients, families, and community members to achieve quality outcomes. ´7. Integrate health promotion and disease prevention strategies across diverse settings and vulnerable populations to address health disparities and population health.

Kinesthetic Learner

· Keep verbal discourse short and to the point. · Actively participate in discussions. · Use all of your senses sight, touch, taste, smell, hearing. · Use direct involvement, physical manipulation, imagery, and "hands on" activities to improve motivation, interest, and memory. · Organize information into the steps that were used to physically complete a task. · Seek out courses that have laboratories, field trips, etc. and lecturers who give real life examples. · Use case studies and applications (example) to help with principles and abstract concepts. · Allow for physical action in solving problems. · Read or summarize directions, especially if they are lengthy and complicated, to discourage starting a task without instructions. · Use taped reading materials. · Use practice, play acting, and modeling to prepare for tests. · Allow for physical movement and periodic breaks during tests, while reading, or while composing written assignments. · Role play the exam situation. · Teach the material to someone else. · Write practice answers, paragraphs or essays.

Autonomy

•Recognize and respect the rights of patients or surrogates to make health care decisions • Teach people to be able to make their own choices •Support people in their individual choices • Do not force or coerce people to do things • Nurses are expected to uphold the rights of patients and advocate for patients who are not able to advocate for themselves

Visual Learner

· Organize work and living space to avoid distractions. · Sit in the front of the room to avoid distraction and away from doors or windows where action takes place. Sit away from wall maps or bulletin boards. · Use neatly organized or typed material. · Use visual association, visual imagery, written repetition, flash cards, and clustering strategies for improved memory. · Reconstruct images in different ways try different spatial arrangements and take advantage of blank spaces on the page. · Use note pads, PostIts, todo lists, and other forms of reminders. · Use organizational format outlining for recording notes. Use underlining, highlighting in different colors, symbols, flow charts, graphs or pictures in your notes. · Practice turning visual cues back into words as you prepare for exams. · Allow sufficient time for planning and recording thoughts when doing problemsolving tasks. · Use test preparation strategies that emphasize organization of information and visual encoding and recall. · Participate actively in class or group activities. · Develop written or pictorial outlines of responses before answering essay questions.

Auditory Learner

· Work in quiet areas to reduce distractions, avoiding areas with conversation, music, and television. · Sit away from doors or windows where noises may enter the classroom. · Rehearse information orally. · Attend lectures and tutorials regularly. · Discuss topics with other students, professors and GTAs. Ask others to hear your understanding of the material. · Use mnemonics, rhymes, jingles, and auditory repetition through tape recording to improve memory. · Practice verbal interaction to improve motivation and selfmonitoring. · Use tape recorders to document lectures and for reading materials. · Remember to examine illustrations in textbooks and convert them into verbal descriptions. · Read the directions for tests or assignments aloud, or have someone read them to you, especially if the directions are long and complicated. · Remind yourself to review details. · Use time managers and translate written appointment reminders into verbal cues. · Use verbal brainstorming and tape recording writing and proofing. · Leave spaces in your lecture notes for later recall and 'filing'. Expand your notes by talking with others and collecting notes from the textbook. · Read your notes aloud. · Practice writing your answers using old exams and speak your answers.

Advocacy

• Advocacy is the protection and support of another's rights. • The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient (Code of Ethics). • There is a moral and ethical imperative for the profession of nursing to understand and apply the concept of nursing advocacy in the intimate, interpersonal nature of nurse-patient relationships.

Non-Maleficence

• Avoid causing harm (do no harm/evil) • Seek to prevent harm or risk of harm whenever possible • Do not cause pain or suffering • Do not incapacitate • Do not deprive people • Do not kill Non-Maleficence must be balanced by beneficence (principle of doing good ), while providing care. Example: preventing falls and instituting changes to ensure patients are not harmed.

Fidelity

• Involves loyalty, truthfulness, fairness, and dedication to our patients • Maintaining the duty to care for all no matter who they are or what they may have done • Keep promises, if you make a promise follow through • Duty to be faithful to one's commitments - Includes implicit and explicit promises EXAMPLE: Implicit - those promises that are implied, not verbally communicated ◦When a patient comes into the hospital, they expect to be cared for. Explicit - those promises that we verbally communicate

Justice

• Treat people fairly • Do not favour some individuals / groups over others • Act in a non-discriminatory / non-prejudicial way • Respect all people's rights • Respect for the law Example: A hospital organization is donating no-cost pediatric dental service to the community. There is openings for 45 children per month. Justice requires a fair method, that is free from bias, to determine who will receive these services.

Tips for first year students...........

• While you are busy learning to take care of patients (which is challenging and rewarding), you need to also take care of yourself • Always remember why you started this journey. This will help you stay motivated and focused. • You will be expected to act in a professional manner all the time! • Familiarize yourself with the college supports and resources. • Be organized. • Someone's life may depend on your ability to ask for help. • Find balance between study, work, and your social life. • Get enough sleep, eat healthy, and if you find that you are struggling, ask for help sooner than later. • You will be expected to critically analyze everything. Do not be afraid to question what you see. • Look for support - people are here to help you pass not to watch you fail. • There are many areas of the profession that you will love, and everyone finds a place here they feel at home. • Work hard and be patient, you will get there.

ANAs 18 Standards

•Describe the fundamental and foundational competent levels. •The first 6-Standards are competencies associated with the nursing care process. •1. Assessment •2. Diagnosis (nursing not medical) •3. Outcomes Identiication •4. Planning •5. Implementation •6. Evaluation An introduction to the nursing process will be presented later on the course.

Standards of Professional Performance

•Standards 7 to 18 are professional role expectations. •7. Ethics •8. Advocacy •9. Respectful and Equitable Practice •10. Communication •11. Collaboration •12. Leadership •13. Education •14. Scholarly Inquiry •15. Quality of Practice •16. Professional Practice Evaluation •17. Resource Stewardship •18. Environmental Health

Undergraduate Nursing Program is guided by the following standards and guidelines.

•The Essentials: Core Competencies for Professional Education (American Association of Colleges of Nursing [AACN], 2021). •American Nurses Association, Code of Ethics for Nurses, © American Nurses Publishing, American Nurses Foundation/American Nurses Association, Washington, D.C. •American Association of Colleges of Nursing (2017, March). Diversity, Equity, and Inclusion in Academic Nursing. Retrieved from: https://www.aacnnursing.org/News-Information/Position-Statements-White-Papers/Diversity •Standards of Best Practice: Simulations (2016). International Nursing Association for Clinical Simulation and Learning (www.INACSL.org).

Privacy and Confidentiality:

◦ Nurses advocate for an environment that provides for sufficient physical privacy, including privacy for discussions of a personal nature. ◦ With respect to an individual's personal health information, it is our ethical and legal obligation as health care providers to maintain confidentiality of all patient information.


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