Minimum Course Hours: 180

Course Description

Learners build on the foundation of Level 1 and continue to develop clinical judgment and decision-making skills, critical thinking, nursing assessments, and interventions to promote the health of older adults, including those with chronic illnesses and/or mental health conditions. Cultural safety, cultural humility, and anti-racism are all woven through the learning with a focus on Indigenous-specific anti-racism. A variety of approaches (such as simulation) will help learners to integrate theory from Level 1 and 2 courses to provide safe, competent, and ethical nursing care.

Prerequisites: Successful completion of all Level 1 courses and Consolidated Practice Experience 1

Corequisites: Professional Communication 2; Professional Practice 2; Variations in Health 2; Health Promotion 2; Pharmacology 2

Learning Outcomes

Upon successful completion of this course, in the simulated learning environment the learner will be able to:

1. Use the current British Columbia College of Nurses and Midwives (BCCNM) LPN Professional Standards, Practice Standards, and Entry-Level Competencies to guide practice in complex care settings.
   • 1.1 Perform comprehensive holistic nursing assessments and interventions with older adults, including those with chronic illness and/or mental health conditions, in a competent and safe manner.
   • 1.2 Demonstrate a trauma-informed, culturally humble, and person-centred approach with clients.
   • 1.3 Document assessments and care provided using objective and non-stigmatizing language.
   • 1.4 Use appropriate practice standards and clinical guidelines to support the implementation of specific clinical skills used in complex care settings.
   • 1.5 Use critical thinking and clinical judgment to assess clinical situations where select medications can be given without an order (asthma, anaphylaxis, and hypoglycemia medications).
   • 1.6 Discuss the legal implications of restraint use in complex care settings.
   • 1.7 Identify personal learning needs to enhance competence and take actions to remediate.
2. Use clinical skills and assessments competently and safely in complex care settings.
   • 2.1 Demonstrate personal safety practices when providing care (e.g., safe disposal of sharps, ergonomics and body mechanics).
   • 2.2 Use critical thinking, clinical judgment, and knowledge of assessment to autonomously plan, implement, and evaluate care.
   • 2.3 Use decision support tools to assist with decision making and implementation of care.
   • 2.4 Demonstrate safe medication administration.
3. Collaborate with older adults, including those with chronic illnesses and/or mental health conditions, as well as the interprofessional health care team, peers, and faculty.
   • 3.1 Provide a caring environment for older adults, including those with chronic illnesses and/or mental health conditions, by connecting, sharing, and exploring with them in a collaborative relationship.
   • 3.2 Initiate, maintain, and conclude a therapeutic relationship when caring for older adults, including those with chronic illnesses and/or mental health conditions.
4. Analyze potential sources of violence de-escalation and safety strategies in complex care and home and community care settings.
   • 4.1 Describe a quality practice environment.
   • 4.2 Describe factors that put individuals at risk for injury in complex care and home and community settings.
   • 4.3 Describe fall risk-management tools and related assessments.
   • 4.4 Demonstrate nursing management of clients at risk for unintended injury.
   • 4.5 Complete incident reports and other documentation related to quality practice environments.
5. Provide person‐centred care that recognizes and respects the uniqueness of each individual and demonstrates cultural safety, cultural humility, and anti-racism, particularly Indigenous-specific anti-racism.
   • 5.1 Identify one’s own values, biases, and assumptions as a self‐reflective, responsible, and accountable practitioner.
   • 5.2 Demonstrate appropriate and required actions in a simulated environment when observing racist or discriminatory behaviour.

Course Concepts

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

• Comprehensive health assessment of older adults, including those with chronic illness and/or mental health conditions
• Reporting and documentation in complex care settings
• Establishing therapeutic relationships
• Cultural safety, cultural humility, and anti-racism—particularly Indigenous-specific anti-racism
• Diversity, equity, and inclusion
• Clinical decision making
• Nursing interventions
• Safety specific to the care of older adults
• Infection control
• Chronic wound management
• Foot assessment and care (see more information below)
• Pain management
• End-of-life care
• Oral and nasal suctioning
• Oxygen therapy, continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BIPAP)
• Care of established ostomies
• Specimen collection (sputum, urine, and stool)
• Blood glucose monitoring
• Enteral feedings and medications via nasogastric, jejunostomy and gastrostomy tubes
• Quality practice environments
• Individualizing nursing care plans
• Medication administration
• Medication routes: oral, subcutaneous, intramuscular, and intradermal, percutaneous
• Inserting a subcutaneous infusion device
• Opioid administration
• Decision making and autonomy in administering medications (e.g., medications “as needed” for asthma, anaphylaxis, and hypoglycemia)
• Taking and transcribing physician orders
• Documentation of response to medication
• Safety: Needlestick injury and prevention