Issues with Performance
The learner’s instructor is ultimately responsible to address any issues or concerns with the learner. It is best to seek assistance early from the Instructor when identifying learner problems when they first arise rather than waiting until these are major concerns or the learner is failing.
During clinical practice, learners must avoid actions that may lead to failure. Such behaviours may be, but not limited to:
- Applying unsafe practice and making questionable interventions
- Lacking insight and understanding of own behaviour and behaviour of others
- Having difficulty accepting own weakness or mistakes
- Having difficulty accepting ways to improve weakness
- Needing constant specific and detailed supervision with little to no growth
- Failing to respect client’s rights
- Failing to provide respect and dignity while giving care to clients and their family
- Having difficulty to adapt to nursing responsibilities and roles after significant guidance
- Having difficulty to adapt to new ways to perform techniques after significant guidance
- Failing to report medication error or any other incident
- Falsifying documents, breeching confidentiality
Red Flag Behaviours
There are some issues/concerns with learner’s clinical performance that are not as easy to identify as clear ‘failures’ or potential for ‘failure’. These type of behaviours fall under the category of ‘red flag’ behaviours. Red flags or the feeling that things are not going well. The behaviours once identified must be discussed with the learner so as to provide opportunities to correct them. Contact the Course Instructor as soon as possible when concerned about feeling things are not going well with the learner. Early intervention is best.
Some examples of red flag behaviours may be, but not limited to:
- Unmotivated, disinterested, scattered
- Unable to think critically
- Too concrete
- Lacks basic nursing skills.
- Under the radar (i.e., tries to avoid being noticed)
- Jeopardizes patient safety and commits legal–ethical violations
- Unsafe behaviors legal–ethical issues
- Is not prepared for the clinical experience and does not show improvement
- Patterns of negative behaviors that do not improve with feedback
- Unprepared for the clinical experience
- Excessively tardy
- Does not take responsibility for learning
- Makes excuses
- Not following health authority, agency, and/or BCIT BSN policies
- Inaccurate or poor written documentation
- Has difficulty in communication with patients, faculty, peers, and clinical staff
- Poor communication with patients
- Poor professional communication
- Received complaints
- Does not show caring behaviours
Further, there are two major categories of actions if demonstrated by learners in their clinical practice course, would result in a failure of the course. These are:
The learner is expected to adhere to the policies and procedures of the Health Authority, agency, BCIT and BCIT BSN program. Any concerns regarding misconduct should be communicated to the Course Instructor immediately. They can assist and provide advice regarding the process and consequences for the learner. The instructor will immediately meet with any learner whose behaviour places them, patients/clients, or the agency at‐risk, or learners whose performance does not meet the requirements of the nursing practice course.
Harassment and/or Abuse
The BSN program is committed to ensuring the safety of learners, staff and patients and their families during nursing practice. The BCIT BSN program recognizes that learners, nurses and patients/clients may encounter situations involving abuse or harassment. Learners are responsible to become familiar with the Health Authority and/or agency’s policies and procedures related to harassment and abuse. Any issues around harassment and/or abuse require the Course Instructor to be contacted immediately.
Addressing Practice Concerns During Preceptorship
The Process to Address Practice Concerns:
- For a learner whose performance is questionable and has had no other previous concerns, the learner and instructor meet to discuss the situation. Clear evidence based on written notes on the learner’s performance are kept by the instructor to inform the development of a Learning Plan which is filled out and signed. This form identifies concerns with the learner’s practice and identifies a clear plan of action to support the learner to address areas of concern that if addressed adequately could result in a passing grade.
- The learner is expected to share their learning plan with their preceptor and ask for feedback.
- At anytime the preceptor feels they need support working with the learner, they should contact the instructor for support and guidance.
- The instructor is responsible to continue to monitor, weekly or more often as needed, the learner’s learning and meeting of the Learning Plan requirements that result in an improvement in practice.
- If the learner’s performance remains a concern, then further action is needed that could result in the creation of another Leaning Plan, removal from clinical placement and/or course failure.
- The course instructor will be frequent contact with Preceptor to collect feedback on the learner’s practice.
- It is the responsibility of the BCIT Instructor to assign a failing grade to the learner.
- The BCIT Instructor to notify the Course/Term Lead as well as the Program Head of any practice concerns with a learner immediately.