Minimum Course Hours: 200

Course Description

Learners integrate theory from all courses into the role of the practical nurse in the acute care setting and other practice areas as appropriate. Learners focus on clients with exacerbations of chronic illness and/or acute illness across the lifespan, including clients with concurrent mental health and/or substance use conditions. Learners consolidate knowledge and skills such as post-operative care, surgical wound management, intravenous therapy, focused assessment, and clinical decision making in acute care settings. Learners demonstrate and reflect on advocacy, cultural safety, cultural humility, and anti-racism, with a focus on Indigenous-specific anti-racism.

Note: Up to 30% of these hours may be integrated as clinical practice hours within the semester (not to be included in the Integrated Nursing Practice 4 course hours).

Prerequisites: Professional Communication 3; Professional Practice 3; Variations in Health 3; Health Promotion 3; Integrated Nursing Practice 3

Corequisites: Variations in Health 4; Health Promotion 4; Integrated Nursing Practice 4

Learning Outcomes

Upon successful completion of this course and with faculty guidance and input from the interprofessional health care team, the learner will be able to:

1. Practise within legislation; current British Columbia College of Nurses and Midwives (BCCNM) LPN Professional Standards, Practice Standards, and Entry-Level Competencies for LPNs; and facility-specific policy and procedures relevant to practice in an acute care setting.
   • 1.1 Demonstrate accountability and responsibility for one’s own decisions and actions.
   • 1.2 Use facility-specific resources, policies, and procedures that inform nursing practice.
   • 1.3 Provide leadership, direction, assignment, and supervision of unregulated care providers in the acute care setting.
   • 1.4 Document according to established legislation, standards of practice, ethics, and organizational policies.
   • 1.5 Obtain informed consent to support the client’s informed decision making.
2. Apply critical thinking, clinical judgment, and knowledge of holistic assessment to plan, develop nursing diagnoses, implement, and evaluate the agreed-upon plan of care for stable or predictable post-operative or medical clients across the lifespan, including clients with concurrent acute mental health and/or substance use conditions, in an independent manner.
   • 2.1 Make practice decisions, including nursing interventions, that are client-specific and consider client acuity, complexity, variability, and available resources, in an independent manner.
   • 2.2 Apply relevant clinical data to practice decision, interventions, and care.
   • 2.3 Formulate clinical decisions consistent with client needs and priorities.
   • 2.4 Apply clinical skills for nursing practice competently in the acute care setting.
   • 2.5 Demonstrate quick priority assessments on clients competently and independently.
   • 2.6 Apply principles of safe medication administration.
   • 2.7 Respond immediately when a client’s condition is deteriorating.
   • 2.8 Demonstrate effective time management skills by setting priorities and organizing workload.
3. Demonstrate respect for the roles and abilities of other members of the health care team in the acute care setting.
   • 3.1 Collaborate with other members of the health care team to develop a plan of care when a client’s status has changed.
   • 3.2 Collaborate with the health care team in transitions and transfer of responsibility of care.
4. Provide a caring environment for clients and families by connecting, sharing, and exploring with them in a collaborative relationship.
   • 4.1 Facilitate the involvement of the client’s family and others as needed and requested.
   • 4.2 Initiate, maintain, and conclude therapeutic relationships in the context of caring for clients in acute care settings and/or experiencing crisis, including clients with a mental health and/or substance use condition.
5. Use a trauma-informed, person-centred, and recovery-oriented approach when providing care to clients in acute care, including clients experiencing mental health and/or substance use conditions, especially as it relates to a person’s perception of health care and health care services.
   • 5.1 Communicate both verbally and in writing in a non-stigmatizing manner.
   • 5.2 Ensure one’s own biases, values, and assumptions do not negatively influence client care or interactions with other members of the health care team.
6. Advocate as needed when caring for clients in the acute care setting, including clients with mental health and/or substance use conditions.
   • 6.1 Advocate for and lead change reflective of evidence‐informed practice.
   • 6.2 Advocate for clients or their representatives, especially when they are unable to advocate for themselves.
7. Provide culturally informed, trauma-informed, and relational care that recognizes diversity and respects the uniqueness of each individual.
   • 7.1 Incorporate Indigenous cultural rights, values, and practices into the plan of care for Indigenous clients, including ceremonies and protocols significant to health and healing.
   • 7.2 Demonstrate appropriate and required actions when observing racist or discriminatory behaviour.
8. Demonstrate teaching and learning through a continuum of care and discharge planning.
   • 8.1 Assess clients’ health literacy, knowledge, and readiness to learn.
   • 8.2 Apply the nursing process to the teaching and learning process.
   • 8.3 Provide information and access to resources to facilitate health education.
9. Engage in continuous learning based on one’s desired growth in personal and professional competence.
   • 9.1 Use self-reflective processes to identify practice areas for improvement.
   • 9.2 Cope constructively with unanticipated or unusual situations.
   • 9.3 Respond non-defensively to feedback, even when provided in a critical or confrontational manner.
   • 9.4 Develop a learning plan to be implemented in the Final Practice Experience.

Course Concepts

Course outcomes will be met through examination and exploration of the following:

• Leadership
• Professional practice and communication
• Therapeutic relationships
• Reporting off and transition of care
• Advocacy
• Clinical decision making
• Interprofessional approach to practice
• Comprehensive and focused assessments
• Medication administration
• Wound care
• Discharge planning
• Self‐reflective approach to practice and lifelong learning
• Cultural safety, cultural humility, and anti-racism, particularly Indigenous-specific anti-racism
• Diversity, equity, and inclusion